Mortality, disability, and falls in older persons: the role of underlying disease and disability.

Dunn, Julie E.; Rudberg, Mark A.; Furner, Sylvia E.; Cassel, Christine K.

doi:10.2105/ajph.82.3.395

Cited by 176 publications

(103 citation statements)

References 15 publications

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“…Donald and Bulpitt [36] showed an increased risk of death at the 1- and 3-year follow-up in elderly non-uremic subjects over 75 years of age for ‘recurrent fallers’ but not for ‘single fallers’. Similarly, Dunn et al [37] showed a 2.2-fold increase risk for death in ‘recurrent fallers’ versus only 1.5-fold for ‘single fallers’.…”

Section: Discussionmentioning

confidence: 96%

Long-Term Morbidity and Mortality Related to Falls in Hemodialysis Patients: Role of Age and Gender – A Pilot Study

Abdel‐Rahman¹,

Gao²,

Turgut³

et al. 2011

Nephron Clin Pract

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Background: Patients with end-stage renal disease (ESRD) on hemodialysis (HD) are prone to falls. In this pilot study, we aimed to determine the incidence of falls in a cohort of HD patients during a 1-year period, to identify any specific risk factors that may predict falls in this cohort, and to assess whether falls can independently predict hospitalization, nursing home admissions and/or mortality over an additional 2 years. Materials and Methods: Baseline assessments followed by documentation of falls prospectively during a 1-year period were done on 76 HD patients. Patients were followed for an additional 2 years and four outcomes were recorded: all-cause death, nursing home admission, the number and duration of all hospitalizations. Results: 20 patients (26.3%) fell over a 12-month period. Elderly and females had a higher risk of falls than the younger and male population (p = 0.034 and 0.006 respectively). During the 2-year follow-up, compared to non-fallers, fallers had a 2.13-fold increase in risk of death, a 3.5-fold increase in risk of nursing home admission, and nearly a 2-fold increase in the number and duration of hospitalizations. Conclusions: Falls are common in HD patients, with a higher incidence in females and elderly, and are associated with worse outcomes, more so in recurrent fallers.

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Section: Discussionmentioning

confidence: 96%

Long-Term Morbidity and Mortality Related to Falls in Hemodialysis Patients: Role of Age and Gender – A Pilot Study

Abdel‐Rahman¹,

Gao²,

Turgut³

et al. 2011

Nephron Clin Pract

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“…In a community based cross sectional study it has been shown that from one-fourth up to one-third of the persons 65 years or older reported a fall in the previous year [2,3]. In the elderly, between 10 % and 15 % of the falls result in serious injury and between 5 % and 10 % cause a fracture [4].…”

Section: Introductionmentioning

confidence: 99%

Falls in frequent neurological diseases

Stolze

Klebe

Zechlin

et al. 2004

Journal of Neurology

318

100

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The prevalence of falls among neurological patients is unknown, although disturbances of gait and posture are common. Falls may lead to burdens for the patient, the caregivers and the health system. We designed a prospective study and investigated all patients for a history of falls admitted to a neurological hospital during a 100-day period. Clinical investigation was carried out and several disease specific rating scales were applied. A total of 548 patients were investigated. Of all patients 34% had fallen once or more often during the last twelve months. A disturbance of gait was blamed for the fall in 55%, epileptic seizures in 12%, syncope in 10 % and stroke in 7%. Intrinsic risk factors for falls were high age, disturbed gait, poor balance and a fear of falling. As extrinsic factors we identified the treatment with antidepressants, neuroleptics and different cardiovascular medications, adverse environmental factors in the patients' home and the use of walking aids. Within the diagnoses, falls were most frequent in Parkinson's disease (62 %), syncope (57%) and polyneuropathy (48 %). According to these findings falls in neurological in-patients are twice as frequent as in an age-matched population living in the community. Falls in neurological patients are particularly linked to medication and disorders affecting gait and balance.

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“…Among the elderly, approximately 1 to 3 percent of falls results in a hip fracture, and over 90 percent of hip fractures are caused by a fall (4)(5)(6). Falls also may lead to various other types of fractures, soft tissue injury, head traumas, and increased mortality (7,8). The cumulative incidence of falling among elderly people varies between 30 percent and 50 percent over a 1-year period (6,(9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

Daily physical activity and the use of a walking aid in relation to falls in elderly people in a residential care setting

Graafmans¹,

Lips

Wijlhuizen³

et al. 2003

Zeitschrift f�r Gerontologie und Geriatrie

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Zusammenhang zwischen Stürzen, täglichen körperlichen Aktivitäten und dem Gebrauch von Gehhilfen bei älteren Menschen in Altenheimen und Betreutem Wohnenn Summary Physical activity is usually considered as an important component of a healthy lifestyle, including a preventive effect on the risk of falls in the elderly. The relationship between physical activity and falls is complex: physical activity is a prerequisite to maintain neuromuscular functioning, necessary to keep balance and to react to a fall, but a higher level of physical activity also implies a greater exposure to environmental threats, possibly leading to a fall. Related to this greater exposure to threats, the use of a walking aid may protect against falls in those who have impaired mobility. In this cross-sectional study we investigated the relationship between daily physical activity and falls and the use of a walking aid in elderly subjects. Participants were 131 men and 563 women, aged 70 years and over (mean age and standard deviation: 82 ± 6 years), living in homes for the elderly (n = 335) and apartment houses for elderly (n = 359). Data on baseline characteristics and falls in the previous year were obtained using a questionnaire. The level of daily physical activity in the previous year was obtained by means of a questionnaire regarding household and leisure activities. Subjects with a lower extremity fracture in the previous year were excluded from the analyses. Data were analysed using multiple logistic regression, adjusted for age, gender, and residence. In the past year, 40% of the participants fell at least one time, and 19% of the participants fell two times or more. Since falls and recurrent falls were nonlinearly related to the level of daily physical activity, the physical activity score was grouped into quartiles: the highest quartile corresponding to the highest activity level. Odds ratios (and 95% confidence intervals) for falls and recurrent falls for subjects in the highest quartile contrasted with those in the lowest quartile were 0.5 (0.3-0.9) and 0.3 (0.2-0.6), respectively. The risk of falls and recurrent falls was not lower for those with intermediate levels of daily physical activity. The use of a walking aid protected against falls in those with intermediate high activity levels (third quartile). It was suggested that the exposure to environmental hazards, due to some degree of physical activity may have been responsible for the nonlinear relationship between daily physical activity and falling. We conclude that a high activity level and the use of a walking aid may protect against falls.

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Mortality, disability, and falls in older persons: the role of underlying disease and disability.

Cited by 176 publications

References 15 publications

Long-Term Morbidity and Mortality Related to Falls in Hemodialysis Patients: Role of Age and Gender – A Pilot Study

Long-Term Morbidity and Mortality Related to Falls in Hemodialysis Patients: Role of Age and Gender – A Pilot Study

Falls in frequent neurological diseases

Daily physical activity and the use of a walking aid in relation to falls in elderly people in a residential care setting

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