Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-28T07:22:52.548Z Has data issue: false hasContentIssue false

Risk Factors for Serious Falls Among Community-Based Seniors: Results from the National Population Health Survey

Published online by Cambridge University Press:  31 March 2010

Paula C. Fletcher
Affiliation:
Wilfrid Laurier University
John P. Hirdes
Affiliation:
University of Waterloo and Homewood Research Institute

Abstract

This paper examines factors associated with falling among approximately 3,100 individuals aged 65 and older who were participants in the 1994 National Population Health Survey (NPHS). The intent of the NPHS is to monitor the health of Canadians and risk factors that affect their health. Several factors were identified as increasing the risk of falling, such as advanced age, being female, certain medical conditions, medication use and impaired mobility. The results from this survey, conducted on a national level, confirm the findings of many studies utilizing smaller samples within individual communities. Continuation of the NPHS will aid in offering longitudinal data with respect to falls, and allow for establishing a temporal order prior to the fall event, in order to provide more definitive evidence with respect to risk factors for falls.

Résumé

Ce document examine les facteurs associés aux chutes dans un groupe d'environ 3,100 personnes âgées de 65 ans et plus ayant participé à l'Enquête nationale sur la santé de la population de 1994. L'Enquête visait à étudier la santé des Canadiens et les facteurs de risque qui la menacent. Elle a permis de relever divers facteurs influant sur le risque de chute, notamment l'avancement en âge, le fait d'être une femme, certains états de santé, l'utilisation de certains médicaments et la difficulté de se déplacer. Les résultats de cette étude menée à l'échelle nationale confirment les conclusions de plusieurs études de moindre ampleur effectuées au sein de collectivités. La poursuite de l'Enquête permettra d'établir des données longitudinales en ce qui a trait aux chutes ainsi qu'une séquence temporelle précédant les chutes, ce qui fournira des données plus solides sur les facteurs de risque de chutes.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2002

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Baker, S.P., & Harvey, A.H. (1985). Fall injuries in the elderly. Clinics in Geriatric Medicine, 1(3), 501512.CrossRefGoogle ScholarPubMed
Bergland, A., Pettersen, A.M., & Laake, K. (1998). Falls reported among elderly Norwegians living at home. Physiotherapy Research International, 3(3), 164174.CrossRefGoogle ScholarPubMed
Blake, A.J., Morgan, K., Bendall, M.J., Dallosso, H., Ebrahim, S.B.J., Arie, T.H.D., Fentem, P.H., & Bassey, E.J. (1988). Falls by elderly people at home: Prevalence and associated factors. Age and Ageing, 17(6), 365372.CrossRefGoogle ScholarPubMed
Cali, C.M., & Kiel, D.P. (1995). An epidemiologic study of fall-related fractures among institutionalized older people. Journal of the American Geriatrics Society, 43(12), 13361340.CrossRefGoogle ScholarPubMed
Campbell, A.J. (1991). Drug treatment as a cause of falls in old age: A review of the offending agents. Drugs and Aging, 1(4), 289302.CrossRefGoogle ScholarPubMed
Campbell, A.J., Borrie, M.J., & Spears, G.F. (1989). Risk factors for falls in a community-based prospective study of people 70 years and older. Journal of Gerontology, 44(4), M112M117.Google Scholar
Campbell, A.J., Reinken, J., Allan, B.C., & Martinez, G.S. (1981). Falls in old age: A study of frequency and related clinical factors. Age and Ageing, 10, 264270.Google Scholar
Campbell, A.J., Spears, G.F., & Borrie, M.J. (1990). Examination by logistic regression modelling of the variables which increase the relative risk of elderly women falling compared to elderly men. Journal of Clinical Epidemiology, 43(12), 14151420.Google Scholar
Canadian Institute of Health Information. (2000a). http://www.cihi.ca/medrls/jan26_99/fig1.htm.Google Scholar
Craven, R., & Bruno, P. (1986). Teach the elderly to prevent falls. Journal of Gerontological Nursing, 12(8), 2733.Google Scholar
Cumming, R.G., Miller, J.P., Kelsey, J.L., Davis, P., Arfken, C.L., Birge, S.J., & Peck, W.A. (1991). Medications and multiple falls in elderly people: The St. Louis OASIS study. Age and Ageing, 20, 455461.CrossRefGoogle Scholar
Dunn, J.E., Rudberg, M.A., Furner, S.E., & Cassel, C.K. (1992). Mortality, disability, and falls in older persons: The role of underlying disease and disability. American Journal of Public Health, 82(3), 395400.CrossRefGoogle ScholarPubMed
Gabell, A., Simons, M.A., & Nayak, U.S.L.- (1985). Falls in the healthy elderly: Predisposing causes. Ergonimics, 28(7), 965975.Google Scholar
Gryfe, C.I., Amies, A., & Ashley, M.J. (1977). A longitudinal study of falls in an elderly population: (I) Incidence and morbidity. Age and Ageing, 6, 210210.Google Scholar
Hirdes, J.P., & Forbes, W.F. (1992). The importance of social relationships, socioeconomic status and health practices with respect to mortality among healthy Ontario males. Journal of Clinical Epidemiology, 45(2), 175182.CrossRefGoogle ScholarPubMed
Kane, R.L., Ouslander, J.G., & Abrass, I.B. (1989). Essentials of clinical geriatrics. (2nd ed.). New York: R.R. Donnelley & Sons Company.Google Scholar
Langlois, J.A., Smith, G.S., Nelson, D.E., Sattin, R.W., Stevens, J.A., & DeVito, C.A. (1995). Dependence in activities of daily living as a risk factor for fall injury events among older people living in the community. Journal of the American Geriatrics Society, 43(3), 275278.CrossRefGoogle ScholarPubMed
Lilley, J.M., Arie, T., & Chilvers, C.E.D. (1995). Accidents involving older people: A review of the literature. Age and Ageing, 24, 346365.CrossRefGoogle ScholarPubMed
Lindsay, R. (1988). Osteoporosis. Clinics in Geriatric Medicine, 4(2), 411430.CrossRefGoogle ScholarPubMed
Liu, B.A., Topper, A.K., Reeves, R.A., Gryfe, C., & Maki, B.E. (1995). Falls among older people: Relationship to medication use and orthostatic hypotension. Journal of the American Geriatrics Society, 43(10), 11411145.Google Scholar
Lord, S.R., Ward, J.A., Williams, P., & Anstey, K.J. (1994). Physiological factors associated with falls in older community-based women. Journal of the American Geriatrics Society, 42(10), 11101117.Google Scholar
Macdonald, J.B. (1985). The role of drugs in falls in the elderly. Clinics in Geriatric Medicine, 1(3), 621636.CrossRefGoogle ScholarPubMed
Macdonald, J.B., & Macdonald, E.T. (1977). Nocturnal femoral fracture and continuing widespread use of barbiturate hypnotics. British Medical Journal, 2, 483485.CrossRefGoogle ScholarPubMed
Maxwell, C.J., Neutel, C.I., & Hirdes, J.P. (1997). A prospective study of falls after benzodiazepine use: A comparison of new and repeat use. Pharmacoepidemiology and Drug Safety, 6, 2735.3.0.CO;2-S>CrossRefGoogle ScholarPubMed
Melton, L.J., & Riggs, B.L. (1985). Risk factors for injury after a fall. Clinics in Geriatric Medicine, 1(3), 525540.CrossRefGoogle ScholarPubMed
Neutel, C.I., Hirdes, J.P., Maxwell, C.J., & Patten, S.B. (1996). New evidence on benzodiazepine use and falls: The time factor. Age and Ageing, 25, 273278.CrossRefGoogle ScholarPubMed
Nevitt, M.C., Cummings, S.R., & Hudes, E.S. (1991). Risk factors for injurious falls: A prospective study. Journal of Gerontology, 46(5), M164M170.Google Scholar
Nevitt, M.C., Cummings, S.R., Kidd, S., & Black, D. (1989). Risk factors for recurrent nonsyncopal falls: A prospective study. Journal of the American Medical Association, 261(18), 26632668.Google Scholar
O'Loughlin, J.L., Robitaille, Y., Boivin, J.F., & Suissa, S. (1993). Incidence of and risk factors for falls and injurious falls among community-dwelling elderly. American Journal of Epidemiology, 137(3), 342354.Google Scholar
Overstall, P.W., Exton-Smith, A.N., Imms, F.J., & Johnson, A.L. (1977). Falls in the elderly related to postural imbalance. British Medical Journal, 1, 261264.Google Scholar
Perry, B.C. (1982). Falls among the elderly: A review of the methods and conclusions of epidemiologic studies. Journal of the American Geriatric Society, 30(6), 367371.Google Scholar
Prudham, D., & Grimley Evans, J. (1981). Factors associated with falls in the elderly: A community study. Age and Ageing, 10, 141146.Google Scholar
Raina, P., Wong, M., Dukeshire, S., Scanlan, A., Chambers, L., & Lindsay, J. (1999). Beyond mortality and hospitalization data: Self-reported injuries among Canadian seniors. Canadian Journal on Aging, 18(3), 328–247.CrossRefGoogle Scholar
Ray, W.A., & Griffin, M.R. (1990). Prescribed medications and the risk of falling. Topics in Geriatric Rehabilitation, 5(2), 1220.CrossRefGoogle Scholar
Ray, W.A., Griffin, M.R., Schaffner, W., Baugh, D.K., & Melton, L.J. (1987). Psychotropic drug use and the risk of hip fracture. The New England Journal of Medicine, 316(7), 363369.CrossRefGoogle ScholarPubMed
Robbins, A.S., Rubenstein, L.Z., Josephson, K.R., Schulman, B., Osterweil, D., & Fine, G. (1989). Predictors of falls among elderly people: Results of two population-based studies. Archives of Internal Medicine, 149, 16281633.Google Scholar
Rubenstein, L.Z., Robbins, A.S., Schulman, B.L., Rosado, J., Osterweil, D., & Josephson, K.R. (1988). Falls and instability in the elderly. Journal of the American Geriatrics Society, 36(3), 266278.CrossRefGoogle ScholarPubMed
Sattin, R.W., Lambert-Huber, D.A., DeVito, C.A., Rodriguez, J.G., Ros, A., Bacchelli, S., Stevens, J.A., & Waxweiler, R.J. (1990). The incidence of fall injury events among the elderly in a defined population. American Journal of Epidemiology, 131, 10281037.Google Scholar
Sheldon, J.H. (1960). On the natural history of falls in old age. British Medical Journal, 4, 16851690.Google Scholar
Sorock, G.S., & Shimkin, E.E. (1988). Benzodiazepine sedatives and the risk of falling in a community-dwelling elderly cohort. Archives of Internal Medicine, 148, 24412444.CrossRefGoogle Scholar
Statistics Canada. (1996). National Population Health Survey. Ottawa, Canada: Statistics Canada.Google Scholar
Stewart, R.B., Moore, M.T., May, F.E., Marks, R.G., & Hale, W.E. (1992). Nocturia: A risk factor for falls in the elderly. Journal of the American Geriatrics Society, 41 (12), 12171220.Google Scholar
Teno, J., Kiel, D.P., & Mor, V. (1990). Multiple stumbles: A risk factor for falls in community-dwelling elderly: A prospective study. Journal of the American Geriatrics Society, 38(12), 13211325.Google Scholar
Tideiksaar, R. (1989). Falling in old age: Its prevention and treatment (Vol. 2). New York: Springer Series on Adulthood and Aging.Google Scholar
Tideiksaar, R., & Kay, A.D. (1986). What causes falls? A logical diagnostic procedure. Geriatrics, 41(12), 3250.Google Scholar
Tinetti, M.E., Doucette, J., & Claus, E. (1995a). The contribution of predisposing and situations risk factors to serious injuries. Journal of the American Geriatrics Society, 43(11), 12071213.Google Scholar
Tinetti, M.E., Doucette, J., Claus, E., & Marottoli, R. (1995b). Risk factors for serious injury during falls by older persons in the community. Journal of the American Geriatrics Society, 43(11), 12141221.Google Scholar
Tinetti, M.E., Liu, W.L., & Claus, E.B. (1993). Predictors and prognosis of inability to get up after falls among elderly persons. Journal of the American Medical Association, 269(1), 6570.Google Scholar
Tinetti, M.E., Speechley, M., & Ginter, S.F. (1988). Risk factors for falls among elderly persons living in the community. The New England Journal of Medicine, 319(26), 17011707.Google Scholar
Tinetti, M.E., & Williams, C.S. 1998). The effect of falls and fall injuries on functioning in community-dwelling older person. Journal of Gerontology, 53A(2), M112M119.Google Scholar
Vellas, B., Cayla, F., Bocquet, H., de Pemille, F., & Albarede, J.L. (1987). Prospective study of restriction of activity in old people after falls. Age and Ageing, 16(3), 189193.CrossRefGoogle ScholarPubMed
Vellas, B.J., Wayne, S.J., Garry, P.J., & Baumgartner, R.N. (1998). A two-year longitudinal study of falls in 482 community-dwelling elderly adults. Journal of Gerontology, 53A(4), M264M274.Google Scholar
Waller, J.A. (1978). Falls among the elderly: Human and environmental factors. Accident Analysis and Prevention, 10(1), 2133.Google Scholar
Wickham, C., Cooper, C., Margetts, B.M., & Barker, D.J.P. (1989). Muscle strength, activity, housing and the risk of falls in elderly people. Age and Ageing, 18, 4751.Google Scholar
Wild, D., Nayak, U.S.L., & Isaacs, B. (1981). How dangerous are falls in old people at home? British American Journal, 282(24), 266268.Google Scholar
World Health Organization. (1977). Manual of the International Statistical Classification of Diseases, Injuries and Causes of Death. (Vol. 1). Geneva.Google Scholar
Yasumura, S., Haga, H., Nagai, H., Suzuki, T., Amano, H., & Shibata, H. (1994). Rate of falls and the correlates among elderly people living in an urban community in Japan. Age and Ageing, 23, 323327.Google Scholar