Fall Characteristics In Community-living Older Adults

Abstract

Falls among older adults represent a significant health concern due to the high number of incidents, the involvement of many different risk factors, and the consequential post-fall morbidity and mortality. Prospective studies are beneficial as they help to identify the causes and outcomes of falls in older adults, and in turn, help health care providers better assess fall risk. PURPOSE: The specific aim was to characterize fall information through a 12 month prospective fall study among older adults. METHODS: Ninety-three independent community-living otherwise healthy older adults (age 86±6 years) were recruited from multiple facilities. Participants were asked how many times they had fallen in the past six months. Participants were called weekly for 12 months to evaluate falls after the baseline assessment. The date, time, location, activity at the time of the fall, injuries, assistive device use, and medication changes were all recorded at each follow up call. Fall characteristic data were presented as percentages of total falls. RESULTS: At the time of testing, 36/93 participants (38.7%) self-reported at least one fall in the preceding six months. Of the 36 participants with a self-reported fall history, 24 (66.7%) fell at least once in the subsequent 12 months of follow-up. Of the 57 participants without a self-reported fall history, 30 (52.6%) fell at least once in the subsequent 12 months of follow-up. A majority of the 147 total falls occurred inside (78.2%) and/or at home (67.3%), and sometime between 6:00 a.m.-10:00 p.m. (83.0%). An injury was reported in 40.1% of the falls and 6.1% resulted in a fracture. Falls that occurred while using an assistive device comprised of 18.4%. Lastly, a recent medication change was found in 5.4% of the falls. CONCLUSIONS: Due to the high incidence of falls that occurred during the 12-month follow up period (many injurious) in those with and without a recent history of falls, this study suggests that greater precautions must be taken to ensure the safety of these older adults regardless of perceived fall risk. Given that most falls occurred at home during waking hours, it is advised that the home environment be evaluated more rigorously and appropriate preventive modifications made. It may also be prudent to further assess the proper use of assistive devices, as it is presently unclear whether the device contributed to a fall or if individuals already at an increased risk of falling use an assistive device.