Falls in the Elderly: A Prospective Study of Risk Factors and Risk Profiles

作者：W.C. Graafmans, Marius Ooms, Herman M. A. Hofstee, P. Dick Bezemer, L.M. Bouter, Paul T.A.M. Lips · 发表于：American Journal of Epidemiology · 年份：1996 · DOI：10.1093/oxfordjournals.aje.a008690 · 被引用次数：795 · 研究领域：Balance, Gait, and Falls Prevention、Cerebral Palsy and Movement Disorders、Frailty in Older Adults

In this prospective study, the authors determined intrinsic risk factors for falls and recurrent falls and constructed a risk profile that indicated the relative contribution of each risk factor and also estimated the probabilities of falls and recurrent falls. In 1992, over a 28-week period, falls were recorded among 354 elderly subjects aged 70 years or over who were living in homes or apartments for the elderly in Amsterdam and the vicinity. During the study period, 251 falls were reported by 126 subjects (36%), and recurrent falls (> or =2 falls) were reported by 57 subjects (16%). Associations of falls and recurrent falls with potential risk factors were identified in logistic regression models. Mobility impairment regarding one or more of the tested items (i.e., impairment of balance, leg-extension strength, and gait) was associated with falls (adjusted odds ratio (OR) =2.6) and was strongly associated with recurrent falls (OR = 5.0). Dizziness upon standing was associated with falls (OR = 2.1) and recurrent falls (OR = 2.1). However, several risk factors were associated with recurrent falls only: history of stroke (OR = 3.4), poor mental state (OR = 2.4), and postural hypotension (OR = 2.0). The authors constructed a risk profile for recurrent falls that included the five risk factors mentioned above. Inclusion of all risk factors in the profile implied an 84% probability of recurrent falls over a period of 28 weeks, compared with 3% when no risk factor was present. Th...