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Fall predictors in the community dwelling elderly: a cross sectional and prospective cohort study
A J Sai1, J C Gallagher, L M Smith
1Bone Metabolism Unit, Creighton University School of Medicine, Omaha, NE, USA.
Objectives:
To ascertain the risk factors for falls, stumbles and recurrent falls in a cohort of elderly people with mean age of 76.7-/+6.1 years.
Methods:
137 community dwelling elderly living independently or in assisted living institutions participated in the study. Each subject was assessed by history, physical examination and physical performance tests at the beginning and end of study. Falls and stumbles were recorded in a falls dairy for 1 year.
Results:
Significant predictors of being a faller were a history of falls at baseline (Odds Ratio (OR) = 3.85, 95% Confidence Interval (CI) = 1.56 - 9.50), depression (OR = 1.19, 95% CI = 1.02 - 1.38) and timed rise (Incident Rate Ratio (IRR) = 1.24, 95% CI = 1.03 - 1.50). For predicting recurrent fallers Receiver Operator Characteristic (ROC) curves were as follows: 0.71 (95%CI 0.61-0.81) for timed up and go, 0.67 (95%CI 0.56-0.78) for timed rise and 0.70 (95%CI 0.60-0.80) for timed walk fast pace.
Conclusions:
Timed rise was the single most important test that was able to predict both a first time faller and recurrent faller. Timed up and go was the most significant test to predict recurrent fallers.
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