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Risk Factors for Falling Among Community-Based Seniors

Fletcher, Paula C. PhD*; Berg, Katherine PhD, PT; Dalby, Dawn M. PhD*; Hirdes, John P. PhD

Journal of Patient Safety: June 2009 - Volume 5 - Issue 2 - p 61-66
doi: 10.1097/PTS.0b013e3181a551ed
Original Articles

Background: Falling constitutes a significant risk to the health and well-being of seniors. Although a number of risk factors have been established within the literature for falling, limited work has differentiated risk factors for 1-time versus recurrent or multiple fallers.

Methods: The purpose of this research was to examine 2 relationships: (1) the risk factors for nonfallers versus fallers (1+ falls); and (2) the risk factors for nonfallers/1-time fallers versus multiple fallers (2+ falls). All participants (n = 453) were subjects within 5 different fall intervention programs funded through the Falls Prevention Initiative sponsored by Health Canada and Veterans Affairs Canada. In total, 5 project sites funded in Ontario conducted independent fall intervention programs. At the onset of their programs and at the completion of their programs, each project site assessed all of their subjects or a predetermined number of seniors (if the subject pool was extensive) using 2 instruments, namely the interRAI Community Health Assessment and the Berg Balance Scale, so that comparisons could be made between sites.

Results: Of the 453 individuals, 67% of the sample was classified as nonfallers, with 33% classified as experiencing 1 or more falls. Risk factors significant within the model examining nonfallers versus 1+ fallers included increased medication use and a previous history of falling. For the second analyses, examining 0 falls/1 fall versus recurrent fallers, the following factors were associated with increased risk: medication use, previous history of falling, and compromised activities of daily living (ADL). Fourteen percent of the sample experienced 2+ falls.

Conclusions: It is important to distinguish fallers based on fall status because recurrent or multiple fallers are more likely to benefit from fall prevention efforts. Using a standardized and comprehensive tool such as the interRAI-CHA would assist researchers in making comparisons between different research groups.

From the *Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo; †Department of Physical Therapy, University of Toronto, Toronto; and ‡Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario.

Reprints: Paula C. Fletcher, PhD, Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, Ontario, Canada N2L 3C5 (e-mail:

Funding: Health Canada & Veterans Affairs Canada.

Presentations: An earlier version of this paper was presented at the Gerontological Society of America Conference in San Francisco in November 2007.

The views expressed herein do not necessarily represent the official policy of Health Canada or Veterans Affairs Canada. The interRAI Community Health Assessment is a comprehensive assessment instrument developed and owned by interRAI, a not-for-profit network of researchers and clinicians.

© 2009 Lippincott Williams & Wilkins, Inc.