Circumstances and consequences of falls in independent community-dwelling older adults

Abstract

BACKGROUND: knowledge of the circumstances and consequences of falls in older adults is important for understanding the aetiology of falls as well as for effective clinical assessment and design of fall prevention strategies. Such data, however, are relatively scarce, especially in community-dwelling elders. METHOD: accidental falls (including their circumstances and consequences) occurring in 96 male and female participants between 60 and 88 years of age were monitored prospectively for 1 year. After the monitoring period, participants were divided into three groups based on fall status: non-fallers (n = 46), one-time fallers (n = 27) and recurrent fallers (n = 23). Frequency distributions were created for selected circumstances and consequences of falls and the prevalence of these consequences were examined. RESULTS: 50 participants (52%) fell during the 1 year period, amassing 91 falls. Trips and slips were the most prevalent causes of falls, accounting for 59% of falls. Falls most often occurred during the afternoon and while subjects walked on level or uneven surfaces. Fallers most commonly attributed falls to hurrying too much. Fractures resulted from five of the 91 falls and eight other falls resulted in soft tissue injuries that required treatment by a physician. There were no differences between one-time and recurrent fallers in the circumstances and consequences of falls. However, several notable differences were found between men (n = 20) and women (n = 30) who fell. Falls by men most often resulted from slips whereas falls by women most often resulted from trips. Moreover, women and men differed in the time of the year in which falls occurred, with men falling most often during winter and women during summer. CONCLUSIONS: the results of this study provide insight into the circumstances and consequences of falls among independent community-dwelling older adults and suggest some possible ways of preventing falls. Preventive services, however, should not solely target recurrent fallers, nor should the type of services necessarily differ for one-time and recurrent fallers.