Abstract
BackgroundAlthough population-based studies have shown frailty predicted future falls, their follow-up periods were one year or longer and short-term fall risks associated with frailty are unknown.MethodsA prospective cohort study nested within a randomised controlled trial was conducted to examine associations between frailty and short-term incident future falls among community-dwelling older people. Two hundred forty eight community-dwelling people > =65 years without history of > =three falls and allocated to a usual care arm of exercise intervention trial were prospectively monitored for falls over 24 weeks. Frailty index (FI) was constructed from 40 deficits at baseline. The future fall risks according to frailty status was examined using logistic regression models.ResultsOf 248 participants, 46 were classified as frail and 57 had one or more falls during follow-up. Both each 0.01 increase in FI and frailty defined as FI > =0.25 were significantly associated with higher risks of future falls in multivariate logistic regression models adjusted for age, gender and history of two falls in the previous year (odds ratio (OR) = 1.05, 95 % confidence interval (95 % CI) = 1.02–1.07, p < 0.001; OR = 3.04, 95 % CI = 1.53–6.02, p = 0.001, respectively). Receiver operating characteristic (ROC) curve analysis showed FI predicted future falls with fair accuracy with area under ROC curve of 0.62 (95 % CI = 0.53–0.71, p < 0.01).ConclusionsFrailty was a significant and independent predictor of short-term future falls among community-dwelling older people who had volunteered for a physical activity study. It is important for healthcare practitioners to recognise frailty as a risk factor of imminent future falling even in older people who appear to be ageing well.
Highlights
Population-based studies have shown frailty predicted future falls, their follow-up periods were one year or longer and short-term fall risks associated with frailty are unknown
The negative consequences related to falls include fear of falling, loss of confidence, anxiety, depressive symptoms and decreased self-efficacy, which may lead to social isolation or avoiding physical activity [7, 8]
The objective of this study was to examine the associations between baseline frailty status and short-term incidence of future falls among community-dwelling older people who participated in an exercise promotion trial
Summary
Population-based studies have shown frailty predicted future falls, their follow-up periods were one year or longer and short-term fall risks associated with frailty are unknown. Are falls related to injuries or fractures and are a leading cause of morbidity and mortality in older people, [6] but falls are shown to have a negative psychological impact. The negative consequences related to falls include fear of falling, loss of confidence, anxiety, depressive symptoms and decreased self-efficacy, which may lead to social isolation or avoiding physical activity [7, 8]. Because of these detrimental physical and psychological impacts on older people, falling is a major public health problem [6]. Assessment of frailty should lead to interventions to reduce falls
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