Abstract
BackgroundThe functional consequences of injurious falls are well known. However, studies of the factors that can modify trajectories of disability after an injury from a fall are scarce.AimsWe aimed to investigate whether sociodemographic and health-related factors may impact this association.MethodsThe study population consisted of 1426 community-dwelling older adults (≥ 60 years) from the SNAC-K cohort study in Stockholm, Sweden. Functional status over 12 years of follow-up was assessed using the number of limitations in basic and instrumental activities of daily living. Sex, cohabitation status, physical activity, and self-rated health were assessed at baseline. Injurious falls were defined as falls requiring healthcare and were assessed over 3 years starting at baseline. Data were analyzed using linear-mixed effects models.ResultsThe fastest increase in the number of disabilities was observed in those who had endured an injurious fall and were living alone (β coefficient = 0.408; p < 0.001), been physically inactive (β coefficient = 0.587; p < 0.001), and had poor self-rated health (β coefficient = 0.514; p < 0.001). The negative impact of these factors was more pronounced among fallers compared to non-fallers.DiscussionLiving alone, being physically inactive, and having poor self-rated health magnifies the negative effect of an injurious fall on functional status. Among individuals who endure an injurious fall, the heterogeneity in long-term functional status is substantial, depending on the individuals’ characteristics and behaviors.ConclusionsThese findings emphasize the need for a person-centered approach in care provision and can guide secondary prevention within health care.
Highlights
Injurious falls are the most common cause of hospitalization among older adults [1]
Previous studies, including our research, suggest that men and women may differ in terms of risk factors for falls [8,9,10]
Only a few studies have investigated whether recovery of functional status differs between men and women who survive a fall-injury hospitalization, and with inconsistent results [7, 11,12,13]
Summary
Living with someone has been shown to improve the course of disability after an injury [7], and findings from our research group have indicated that living alone is an important risk factor for injurious falls [14] Both low physical activity and poor self-rated health are known risk factors for falls [15], and inactivity and poor health-related quality of life have shown to be consequences of an injury [2, 16]. Discussion Living alone, being physically inactive, and having poor self-rated health magnifies the negative effect of an injurious fall on functional status. Conclusions These findings emphasize the need for a person-centered approach in care provision and can guide secondary prevention within health care
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