Characteristics of Falls among Community-Dwelling Older Adults: The SCOPE Study

Abstract

Introduction: Falls among older adults are frequent and will remain a health concern. We describe fall characteristics among older adults living independently in the community based on location, severity, and sex.

Methods: As part of the SCOPE study, fall occurrence, location, causes, circumstances, and consequences were reported by 1,754 community-dwelling older adults across Europe at baseline (F0), 12-month follow-up (FU12), and 24-month follow-up (FU24). A geriatric assessment that included demographics, clinical and medication assessment, depression, Cumulative Illness Rating Scale, blood and urine examination, hand grip strength, and fear of falling was performed. Falls characteristics were described, and a multivariate logistic regression analysis was performed to examine the probability of being severely injured because of a fall, inside or outdoors.

Results: Data on falls revealed 938 falls at baseline, 773 falls at FU12, and 797 falls at FU24. Approximately 70% of these falls resulted in no injury or untreated injuries, while 8.5% led to bone fractures. Most falls (54.8%) occurred outdoors, primarily during ambulation (64.6%). About 50% of the falls were due to trips, slips, or bumping into objects, while 20.3% were due to balance and gait impairments. Women experienced falls about 30% more frequently than men.

Conclusions: Our findings offer new insights into the patterns of falls by location, sex, and injury type. This may help suggest ways of preventing falls. It is reasonable to recommend that older adults train their balance and specifically balance reactive responses to a situation whenever balance is lost accidently and unexpectedly.

Keywords: Community-dwelling old adults; Fall; Injurious falls.

Fig. 1.

Study flowchart.

Fig. 2.

Circumstances of falls presented as the percentage of self-reported cases for location of fall (N = 2,067) (a), activity during fall (N = 2,065) (b), causes of fall (N = 2,064) (c), and consequences of fall (N = 2,058) (d).

Fig. 3.

Location of fall (N = 2,065), categorized as inside the home (n = 779), outside the home but within the building (n = 155), and outside the home (n = 1,131), presented as the percentage of self-reported cases for activities (a), causes (b), and consequences of falls (c), across these locations.

Fig. 4.

Consequences of falls (N = 2,056), bone fracture (n = 174), treated injury (n = 427), untreated injury (n = 590), and no injury (n = 865), presented as the percentage of self-reported cases for activities during fall (a), causes of fall (b), and location of fall (c).

Fig. 5.

Sex differences between woman (N = 1,568) and man (N = 940) presented as percentages for location of fall (n = 2,067) (a), activity during fall (n = 2,065) (b), causes of fall (n = 2,064) (c), and consequences of fall (n = 2,058) (d).