Intrinsic and Extrinsic Risk Factor for Fall among Community Dwelling Indonesian Elderly

Abstract

BACKGROUND: Fall-related injuries are identified as a public health problem that has major consequences in affecting the lives of elderly people. Recent studies showed that one out of four elderly people suffers from this condition annually. AIM: This study aims at identification of fall risk factors that involve intrinsic and extrinsic factor to predict the future fall. MATERIALS AND METHODS: This study uses an observational design and a descriptive-analytic approach with a cross-sectional method which was used to identify risk factors for falls. This study targeted 60 years and above who live in West Java region. Afterward, a total of 420 people were obtained and divided into two regions, 215 people in Bandung Regency and 205 people in Bandung City. Furthermore, the sampling technique used was for cluster random sampling. RESULTS: The elderly who experienced incontinence in controlling urination had the potential of falling by 4 times compared to those who did not AOR = 3.73; 95% CI (1.038–13.428). Furthermore, those who had history of falling in the past 12 months were 2.4 times exposed compared to those who had not fallen AOR = 2.438; 95% CI (1.219–4.875). Balance disorders also contributed in increasing the risk of fall by 2 times with a value of AOR = 1.703; 95% CI (1.018–2.849). An extrinsic factor, namely, unsafe home environment has higher possibility to increase the risk of falling 2.6 times compared to those in safer environment (AOR = 2.603; 95% CI [1.331–5.087]). CONCLUSION: This study succeeded in identifying the risk factors for falls among the elderly in intrinsic and extrinsic approach. This finding can be used as a reference in planning health promotion programs for elderly people, specifically in the primary prevention of morbidity and mortality that occur due to falls.

A Randomized Control Trial for a Comprehensive Fall Prevention Model for Self-Supporting Older Adults (PMACTIVAS): A Study Protocol

“…The factors that most frequently result in falls among older people include extrinsic factors, such as hazards in the physical environment, and intrinsic factors related to in-creased individual susceptibility and risk behaviours, most of which are potentially modifiable or manageable with preventive measures [19]. The most relevant extrinsic factors are limited mobilization space due to the overcrowding of objects and the lack of security in the home and environment [14,20].…”

“…The houses in which older adults reside lack the required security, habitability, and accessibility facilities, thereby generating situations of fall risks that need special care and adaptations for greater security and a suitable living environment [20,24]. Effective fall prevention among older adults requires a comprehensive approach [12,13,19,25]. The most effective fall reduction programs include systematic fall risk assessment and selected interventions, such as exercise programs and inspections of the physical environment with risk reduction programs [26,27].…”

“…Considering the promising results of a previous controlled trial [28] and recent studies [1,14,19,20], an intervention was designed to address the lack of interventions for fall prevention in self-care older adults living at home. We hypothesized that older adults who participate in the PM ACTIVAS Model will present a lower frequency of falls, will improve the management of risk factors, and will achieve a greater perception of risk factors for falls.…”