Fall Risk Prediction in Community Dwelling Hong Kong Elderly Chinese Based on their 12-Month Prospective Fall History, Longest Pre-Retirement Occupation and Bone Mineral Density

Abstract

Background: Falls are common among older adults worldwide. This study aimed to investigate and predict fall risk based on the fall incidence, longest pre-retirement occupation and bone mineral density in community dwelling Hong Kong Chinese elderly. Methods: 3,983 subjects consisting of 2,000 men (aged 72.39±5.01) and 1,983 women (aged 72.58±5.4) of community dwelling Hong Kong Chinese at age 65 or above were recruited. The subjects’ fall history in a 12-month prospective cohort, longest pre-retirement occupations, bone mineral density (BMD) level, and physical capability by the Physical Activity Scale for the Elderly Questionnaire were evaluated with their fall history four-monthly by telephone contacts. Results: Fall incidence per 1,000 person-years in women and men was 245.75 and 158.60 in osteoporosis, 246.99 and 152.98 in osteopenia, and 252.35 and 182.57 in normal BMD respectively (p<0.001). Women had higher fall incidence than in men (p<0.001). Older age (73.3± 5.2) had 2 or more falls than no fall in younger age (72.1± 4.8) [RR (95% CI) 1.21 (1.14, 1.28) per 5 years increase]. PASE scores were 92.0±48.8 in older age and 98.4±49.9 in younger age [RR (95% CI): 0.93 (0.87, 0.99) per 50-unit increase]. Pre-retired longest occupation in Building/Maintenance jobs showed the lowest fall risk [RR (95% CI): 0.58 (0.37, 0.90)], followed by Business/Finance [RR (95% CI): 0.80 (0.68, 0.95)] and Art/Design/Office [RR (95% CI): 0.81 (0.68, 0.97)] as compared to Management jobs as a standard reference. Conclusion: Women had a higher fall risk than men due to their decreasing physical capability with increasing age in Hong Kong Chinese. Longest pre-retired occupation with physically demanding jobs showed the lowest fall risk.