Journal Article

A risk profile for identifying community-dwelling elderly with a high risk of recurrent falling: results of a 3-year prospective study

Tromp, E. A. M., Bouter, L. M., Pluijm, S. M. F., Smit, J. H., Deeg, D. J. H., Stel, V. S., Lips, P.

2006

Overview

The aim of the prospective study reported here was to develop a risk profile that can be used to identify community-dwelling elderly at a high risk of recurrent falling. The study was designed as a 3-year prospective cohort study. A total of 1365 community-dwelling persons, aged 65 years and older, of the population-based Longitudinal Aging Study Amsterdam participated in the study. During an interview in 1995/1996, physical, cognitive, emotional and social aspects of functioning were assessed. A follow-up on the number of falls and fractures was conducted during a 3-year period using fall calendars that participants filled out weekly. Recurrent fallers were identified as those who fell at least twice within a 6-month period during the 3-year follow-up. The incidence of recurrent falls at the 3-year follow-up point was 24.9% in women and 24.4% in men. Of the respondents, 5.5% reported a total of 87 fractures that resulted from a fall, including 20 hip fractures, 21 wrist fractures and seven humerus fractures. Recurrent fallers were more prone to have a fall-related fracture than those who were not defined as recurrent fallers (11.9% vs. 3.4%; OR: 3.8; 95% CI: 2.3-6.1). Backward logistic regression analysis identified the following predictors in the risk profile for recurrent falling: two or more previous falls, dizziness, functional limitations, weak grip strength, low body weight, fear of falling, the presence of dogs/cats in the household, a high educational level, drinking 18 or more alcoholic consumptions per week and two interaction terms (high education x 18 or more alcohol consumptions per week and two or more previous falls x fear of falling) (AUC=0.71). At a cut-off point of 5 on the total risk score (range 0-30), the model predicted recurrent falling with a sensitivity of 59% and a specificity of 71%. At a cut-off point of 10, the sensitivity and specificity were 31% and 92%, respectively. A risk profile including nine predictors that can easily be assessed seems to be a useful tool for the identification of community-dwelling elderly with a high risk of recurrent falling.

• Publisher: Springer,Springer Nature B.V
• Subject: Accidental Falls - prevention & control / Aged / Aged, 80 and over / Aging / Alcohol Drinking / Animals / Animals, Domestic / Biological and medical sciences / Cohort analysis / Data collection / Diseases of the osteoarticular system / Dizziness - complications / Epidemiologic Methods / Falls / Fear / Female / Fractures / Fractures, Bone - etiology / Health Surveys / Hip joint / Humans / Injuries / Injuries of the limb. Injuries of the spine / Male / Medical sciences / Netherlands / Older people / Osteoporosis / Osteoporosis. Osteomalacia. Paget disease / Recurrence / Thinness / Traumas. Diseases due to physical agents / Women