[Risk factors for falls amongst older people living in nursing home. A cohort study]

To determine factors associated with falls in institutionalized elderly.

A prospective cohort study was carried out, over a 18 months period. We included 203 subjects aged 65 and over who were able to walk. We recorded: age, sex, BMI, Barthel, Pfeiffer, Tinetti and FRAT tests, history of falls during the previous year, walking aids, the existence of orthostatic hypotension, delirium in the previous month, presence of various chronic diseases (10), number and nature of the usual drugs (15). Each fall was recorded by the nurse in charge of the patient. The analysis was carried out using logistic regression.

The average age of participants was 80.1 (SD=9.1) years, male 37.9%. There were 35 losses (11.5%/year). 204 falls were registered in 99 people (48.8% cumulative incidence at 18 months of follow-up). 44 people (21.7%) suffered repeated falls. Regression analysis showed association with the presence of delirium in the month prior to the inclusion in the study (OR 6.7; CI95% 1.6-30.3) and a smaller BMI (OR 1.1; CI95% 1.01-1.12), and visual impairment in the case of repeated falls (OR 2.2; CI95% 1.1-4.5).

The incidence of falls in institutionalized elderly is high. It was found strong association with some conditions of fragility as indicators of risk.