Abstract
Falls are a serious health problem in older adults. A limited number of studies assessed their multifactorial nature in geriatric ward patients. The aim of this study is to explore health, functional and nutritional correlates of experiencing fall(s) in the previous year by older inpatients. A cross-sectional study of patients admitted to the department of geriatrics was conducted. A “faller status” was defined based on positive history of falls in the previous 12 months. Health, functional and nutritional factors associated with falls were evaluated, and multivariable logistic regression analysis models were built. A total of 358 patients (median age 82 (IQR 76–86) years, 77.9% women) were recruited, 43.9% of whom reported falls. The “fallers” presented with a significantly higher number of chronic diseases, higher prevalence of Parkinson’s disease, peripheral arterial disease, chronic osteoarthritis, more frequently reported urinary incontinence and were dependent on others for daily living activities. They had significantly worse results for the assessment of gait, balance and frailty status. The Mini Nutritional Assessment-Short Form scores and the mean value of serum albumin were significantly lower in the fallers’ group. Parkinson’s disease (OR = 2.82, CI—1.07–7.45; p = 0.04) and osteoarthritis (OR = 2.08, CI—1.02–4.23; p = 0.04) were the main variables for the outcome prediction, according to the direct multivariable logistic regression analysis. Our findings suggest that Parkinson’s disease and osteoarthritis are the main predictors independently associated with a history of falls in patients admitted to the geriatric ward, although the influence of some factors may be underestimated due to the tendency of not taking the history of falls in very frail, functionally dependent and bedridden individuals.
Highlights
Falls are a major health problem in older adults
Our study has confirmed that falls are a common problem among geriatric ward patients. 40% of patients in the study group reported falls in the previous year
A high prevalence of such recognized risk factors for falls as Parkinson’s disease, osteoarthritis, urinary incontinence, peripheral arterial disease and dependency on others in basic and instrumental activities of daily living was observed in our study participants
Summary
Falls are a major health problem in older adults. A high percentage of the geriatric population experienced a fall each year [1,2]. Falls are connected with high morbidity, increased odds for hospitalization caused by serious injuries, increased risk of mortality, fear of falling (post-fall syndrome), and lead to lower quality of life [3]. Many intrinsic and extrinsic factors can contribute to or cause falls. The intrinsic factors include gait and balance disorders, cognitive deterioration, abnormal nutritional status, orthostatic hypotension and different medical conditions such as Parkinson’s disease, stroke and its consequences. Res. Public Health 2020, 17, 4768; doi:10.3390/ijerph17134768 www.mdpi.com/journal/ijerph
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