Abstract
The survival rate of 207 nursing home residents who fell during a two- month study period was followed for 12 months and compared with that of 94 residents of the same nursing home who did not fall during the same period. One year after the fall, 74 fallers and 13 controls had died. In the group of fallers, the main factors associated with mortality were male gender, dementia, Parkinsonism, the use of antidepressants, diuretics and vasodilators. Among the controls, the main factors associated with mortality were Parkinsonism, diabetes and the use of diuretics. Thirty- eight fallers (33 women and 5 men) and one (female) control suffered a fracture; 32 of them required hospital attention, and 15 (47%) died during the same hospital stay. These results indicate that falls are an ominous sign, particularly if the subject has dementia, depression or Parkinsonism, or uses diuretics. The male subjects in this study had a lower injury rate than females, but their mortality rate was higher. In terms of prevention, the major concern should be the effective treatment of depression and Parkinsonism. Withdrawal of diuretics, when possible, may have an effect on mortality. Physical training and other stimulating activities should be beneficial, but subjects with severe dementia seem to be beyond this kind of prevention. (Agin Clin. Exp. Res. 7: 23–27, 1995)
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References
Rubenstein L.Z.: Falls in the elderly: A clinical approach. West J. Med. 136: 273–275, 1983.
Causes of Death in Finland. Official Statistics of Finland, 1989.
Wild D., Nayak U.S.L., Isaacs B.: Prognosis of falls in old people at home. J. Epidemiol. Community Health 35: 200–204, 1981.
Campbell A.J., Diep C., Reinken J., McCosh L.: Factors predicting mortality in a population sample of the elderly. J. Epidemiol. Community Health 39: 337–342, 1985.
Evans J.G., Prudham D., Wandless I.: A prospective study of fractured proximal femur: factors predisposing to survival. Age Ageing 8: 246–250, 1979.
White B.L., Fisher W.D., Laurin C.A.: Rate of mortality for elderly patients after fracture of the hip in the 1980’s. J. Bone Joint Surg. (Am.) 69-A: 1335–1339, 1987.
Rubenstein L.Z., Robbins A.S., Josephson K.R., Schulman B.L., Osterweil D.: The value of assessing falls in an elderly population. Ann. Intern. Med. 113: 308–316, 1990.
Jänrti P.O., Pyykkö V.I., Hervonen A.L.J.: Falls among elderly nursing home residents. Public Health 107: 89–96, 1993.
Dixon W.J.: BMDP Statistical Software. Berkeley, University of California Press, 2: 689–742, 1988.
Tilvis R.S., Visapää J., Sorva A.: Survival prognosis in geriatric patients admitted to permanent institutional care. Aging Clin. Exp. Res. 4: 77–84, 1992.
Ryynänen O-P., Kivelä S-L., Honkanen R., Laippala P.: Falls and lying helpless in the elderly. Z. Gerontol. 25: 278–282, 1992.
Maule M.M., Milne J.S., Williamson J.: Mental illness and physical health in older people. Age Ageing 13: 349–356, 1984.
Bruce M.L., Leaf P.J.: Psychiatric disorders and 15-month mortality in a community sample of older adults. Am. J. Public Health 79: 727–730, 1989.
Thomas C., Kelman H.R., Kennedy G.J., Ahn C., Yang C.: Depressive symptoms and mortality in elderly persons. J. Gerontol. 47: S80–87, 1992.
Elliott D.F.: Accidents in nursing homes: Implications for patients and administrators. In: Miller M. (Ed.), Current issues in clinical geriatrics. Tiresias Press, New York, 1979, pp. 97–137.
Nickens H.: Intrinsic factors in falling among the elderly. Arch. Intern. Med. 145: 1089–1093, 1985.
Waller J.A.: Falls among the elderly — Human and environmental factors. Accid. Anal. Prev. 10: 21–33, 1978.
Tinetti M.E., Liu W-L., Claus E.B.: Predictors and prognosis of inability to get up after falls among elderly persons. JAMA 269: 65–70, 1993.
Panzram G., Zakel-Langhenning R.: Prognosis of diabetes mellitus in a geographically defined population. Diabetologia 20: 587–591, 1981.
Staessen J., Bulpitt C., Clement D., De Leeuw P., Fagard R., Fletcher A., Forette F., Leonetti G., Nissinen A., O’Malley K., Tuomilehto J., Webster J., Williams B.O.: Relation between mortality and treated blood pressure in elderly patients with hypertension: report of the European Working Party on High Blood Pressure in the Elderly. Br. Med. J. 298: 1552–1556, 1989.
Robbins A.S., Rubenstein L.Z.: Postural hypotension in the elderly. J. Am. Geriatr. Soc. 32: 769–774, 1984.
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Jäntti, P., Pyykkö, I. & Laippala, P. Prognosis of falls among elderly nursing home residents. Aging Clin Exp Res 7, 23–27 (1995). https://doi.org/10.1007/BF03324286
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DOI: https://doi.org/10.1007/BF03324286