Social status, life changes, housing conditions, health, functional abilitiesand life-style as risk factors for recurrent falls among the home-dwelling elderly

Abstract

Objective To define the risk factors for recurrent falls in the home-dwelling elderly. Design A prospective population-based study covering two years. Setting Five rural municipalities around the city Oulu, northern Finland. Participants All home-dwelling elderly persons ( N = 1,016) aged 70 years or older living in the municipalities. Outcome measures The risk factors of recurrent falling by variables related to social status, life changes,housing conditions, health, functional abilities and life style, using cross-tabulations and multivariate analyses. Results The recurrent fallers (at least two falls within 365 days after the examination day) consisted of 17 men (6% of the men) and 71 women (14%). Logistic regression analyses showed female sex, urinary urgency, frequent fear of falling, dizziness, a poor pulse rate rise 30 seconds after standing up and falling during the previous year to be risk factors for recurrent falls. After the variable representing previous falls had been removed from the analysis, urinary incontinence and a change in housing conditions during the past two years emerged and urinary urgency dropped out of the model. Conclusions Women particularly are a target group for the prevention of falls among the elderly. Urinary urgency and urinary incontinence, fear of falling, dizziness and changes in the housing conditions should be inquired about to identify the elderly at risk for falling and to take preventive interventions. In addition to testing blood pressure changes after standing up, the changes in pulse rate should be determined to identify and treat elderly people who have orthostatic conditions.