Abstract
Objective
To describe the different falls typology and to investigate whether different falls profiles and faller profiles could be identified among a cohort of community-dwelling women aged 75 years and older.
Design
Prospective cohort study.
Participants
Women aged 75 years and older were enrolled in five French centers after a random selection from electoral lists and included in the EPIDOS study.
Measurements
During a 4 year follow-up, women were contacted by telephone every 4 months to investigate the occurrence of falls. To minimize the memory bias, the specific questionnaire on falls was completed only if the fall took place in the week preceding the contact. A multiple correspondence analysis followed by clustering was carried out to identify the typology of falls.
Results
727 women described at least one fall. A full description of 662 falls was obtained during the follow-up period. In the multiple correspondence analysis the main discriminant item was outside versus inside falls. Moreover, four clusters were showed: outside falls linked to lack of attention (28% of women), outside falls related to exogenous/environmental factors (16%), inside falls associated with frailty (44%) and in height falls (11%). We also found that each type of falls was correlated with particular health or functional status (i.e.;dependence, motion difficulty, weakness, use of walking aid,…).
Conclusion
From frailty to hyperactivity there are different falls and fallers profiles. Assessing such fall profiles could be helpful to develop new dedicated fall prevention programs in the elderly.
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References
Masud T, Morris RO. Epidemiology of falls. Age Ageing. 2001 Nov;30Suppl 4:3–7.
Nevitt MC, Cummings SR. Type of fall and risk of hip and wrist fractures: the study of osteoporotic fractures. The Study of Osteoporotic Fractures Research Group. J Am Geriatr Soc. 1993 Nov;41(11):1226–1234.
Rizzo JA, Friedkin R, Williams CS, Nabors J, Acampora D, Tinetti ME. Health care utilization and costs in a Medicare population by fall status. Med Care. 1998 Aug;36(8):1174–1188.
Salkeld G, Cameron ID, Cumming RG, Easter S, Seymour J, Kurrle SE, et al. Quality of life related to fear of falling and hip fracture in older women: a time trade off study. BMJ. 2000 Feb 5;320(7231):341–346.
Vellas BJ, Wayne SJ, Romero LJ, Baumgartner RN, Garry PJ. Fear of falling and restriction of mobility in elderly fallers. Age Ageing. 1997 May;26(3):189–193.
Cumming RG, Salkeld G, Thomas M, Szonyi G. Prospective study of the impact of fear of falling on activities of daily living, SF-36 scores, and nursing home admission. J Gerontol A Biol Sci Med Sci. 2000 May;55(5):M299–M305.
Gill DP, Zou GY, Jones GR, Speechley M. Injurious falls are associated with lower household but higher recreational physical activities in community-dwelling older male veterans. Gerontology. 2008;54(2):106–115.
Dargent-Molina P, Favier F, Grandjean H, Baudoin C, Schott AM, Hausherr E, et al. Fall-related factors and risk of hip fracture: the EPIDOS prospective study. Lancet. 1996 Jul 20;348(9021):145–149.
Tromp AM, Smit JH, Deeg DJ, Bouter LM, Lips P. Predictors for falls and fractures in the Longitudinal Aging Study Amsterdam. J Bone Miner Res. 1998 Dec;13(12):1932–1939.
Pluijm SM, Smit JH, Tromp EA, Stel VS, Deeg DJ, Bouter LM, et al. A risk profile for identifying community-dwelling elderly with a high risk of recurrent falling: results of a 3-year prospective study. Osteoporos Int. 2006;17(3):417–425.
Ziere G, Dieleman JP, Hofman A, Pols HA, van der Cammen TJ, Stricker BH. Polypharmacy and falls in the middle age and elderly population. Br J Clin Pharmacol. 2006 Feb;61(2):218–223.
van der Velde N, Stricker BH, Pols HA, van der Cammen TJ. Risk of falls after withdrawal of fall-risk-increasing drugs: a prospective cohort study. Br J Clin Pharmacol. 2007 Feb;63(2):232–237.
Lord SR. Visual risk factors for falls in older people. Age Ageing. 2006 Sep;35Suppl 2:ii42–ii45.
Pijnappels M, van der Burg PJ, Reeves ND, van Dieen JH. Identification of elderly fallers by muscle strength measures. Eur J Appl Physiol. 2008 Mar;102(5):585–592.
Moreland JD, Richardson JA, Goldsmith CH, Clase CM. Muscle weakness and falls in older adults: a systematic review and meta-analysis. J Am Geriatr Soc. 2004 Jul;52(7):1121–1129.
Dhesi JK, Bearne LM, Moniz C, Hurley MV, Jackson SH, Swift CG, et al. Neuromuscular and psychomotor function in elderly subjects who fall and the relationship with vitamin D status. J Bone Miner Res. 2002 May;17(5):891–897.
Cao ZB, Maeda A, Shima N, Kurata H, Nishizono H. The effect of a 12-week combined exercise intervention program on physical performance and gait kinematics in community-dwelling elderly women. J Physiol Anthropol. 2007 May;26(3):325–332.
Gardner MM, Robertson MC, Campbell AJ. Exercise in preventing falls and fall related injuries in older people: a review of randomised controlled trials. Br J Sports Med. 2000 Feb;34(1):7–17.
Freiberger E, Menz HB, Abu-Omar K, Rutten A. Preventing falls in physically active community-dwelling older people: a comparison of two intervention techniques. Gerontology. 2007;53(5):298–305.
Bischoff HA, Stahelin HB, Dick W, Akos R, Knecht M, Salis C, et al. Effects of vitamin D and calcium supplementation on falls: a randomized controlled trial. J Bone Miner Res. 2003 Feb;18(2):343–351.
Cumming RG, Thomas M, Szonyi G, Salkeld G, O’Neill E, Westbury C, et al. Home visits by an occupational therapist for assessment and modification of environmental hazards: a randomized trial of falls prevention. J Am Geriatr Soc. 1999 Dec;47(12):1397–1402.
Nikolaus T, Bach M. Preventing falls in community-dwelling frail older people using a home intervention team (HIT): results from the randomized Falls-HIT trial. J Am Geriatr Soc. 2003 Mar;51(3):300–305.
Day L, Fildes B, Gordon I, Fitzharris M, Flamer H, Lord S. Randomised factorial trial of falls prevention among older people living in their own homes. BMJ. 2002 Jul 20;325(7356):128.
Kannus P, Sievanen H, Palvanen M, Jarvinen T, Parkkari J. Prevention of falls and consequent injuries in elderly people. Lancet. 2005 Nov 26;366(9500):1885–1893.
Lohman TG, Roche AF. Anthropometric Standardization Reference Manual.. Human Kinetics Pub; 1988.
Pfeiffer E. A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc. 1975 Oct;23(10):433–441.
Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969 Autumn;9(3):179–186.
Nagi SZ. An epidemiology of disability among adults in the United States. Milbank Mem Fund Q Health Soc. 1976 Fall;54(4):439–467.
Benzécri J. L’analyse des données. 2, L’analyse des correspondances: introduction, théorie, applications diverses notamment à l’analyse des questionnaires, programmes de calcul. Dunod, Paris; 1981.
Greenacre M, Blasius J. Multiple Correspondence Analysis And Related Methods. Chapman & Hall/CRC; 2006.
Benzécri J. Sur le calcul des taux d’inertie dans l’analyse d’un questionnaire. Cahiers de l’Analyse des Données. 1979;3:p377–378.
Lebart L, Morineau A, Piron M. Statistique exploratoire multidimensionnelle. Paris: Dunod; 1997.
SAS/STAT User’s Guide, version 9.2. Cary, NC: SAS institute Inc.; 2008.
Fletcher PC, Hirdes JP. Risk factors for falling among community-based seniors using home care services. J Gerontol A Biol Sci Med Sci. 2002 Aug;57(8):M504–M510.
Lord SR, March LM, Cameron ID, Cumming RG, Schwarz J, Zochling J, et al. Differing risk factors for falls in nursing home and intermediate-care residents who can and cannot stand unaided. J Am Geriatr Soc. 2003 Nov;51(11):1645–1650.
Bath PA, Morgan K. Differential risk factor profiles for indoor and outdoor falls in older people living at home in Nottingham, UK. Eur J Epidemiol. 1999 Jan;15(1):65–73.
Menz HB, Morris ME, Lord SR. Footwear characteristics and risk of indoor and outdoor falls in older people. Gerontology. 2006;52(3):174–180.
O’Loughlin JL, Boivin JF, Robitaille Y, Suissa S. Falls among the elderly: distinguishing indoor and outdoor risk factors in Canada. J Epidemiol Community Health. 1994 Oct;48(5):488–489.
Campbell AJ, Borrie MJ, Spears GF, Jackson SL, Brown JS, Fitzgerald JL. Circumstances and consequences of falls experienced by a community population 70 years and over during a prospective study. Age Ageing. 1990 Mar;19(2):136–141.
Nevitt MC, Cummings SR, Hudes ES. Risk factors for injurious falls: a prospective study. J Gerontol. 1991 Sep;46(5):M164–M170.
Speechley M, Tinetti M. Falls and injuries in frail and vigorous community elderly persons. J Am Geriatr Soc. 1991 Jan;39(1):46–52.
Massion J. Movement, posture and equilibrium: interaction and coordination. Prog Neurobiol. 1992;38(1):35–56.
Pai YC, Wening JD, Runtz EF, Iqbal K, Pavol MJ. Role of feedforward control of movement stability in reducing slip-related balance loss and falls among older adults. J Neurophysiol. 2003 Aug;90(2):755–762.
Mackey DC, Robinovitch SN. Mechanisms underlying age-related differences in ability to recover balance with the ankle strategy. Gait Posture. 2006 Jan;23(1):59–68.
Santello M. Review of motor control mechanisms underlying impact absorption from falls. Gait Posture. 2005 Jan;21(1):85–94.
Rogers MW, Pai YC. Dynamic transitions in stance support accompanying leg flexion movements in man. Exp Brain Res. 1990;81(2):398–402.
Nashner LM, McCollum G. The organisation of human postural movements: A formal basis and experimental synthesis. Behav Brain Sci. 1985;8:135–172.
Covinsky KE, Kahana E, Kahana B, Kercher K, Schumacher JG, Justice AC. History and mobility exam index to identify community-dwelling elderly persons at risk of falling. J Gerontol A Biol Sci Med Sci. 2001 Apr;56(4):M253–M259.
Cummings SR, Nevitt MC. Falls. N Engl J Med. 1994 Sep 29;331(13):872–873.
Cummings SR, Nevitt MC, Kidd S. Forgetting falls. The limited accuracy of recall of falls in the elderly. J Am Geriatr Soc. 1988 Jul;36(7):613–616.
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Decullier, E., Couris, C.M., Beauchet, O. et al. Falls’ and fallers’ profiles. J Nutr Health Aging 14, 602–608 (2010). https://doi.org/10.1007/s12603-010-0130-x
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DOI: https://doi.org/10.1007/s12603-010-0130-x