Abstract
Falls may cause devastating consequences in older people. Conducting surveys on falls and factors associated with falls will inform better preventive health practices among older people to improve their quality of life. This study aimed to assess the prevalence and associated risk factors of falls and recurrent falls among rural community-dwelling older people in Southern Sri Lanka. A cross-sectional study was conducted in Nagoda Divisional Secretariat area, Galle, with 300 participants (females=175) aged 65 years and above. An interviewer-administered questionnaire was used to collect the data. To assess the prevalence of falls, participants were asked if they had fallen in the past year, and if so how many times. If any individual reported two or more falls, it was considered a recurrent fall. Biological, behavioral, environmental, and socioeconomic factors were documented as potential risk factors for falls. Multivariate logistic regression was performed with adjusted Odds Ratio (OR). Mean (SD) age was 73 (6.7) years. The prevalence of falls and recurrent falls were reported as 34.3% (95%CI; 29.03-40.04) (n=103) and 9.6% (95%CI; 6.68-13.73) (n=29), respectively. Out of 103 fallers, 37 (35.9%) had sustained injuries, with 40.5% affecting the wrist and 24.3% the hip. The associated factors for falls were age (OR=0.1), gender (OR=3.0), diabetes mellitus (OR=2.7), balance or gait problems (OR=4.2), use of antihypertensive medication (OR=0.2), and use of at least one long-term medication (OR=3.5). Associated factors for recurrent falls were age (OR=0.3), hypertension (OR=3.7), balance or gait problems (OR=3.8), sleep disturbances (OR=2.0), use of antihypertensive medication (OR=0.1), and use of at least one long-term medication (OR=3.4). A high prevalence of falls and low prevalence of recurrent falls among older people were observed. Biological and behavioral factors were reported as associated risk factors. This information is important to inform strategies to prevent falls in older people in Sri Lanka.
Highlights
With an increase in the elderly population, falls and fallrelated injuries among older people have become a major public health concern in many countries
Lower incidence of falls has been reported in developed countries such as UK, China, and Japan where rates have been reported as 22.4%, 19.3%, and 20% per year, respectively [2]
The individual cluster size was considered as 60 participants and the design effect was considered as “1” assuming all clusters are equal in nature [10]
Summary
With an increase in the elderly population, falls and fallrelated injuries among older people have become a major public health concern in many countries. According to World Health Organization (WHO) statistics, every year 28-35% of people over 65 years and 32-42% of people over 70 years experience falls [2]. Lower incidence of falls has been reported in developed countries such as UK, China, and Japan where rates have been reported as 22.4%, 19.3%, and 20% per year, respectively [2]. Falls in older people may cause fractures and soft tissue injuries leading to disability, loss of independence, and increased mortality [3]. In addition to falls related injuries, many older people experience emotional problems such as loss of confidence, fear, and anxiety that may further restrict their
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