Background
Falls are one of the major causes of disability in older people. A wide range of risk factors for falls are described according to setting – inpatient, nursing homes and community. The aim of this study was to identify the risk factors for falls in an outpatient setting.
Methods
In this cross‐sectional observational study, 160 consenting subjects were enrolled randomly, from the Geriatric Medicine outpatient department, All India Institute of Medical Sciences, New Delhi, India. Non‐ambulatory, seriously ill subjects were excluded. The subjects underwent brief evaluation including falls and geriatric assessment. They were grouped into fallers and non‐fallers. A multivariable logistic regression analysis was used to identify the factors associated with falls.
Results
The prevalence of falls was 23.75% (38/160). Women were proportionately higher (26.31%) in the fallers group vis‐à‐vis 19.67% in the non‐fallers group. After multivariate analysis, opioids (odds ratio [OR] 5.24 [95% CI, 2.0 18‐13.611]), vision impairment (OR 2.71 [95% CI, 1.050‐07.011]), fear of falling (OR 3.17 [95% CI, 1.167‐08.629]), instrumental activity of daily living (IADL) impairment (OR 3.41 [95% CI, 1.251‐09.301]), anti‐anginal medications (OR 8.90 [95% CI, 0.997‐79.564]) and self‐employment (OR 5.37 [95% CI, 1.058‐27.329]) were associated with falls. Adequate nutrition (OR 0.82 [95% CI, 0.688‐00.976]) and caregiver support (OR 0.46 [95% CI, 0.275‐00.801]) were protective of falls.
Conclusion
We identified the multi‐factorial etiology of falls. Patients having any of the above risk factors should undergo detailed fall risk assessment and preventive measures afterwards.
Background
The integral part of the definition of frailty is the outcome associated with it. Older adults at risk of frailty are in the process of becoming frail. This study looked at the clinical characteristics and outcomes of older adults at risk of frailty.
Methodology
The study population was selected from outpatient department of the geriatric medicine department in a tertiary care hospital. Older adults identified as at risk of frailty were assessed at baseline and then followed up after 1 year for the composite primary outcome of death, falls, hospitalization, and self‐rated poor quality of life in the follow‐up period.
Results
The study included 324 older adults who had completed 1‐year follow up. Mean (SD) age was 74.49 (4.58) years, and males were 241 (74.15%). Frail and pre‐frail at baseline among the study population were 31.17% and 61.11%, respectively. The primary outcome occurred in 43 (13.27%) patients. Poor baseline IADL was significantly associated with primary outcome at the end of 1 year.
Conclusion
An unfavorable outcome in older adults at risk of frailty was significantly higher and independent of their baseline frailty status. Poor baseline IADL value may be considered as a predictor for primary outcome at 1 year of follow up.
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