Risk factors for falls among elderly men in a veterans home

Abstract

Background: Falls are major causes of mortality and morbidity in the elderly. Cognitive dysfunction, poor physical function and medical comorbidities are associated with many factors contributing to falls. The main purpose of this study was to explore the risk factors of falls among older institutionalized Chinese men in Taiwan.

Methods: Residents aged over 65 in a veterans care home in northern Taiwan were enrolled for study after they gave their full consent. Falling was defined as a fall within the past 180 days as defined by the Minimum Data Set (MDS). Physical function was determined by MDS resource utilization group activity of daily living score (RUG ADL score). Cognitive status was measured by MDS cognition scale (MDS COGS).

Results: In total, 585 residents (mean age, 80.9 +/- 5.4 years) were enrolled. Among all study subjects, 92.8% were physically independent and 20.2% were moderately cognitive impaired according to MDS COGS. By definition, 48 subjects (8.2%) had a past history of fall. Compared with non-fallers, fallers were significantly older (82.4 +/- 5.5 years vs. 80.7 +/- 5.4 years; p = 0.047) and had poorer functional status according to the MDS RUG ADL score (5.0 +/- 2.3 vs. 4.3 +/- 1.6; p = 0.044). Subjects with past history of anxiety disorder and cardiovascular disease were more prone to fall, and subjects who took hypnotics were also at a higher risk of falling. By using multivariate logistic regression, we found that higher RUG ADL score (odds ratio [OR], 1.18; 95% confidence interval [CI], 1.08-1.37; p = 0.017) and hypnotic use (OR, 2.0; 95% CI, 1.0-4.1; p = 0.048) were both independent risk factors for falls.

Conclusion: The prevalence of fall in the past 180 days was 8.2% among elderly residents in a veterans care home in northern Taiwan. The independent risk factors for falls in this setting included poorer functional status and hypnotic use.