HOME HAZARDS AND FALLS IN THE ELDERLY - THE ROLE OF HEALTH AND FUNCTIONAL STATUS

Objectives. This study was undertaken to determine whether vigorous an d frail older people who identify environmental hazards in their homes have an increased risk for falls. Methods. A 1-year prospective study was conducted among 266 female and 59 male community-dwelling volunte ers aged 60 to 93 years who had fallen at least once during the previo us year. Composite measures of home safety and of frailty were derived using principal components analysis. Participants were divided into v igorous and frail groups, and associations between baseline home safet y measures and falls at home over the follow-up year were compared bet ween the two groups. Results. Frail individuals were more than twice a s likely as vigorous individuals to fall during follow-up (rate ratio [RR] = 2.24; 95% confidence interval [C] = 1.54, 3.27). In the study g roup as a whole, falls were not strongly associated with the presence of home hazards. However, when compared with vigorous older persons li ving with fewer home hazards, vigorous older persons living with more home hazards were more likely to fall. The increased risk for falls am ong vigorous elderly was limited to falls where home hazards were pres ent. By contrast, living with more home hazards was not associated wit h increased likelihood of falls among frail older persons. Conclusions . While frail older persons experience higher overall fall rates, vigo rous older persons should not be overlooked in fall prevention project s.