Risk Factors for Falls in Older Korean Adults: The 2011 Community Health Survey

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Abstract

Falls are a major health problem for elderly populations worldwide. We analyzed data from the 2011 Korean Community Health Survey to identify potential risk factors for falls in a representative population-based sample of community-dwelling older Korean adults. Risk factors for falls were assessed by multivariate survey logistic regression models. The prevalence of falls was 36.5% in males and 63.5% in females. Age and female sex were associated with a higher risk of falls. Similarly, living alone, living in an urban area, poor self-rated health, and high stress were associated with a high risk of falls. Subjects with diabetes mellitus, stroke, osteoarthritis, osteoporosis, urinary incontinence, cataracts, or depression had a high risk of falls. However, subjects with hypertension were at low risk for falls. In conclusion, age, female sex, marital status, residence location, self-rated health, stress, and several chronic conditions were significantly associated with the risk for falls in the older Korean adults. Our findings suggest that these risk factors should be addressed in public health policies for preventing falls.

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The patient who falls: "It's always a trade-off".

Mary Tinetti, Chandrika Kumar (2010)

Falls are common health events that cause discomfort and disability for older adults and stress for caregivers. Using the case of an older man who has experienced multiple falls and a hip fracture, this article, which focuses on community-living older adults, addresses the consequences and etiology of falls; summarizes the evidence on predisposing factors and effective interventions; and discusses how to translate this evidence into patient care. Previous falls; strength, gait, and balance impairments; and medications are the strongest risk factors for falling. Effective single interventions include exercise and physical therapy, cataract surgery, and medication reduction. Evidence suggests that the most effective strategy for reducing the rate of falling in community-living older adults may be intervening on multiple risk factors. Vitamin D has the strongest clinical trial evidence of benefit for preventing fractures among older men at risk. Issues involved in incorporating these evidence-based fall prevention interventions into outpatient practice are discussed, as are the trade-offs inherent in managing older patients at risk of falling. While challenges and barriers exist, fall prevention strategies can be incorporated into clinical practice.

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Falls in old age: a study of frequency and related clinical factors.

J Reinken, David B. Allan, Ian G. Campbell … (1981)

An analysis of falls experienced by a stratified population sample of 553 subjects, 65 years and over, was performed. It is estimated that one third of people 65 years and over experience one or more falls in a year. To analyse the association of physical and social variables with falls, the falls were divided into pattern falls and occasional falls. Pattern falls were those which, on history and examination, were assessed as arising from only minimal external upset and primarily from a disorder of balance or postural stability in the subject. Occasional falls were those which had arisen under circumstances which would be liable to cause a fit person to fall. Bivariate analysis showed those having pattern falls tended to have more functional disability, to have increased impairment of mobility, to use more aids to mobility, to be more depressed, to have lower mental test scores and to need more professional support. Women experiencing pattern falls also tended to be older and have poorer vision, while men had lower systolic blood pressure. Discriminant analysis showed that the principal effective 'predictors' of pattern falls in women were functional disability, the need for support services and informal help and the use of walking aids. In men they were functional disability and the need for support services and informal help.

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Chronic disease and falls in community-dwelling Canadians over 65 years old: a population-based study exploring associations with number and pattern of chronic conditions

Kathryn M. Sibley, Jennifer Voth, Sarah Munce … (2014)

Background Falls and chronic disease are both important health issues in older adults. The objectives of this study were to quantify the prevalence of falls and multi-morbidity (≥2 chronic conditions) in Canadian older adults; examine associations between falls and number of chronic conditions; and explore whether certain patterns of chronic disease were associated with a greater risk of falling. Methods Data were derived from the Canadian Community Health Survey- Healthy Aging. Primary outcomes from 16,357 community-dwelling adults aged 65 years and over were self-reported falls in the previous 12 months and presence of 13 chronic conditions. Prevalence estimates were calculated with normalized sampling weights, and hierarchical cluster analysis was used to identify clusters based on chronic condition patterns, and tested for association to falls with logistic regression. Results Overall prevalence of falling and multi-morbidity were 19.8% and 62.0% respectively. Fall risk was significantly greater in individuals with one, two, four, five and six or more chronic conditions relative to those with none (all p < 0.05). A seven-cluster model was selected, including groups with low prevalence of chronic disease, or high prevalence of hypertension and arthritis, visual impairment, hypertension, chronic obstructive pulmonary disease (COPD), diabetes, or heart disease and hypertension. Only the hypertension cluster (Odds Ratio [OR] = 1.2) and COPD cluster (OR = 1.6) were significantly associated with increased falls relative to the low prevalence group. Conclusions Both the number and pattern of chronic conditions were related to falls. COPD emerged as a significant predictor of falls despite affecting a smaller proportion of respondents. Continued study is warranted to verify this association and determine how to incorporate consideration of chronic disease and multi-morbidity into fall risk assessments.

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Author and article information

Journal

Journal ID (nlm-ta): J Korean Med Sci

Journal ID (iso-abbrev): J. Korean Med. Sci

Journal ID (publisher-id): JKMS

Title: Journal of Korean Medical Science

Publisher: The Korean Academy of Medical Sciences

ISSN (Print): 1011-8934

ISSN (Electronic): 1598-6357

Publication date (Print): November 2014

Publication date (Electronic): 04 November 2014

Volume: 29

Issue: 11

Pages: 1482-1487

Affiliations

[1 ]Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea.

[2 ]Gwangju-Jeonnam Regional Cardiocerebrovascular Center, Chonnam National University Hospital, Gwangju, Korea.

[3 ]Center for Creative Biomedical Scientists, Chonnam National University, Gwangju, Korea.

Author notes

Address for Correspondence: Min-Ho Shin, MD. Department of Preventive Medicine, Chonnam National University Medical School, 160 Baekseo-ro, Dong-gu, Gwangju 501-746, Korea. Tel: +82.62-220-4166, Fax: +82.62-233-0305, mhshinx@ 123456paran.com

Author information

Eun jin Choi http://orcid.org/0000-0001-7827-9150

Sun A Kim http://orcid.org/0000-0003-2914-4422

Nu Ri Kim http://orcid.org/0000-0003-3348-610X

Jung-Ae Rhee http://orcid.org/0000-0003-1610-1001

Yong-Woon Yun http://orcid.org/0000-0001-6715-1768

Min-Ho Shin http://orcid.org/0000-0002-2217-5624

Article

DOI: 10.3346/jkms.2014.29.11.1482

PMC ID: 4234914

PubMed ID: 25408578

SO-VID: b74391fb-33f0-412a-959f-e21266a35220

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 21 April 2014

Date accepted : 25 July 2014

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Risk Factors for Falls in Older Korean Adults: The 2011 Community Health Survey

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Most cited references 37

The patient who falls: "It's always a trade-off".

Falls in old age: a study of frequency and related clinical factors.

Chronic disease and falls in community-dwelling Canadians over 65 years old: a population-based study exploring associations with number and pattern of chronic conditions

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