Risk factors for falling among community-based seniors using home care services

被引:98
作者
Fletcher, PC [1 ]
Hirdes, JP
机构
[1] Wilfrid Laurier Univ, Dept Kinesiol & Phys Educ, Waterloo, ON N2L 3C5, Canada
[2] Univ Waterloo, Dept Hlth Studies & Gerontol, Waterloo, ON N2L 3G1, Canada
[3] Canadian Collaborating Ctr InterRAI, Homewood Res Inst, Guelph, ON, Canada
来源
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES | 2002年 / 57卷 / 08期
关键词
D O I
10.1093/gerona/57.8.M504
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Background. Despite the plethora of information concerning risk factors for falls, limited research efforts have focused on the issue of the differences in risk factors for falls based on fall status, or more specifically one-time versus chronic/recurrent fallers. Given that multiple falls have been found to be associated with negative outcomes, such as an increased risk of institutionalization, more research in this area is warranted. Methods. The purpose of this investigation was to determine the risk factors for nonfallers versus fallers (1 + falls), and for nonfallers/one-time fallers versus recurrent falters (2+ falls). All participants (N = 2304) in this study were receiving home care services from 10 community-based agencies (Community Care Access Centres) in Ontario, Canada. The Minimum Data Set-Home Care (MDS-HC) is an assessment instrument that covers several key domains, such as service use, function, health, and social support. Nurses trained to administer the MDS-HC assessed each of the participants within their homes. Results. Of the 2304 participants in the study, 27% fell one or more times, and 10% experienced multiple falls (2+ falls). In the two final logistic regression models for risk of falling (0 falls vs 1 + falls) and multiple falling (0 falls/1 fall vs 2+ falls), the independent variables that remained significant included gender, gait, environmental hazards, and the Changes in Health, End Stage Disease and Signs and Symptoms of Medical Problems Scale. Also significant in the model for multiple falls was the Cognitive Performance Scale, Parkinson's disease, and perceived health status. Conclusions. Overall, distinguishing individuals into different fall status classifications is important from a clinical perspective, as it is the recurrent faller who would benefit to the greatest extent from fall prevention efforts and from the negative outcomes associated with multiple falls (i.e., mortality). One of the most significant barriers in determining risk factors for falls is the lack of consistency in the variables/tools used in the research. As such, utilizing a standardized tool, such as the MDS-HC, would assist researchers in making comparisons between different settings.
引用
收藏
页码:M504 / M510
页数:7
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