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Falls in the general elderly population: a 3- and 6- year prospective study of risk factors using data from the longitudinal population study 'Good ageing in Skane'.

Stenhagen M, Ekström H, Nordell E, Elmståhl S - BMC Geriatr (2013)

Bottom Line: Accidental falls in the elderly are a major health problem, despite extensive research on risk factors and prevention.Three main components predicting falls were identified in a general elderly population after three and six years: reduced mobility, heart dysfunction and functional impairment including nocturia.The use of neuroleptic drugs was also a prominent individual risk factor, although the prevalence was low.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Health Sciences, Division of Geriatric Medicine, Lund University, Skåne University Hospital, Malmö SE-205 02, Sweden. magnus.stenhagen@med.lu.se

ABSTRACT

Background: Accidental falls in the elderly are a major health problem, despite extensive research on risk factors and prevention. Only a limited number of multifactorial, long-term prospective studies have been performed on risk factors for falls in the general elderly population. The aim of this study was to identify risk factors predicting falls in a general elderly population after three and six years, using a prospective design.

Methods: The prevalence of 38 risk factors was recorded at a baseline assessment of 1763 subjects (aged 60-93 years). The incidence of one or more falls was recorded after three and six years. The predicted risk of falling, after exposure to the various risk factors, was analysed in a multiple logistic regression model, adjusted for age and sex, and presented as odds ratios (OR). A principal component analysis (PCA), including the statistical significant factors, was also performed to identify thematic, uncorrelated components associated with falls.

Results: The use of neuroleptics (OR 3.30, 95% CI: 1.15-9.43), heart failure with symptoms (OR 1.88, 95% CI: 1.17-3.04) and low walking speed (OR 1.77, 95% CI: 1.28-2.46) were prominent individual risk factors for falls. In the PCA, three main components predicting falls were identified: reduced mobility, OR 2.12 (95% CI 1.54-2.91), heart dysfunction, OR 1.66 (95% CI 1.26-2.20) and functional impairment including nocturia, OR 1.38 (95% CI 1.01-1.88).

Conclusions: Three main components predicting falls were identified in a general elderly population after three and six years: reduced mobility, heart dysfunction and functional impairment including nocturia. The use of neuroleptic drugs was also a prominent individual risk factor, although the prevalence was low. Heart failure with symptoms was a significant risk factor for falls and may be of clinical importance as the prevalence of this condition in the elderly is increasing worldwide. There is need for further research on the relation between heart failure and falls in the elderly, as the treatment for this condition is poorly documented in this demographic. The findings of this study may be valuable in the development of intervention programmes aimed at sustainable, long-term reduction of falls in the elderly.

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Flow sheet explaining the enrolment of subjects and the numbers participating at the 3- and 6-year follow-up assessments.
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Figure 1: Flow sheet explaining the enrolment of subjects and the numbers participating at the 3- and 6-year follow-up assessments.

Mentions: This a prospective cohort study based on data from the on-going longitudinal, Swedish population study ‘Good Ageing in Skåne’[24]. Initially, 5370 subjects from five municipalities, covering both urban and rural areas, in the region of Skåne, southern Sweden, were invited to participate by letter. The subjects were randomly selected from the National Population Register using a computerised random number generator. The only exclusion criterion was the inability to speak Swedish. The study included men and women from nine age cohorts: 60, 66, 72, 78, 81, 84, 87, 90 and 93 years. Nearly 3000 individuals (2931) agreed to participate, giving a response rate of 60%. These subjects were recruited to a baseline assessment which took place from February 2001 to July 2004; a lengthy inclusion period was needed due to the scope of the study. The assessments were performed at a research centre or at the subject’s own home (9.7%), or in sheltered housing (2.5%). The older cohorts, 78 years and older, were invited to a 3-year follow-up assessment between January 2005 and June 2006. All cohorts were invited to a 6-year follow-up between March 2007 and December 2011. Figure 1 illustrates the study population, which initially consisted of 2535 subjects in which no falls were recorded at the baseline assessment. After recruitment, 772 subjects did not participate in the follow-up assessments, and were thus categorised as non-participants. In total, 1763 subjects with complete data from the 3- or/and 6-year follow-up assessments were included in our study.\


Falls in the general elderly population: a 3- and 6- year prospective study of risk factors using data from the longitudinal population study 'Good ageing in Skane'.

Stenhagen M, Ekström H, Nordell E, Elmståhl S - BMC Geriatr (2013)

Flow sheet explaining the enrolment of subjects and the numbers participating at the 3- and 6-year follow-up assessments.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3750524&req=5

Figure 1: Flow sheet explaining the enrolment of subjects and the numbers participating at the 3- and 6-year follow-up assessments.
Mentions: This a prospective cohort study based on data from the on-going longitudinal, Swedish population study ‘Good Ageing in Skåne’[24]. Initially, 5370 subjects from five municipalities, covering both urban and rural areas, in the region of Skåne, southern Sweden, were invited to participate by letter. The subjects were randomly selected from the National Population Register using a computerised random number generator. The only exclusion criterion was the inability to speak Swedish. The study included men and women from nine age cohorts: 60, 66, 72, 78, 81, 84, 87, 90 and 93 years. Nearly 3000 individuals (2931) agreed to participate, giving a response rate of 60%. These subjects were recruited to a baseline assessment which took place from February 2001 to July 2004; a lengthy inclusion period was needed due to the scope of the study. The assessments were performed at a research centre or at the subject’s own home (9.7%), or in sheltered housing (2.5%). The older cohorts, 78 years and older, were invited to a 3-year follow-up assessment between January 2005 and June 2006. All cohorts were invited to a 6-year follow-up between March 2007 and December 2011. Figure 1 illustrates the study population, which initially consisted of 2535 subjects in which no falls were recorded at the baseline assessment. After recruitment, 772 subjects did not participate in the follow-up assessments, and were thus categorised as non-participants. In total, 1763 subjects with complete data from the 3- or/and 6-year follow-up assessments were included in our study.\

Bottom Line: Accidental falls in the elderly are a major health problem, despite extensive research on risk factors and prevention.Three main components predicting falls were identified in a general elderly population after three and six years: reduced mobility, heart dysfunction and functional impairment including nocturia.The use of neuroleptic drugs was also a prominent individual risk factor, although the prevalence was low.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Health Sciences, Division of Geriatric Medicine, Lund University, Skåne University Hospital, Malmö SE-205 02, Sweden. magnus.stenhagen@med.lu.se

ABSTRACT

Background: Accidental falls in the elderly are a major health problem, despite extensive research on risk factors and prevention. Only a limited number of multifactorial, long-term prospective studies have been performed on risk factors for falls in the general elderly population. The aim of this study was to identify risk factors predicting falls in a general elderly population after three and six years, using a prospective design.

Methods: The prevalence of 38 risk factors was recorded at a baseline assessment of 1763 subjects (aged 60-93 years). The incidence of one or more falls was recorded after three and six years. The predicted risk of falling, after exposure to the various risk factors, was analysed in a multiple logistic regression model, adjusted for age and sex, and presented as odds ratios (OR). A principal component analysis (PCA), including the statistical significant factors, was also performed to identify thematic, uncorrelated components associated with falls.

Results: The use of neuroleptics (OR 3.30, 95% CI: 1.15-9.43), heart failure with symptoms (OR 1.88, 95% CI: 1.17-3.04) and low walking speed (OR 1.77, 95% CI: 1.28-2.46) were prominent individual risk factors for falls. In the PCA, three main components predicting falls were identified: reduced mobility, OR 2.12 (95% CI 1.54-2.91), heart dysfunction, OR 1.66 (95% CI 1.26-2.20) and functional impairment including nocturia, OR 1.38 (95% CI 1.01-1.88).

Conclusions: Three main components predicting falls were identified in a general elderly population after three and six years: reduced mobility, heart dysfunction and functional impairment including nocturia. The use of neuroleptic drugs was also a prominent individual risk factor, although the prevalence was low. Heart failure with symptoms was a significant risk factor for falls and may be of clinical importance as the prevalence of this condition in the elderly is increasing worldwide. There is need for further research on the relation between heart failure and falls in the elderly, as the treatment for this condition is poorly documented in this demographic. The findings of this study may be valuable in the development of intervention programmes aimed at sustainable, long-term reduction of falls in the elderly.

Show MeSH
Related in: MedlinePlus