Abstract
BackgroundStudies on falls in older adults have mainly been conducted in high income countries. Scant, if any, information exists on risk factors for falls in the older population of sub-Saharan African countries.MethodsA cross-sectional survey and a 12-month follow-up study were conducted to determine risk factors for falls in a representative multi-ethnic sample of 837 randomly selected ambulant community-dwelling subjects aged ≥65 years in three suburbs of Cape Town, South Africa. Logistic regression models were fitted to determine the association between (1) falls and (2) recurrent falls occurring during follow-up and their potential socio-demographic, self-reported medical conditions and physical assessment predictors.ResultsPrevalence rates of 26.4 % for falls and 11 % for recurrent falls at baseline and 21.9 % for falls and 6.3 % for recurrent falls during follow-up. In both prospective analyses of falls and recurrent falls, history of previous falls, dizziness/vertigo, ethnicity (white or mixed ancestry vs black African) were significant predictors. However, poor cognitive score was a significant predictor in the falls analysis, and marital status (unmarried vs married) and increased time to perform the timed Up and Go test in the recurrent fall analysis but not in both. Other than the timed Up and Go test in recurrent falls analysis, physical assessment test outcomes were not significant predictors of falls.ConclusionOur study provides simple criteria based on demographic characteristics, medical and physical assessments to identify older persons at increased risk of falls. History taking remains an important part of medical practice in the determination of a risk of falls in older patients. Physical assessment using tools validated in developed country populations may not produce results needed to predict a risk of falls in a different setting.
Highlights
Studies on falls in older adults have mainly been conducted in high income countries
Unlike biological risk factors for falls, psychosocial risk factors have varied from region to region
Factors associated with falls at baseline in an urban community-dwelling older population of Cape Town were identified as being, poor cognitive function, selfreported medical conditions (Parkinson’s disease, stroke, foot disorders and urinary incontinence), number of comorbid conditions, number of medications, self-rated health as poor, perceived worse health than a year ago, number of residents in a household, and occupational history
Summary
Studies on falls in older adults have mainly been conducted in high income countries. Unintentional injuries have been listed as the fifth highest cause of death in older adults, after cardiovascular disease, cancer, stroke and pulmonary disorders [3]; the injuries account for 10 % of emergency hospital visits and six per cent of hospital admissions [4]. Socio-economic status, determined by low income, low education, a poor housing environment and limited access to social services, is a predisposing factor to the development of chronic disease, which in turn is a risk factor for falls [5, 6]. A large primary care study in the United Kingdom reported an inverse relationship between socio-economic status and the incidence of falls [8]
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