Assessing falls risk and associated factors among urban community dwellers older adults in Gondar town, Northwest Ethiopia 2019: A cross sectional study

Abstract

Background: Falls are the major public health problems among older adults of age 65 years and older. The risk of falling in the elderly is a combined result of multiple factors that can be from intrinsic or extrinsic in its origin. In Ethiopia, there is no study done to assess the falls risk status among older adults. Objective: The objective of this study was to assess the magnitude of falls risk and its associated factors in urban community dwellers older adults. Methods: A community based cross sectional study was conducted from April 22 to May 22, 2019. A multistage stratified systematic random sampling was used to select 607 community older adults using a pre validated questionnaire. Falls risk among older adults was assessed by Timed Up and Go Test. Bivariable and multivariable logistic regression was used to identify factors associated with falls. Variables with a p-value less than 0.2 in the bivariable analyses were fitted with the multivariable analysis. Results: A total of 607 urban community dwellers older adults were participated in this study. The overall magnitude of falls risk among urban community dwellers older adults was 38.2% (95% CI 34.3–42.3). Female participants were more likely to have falls risk (AOR = 8.2, 95%CI 4.2, 16.1). Foot problem and lower extremity were increased the risk of falling by (AOR = 2.4, 95%CI 1.4–4.3) and (AOR = 28.4, 95%CI15.22–52.95) respectively. Using diabetic control drug was found a protective factor of falls risk. Depressive symptoms were found increased the chance of falling in older adults (AOR = 1.8, 95% CI 1.01–3.24). Older adults with a habit of using assistive device increased the risk of falling by 2.56 (AOR = 2.56, 95%CI 1.3–5.2). Conclusions and recommendation: The overall incidence of failing risk among urban community dwellers older adults aged 60 years and older is higher compared with most studies conducted in the world. Older age 60 years and older, being female, medical comorbidity with foot problem and lower extremity weakness, using diabetic controlling drug, depression and using assistive device were identified as risk factors for falling. Highlights:

Prevalence of Polypharmacy and Risks of Potentially Inappropriate Medication Use in the Older Population in a Developing Country: A Systematic Review and Meta-Analysis

“…The United Nations population division estimated that the population aged 65 years and above accounted for 3.5% of Ethiopia's total population in 2019 [24], and this proportion is expected to increase to 3.8% by 2050. Already several studies conducted on the older population in Ethiopia reported a higher occurrence of falls [25,26], depression [27], hypertension [28], higher eye care service utilization [29], patterns of extensive psychotic medications use [30], polypharmacy, and PIM use [31][32][33][34][35][36][37][38]. On the other hand, deprescribing strategies [23] and emphasis on the importance of medication safety and medication-related quality of life have also been described [39].…”

Prevalence and factors associated with depression among older adults in the case of a low-income country, Ethiopia: a systematic review and meta-analysis

“…Four regional states (counties) of Ethiopia were represented in the studies. Four studies were conducted in the Amhara region [ 23 , 33 , 51 , 52 ], three studies conducted in Addis Ababa [ 31 , 36 , 53 ], two studies were conducted in Oromia [ 1 , 24 ] and two studies were conducted in Harar [ 50 , 54 ]. Three studies [ 31 , 53 , 54 ] did not report the mean age of their study participants, whereas the mean age of the participants in the other included studies ranged from 66.69 to 75.46 years.…”

“…Because the prevalence of cognitive impairment increases with age, the differential diagnosis of depression and dementia becomes increasingly difficult with age. Our review identified only two studies [ 50 , 52 ] that assessed cognitive impairment among older people. The underlying neuropathological conditions that lead to mild cognitive impairment (MCI) or dementia may also contribute to depression; thus later-life depression, MCI, and dementia may fall in a clinical continuum [ 81 ].…”