Falls in Mexican older adults aged 60 years and older

  • Luis M Valderrama-Hinds
  • Soham Al Snih
  • Nai-wei Chen
  • Martin A Rodriguez
  • Rebeca Wong
Original Article
  • 3 Downloads

Abstract

Background

Falls are a major cause of disability, morbidity, institutionalization, and mortality in older adults.

Objectives

The purpose of the study was to examine the risk factors for falls among Mexican older adults aged 60 years and older.

Methods

This study included 6247 participants and their spouse or partner aged 60 years and older from the Mexican Health and Aging Study, an ongoing longitudinal study (2001–2012) conducted in Mexico. Measures included socio-demographics, falls, physical activity, comorbid conditions, pain, vertigo, vision and hearing impairments, urinary incontinence, lower extremity functional limitation, activities of daily living (ADLs), cognitive function, and depressive symptoms.

Results

Mean age was 69.6 years (standard error = 0.18) and 51.8% were female. Forty percent reported one or more falls at baseline. Older age, being female, obesity, arthritis, fractures, stroke, suffering pain, vertigo, lower extremity functional limitations, physical activity, depressive symptoms, urinary incontinence, and ADL disability were significant factors associated with one or more falls over time.

Discussion

Early detection and treatment of the risk factors for falls in this population will help improve the quality of life and reduce medical complications and health care costs.

Keywords

Falls Mexico Older adults Epidemiology MHAS 

Notes

Acknowledgements

This study was supported by the National Institutes of Health/National Institute on Aging (R01-AG018016, R.W. [PI]), INEGI in Mexico and by the University of Texas Medical Branch (UTMB) Sealy Center on Aging and the Pepper Center (P30-AG024832, E.V. [PI]). Dr. Valderrama-Hinds was a visiting scholar in the WHO/PAHO Collaborating Center on Aging and Health at UTMB during this study. The study sponsors had no role in the study design, analysis, or interpretation of the data. Study sponsors did not have any role in the writing of the article or the submission to a journal. The authors acknowledge the assistance of Sarah Toombs Smith, PhD, ELS, in article preparation. Dr. Toombs Smith received no compensation for this effort beyond her salary at the UTMB Sealy Center on Aging.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

The MHAS study was approved by the Institutional Review Boards or Ethics Committees of the University of Texas Medical Branch (in the United States) and the Instituto Nacional de Estadistica y Geografia (INEGI) and the Instituto Nacional de Salud Pública (INSP) (in Mexico); and have been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki.

Informed consent

Oral informed consent was obtained from all individual participants included in the study.

References

  1. 1.
  2. 2.
    Centers for Disease Control and Prevention (2018) Important facts about falls. https://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html. Accessed 16 March 2018
  3. 3.
    Bergen G, Stevens M, Burns ER (2016) Falls and fall injuries among adults aged ≥ 65 years—United States, 2014. MMWR Morb Mortal Wkly Rep 65:993–998CrossRefPubMedGoogle Scholar
  4. 4.
    Murphy SL, Xu J, Kochanek KD et al (2017) Deaths: final data for 2015, vol 66. National Center for Health Statistics, HyattsvilleGoogle Scholar
  5. 5.
    Estrella-Castillo DF, Euán-Paz A, Pinto-Loría ML et al (2011) Alteraciones del equilibrio como predictoras de caídas en una muestra de adultos mayores de Mérida Yucatán, México. Rehabilitación 45:7CrossRefGoogle Scholar
  6. 6.
    World Health Organization (2015) World report on aging and health. World Health Organization, LuxembourgGoogle Scholar
  7. 7.
    Becker C, Woo J, Todd C (2018) Falls. In: Michel J-P, Beattie BL, Martin FC, Walston JD (eds) Oxford textbook of geriatric medicine, 3rd edn. Oxford University Press, Oxford, pp 373–382CrossRefGoogle Scholar
  8. 8.
    Deandrea S, Lucenteforte E, Bravi F et al (2010) Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology 21:658–668.  https://doi.org/10.1097/EDE.0b013e3181e89905 CrossRefPubMedGoogle Scholar
  9. 9.
    Lusardi MM, Fritz S, Middleton A et al (2017) Determining risk of falls in community dwelling older adults: a systematic review and meta-analysis using posttest probability. J Geriatr Phys Ther 40:1–36CrossRefPubMedGoogle Scholar
  10. 10.
    Reyes-Ortiz CA, Al Snih S, Loera J et al (2004) Risk factors for falling in older Mexican Americans. Ethn Dis 14:417–422PubMedGoogle Scholar
  11. 11.
    Encuesta Nacional de Salud y Nutrición 2012 (2013) Resultados Nnacionales, Segunda Edicion, MexicoGoogle Scholar
  12. 12.
    Aranda M, López-Ortega M, Robledo L (2015) Prevalence and determinants of falls among Older Mexicans: findings from the Mexican National Health and Nutrition Survey. In: Vega W, Markides K, Angel J, Torres-Gil F (eds) Challenges of Latino aging in the Americas. Springer, Cham, pp 171–188Google Scholar
  13. 13.
    France CB, Rietjens Judith AC, Burdorf A et al (2017) A prospective study on the variation in falling and fall risk among community-dwelling older citizens in 12 European countries. BMJ Open 7:e015827CrossRefGoogle Scholar
  14. 14.
    Gale CR, Cooper C, Sayer AA (2016) Prevalence and risk factors for falls in older men and women: the English Longitudinal Study of Ageing. Age Ageing 45:89–794CrossRefGoogle Scholar
  15. 15.
    Verma SK, Willetts JL, Corns HL et al (2016) Falls and fall-related injuries among community-dwelling adults in the United States. PLoS ONE 11:e0150939.  https://doi.org/10.1371/journal.pone.0150939 CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Demographic transition, demographic bonus and ageing in Mexico. Prepared for United Nations Expert Group Meeting on Social and Economic Implications of Changing Population Age Structures (Mexico City, Mexico: Population Division, Department of Economic and Social Affairs, United Nations, 2005) (2005). http://www.un.org/esa/population/meetings/Proceedings_EGM_Mex_2005/partida.pdf
  17. 17.
  18. 18.
    Wong R, Michaels-Obregon A, Palloni A (2017) Cohort profile: the Mexican health and aging study (MHAS). Int J Epidemiol 46:e2.  https://doi.org/10.1093/ije/dyu263 CrossRefPubMedGoogle Scholar
  19. 19.
    Nicklett EJ, Taylor RJ (2014) Racial/Ethnic predictors of falls among older adults: the health and retirement study. J Aging Health 26:1060–1075.  https://doi.org/10.1177/0898264314541698 CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Reyes-Ortiz CA, Al Snih S, Markides KS (2005) Falls among elderly persons in Latin America and the Caribbean and among elderly Mexican-Americans. Rev Panam Salud Publica 17:362–369CrossRefPubMedGoogle Scholar
  21. 21.
    Sun DQ, Huang J, Varadhan R et al (2016) Race and fall risk: data from the National Health and Aging Trends Study (NHATS). Age Ageing 45:8CrossRefGoogle Scholar
  22. 22.
  23. 23.
  24. 24.
    Diaz de Leon Gonzalez E, Gutierrez Hermosillo H, Martinez Beltran JA et al (2016) Validation of the FRAIL scale in Mexican elderly: results from the Mexican Health and Aging Study. Aging Clin Exp Res 28:901–908.  https://doi.org/10.1007/s40520-015-0497-y CrossRefPubMedGoogle Scholar
  25. 25.
    Albala C, Lebrao ML, Leon Diaz EM et al (2005) [The Health, Well-Being, and Aging (“SABE”) survey: methodology applied and profile of the study population]. Rev Panam Salud Publica 17:307–322CrossRefPubMedGoogle Scholar
  26. 26.
    Valderrama-Hinds LM, Al Snih S, Rodriguez MA et al (2017) Association of arthritis and vitamin D insufficiency with physical disability in Mexican older adults: findings from the Mexican Health and Aging Study. Rheumatol Int 37:607–616.  https://doi.org/10.1007/s00296-016-3622-0 CrossRefPubMedGoogle Scholar
  27. 27.
    Gerst K, Michaels-Obregon A, Wong R (2011) The impact of physical activity on disability incidence among older adults in Mexico and the United States. J Aging Res 2011:420714.  https://doi.org/10.4061/2011/420714 CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Monserud MA, Wong R (2015) Depressive symptoms among older Mexicans: the role of widowhood, gender, and social integration. Res Aging 37:856–886.  https://doi.org/10.1177/0164027514568104 CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Diggle P, Heagerty P, Liang KY et al (2013) Generalized linear mixed models for longitudinal data. In: Analysis of longitudinal data, 2nd edn. Oxford University Press, Oxford, pp 126–137Google Scholar
  30. 30.
    Himes CL, Reynolds SL (2012) Effect of obesity on falls, injury, and disability. J Am Geriatr Soc 60:124–129.  https://doi.org/10.1111/j.1532-5415.2011.03767.x CrossRefPubMedGoogle Scholar
  31. 31.
    Stenhagen M, Ekstrom H, Nordell E et al (2013) Falls in the general elderly population: a 3- and 6-year prospective study of risk factors using data from the longitudinal population study ‘Good ageing in Skane’. BMC Geriatr 13:81.  https://doi.org/10.1186/1471-2318-13-81 CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Mackenzie L, Byles J, D’Este C (2006) Validation of self-reported fall events in intervention studies. Clin Rehabil 20:331–339.  https://doi.org/10.1191/0269215506cr947oa CrossRefPubMedGoogle Scholar
  33. 33.
    Hansen H, Schafer I, Schon G et al (2014) Agreement between self-reported and general practitioner-reported chronic conditions among multimorbid patients in primary care—results of the MultiCare Cohort Study. BMC Fam Pract 15:39.  https://doi.org/10.1186/1471-2296-15-39 CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Sanders KM, Stuart AL, Scott D et al (2015) Validity of 12-month falls recall in community-dwelling older women participating in a clinical trial. Int J Endocrinol 2015:210527.  https://doi.org/10.1155/2015/210527 CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Panel on Prevention of Falls in Older Persons, American Geriatrics Society and British Geriatrics Society (2011) Summary of the updated American Geriatrics Society/British Geriatrics Society Clinical Practice guideline for prevention of falls in older adults. J Am Geriatr Soc 59 (1):148–157CrossRefGoogle Scholar
  36. 36.
    Tricco AC, Thomas SM, Veroniki AA et al (2017) Comparisons of interventions for preventing falls in older adults: a systematic review and meta-analysis. JAMA 318:1687–1699.  https://doi.org/10.1001/jama.2017.15006 CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Sealy Center on AgingUniversity of Texas Medical BranchGalvestonUSA
  2. 2.Division of Rheumatology, Department of Internal Medicine, Hospital Universitario de CaracasUniversidad Central de VenezuelaCaracasVenezuela
  3. 3.Centro Nacional de Enfermedades Reumáticas, Hospital Universitario de CaracasUniversidad Central de VenezuelaCaracasVenezuela
  4. 4.Division of Rehabilitation Sciences, School of Health ProfessionsUniversity of Texas Medical BranchGalvestonUSA
  5. 5.Division of Geriatrics, Department of Internal MedicineUniversity of Texas Medical BranchGalvestonUSA
  6. 6.Department of Preventive Medicine and Community HealthUniversity of Texas Medical BranchGalvestonUSA

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