Elders suffering recurrent injurious falls: causal analysis from a rural tribal community in the eastern part of India.

Abstract

Falls among the elderly are prevalent but preventable. There is a knowledge gap regarding the factors causing recurrent injurious falls among the elderly, especially in tribal areas. The aim of the present study was to find out the incidence of injurious falls among elderly participants and measure the effect of selected predictors on recurrent injurious falls. A longitudinal observational study was conducted among 536 community-dwelling elderly individuals residing in 16 tribal dominated villages under two community development blocks of North 24-Parganas, West Bengal, India from December 2017 to January 2019. Participants were followed up for 1 year. The predictors of recurrent injurious falls were assessed through Prentice, Williams and Peterson Gap Time hazard model. The mean age of the participants at the baseline was 69.16 (±2.95) years. The majority were male (55.60%), with sedentary physical activity (49.63%). At baseline, history of injurious fall in the preceding 1 year was present in 37.69% of participants. At baseline, 53.17% had malnutrition and 54.29% were dependent on caregivers for activities of daily living. During the follow-up period there were 153 episodes of injurious falls. The incidence of fall was 29.88 episodes per 100 person-years. History of fall had a hazard ratio of 2.33 (95% confidence interval (CI): 1.01-5.38). The hazard ratios for malnutrition, impaired balance and faster walking speed respectively were 1.20 (95%CI: 1.01-3.60), 5.96 (95%CI: 3.52-6.34) and 3.23 (95%CI: 2.12-5.26), and were statistically significant. Physical status indicators such as nutritional status, balance and walking speed appeared to be key factors contributing to recurrent injurious falls. Proper nutrition, and regular check-up and rehabilitative measures, are needed to reduce recurrent falls.