Incidence rate of falls in an aged population in Northern Finland

doi:10.1016/0895-4356(94)90187-2

Journal of Clinical Epidemiology

Volume 47, Issue 8, August 1994, Pages 843-850

https://doi.org/10.1016/0895-4356(94)90187-2 Get rights and content

Abstract

The total elderly population aged 70 years or over living in five rural districts in northern Finland, 1159 persons in all, were monitored by 'phone prospectively for 1 year, all falls being recorded separately for those living at home and in institutions. Of those living at home, 30% fell at least once during the year, 19% just once, this proportion not depending on age or sex. The home-dwelling men and women experienced $3681000 PY$ and $6111000 PY$ falls, respectively, the incidences tending to increase with advancing age. The men in institutions experienced $2021 falls 1000 PY$ and the women $14231000 PY$ , without clear age dependence. The home-dwelling women had a greater risk of falling repeatedly than the men, but the sex differences disappeared with advancing age. The falls among home-dwellers were concentrated in the day-time, whereas no variation with time of day was found in the institutions. Falls are common in the elderly, but their incidence and certain characteristics differ considerably between the home-dwellers and those living in institutions.

References (24)

S.P. Baker et al.
Fall injuries in the elderly
Clin Geriatr Med
(1985)
C. Blake et al.
Falls and staffing in a residential home for elderly people
Public Health
(1986)
M.E. Tinetti et al.
Fall risk index for elderly patients based on a number of chronic disabilities
Am J Med
(1986)
A.J. Campbell et al.
Falls in old age: a study of frequency and clinical factors
Age Ageing
(1981)
D. Prudham et al.
Factors associated with falls in the elderly
Age Ageing
(1981)
A.J. Blake et al.
Falls by elderly people at home: prevalence and associated factors
Age Ageing
(1988)
S.J. Winner et al.
Perimenopausal risk of falling and incidence of distal forearm fracture
Br Med J
(1989)
M.E. Tinetti et al.
Risk factors for falls among elderly persons living in the community
N Engl J Med
(1988)
A.J. Campbell et al.
Circumstances and consequences of falls experienced by a community population 70 years and over during a prospective study
Age Ageing
(1990)
E.V. Morris et al.
Prevention of falls in a geriatric hospital
Age Ageing
(1980)

P. Sehested et al.

Falls by hospitalized elderly patients: Causes, prevention

Geriatrics

(1977)

C.I. Gryfe et al.

A longitudinal study of falls in an elderly population. I. Incidence and morbidity

Age Ageing

(1977)

Cited by (175)

Clinical Mimics: An Emergency Medicine–Focused Review of Syncope Mimics
2018, Journal of Emergency Medicine
Citation Excerpt :
Syncope and syncope mimics are more common in older populations. Multiple prospective studies have shown approximately 30–60% of elderly patients will experience a fall each year (29–31). Often elderly patients may present after a fall, and part of the evaluation, outside of treating any trauma from the fall, needs to focus on determining whether the cause of the fall was from syncope, any of the mimics described here, or other conditions.
Syncope is an event that causes a transient loss of consciousness (LOC) secondary to global cerebral hypoperfusion. The transient nature of the event can make diagnosis in the emergency department (ED) difficult, as symptoms have often resolved by time of initial presentation. The symptoms and presentation of syncope are similar to many other conditions, which can lead to difficulty in establishing a diagnosis in the ED.
This review evaluates patients presenting with a history concerning for possible syncope, mimics of syncope, and approach to managing syncope mimics.
Syncope is caused by transient LOC secondary to global cerebral hypoperfusion. Many conditions can present similarly to syncope, making diagnosis in the ED difficult. Some of the most emergent conditions include seizures, stroke, metabolic disorders, and head trauma. Other nonemergent conditions include cataplexy, pseudosyncope, or deconditioning. Many laboratory studies and imaging can be nondiagnostic during ED evaluation. For patients presenting with apparent syncope, immediate treatment should focus on identifying and treating life-threatening conditions. History and physical examination can help guide further diagnostic evaluation and management.
Patients with apparent syncope should be evaluated for potential immediate life-threatening conditions. A thorough history and physical examination can aid in distinguishing syncope from common mimics and help identify and subsequently treat life-threatening conditions.
The circumstances, orientations, and impact locations of falls in community-dwelling older women
2017, Archives of Gerontology and Geriatrics
Citation Excerpt :
Some previous studies required weekly (Maki et al., 1994) or biweekly (Berg et al., 1997) reports of falls. However, other studies had participants return reports on a monthly basis (Campbell et al., 1990; Freiberger & Menz, 2006; Hill et al., 1999; O’loughlin et al., 1993) or less frequently (Davis et al., 1997; Luukinen et al., 1994; Rapp et al., 2014). Given the potential benefit of our frequent fall-tracking methods, along with the high adherence (97.5%) to returning fall reports, we believe the present results accurately represent the fall risk in our cohort of community-dwelling, ambulatory, older women.
We sought to characterize the circumstances, orientations, and impact locations of falls in community-dwelling, ambulatory, older women.
For this longitudinal, observational study, 125 community-dwelling women age ≥ 65 years were recruited. Over 12-months of follow-up, fall details were recorded using twice-monthly questionnaires.
More than half (59%) of participants fell, with 30% of participants falling more than once (fall rate = 1.3 falls per person-year). Slips (22%) and trips (33%) accounted for the majority of falls. Approximately 44% of falls were forward in direction, while backward falls accounted for 41% of falls. About a third of all falls were reported to have lateral (sideways) motion. Subjects reported taking a protective step in response to 82% of forward falls and 37% of backward falls. Of falls reporting lateral motion, a protective step was attempted in 70% of accounts. Common impact locations included the hip/pelvis (47% of falls) and the hand/wrist (27%). Backwards falls were most commonly reported with slips and when changing direction, and increased the risk of hip/pelvis impact (OR = 12.6; 95% CI: 4.7–33.8). Forward falls were most commonly reported with trips and while hurrying, and increased the risk of impact to the hand/wrist (OR = 2.6; 95% CI: 1.2–5.9).
Falls in older ambulatory women occur more frequently than previously reported, with the fall circumstance and direction dictating impact to common fracture locations. Stepping was a common protective recovery strategy and that may serve as an appropriate focus of interventions to reduce falls in this high risk population.
Design of Variable-friction devices for shoe-floor contact
2017, Mechatronics
Citation Excerpt :
Unintentional falls are a leading cause of serious injury, loss of independence, and even death, especially among the elderly. Statistics from the United States [12], Canada [13], China [14] and Finland [15] indicate that one third of adults aged 65 and over will fall at least once every year, causing up to 88% of injuries in this age group [13]. Considering the numerous problems that a fall can cause, many research programs have developed gait analysis systems.
In rehabilitation training, high-fidelity simulation environments are needed for reproducing the effects of slippery surfaces, in which potential balance failure conditions can be reproduced on demand. Motivated by these requirements, this article considers the design of variable-friction devices for use in the context of human walking on surfaces in which the coefficient of friction can be controlled dynamically. Various designs are described, aiming at rendering low-friction shoe-floor contact, associated with slippery surfaces such as ice, as well as higher-friction values more typical of surfaces such as pebbles, sand, or snow. These designs include an array of omnidirectional rolling elements, a combination of low- and high-friction coverings whose contact pressure distribution is controlled, and modulation of low-frequency vibration normal to the surface. Our experimentation investigated the static coefficient of friction attainable with each of these designs. Rolling elements were found to be the most slippery, providing a coefficient of friction as low as 0.03, but with significant drawbacks from the perspective of our design objectives. A controlled pressure distribution of low- and high-friction coverings allowed for a minimum coefficient of friction of 0.06. The effects of vibration amplitude and frequency on sliding velocity were also explored. Increases in amplitude resulted in higher velocities, but vibration frequencies greater than 25 Hz reduced sliding velocities. To meet our design objectives, a novel approach involving a friction-variation mechanism, embedded in a shoe sole, is proposed.
Greater Fall Risk in Elderly Women Than in Men Is Associated With Increased Gait Variability During Multitasking
2016, Journal of the American Medical Directors Association
As 90% of fractures are caused by falls, and as fractures are more common in elderly women than in elderly men, a better understanding of potential sex differences in fall rates and underlying mechanisms is needed. The purpose of this study was to determine whether women are more prone than men to falling, and to evaluate whether the risk of falling is associated with variations in gait patterns.
The cohort for this prospective observational study consisted of 1390 community-dwelling men and women aged 70 years, examined in a health survey between July 2012 and November 2014.
Gait patterns were measured using a computerized walkway system during normal-speed, fast-speed, and dual-task trials. Triaxial accelerometers were used to collect objective data on physical activity, and self-reported fall data were collected by telephone 6 and 12 months after examination. Incident low-energy falls were defined as unexpected events in which participants came to rest on the ground.
During the follow-up period, 148 study participants (88 women, 60 men; P = .01) reported falls. After adjusting for multiple confounders, including objective measures of physical activity, socioeconomic factors, cardiovascular disease, and cognitive function, the odds ratio for falling in women was 1.49 (95% confidence interval [CI] 1.02–2.19). Variations in gait pattern were significantly (20%–40%) increased in fallers compared with nonfallers during the dual-task trial for step width, step length, stride length, step time, stance time, stride velocity, and single support time (all P < .05). Furthermore, women showed 15% to 35% increased variability in all of these gait parameters during the dual-task trial compared with men (all P < .01).
In the present cohort, 70-year-old women were at greater risk of falls compared with their male counterparts. This increased risk was associated with increased variation in gait pattern during dual-task activities, and may contribute to women's greater fracture risk compared with men.
Falls in young adults: Perceived causes and environmental factors assessed with a daily online survey
2016, Human Movement Science
Falls are the third leading cause of unintentional injuries for ages 18–35 years (CDC), but the causes and circumstances of falls in this age group are understudied. The purpose of this study was to document the frequency and circumstances of falls in young adults with a daily online survey. Ninety-four undergraduate students (19.9 ± 0.9 years) received a daily email for 16 weeks regarding slips, trips and falls in the past 24 h (93% response rate). More than half of the participants (52%) fell in the 16-week interval. Injuries were reported in 16% of falls, and medical treatment was received in 4% of all falls. The majority of falls occurred while walking (58%), and the main cause of the fall was a slip (48%) or trip (25%). On average, participants fell once out of every 18 perceived slips and trips. Physical activity level did not distinguish fallers from non-fallers (p = 0.45), but for those who did fall, falls were more frequent as physical activity level increased (p = 0.007). The high fall and injury rate in a short interval reflects the inherent instability of bipedal locomotion and indicates that falls are not a trivial problem for young adults.
Effectiveness of Exergaming Training in Reducing Risk and Incidence of Falls in Frail Older Adults with a History of Falls
2015, Archives of Physical Medicine and Rehabilitation
To use Nintendo's Wii Fit balance board to determine the effectiveness of exergaming training in reducing risk and incidence of falls in older adults with a history of falls.
Randomized controlled trial.
Nursing home for older adults.
Adults aged 65 years and older (N=60).
Participants who lived in a nursing home had 6 weeks of balance training with either Wii Fit equipment or conventional exercise.
Physiological Profile Assessment scores and incidence of falls were observed with subsequent intention-to-treat statistical analyses.
Physiological Profile Assessment scores and incidence of falls improved significantly in both groups after the intervention (all P<.01), but participants in the Wii Fit training group showed a significantly greater improvement in both outcome measures (P=.004 and P<.001, respectively).
In institutionalized older adults with a history of falls, Wii Fit balance training was more effective than conventional balance training in reducing the risk and incidence of falls.

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Original articleIncidence rate of falls in an aged population in Northern Finland

Abstract

Clin Geriatr Med

Public Health

Am J Med

Falls in old age: a study of frequency and clinical factors

Age Ageing

Factors associated with falls in the elderly

Age Ageing

Falls by elderly people at home: prevalence and associated factors

Age Ageing

Perimenopausal risk of falling and incidence of distal forearm fracture

Br Med J

Risk factors for falls among elderly persons living in the community

N Engl J Med

Circumstances and consequences of falls experienced by a community population 70 years and over during a prospective study

Age Ageing

Prevention of falls in a geriatric hospital

Age Ageing

Falls by hospitalized elderly patients: Causes, prevention

Geriatrics

A longitudinal study of falls in an elderly population. I. Incidence and morbidity

Age Ageing

Original article
Incidence rate of falls in an aged population in Northern Finland