[Factors contributing to falls in elderly subjects leading to acute-care hospitalization]

Falls are a frequent reason for hospitalization in short-stay geriatric units. Paradoxically, the factors determining such hospitalization remain unknown. The objective of our study was to identify the explanatory factors of falls leading to acute-care hospitalization of elderly subjects.

We prospectively compared patients hospitalized for falls and those hospitalized for another reason in a short-stay geriatric unit. Data were collected over a 6-month period starting with a questionnaire and a physical examination.

Patients admitted for falls were predominantly women (76.9%) living alone (76.9%). Falls depended mainly on intrinsic factors. The precipitating factor was a medical condition (84%) and acute (96%). The pattern of multiple disease conditions was not specific for patients who fell. Inversely, osteoarthritis and visual and auditory deficits with direct effects on motor functions were correlated with falls. The environment played a determining role, but was primarily a predisposing and not a precipitating factor as is was directly the cause of falls in only 4% of cases. The loss of self-sufficiency for daily activities was also significantly more frequent in patients who fell.

The explanatory factors of falls as the reason for hospitalization of elderly subjects in short-stay geriatric units are intrinsic factors. They are associated with a precipitating factor which is usually an acute medical condition and a chronic multiple disease state having an effect on postural balance leading to the fall. These factors are combined in a context of social and environmental isolation.