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Prevalence of falls in an urban community-dwelling older population of Cape Town, South Africa

  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

Falls are a major cause of disability and mortality in older adults. Studies on falls in this population have mainly been conducted in high income countries, and scant attention has been given to the problem in low and middle income countries, including South Africa. The aim of the study was to establish a rate for falls in older adults in South Africa.

Design

A cross-sectional survey with a 12-month follow-up survey.

Setting

Three purposively selected suburbs of Cape Town: Plumstead, Wynberg Central and Gugulethu.

Participants

Eight hundred and thirty seven randomly sampled ambulant community-dwelling subjects aged ≥ 65 years grouped according to ethnicity in three sub-samples: black Africans, coloureds (people of mixed ancestry) and whites.

Measurements

Data were collected on socio-demographic and health characteristics, and history of falls using a structured questionnaire and a protocol for physical assessments and measurements.

Results

Of the total baseline (n=837) and follow-up (n=632) survey participants, 76.5% and 77.2 %were females with a mean (S.D) age of 74 years (6.4) and 75 years (6.2), respectively. Rates of 26.4% and 21.9% for falls and of 11% and 6.3% for recurrent falls, respectively, were calculated at baseline and follow-up. Fall rates differed by ethnic sub-sample at baseline: whites 42 %, coloureds 34.4% and black Africans 6.4 % (p=0.0005). Rates of 236, 406 and 354 falls per 1000 person years were calculated for men, women and both genders, respectively. Recurrent falls were more common in women than in men.

Conclusion

Falls are a significant problem in older adults in South Africa. Effective management of falls and falls prevention strategies for older people in South Africa, need to be developed and implemented.

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References

  1. King MB, Tinetti ME. Falls in community-dwelling older persons. J Am Geriatr Soc 1995 Oct;43(10):1146–1154.

    Article  CAS  PubMed  Google Scholar 

  2. Stevens J, Corso P, Finkelstein E, Miller T. The costs of fatal and non-fatal falls among older adults. Inj Prev 2006;12(5):290–295.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Cesari M, Landi F, Torre S, Onder G, Lattanzio F, Bernabei R. Prevalence and risk factors for falls in an older community-dwelling population. J Gerontol A: Biol Sci Med Sci 2002;57(11):M722–M726.

    Article  Google Scholar 

  4. Sayer AA, Syddall HE, Martin HJ, Dennison EM, Anderson FH, Cooper C. Falls, sarcopenia, and growth in early life: findings from the Hertfordshire cohort study. Am J Epidemiol 2006;164(7):665–671.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Bonguea B, Dupré C, Beauchet O Arnaud Rossat A. Fantino B, Colveza A. A screening tool with five risk factors was developed for fall-risk prediction in community-dwelling elderly. J Clin Epidemiol 2011;64(10):1152–1160

    Article  Google Scholar 

  6. Gill T, Taylor AW, Pengelly A. A population-based survey of factors relating to the prevalence of falls in older people. Gerontology 2005 Sep-Oct;51(5):340–345.

    Article  PubMed  Google Scholar 

  7. Morris M, Osborne D, Hill K, Kendig H, Lundgren-Lindquist B, Browning C, et al. Predisposing factors for occasional and multiple falls in older Australians who live at home. Australian journal of physiotherapy 2004;50(3):153–162.

    Article  PubMed  Google Scholar 

  8. Chu L, Chi I, Chiu A. Incidence and predictors of falls in the Chinese elderly. Ann Acad Med Singap 2005;34(1):60–72.

    CAS  PubMed  Google Scholar 

  9. Cummings SR, Nevitt MC, Kidd S. Forgetting falls: The limited accuracy of recall of falls in the elderly. J Am Geriatr Soc 1988;36(7):613–616.

    Article  CAS  PubMed  Google Scholar 

  10. Aoyagi K, Ross PD, Davis JW, Wasnich RD, Hayashi T, Takemoto TI. Falls among community-dwelling elderly in Japan. J Bone Miner Res 1998;13(9):1468–1474.

    Article  CAS  PubMed  Google Scholar 

  11. Davis JW, Ross PD, Nevitt MC, Wasnich RD. Incidence rates of falls among Japanese men and women living in Hawaii. J Clin Epidemiol 1997;50(5):589–594.

    Article  CAS  PubMed  Google Scholar 

  12. Yasumura S, Haga H, Nagai H, Suzuki T, AMANO H, SHIBATA H. Rate of falls and the correlates among elderly people living in an urban community in Japan. Age Ageing 1994;23(4):323–327.

    Article  CAS  PubMed  Google Scholar 

  13. Kwan, M.M., Close, J.C., Wong, A.K., Lord, S.R., 2011. Falls incidence, risk factors, andconsequences in Chinese older people: a systematic review. J. Am. Geriatr. Soc. 59, 536–543.

    Article  PubMed  Google Scholar 

  14. Wu TY, Chie WC, Yang RS, Kuo KL, Wong WK, Liaw CK. Risk factors for single and recurrent falls: A prospective study of falls in community dwelling seniors without cognitive impairment. Prev Med. 2013 57(5):511–517.

    Article  PubMed  Google Scholar 

  15. Adebajo A, Cooper C, Evans JG. Fractures of the hip and distal forearm in West Africa and the United Kingdom. Age Ageing 1991;20(6):435.

    Article  CAS  PubMed  Google Scholar 

  16. El Maghraoui A, Koumba BA, Jroundi I, Achemlal L, Bezza A, Tazi MA. Epidemiology of hip fractures in 2002 in Rabat, Morocco. Osteoporos Int 2005 06;16(6):597–602.

    Article  PubMed  Google Scholar 

  17. Zebaze RMD, Seeman E. Epidemiology of hip and wrist fractures in Cameroon, Africa. Osteoporosis Int 2003;14(4):301–305.

    Article  Google Scholar 

  18. Seleye-Fubara S, Ekere AU. Domestic accidental deaths in the Niger Delta Region, Nigeria. East Afr Med J 2003 12;80(12):622–626.

    CAS  PubMed  Google Scholar 

  19. Mock C, Abantanga F, Cummings P, Koepsell T. Incidence and outcome of injury in Ghana: a community-based survey. Bull World Health Organ 1999;77(12):955.

    CAS  PubMed  PubMed Central  Google Scholar 

  20. Bekibele CO, Gureje O. Fall incidence in a population of elderly persons in Nigeria. Gerontology 2010 04;56(3):278–283.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Ntagungira EK. Epidemiology of and risk factors for falls among the communitydwelling elderly people in selected districts of Umutara Province, Republic of Rwanda. M.Sc. Dissertation, University of the Western Cape, 2005. http://etd. uwc.ac.za/usrfiles/modules/etd/docs/etd_init_5551_1176902881.pdf (Accessed 17 November 2009).

  22. Statistics South Africa. Statistics South Africa Census 2001. Census in brief. 2003. http://www.statssa.gov.za/census01/html/CInbrief/CIB2001.pdf (Accessed 15 January 2009): Statistics South Africa.

  23. Hauer K, Lamb SE, Jorstad EC, Todd C, Becker C. Systematic review of definitions and methods of measuring falls in randomised controlled fall prevention trials. Age Ageing 2006;35(1):5–10.

    Article  PubMed  Google Scholar 

  24. Chu LW, Chiu AYY, Chi I. Falls and subsequent health service utilization in community-dwelling Chinese older adults. Arch Gerontol Geriatr 2008;46(2):125–135.

    Article  PubMed  Google Scholar 

  25. Chaimowicz F, Ferreira TJXM, Miguel DFA. Use of psychoactive drugs and related falls among older people living in a community in Brazil. Revista de Saúde Pública 2000;34(6):631–635.

    Article  CAS  PubMed  Google Scholar 

  26. Nunes BP, de Oliveira Saes M, Siqueira FV, Tomasi E, Silva SM, da Silveira DS, Soares MU, Facchini LA, Thume E. Falls and self-assessment of eyesight among elderly people: A population-based study in a south Brazilian municipality. 2014;59(1):131–135.

  27. Siqueira FV, Facchini LA, Silveira DS, Piccini RX, Tomasi E, Thumé E, et al. Prevalence of falls in elderly in Brazil: a countrywide analysis. Cadernos de Saúde Pública 2011;27(9):1819–1826.

    Article  PubMed  Google Scholar 

  28. Perracini MR, Ramos LR. Fall-related factors in a cohort of elderly community residents. Revista de Saúde Pública 2002;36(6):709–716.

    Article  PubMed  Google Scholar 

  29. O’Loughlin JL, Robitaille Y, Boivin JF, Suissa S. Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly. Am J Epidemiol 1993;137(3):342–354.

    PubMed  Google Scholar 

  30. Fletcher PC, Hirdes JP. Risk factors for falling among community-based seniors using home care services. J Gerontol A: Biol Sci Med Sci 2002;57(8):M504–M510.

    Article  Google Scholar 

  31. Shumway-Cook A, Ciol MA, Hoffman J, Dudgeon BJ, Yorkston K, Chan L. Falls in the Medicare population: incidence, associated factors, and impact on health care. Phys Ther 2009;89(4):324–332.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Tiedemann A, Shimada H, Sherrington C, Murray S, Lord S. The comparative ability of eight functional mobility tests for predicting falls in community-dwelling older people. Age Ageing 2008;37(4):430–435.

    Article  PubMed  Google Scholar 

  33. Launay C, de Decker L, AnnweiLer C, Kabeshova A, Fantino B, Beauchet O. Association of depressive symptoms with recurrent falls: A cross-sectional elderly population based study and a systematic review. J Nutr Health Aging 2013;17(2):152–157.

    Article  CAS  PubMed  Google Scholar 

  34. Sibley KMC, Voth J, Munce SE, Strauss SE, Jaglal SB. Chronic disease and falls in community-dwelling Canadians over 65 years old: a population-based study exploring associations with number and pattern of chronic conditions. BMC Geriatrics 2014; 14:22.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Fujita T. Osteoporosis in Japan: factors contributing to the low incidence of hip fracture. Adv Nutr Res 1994;9:89–99.

    CAS  PubMed  Google Scholar 

  36. Schnaid E, Mac Phail A, Sweet M. Fractured neck of femur in black patients: a prospective study. J Bone and Joint Surg Br 2000;82(6):872–875.

    Article  CAS  Google Scholar 

  37. Dibba B, Prentice A, Laskey M, Stirling D, Cole T. An investigation of ethnic differences in bone mineral, hip axis length, calcium metabolism and bone turnover between West African and Caucasian adults living in the United Kingdom. Ann Hum Biol 1999;26(3):229–242.

    Article  CAS  PubMed  Google Scholar 

  38. Sayer AA, Robinson SM, Patel HP, Shavlakadze T, Cooper C, Grounds MD. New horizons in the pathogenesis, diagnosis and management of sarcopenia. Age Ageing 2013;42(2):145–150.

    Article  PubMed  PubMed Central  Google Scholar 

  39. 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 01;15(1):65–73.

    Article  CAS  PubMed  Google Scholar 

  40. Boyé NDA, Mattace-Raso FUS, Van der Velde N, van Lieshout EMM, de Vries OJ, Hartholt KA et al. Circumstances leading to injurious falls in older men and women in the Netherlands. Injury, Int. J. Care Injured 2014 (45):1224–1230.

    Article  Google Scholar 

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Authors and Affiliations

  1. Institute of Ageing in Africa, Department of Medicine, University of Cape Town, L51, Old Main Building, Groote Schuur Hospital, Observatory, Cape Town, Western Cape, 7925, South Africa

    S. Zimba Kalula

  2. International Longevity Centre, Institute of Ageing in Africa, University of Cape Town, Cape Town, South Africa

    M. Ferreira

  3. Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa

    G. Swingler

  4. Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa

    M. Badri

  5. Academic Geriatric Medicine, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK

    A. Aihie Sayer

  6. King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia

    M. Badri

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  1. S. Zimba Kalula
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  2. M. Ferreira
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  3. G. Swingler
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  4. M. Badri
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  5. A. Aihie Sayer
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Correspondence to S. Zimba Kalula.

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Zimba Kalula, S., Ferreira, M., Swingler, G. et al. Prevalence of falls in an urban community-dwelling older population of Cape Town, South Africa. J Nutr Health Aging 19, 1024–1031 (2015). https://doi.org/10.1007/s12603-015-0664-z

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  • DOI: https://doi.org/10.1007/s12603-015-0664-z

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