Academic journal article Journal of Allied Health

Falls in Community-Dwelling Adults Aged 50 Years and Older: Prevalence and Contributing Factors

Academic journal article Journal of Allied Health

Falls in Community-Dwelling Adults Aged 50 Years and Older: Prevalence and Contributing Factors

Article excerpt

The current descriptive study examined the prevalence, selected fall-related contributing factors, and ramifications of falls over 4 yrs in 663 community-dwelling adults older than 50 yrs. The current findings demonstrated an appreciably higher percentage of falls (62.1%) than the national average (33%). Unlike in past studies, those 50 to 60 yrs old reported more falls than those in the other three age categories (61-70, 71-80, and 81+ yrs). The current population reported a higher percentage of injuries from falls (80.3%) and sustained more cuts and bruises than reported in previous studies. Walking was cited as the most frequent cause of falling among both genders and all age groups. Significant findings were as follows: (1) women fell more often than men in the 71- to 80-yr-old group (χ^sup 2^ p value < 0.005); (2) women informed others about falls more often than men (χ^sup 2^ p value = 0.002); (3) falls occurred more often among those who lived alone (χ^sup 2^ p value = 0.0005); (4) more women living alone fell compared with men (χ^sup 2^ p value = 0.0005); (5) women who lived alone fell more often than women who lived with others (χ^sup 2^ p value = 0.023); (6) those living alone were more likely to tell a friend(s) whereas those living with others were more likely to tell a relative(s) about the fall(s) (χ^sup 2^ p value = 0.012); and (7) about 36% of respondents who indicated a fear of falling self-restricted engagement in activities (χ^sup 2^ p value < 0.005). J Allied Health 2009; 38:201-207.

FALLS AND FALL-RELATED INJURIES will become an escalating health care problem with the anticipated tsunami of aging baby boomers. Falls are responsible for about 10,000 deaths annually, making falls the sixth leading cause of death among adults older than 65 yrs.1 A fall may be described as unintentionally coming to rest on the ground or some lower surface not related to sudden medical conditions or an external object or force.2 Past fall-related investigations have used various age groupings in determining the contributing fall-related factors.3"6 However, a majority of the studies reviewed focused on adults 65 yrs and older and found that one third fall each year.3·7-9 The incidence of falls escalates with age, and women are 67% more likely than men to have a nonfatal fall injury.3 Stevens8 suggested that the rate of fall injuries in those 85 yrs and older is four to five times that of adults 65-74 yrs of age. Fall-related contributing factors may include taking more than four medications, muscle weakness, mobility, balance and walking deficits, visual impairments, certain chronic diseases, history of falls, age, gender, and having multiple risk factors.10,11

FACTORS AFFECTING FALLS

In 2003, about 30.8% of community-dwelling seniors lived alone,12 were more likely to be poorer (18.6%) than those living with families (5.8%),12 and had a higher incidence of falling.13 Further, single women who lived alone reported substantially more fall-related injuries than seniors who lived with a spouse or other people.12,13 Limited literature examined whether people actually reported sustaining a fall and whom they informed about their fall. Further, women are more likely to admit they have fallen because men underreport falling. 14

Past studies have determined that most falls happen midday, and only 20% of falls are between 9 PM and 7 AM.4,15,16 Research has found that 50%-60% of falls occur in the kitchen, bedroom, living room, and bathroom.3,17,18 Falls occurring outside the home (-24%) are prevalent among adults older than 65 yrs of age who are more active in sports and/or climbing, which predisposes them to sustaining a serious fall-related injury.3,19 Adults fall primarily while walking due to stumbling, tripping, or slipping, usually in a single-limb support while taking a step,3,5,20 and while moving from one surface to another surface and/or going up/down steps.20 Further, adults who have severe mobility limitations experience higher rates of falling episodes. …

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