Falls among healthy, community-dwelling, older women: a prospective study of frequency, circumstances, consequences and prediction accuracy

Objective: Most studies of falls among older people have focused on those with some degree of balance or mobility impairment. This study aimed to establish whether falls and associated injuries were a major problem among healthy, older women, whether there were some common features in the falls, and whether these falls could be accurately predicted. Method: Ninety-six healthy, active community-dwelling women in Melbourne, Australia, aged at least 70 years (mean 74.1+/-4.0) were initially measured on a comprehensive series of laboratory and clinical balance tests, gait, strength and psychometric measures. Subjects were monitored for falls events, circumstances and consequences by use of falls diaries and monthly phone calls. Baseline measures of clinical balance measures and gait were comparable to other studies reporting scores on these measures in samples of healthy older people. Results: During the 12-month follow-up period, 49% of subjects fell, with 23% falling more than once; 9% suffered fractures as a result of their fall and 10% suffered strains or other moderate injuries. Many of the falls occurred during nonthreatening activities such as walking, often under altered sensory or environmental conditions. Multivariate logistic regression identified gait symmetry and gait double support duration as the variables most strongly associated with prediction of multiple fallers. Conclusions: The results highlight that falls are a major problem among healthy active older women, and that targeted falls prevention programs are required for this group.