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Vol. 23. Issue 1.
Pages 19-26 (01 January 2019)
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Vol. 23. Issue 1.
Pages 19-26 (01 January 2019)
Original Research
DOI: 10.1016/j.bjpt.2018.05.005
A predictive model of isolated and recurrent falls in functionally independent community-dwelling older adults
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Pilar Pérez-Rosa,
Corresponding author
pilar.perez@ucv.es

Corresponding author at: Espartero 7, 46007 Valencia, Spain.
, Francisco M. Martínez-Arnaua,b, Rafael M. Orti-Lucasa,c, Francisco J. Tarazona-Santabalbinaa,d
a Nursing Faculty, Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
b Department of Physiotherapy, Universitat de València, Valencia, Spain
c Department of Preventive Medicine, Hospital Clinico Universitario de Valencia, Valencia, Spain
d Department of Geriatrics, Hospital Universitario de la Ribera, Valencia, Spain
Highlights

  • Functionally independent older adults have risk of falling.

  • Isolated and recurrent fallers have different fall risk factors.

  • Alpha-blocker use is a predictor of isolated falls.

  • Fractures, increased BMI and benzodiazepine and beta-blocker use are predictors of recurrent fallers.

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Figures (1)
Tables (4)
Table 1. Characteristics of the population at the start of the study.
Table 2. Risk factors for falls.
Table 3. Risk factors in older people with isolated and recurrent falls.
Table 4. Predictive models: falls and recurrent falls.
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Abstract
Background

Aging is associated with an increased risk of accidental falls. Falls in older people have been widely studied in nursing homes and in the elderly with poor functionality, but there have been few investigations into functionally independent community-dwelling older adults.

Objective

To determine the predictive factors for falls in functionally independent community-dwelling older adults.

Methods

A cohort trial-nested case–control study was carried out. The participants were community-dwelling people aged 70 and over who were treated in primary care centers from December 2012 to May 2014 in la Ribera (Valencia, Spain).

Results

There were a total of 374 participants, with a mean age of 76.1 (SD 3.4) years (63.8% females). The subjects presented high functionality scores: Barthel 96.5 (SD 9.4), Lawton 7.2 (SD1.2), Tinetti 25.6 (SD 3.3). The mean number of prescribed drugs was 4.7 (SD 2.9). The cumulative incidence of falls was 39.2%, and 24.1% of these older adults suffered falls. The number of falls in the previous 12 months (OR=1.3; 95%CI: 1.11–1.53; p<0.001) and alpha-blockers (OR=6.72; 95%CI: 1.62–27.79; p=0.009) were predictors of falls. The presence of previous fractures (OR=9.55; 95%CI: 4.1–22.25; p<0.001), a body mass index of ≥30kg/m2 (OR=1.09; 95%CI: 1.01–1.19; p=0.035), and who are using benzodiazepines and beta-blockers (OR=2.77; 95%CI: 1.53–5.02; p<0.001), were predictors of recurrent fallers.

Conclusions

Older people who use alpha-blockers, benzodiazepines and beta-blockers, had previous fractures, with increased body mass index are more likely to fall.

Keywords:
Accidental falls
Older adults
Risk factors
Geriatric assessment
Outcomes

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