Characteristics of falls in elderly persons residing in the community: a population-based study

Abstract Object: to examine the characteristics to the last fall of Brazilian elderly persons who experienced falls in 2008 and 2009, and to identify if there is a relationship with sociodemographic characteristics, physical health, comorbidities, clinical conditions and the circumstances of the falls. Methods: a cross-sectional, population based study was carried out with participants aged 65 and older from Barueri in the state of São Paulo and Cuiabá in the state of Mato Grosso, Brazil. Households were enrolled within each census region according to population density and the number of elderly persons living in each region. A multidimensional questionnaire composed of sociodemographic factors and data regarding falls was used. Associations were analyzed using contingency tables, and Fisher's Exact or Pearson's Chi-square test was used. Results: 774 elderly people were included in the study, 299 of whom reported falling in the previous year. Of these, 176 (58.9%) had fallen once and 123 (41.1%) reported having fallen twice or more. Among fallers the mean age was 72.53 (±6.12) years and 214 (71.6%) were female. About 107 (35.8%) of the elderly reported having fallen forwards, 79 (26.4%) fell to the side and 42(14%) fell backwards. Regarding the circumstances of the falls, 107 (35.8%) reported having lost their balance, 79 (26.4%) said they had stumbled and 42 (14%) said they had slipped. There was an association between the mechanism and circumstances of the falls and having fallen once or twice or more. There was an association between the circumstances of falls and the number of medications taken. Conclusion: The characteristics of falls were different among elderly persons who had fallen once or twice or more, which may guide health professionals, the elderly and their families in relation to specific fall prevention strategies.

摘要 研究目的：探讨2008至2009年巴西老年跌倒人群的跌倒特征，并分析其与社会人口学特征、躯体健康状况、合并症（comorbidities）、临床病症及跌倒发生情境的相关性。方法：本研究为基于人群的横断面研究（cross-sectional study），研究对象为巴西圣保罗州巴鲁埃里市及马托格罗索州库亚巴市的65岁及以上老年人。研究人员依据人口密度及各普查区域内老年人口数量，在各普查区域内招募住户。研究采用包含社会人口学因素及跌倒相关数据的多维调查问卷进行数据收集。采用列联表（contingency tables）分析变量间关联，并使用费希尔精确检验（Fisher's Exact test）或皮尔逊卡方检验（Pearson's Chi-square test）进行统计学检验。结果：本研究共纳入774名老年人，其中299名报告在过去1年内发生过跌倒。在这299名跌倒老年人中，176人（58.9%）仅发生过1次跌倒，123人（41.1%）报告发生过2次及以上跌倒。跌倒老年人的平均年龄为72.53±6.12岁，其中214人（71.6%）为女性。约107人（35.8%）报告为向前跌倒，79人（26.4%）为向侧方跌倒，42人（14%）为向后跌倒。关于跌倒发生情境，107人（35.8%）报告为失去平衡，79人（26.4%）为绊倒，42人（14%）为滑倒。跌倒发生机制与情境与跌倒次数（1次或2次及以上）存在关联；跌倒发生情境与服药数量亦存在关联。结论：仅发生1次跌倒与发生2次及以上跌倒的老年人群，其跌倒特征存在差异，该研究结果可为临床医护人员、老年人及其家属制定针对性跌倒预防策略提供参考依据。