Age and Sex Significantly Influence Fall Risk in Community‐dwelling Elderly People in Japan

Ishimoto, Yasuko; Wada, Taizo; Hirosaki, Mayumi; Kasahara, Yoriko; Kimura, Yumi; Konno, Akiko; Nakatsuka, Masahiro; Sakamoto, Ryota; Ishine, Masayuki; Okumiya, Kiyohito; Fujisawa, Michiko; Otsuka, Kuniaki

doi:10.1111/j.1532-5415.2009.02242.x

Cited by 11 publications

(11 citation statements)

References 7 publications

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“…Older age[15]–[16], female gender[16]–[17], and poorer visual acuity[18]–[19] were noted as risk factors for falling in previous studies. One study showed that falls were significantly associated with poor visual acuity and higher waist-to-hip ratio [19].…”

Section: Discussionmentioning

confidence: 77%

Associated Factors for Falls among the Community-Dwelling Older People Assessed by Annual Geriatric Health Examinations

Lin

Liao

et al. 2011

PLoS ONE

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BackgroundFalls are very common among the older people. Nearly one-third older people living in a community fall each year. However, few studies have examined factors associated with falls in a community-dwelling population of older Taiwanese adults.ObjectivesTo identify the associated factors for falls during the previous 12 months among the community-dwelling Taiwanese older people receiving annual geriatric health examinations.ParticipantsPeople aged sixty-five years or older, living in the community, assessed by annual geriatric health examinationsMethods1377 community-dwellers aged ≥65 years who received annual geriatric health examinations at one hospital in northern Taiwan between March and November of 2008. They were asked about their history of falls during the year prior to their most recent health examination.ResultsThe average age of the 1377 participants was 74.9±6.8 years, 48.9% of which were women. Three-hundred and thirteen of the participants (22.7%) had at least one fall during the previous year. Multivariate analysis showed that odds ratio for the risk of falling was 1.94 (95% CI 1.36-2.76) when the female gender group is compared with the male gender group. The adjusted odds ratios of age and waist circumference were 1.03 (95% CI 1.00–1.06) and 1.03 (95% CI 1.01–1.05) respectively. The adjusted odds ratios of visual acuity, Karnofsky scale, and serum albumin level were 0.34 (95% CI 0.15–0.76), 0.94 (95% CI 0.89–0.98), and 0.37 (95% CI 0.18–0.76) respectively. Larger waist circumference, older age, female gender, poorer visual acuity, lower score on the Karnofsky Performance Scale, and lower serum albumin level were the independent associated factors for falls.ConclusionIn addition to other associated factors, waist circumference should be included as a novel risk factor for falls.

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Section: Discussionmentioning

confidence: 77%

Associated Factors for Falls among the Community-Dwelling Older People Assessed by Annual Geriatric Health Examinations

Lin

Liao

et al. 2011

PLoS ONE

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“…The Working Group for Fall Prevention in the Japanese Ministry of Health, Welfare and Labor has developed a 21‐item Fall Risk Index (FRI) 2 for early detection of the risk of falls in elderly people. It has been found that fallers are older, more disabled, and more depressed and had higher scores on the FRI than nonfallers 3 and that FRI score was closely associated with aging and sex differences in community‐dwelling elderly persons in Japan 4 . Although the significance of the FRI has been demonstrated in cross‐sectional settings, the cutoff score for predicting falls in elderly people has not been established in longitudinal studies.…”

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confidence: 99%

“…Subjects who answered yes to the question were considered to be fallers, and those who answered no, not at all, were considered to be nonfallers. The FRI consists of 21 questionnaire‐based items identified through a search of international and Japanese research articles that surveyed the history of falls within a year on a yes/no basis 2,4,5 . The 21 items included in the FRI encompassed physical, cognitive, emotional, and social aspects of functioning and environmental factors.…”

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confidence: 99%

Twenty‐one‐item Fall Risk Index Predicts Falls in Elderly Community‐dwelling Japanese

Wada

Ishimoto

Hirosaki

et al. 2009

J American Geriatrics Society

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Labor has developed a 21-item Fall Risk Index (FRI) 2 for early detection of the risk of falls in elderly people. It has been found that fallers are older, more disabled, and more depressed and had higher scores on the FRI than nonfallers 3 and that FRI score was closely associated with aging and sex differences in community-dwelling elderly persons in Japan. 4 Although the significance of the FRI has been demonstrated in cross-sectional settings, the cutoff score for predicting falls in elderly people has not been established in longitudinal studies.A cohort study was conducted to evaluate the predictive value of the FRI in community settings. The study population consisted of 1,053 community-dwelling elderly subjects aged 65 and older (443 male, 610 female, mean age 74.6 AE 6.7) living in T town, Kochi, Japan. Participants were assessed using the FRI in June 2004 during their annual geriatric functional assessment, and the question ''Do you often fall?'' was used to detect fallers. Subjects who answered yes to the question were considered to be fallers, and those who answered no, not at all, were considered to be nonfallers. The FRI consists of 21 questionnaire-based items identified through a search of international and Japanese research articles that surveyed the history of falls within a year on a yes/no basis. 2,4,5 The 21 items included in the FRI encompassed physical, cognitive, emotional, and social aspects of functioning and environmental factors. It included history of stumbling, ability to climb stairs, slow walking speed, ability to cross the road within the green signal time interval, ability to walk 1 km without rest, ability to stand on one leg for 5 seconds, use of a cane, ability to squeeze a towel, dizziness, hunched back, knee pain, visual disturbance, hearing disturbance, forgetfulness, fear of falling, use of five or more prescription medications, darkness in the home, presence of obstacles inside the house, presence of barriers on the floor, daily stair use at home, and steep slopes around the house (Appendix A).Response rate of the eligible population was 94.7% at baseline and 74.4% at 1-year follow-up. Statistical analysis was performed using SPSS (SPSS, Inc., Chicago, IL) and a receiver operating characteristic (ROC) curve was used to determine the cutoff point on the FRI for predicting falls.Of 1,053 subjects, 186 (17.7%) were fallers at baseline and 219 (20.8%) at 1-year follow-up. Figure 1 shows the ROC curve of FRI to detect fallers at 1-year follow-up. Area under the ROC (AUC) of FRI was 79.4% (95% confidence interval (CI) 5 76.1-82.6%). Using a cutoff point of 9 out of 10 on the FRI, sensitivity was 67.7%, specificity was 76.4%, positive predictive value was 42.9%, and negative predictive value was 89.8% for fallers at 1-year follow-up.A past history of falls was found to be a strong predictor of falls in community-dwelling elderly people, 5,6 and subjects who reply yes to the question ''Do you often fall?'' LETTERS TO THE EDITOR 2369 JAGS DECEMBER 2009 should be immediately adv...

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“…In our previous cross-sectional study, we found that fallers were older, more disabled, more depressed and had higher FRI-21 scores than non-fallers. 3 We also showed that FRI-21 score was closely associated with age and sex differences, 9 and that a cut-off of 9/10 was a useful predictor of falls in Japanese community-dwelling elderly. 10 History of falls is a known fall risk, 11 and falls themselves are closely correlated with dependence of BADL.…”

Section: Introductionmentioning

confidence: 73%

Fall Risk Index predicts functional decline regardless of fall experiences among community‐dwelling elderly

Ishimoto

Wada

Kasahara

et al. 2012

Geriatrics Gerontology Int

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Aim: The 21‐item Fall Risk Index (FRI‐21) has been used to detect elderly persons at risk for falls. The aim of this longitudinal study was to evaluate the FRI‐21 as a predictor of decline in basic activities of daily living (BADL) among Japanese community‐dwelling elderly persons independent of fall risk. Methods: The study population consisted of 518 elderly participants aged 65 years and older who were BADL independent at baseline in Tosa, Japan. We examined risk factors for BADL decline from 2008 to 2009 by multiple logistic regression analysis on the FRI‐21 and other functional status measures in all participants. We carried out the same analysis in selected participants who had no experience of falls to remove the effect of falls. Results: A total of 45 of 518 participants showed decline in BADL within 1 year. Multivariate logistic regression analysis showed that age (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.05–1.20), FRI‐21 ≥ 10 (OR 3.81, 95% CI 1.49–9.27), intellectual activity dependence (OR 3.25, 95% CI 1.42–7.44) and history of osteoarthropathy (OR 3.17, 95% CI 1.40–7.21) were significant independent risk factors for BADL decline within 1 year. FRI‐21 ≥ 10 and intellectual activity dependence (≤3) remained significant predictors, even in selected non‐fallers. Conclusion: FRI‐21 ≥ 10 and intellectual activity dependence were significant predictive factors of BADL decline, regardless of fall experience, after adjustment for confounding variables. The FRI‐21 is a brief, useful tool not only for predicting falls, but also future decline in functional ability in community‐dwelling elderly persons. Geriatr Gerontol Int 2012; ••: ••–••.

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Age and Sex Significantly Influence Fall Risk in Community‐dwelling Elderly People in Japan

Cited by 11 publications

References 7 publications

Associated Factors for Falls among the Community-Dwelling Older People Assessed by Annual Geriatric Health Examinations

Associated Factors for Falls among the Community-Dwelling Older People Assessed by Annual Geriatric Health Examinations

Twenty‐one‐item Fall Risk Index Predicts Falls in Elderly Community‐dwelling Japanese

Fall Risk Index predicts functional decline regardless of fall experiences among community‐dwelling elderly

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