Prevalence, Severity, and Risk of Future Falls in Community-Dwelling Older Adults Living in a Rural Community: The Atahualpa Project

  • Oscar H. Del BruttoEmail author
  • Robertino M. Mera
  • Carlos D. Peinado
  • Mark J. Sedler
Original Paper


Accidental falls are a leading cause of disability and death in older adults living in urban centers. However, little is known about the consequences of falls in rural communities. We aimed to assess characteristics and risk of falls in community-dwellers aged ≥ 60 years living in rural Ecuador. Of 463 older adults enrolled in the Atahualpa Project, 327 (71%) were included. Multivariate logistic regression models were fitted to assess factors associated with history of falls and risk of future falls. Sensitivity analysis was conducted to determine which component of the Downton fall risk index (DFRI) better predicts risk of future falls. A history of falls was reported by 173 (53%) individuals. Most were related to stumbling due to uneven (non-paved) streets. Only three individuals had bone fractures after the fall. Previous falls were not associated with any of the investigated covariables. The DFRI was positive in 87 (27%) participants, and was associated with age (p < 0.001) and history of stroke (p < 0.001). None of the subjects were taking tranquilizers/sedatives. The most reliable component of the DFRI was the presence of sensory/motor deficits. History of falls in our population is similar to that reported elsewhere. However, the risk of future falls is lower. Such discrepancies are probably because the DFRI does not take into account environmental factors resulting in falls. There were almost no severe complications from falls, which could be partly related to the lack of use of tranquilizers/sedatives.


Falls Downton fall risk index Older adults Population study Rural communities 



This study was partially supported by an unrestricted grant from Universidad Espiritu Santo – Ecuador, Guayaquil, Ecuador.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.School of MedicineUniversidad Espíritu Santo – EcuadorSamborondonEcuador
  2. 2.Department of EpidemiologyGilead Sciences, Inc.Foster CityUSA
  3. 3.School of MedicineStony Brook UniversityNew YorkUSA

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