The Relationship Among Falls, Physical Disability, and Mental Problems in Community-Dwelling Elderly

Abstract

1245 PURPOSE: To investigate the incidence of falls and recurrent falls (more than 2 falls) and the falls-related risk factors, and to clarify the relationship among falls and recurrent falls, physical disability, and mental problems in elderly persons living independently in a local community in Japan. METHODS: The design was a prospective observational study with a 1-year follow-up. The participants were 829 elderly persons aged 60–79 years who participated in baseline assessment in 2002 by the questionnaire concerning the falls with injury during the past 5 years, and they had no injurious fall experience for 5 years before this survey. RESULTS: During prospective monitoring for 1 year, 182 falls were reported by 129 persons (15.6%), and recurrent falls were reported by 36 persons (4.3%). Significant gender difference was observed in falls for 1 year (Falls; men 11.1% vs female 19.9%, Recurrent fall; men 2.7% vs female 6.0%, p<0.05). Relationship between falls and recurrent falls and potential risk factors were identified in multiple logistic regression models. Physical disability score (disability with standing from chair without their arms, balance on the one leg, and walking easily) increased the risk of recurrent falls (adjusted relative risk (RR) = 1.50, 95% confidence interval (95%CI) 1.07–2.11). Mental problems score (stressful, depressive, less willingness, insomnia, and forgetful) increased the risk of falls (Rr = 1.13, 95%CI 1.03–1.24) and recurrent falls (RR = 1.25, 95%CI 1.05–1.49). When the relationship among recurrent falls, physical disability, and mental problems was simultaneously analyzed, the risk of recurrent falls significantly increased in the category that had both physical disability and mental problems simultaneously (RR = 5.76, 95%CI 1.25–26.5). CONCLUSIONS: These results suggest that preventive approach for falling in the elderly may be necessary to consider not only physical but also mental treatments.