INCIDENCE OF AND RISK-FACTORS FOR FALLS AND INJURIOUS FALLS AMONG THECOMMUNITY-DWELLING ELDERLY

To determine the frequency of and risk factors for falls and injurious falls in the noninstitutionalized elderly, the authors conducted a fo llow-up study of 409 community-dwelling persons aged 65 years or more in west-central Montreal, Quebec, Canada, from May 1987 to October 198 8. Following an initial at-home interview, each subject was telephoned every 4 weeks for 48 weeks for collection of data on falls experience d since the last contact. Each of the 12 follow-up interviews was comp leted by at least 90% of the subjects eligible for interview. Data wer e also collected in the follow-up interviews on time-varying exposures . Twenty-nine percent of the subjects fell during follow-up; 17.6% fel l once, and 11.5% fell two or more times. The incidence rate for falls was 41.4 falls per 1,000 person-months. The majority of falls resulte d in no injury or in minor injury only. Potential risk factors investi gated included sociodemographic variables, physical activity, alcohol consumption, acute and chronic health problems, dizziness, mobility, a nd medications. Multivariate analyses showed that the following factor s were statistically significantly associated with an increased rate o f falls: dizziness (incidence rate ratio (IRR) = 2.0), frequent physic al activity (IRR = 2.0), having days on which activities were limited because of a health problem (IRR = 1.8), having trouble walking 400 m (IRR = 1.6), and having trouble bending down (IRR = 1.4). Factors whic h were protective included diversity of physical activities (IRR = 0.6 ), daily alcohol consumption (IRR = 0.5), having days spent in bed bec ause of a health problem (IRR = 0.5), and taking heart medication (IRR = 0.6). Risk factors for injurious falls were similar.