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. 2021 Aug;33(8):2183-2190.
doi: 10.1007/s40520-020-01747-1. Epub 2020 Nov 7.

Predictors for functional decline after an injurious fall: a population-based cohort study

Stina Ek  1   2 , Debora Rizzuto  3   4 , Weili Xu  3 , Amaia Calderón-Larrañaga  3 , Anna-Karin Welmer  3   4   5   6
Affiliations

Predictors for functional decline after an injurious fall: a population-based cohort study

Stina Ek et al. Aging Clin Exp Res. 2021 Aug.

Abstract

Background: The functional consequences of injurious falls are well known. However, studies of the factors that can modify trajectories of disability after an injury from a fall are scarce.

Aims: We aimed to investigate whether sociodemographic and health-related factors may impact this association.

Methods: The study population consisted of 1426 community-dwelling older adults (≥ 60 years) from the SNAC-K cohort study in Stockholm, Sweden. Functional status over 12 years of follow-up was assessed using the number of limitations in basic and instrumental activities of daily living. Sex, cohabitation status, physical activity, and self-rated health were assessed at baseline. Injurious falls were defined as falls requiring healthcare and were assessed over 3 years starting at baseline. Data were analyzed using linear-mixed effects models.

Results: The fastest increase in the number of disabilities was observed in those who had endured an injurious fall and were living alone (β coefficient = 0.408; p < 0.001), been physically inactive (β coefficient = 0.587; p < 0.001), and had poor self-rated health (β coefficient = 0.514; p < 0.001). The negative impact of these factors was more pronounced among fallers compared to non-fallers.

Discussion: Living alone, being physically inactive, and having poor self-rated health magnifies the negative effect of an injurious fall on functional status. Among individuals who endure an injurious fall, the heterogeneity in long-term functional status is substantial, depending on the individuals' characteristics and behaviors.

Conclusions: These findings emphasize the need for a person-centered approach in care provision and can guide secondary prevention within health care.

Keywords: ADL; Disability trajectories; IADL; Older adults; SNAC-K.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Predicted mean number of disabilities associated with injurious falls in combination with sex, cohabitation, physical activity level and self-rated health
See this image and copyright information in PMC

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