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      Risk Factors for Falls among Elderly Persons Living in the Community

      , ,
      New England Journal of Medicine
      Massachusetts Medical Society

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          Abstract

          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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          Author and article information

          Journal
          New England Journal of Medicine
          N Engl J Med
          Massachusetts Medical Society
          0028-4793
          1533-4406
          December 29 1988
          December 29 1988
          : 319
          : 26
          : 1701-1707
          Article
          10.1056/NEJM198812293192604
          3205267
          666893a5-f2fc-407c-9dc9-f1e78aa9d651
          © 1988
          History

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