DOE PAGES title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Circumstances and outcomes of falls among high risk community-dwelling older adults

Journal Article · · Injury Epidemiology
 [1];  [2];  [3]
  1. Centers for Disease Control and Prevention (CDC), Atlanta, GA (United States); DOE/OSTI
  2. Univ. of Wisconsin, Madison, WI (United States). School of Medicine and Public Health. Dept. of Medicine
  3. Centers for Disease Control and Prevention (CDC), Atlanta, GA (United States)

For older adults, falls threaten their health, independence, and quality of life. Knowing the circumstances surrounding falls is essential for understanding how behavioral and environmental factors interact in fall events. It is also important for developing and implementing interventions that are effective and acceptable to older adults. This study investigated the circumstances and injury outcomes of falls among community-dwelling older adults at high risk for falls. In this secondary analysis, we examined the circumstances and outcomes of falls experienced by 328 participants in the Dane County (Wisconsin) Safety Assessment for Elders (SAFE) Research Study. SAFE was a randomized controlled trial of a community-based multifactorial falls intervention for older adults at high risk for falls, conducted from October 2002 to December 2007. Participants were community-dwelling adults aged ≥65 years who reported at least one fall during the year after study enrollment. Falls were collected prospectively using monthly calendars. Everyone who reported a fall was contacted by telephone to determine the circumstances surrounding the event. Injury outcomes were defined as none, mild (injury reported but no treatment sought), moderate (treatment for any injury except head injury or fracture), and severe (treatment for head injury or fracture). Data were available for 1,172 falls. A generalized linear mixed model analysis showed that being aged ≥85 (OR = 2.1, 95% confidence interval [CI] = 1.2–3.9), female (OR = 2.1, 95% CI = 1.3–3.4), falling backward and landing flat (OR = 5.6, 95% CI = 2.9–10.5), sideways (OR = 4.6, 95% CI = 2.6–8.0) and forward (OR = 3.3, 95% CI = 2.0–5.7) were significantly associated with the likelihood of injury. Of 783 falls inside the home, falls in the bathroom were more than twice as likely to result in an injury compared to falls in the living room (OR = 2.4, 95% CI = 1.2–4.9). Most falls among these high risk older adults occurred inside the home. The likelihood of injury in the bathroom supports the need for safety modifications such as grab bars, and may indicate a need for assistance with bathing. These findings will help clinicians tailor fall prevention for their patients and have practical implications for retirement and assisted living communities and community-based fall prevention programs.

Research Organization:
Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, TN (United States)
Sponsoring Organization:
USDOE Office of Science (SC), Biological and Environmental Research (BER). Biological Systems Science Division
OSTI ID:
1630057
Journal Information:
Injury Epidemiology, Journal Name: Injury Epidemiology Journal Issue: 1 Vol. 1; ISSN 2197-1714
Publisher:
BioMed CentralCopyright Statement
Country of Publication:
United States
Language:
English

References (57)

Validation of self-reported fall events in intervention studies journal April 2006
Task-Specific Training Reduces Trip-Related Fall Risk in Women journal January 2012
Fracture Risk Associated with a Fall According to Type of Fall Among the Elderly journal August 2000
The Association of Race, Gender, and Comorbidity With Mortality and Function After Hip Fracture journal August 2008
Traumatic Brain Injury in Older Adults: Epidemiology, Outcomes, and Future Implications: TRAUMATIC BRAIN INJURY AND OLDER ADULTS journal October 2006
Predisposing factors for occasional and multiple falls in older Australians who live at home journal January 2004
Risk Factors for Falls among Elderly Persons Living in the Community journal December 1988
Task-Specific Training Reduces Trip-Related Fall Risk in Women journal January 2012
Effective Exercise for the Prevention of Falls: A Systematic Review and Meta-Analysis: EFFECTIVE EXERCISE FOR THE PREVENTION OF FALLS journal December 2008
Unintentional injuries in the home in the United States journal January 2005
Circumstances and Consequences of Falls in Community-Dwelling Older Women journal December 2007
Repeated-Slip Training: An Emerging Paradigm for Prevention of Slip-Related Falls Among Older Adults journal November 2007
Vitamin d Supplement Intake in Elderly Fallers: Letters to the Editor journal January 2009
Circumstances around the fall in a multinational hip fracture risk study: a diverse pattern for prevention journal September 1998
Fracture Risk Associated with a Fall According to Type of Fall Among the Elderly journal August 2000
Prevalence, circumstances and consequences of falls among community-dwelling older people: results of the 2009 NSW Falls Prevention Baseline Survey journal January 2011
Severity of injuries associated with falls in the community dwelling elderly are not affected by fall characteristics and physical function level journal July 2012
Generalization of motor adaptation to repeated-slip perturbation across tasks journal April 2011
Risk Factors for Falls among Elderly Persons Living in the Community journal December 1988
Relationship between location and activity in injurious falls: an exploratory study journal June 2010
Indoor and Outdoor Falls in Older Adults Are Different: The Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly of Boston Study: INDOOR AND OUTDOOR FALLS IN OLDER ADULTS journal September 2010
Predictors of falls in the elderly by location journal February 2003
Circumstances and Consequences of Falls in Community-Dwelling Older Women journal December 2007
Predisposing factors for occasional and multiple falls in older Australians who live at home text January 2023
The overlap between syncope and falls in the elderly. journal October 1997
A Short Portable Mental Status Questionnaire for the Assessment of Organic Brain Deficit in Elderly Patients† journal October 1975
Outdoor and indoor falls as predictors of mobility limitation in older women journal September 2009
The Activities-specific Balance Confidence (ABC) Scale journal January 1995
Effect of a Perturbation-Based Balance Training Program on Compensatory Stepping and Grasping Reactions in Older Adults: A Randomized Controlled Trial journal April 2010
Fall-risk screening test journal August 2001
Systematic review of definitions and methods of measuring falls in randomised controlled fall prevention trials journal January 2006
Impact near the hip dominates fracture risk in elderly nursing home residents who fall journal March 1993
Monitoring Falls in Cohort Studies of Community-Dwelling Older People: Effect of the Recall Interval: MONITORING FALLS IN COMMUNITY-DWELLING OLDER PEOPLE journal December 2005
The Activities-specific Balance Confidence (ABC) Scale journal January 1995
Predictors of Functional Recovery One Year Following Hospital Discharge for Hip Fracture: A Prospective Study journal May 1990
Outdoor and indoor falls as predictors of mobility limitation in older women journal September 2009
The epidemiology of falls and syncope journal May 2002
Severity of injuries associated with falls in the community dwelling elderly are not affected by fall characteristics and physical function level journal July 2012
Validation of self-reported fall events in intervention studies journal April 2006
The overlap between syncope and falls in the elderly. journal October 1997
Predictors of falls in the elderly by location journal February 2003
Telephone and face-to-face interviews generate similar falls circumstances information from community-dwelling adults with stroke journal June 2009
Relationship between location and activity in injurious falls: an exploratory study journal June 2010
Preventing falls among older adults: No "one size suits all" intervention strategy journal January 2008
Systematic review of definitions and methods of measuring falls in randomised controlled fall prevention trials journal January 2006
A Short Portable Mental Status Questionnaire for the Assessment of Organic Brain Deficit in Elderly Patients† journal October 1975
Effect of a Perturbation-Based Balance Training Program on Compensatory Stepping and Grasping Reactions in Older Adults: A Randomized Controlled Trial journal April 2010
Circumstances of Falls Resulting in Hip Fractures Among Older People journal September 1997
Generalization of motor adaptation to repeated-slip perturbation across tasks journal April 2011
Heterogeneity of Falls Among Older Adults: Implications for Public Health Prevention journal November 2012
Circumstances of Falls Resulting in Hip Fractures Among Older People journal September 1997
Circumstances and consequences of falls in independent community-dwelling older adults journal January 1997
Nonfatal bathroom injuries among persons aged ≥15years—United States, 2008 journal August 2011
The Association of Race, Gender, and Comorbidity With Mortality and Function After Hip Fracture journal August 2008
Repeated-Slip Training: An Emerging Paradigm for Prevention of Slip-Related Falls Among Older Adults journal November 2007
The epidemiology of falls and syncope journal May 2002
Gender differences for non-fatal unintentional fall related injuries among older adults journal April 2005

Cited By (23)

Towards Fairness in Classifying Medical Conversations into SOAP Sections preprint January 2020
Epidemiology and contemporary risk profile of traumatic spinal cord injury in Switzerland journal November 2015
Investigation into Hand Impact Force During Forward Falls on Uneven Terrain journal November 2019
Actions of 2-methyl-1,4-naphthoquinone in Bacillus cereus journal January 1972
Occupational therapist led environmental assessment and modification to prevent falls: Review of current practice in an Australian rural health service journal January 2019
Coordinating Care for Falls via Emergency Responders: A Feasibility Study of a Brief At-Scene Intervention journal December 2016
Non-therapist identification of falling hazards in older adult homes using digital photography journal January 2015
Fall risk factors for individuals under the age of 65 years with type 2 diabetes mellitus journal October 2019
Evaluation of the Home Environment Assessment for the Visually Impaired (HEAVI): an instrument designed to quantify fall-related hazards in the visually impaired journal December 2016
Scoring the home falls and accidents screening tool for health professionals (HOME FAST-HP): Evidence from one epidemiological study journal March 2018
Functional Balance and Gait Characteristics in Men With Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia journal May 2019
Reconstruction of body motion during self-reported losses of balance in community-dwelling older adults journal February 2019
Age-Related Difference in Dynamic Postural Balance Against Tilting Perturbation in men and Women journal November 2017
Falls When Standing, Falls When Walking: Different Mechanisms, Different Outcomes in Parkinson Disease journal August 2019
The perceived feasibility and acceptability of a conceptually challenging exercise training program in older adults journal March 2018
Reliability and validity of the sequential weight-shifting test: a new functional approach to the assessment of the sitting balance of older adults journal January 2016
Sharp Turning and Corner Turning: Comparison of Energy Expenditure, Gait Parameters, and Level of Fatigue among Community-Dwelling Elderly journal January 2014
Launching injury epidemiology journal March 2014
Identifying characteristics and outcomes that are associated with fall-related fatalities: multi-year retrospective summary of fall deaths in older adults from 2005–2012 journal July 2017
Fall Hazards Within Senior Independent Living: A Case-Control Study journal February 2018
Patterns of Home Environmental Modification Use and Functional Health: The Women’s Health Initiative journal December 2019
Implementing Fall Prevention Guidelines with Vulnerable Older Adults: The Social Work Role journal December 2018
Falls are unintentional: Studying simulations is a waste of faking time journal January 2017