Journal Article

Risk Indicators for Falls in Institutionalized Frail Elderly

M. Kron, S. Loy, E. Sturm, Th. Nikolaus and C. Becker

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 158, issue 7, pages 645-653
Published in print October 2003 | ISSN: 0002-9262
Published online October 2003 | e-ISSN: 1476-6256 | DOI:
Risk Indicators for Falls in Institutionalized Frail Elderly

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The aim of this study was to identify individual predisposing risk indicators for falls in a sample of institutionalized frail elderly in southern Germany. The design was a prospective observational study with a 1-year follow-up (October 1998–September 1999). The study population included 472 long-term-care residents whose mean age was 84 years; 77% were female. Risk indicators for accidental falls were analyzed by using logistic regression. Residents were found to have an incidence density rate of falls of 2,558 per 1,000 resident-years. Multiple logistic regression analysis revealed short-term memory loss, transfer assistance, urinary incontinence, positive fall history, and use of trunk restraints as predictors of falls. In a further logistic regression analysis, depressive symptoms, transfer assistance, urinary incontinence, and positive fall history were associated with frequent falls. Using these risk indicators as a screening procedure to identify fallers would be easy to administer and could be accomplished by nursing staff. Study results encourage specifically addressing urinary incontinence, cognitive impairment, use of restraints, depression, and transfer difficulties as modifiable predisposing risk factors for falls. Fall history represents an important nonmodifiable marker to identify residents at high risk.

Keywords: accidental falls; aged; institutionalization; long-term care; risk factors; Abbreviation: CI, confidence interval.

Journal Article.  4611 words.  Illustrated.

Subjects: Public Health and Epidemiology

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