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      An epidemiological study of falls in older community-dwelling women: the Randwick falls and fractures study

        , , ,
      Australian Journal of Public Health
      Wiley

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          Abstract

          Seven hundred and four women aged between 65 and 99 years (mean age 74.6 years), who were randomly selected from the community, took part in a study to determine whether health and lifestyle factors were associated with falls. In the 12 months before the survey, 66.1 per cent of the subjects experienced no falls, 19.7 per cent fell once and 14.2 per cent fell on two or more occasions. The proportion of women who fell outside the home decreased with age, with a corresponding increase in the proportion who fell inside the home on a level surface. The most common causes of falls reported were trips, slips and loss of balance. Some (27 per cent) suffered injuries as a result of a fall, and the proportion suffering injuries increased with age. Those who rated their health and balance as impaired, those with a limitation in activities of daily living, those receiving community services, those taking psychoactive drugs, and those taking four or more drugs had significantly more falls. On the other hand, those taking part in planned exercise and those active for seven or more hours per week had fewer falls. Smoking and alcohol consumption were not significantly associated with falls. Stepwise logistic regression analysis revealed poor vision, inactivity and subjective fall risk as variables that were independently and significantly associated with falling. These findings highlight possible intervention strategies for reducing falls risk in older people.

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          Risk factors for falls among elderly persons living in the community.

          To study risk factors for falling, we conducted a one-year prospective investigation, using a sample of 336 persons at least 75 years of age who were living in the community. All subjects underwent detailed clinical evaluation, including standardized measures of mental status, strength, reflexes, balance, and gait; in addition, we inspected their homes for environmental hazards. Falls and their circumstances were identified during bimonthly telephone calls. During one year of follow-up, 108 subjects (32 percent) fell at least once; 24 percent of those who fell had serious injuries and 6 percent had fractures. Predisposing factors for falls were identified in linear-logistic models. The adjusted odds ratio for sedative use was 28.3; for cognitive impairment, 5.0; for disability of the lower extremities, 3.8; for palmomental reflex, 3.0; for abnormalities of balance and gait, 1.9; and for foot problems, 1.8; the lower bounds of the 95 percent confidence intervals were 1 or more for all variables. The risk of falling increased linearly with the number of risk factors, from 8 percent with none to 78 percent with four or more risk factors (P less than 0.0001). About 10 percent of the falls occurred during acute illness, 5 percent during hazardous activity, and 44 percent in the presence of environmental hazards. We conclude that falls among older persons living in the community are common and that a simple clinical assessment can identify the elderly persons who are at the greatest risk of falling.
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            Risk factors for falls in a community-based prospective study of people 70 years and older.

            We investigated factors associated with falls in a community-based prospective study of 761 subjects 70 years and older. The group experienced 507 falls during the year of monitoring. On entry to the study a number of variables had been assessed in each subject. Variables associated with an increased risk of falling differed in men and women. In men, decreased levels of physical activity, stroke, arthritis of the knees, impairment of gait, and increased body sway were associated with an increased risk of falls. In women, the total number of drugs, psychotropic drugs and drugs liable to cause postural hypotension, standing systolic blood pressure of less than 110 mmHg, and evidence of muscle weakness were also associated with an increased risk of falling. Most falls in elderly people are associated with multiple risk factors, many of which are potentially remediable. The possible implications of this in diagnosis and prevention are discussed.
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              Falls by elderly people at home: prevalence and associated factors.

              Of 1042 individuals aged 65 years and over who were successfully interviewed in a community survey of health and physical activity, 35% (n = 356) reported one or more falls in the preceding year. Although the overall ratio of female fallers to male fallers was 2.7:1, this ratio approached unity with advancing age. Mobility was significantly impaired in those reporting falls. Asked to provide a reason for their falls, 53% reported tripping, 8% dizziness and 6% reported blackouts. A further 19% were unable to give a reason. There was no association between falls and the use of diuretics, antihypertensives or tranquilizers, but a significant association between falls and the use of hypnotics and antidepressants was found. Discriminant analysis of selected medical and anthropometric variables indicated that handgrip strength in the dominant hand and reported symptoms of arthritis, giddiness and foot difficulties were most influential in predicting reports of recent falls.
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                Author and article information

                Journal
                Australian Journal of Public Health
                Wiley
                10357319
                September 1993
                February 12 2010
                : 17
                : 3
                : 240-245
                Article
                10.1111/j.1753-6405.1993.tb00143.x
                8286498
                0abdd0e4-653d-4556-a7ca-9770947e3b05
                © 2010

                http://doi.wiley.com/10.1002/tdm_license_1.1

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