Incidence and risk factors for falls among community-dwelling elderly subjects on a 1-year follow-up: a prospective cohort study from Ernakulam, Kerala, India

Abstract

ObjectivesThere is limited knowledge regarding epidemiology and risk of falls among the elderly living in low-income and middle-income countries. In this situation, the current study aims to report the incidence of falls and associated risk factors among free living elderly population from Kerala, India.DesignProspective cohort study with stratified random cluster sampling.SettingThe study location was Ernakulam, Kerala, India, and we collected information via house visits using a questionnaire. During the research, the subjects were followed up prospectively for 1 year by phone at intervals of 3 months and missing subjects were contacted by house visits.ParticipantsCommunity-dwelling elderly above 65 years of age.ResultsWe recruited a total of 1000 participants out of which a total of 201 (20.1%) subjects reported a fall during the follow-up. The incidence rate of falls was 31 (95% CI 27.7 to 34.6) per 100 person-years. Female sex (OR 1.48, 95% CI 1.05 to 2.10, p=0.027), movement disorders including Parkinsonism (OR 2.26, 95% CI 1.00 to 5.05, p=0.048), arthritis (OR 1.48, 95% CI 1.05 to 2.09, p=0.026), dependence in basic activities of daily living (OR, 3.49, 95% CI 2.00 to 6.09, p<0.001), not using antihypertensive medications (OR, 1.53, 95% CI 1.10 to 2.13, p=0.012), living alone during daytime (OR 3.27, 95% CI 1.59 to 6.71, p=0.001) and a history of falls in the previous year (OR, 2.25, 95% CI 1.60 to 3.15, p<0.001) predicted a fall in the following year.ConclusionsOne in five community-dwelling senior citizen fall annually and one in four who fall are prone to fall again in the following year. Interventions targeting falls among the elderly need to focus on modifiable risk factors such as living alone during daytime, movement disorders, arthritis and dependence on basic activities of daily living.

Prevalence and risk factors of fall-related injury among older adults in India: evidence from a cross-sectional observational study

“…Worldwide, in the older ages, sex difference was found in falling and women were more likely than men to be injured due to falls [ 30 ]. In a cohort-based study in South India, one in four older women fell compared with one in six men during the follow-up [ 31 ]. In line with the results of earlier studies, the present analysis also shows that there exists a statistically significant association of gender with a fall-related injury.…”

“…Further, as evidence suggests, low socioeconomic status is associated with fall as it could lead to a poor household environment and untreated health conditions in older individuals [ 8 , 29 , 30 ]. A couple of community-based studies in India at different regional levels have also found female sex and increasing age to be major risk factors of falls among older population [ 31 – 33 ].…”

Current changes in the epidemiology of fall-related injuries in Al Ain City, United Arab Emirates

“…Geriatric falls is a serious public health problem [ 33 ]. Living alone, the effect of medications, movement disorders, weak sensory power, reduced mobility, and arthritis are risk factors for falls in the elderly population, even if physically active [ 34 – 36 ]. UAE has a fast-ageing population compared with the other Gulf countries [ 37 ].…”

Changes in the epidemiology of fall-related injuries in a high-income developing country

“…Geriatric falls is a serious public health problem [25]. Living alone, effect of medications, movement disorders, weak sensory power, reduced mobility, and arthritis are risk factors for falls in the elderly population even if physically active [26][27][28]. UAE has a fast aging population compared with the other Gulf countries [29].…”