The prevalence of falls and their relation to visual and hearing impairments among a nation-wide cohort of older Poles

Falls are a geriatric syndrome which affects the physical and psychological well-being of the aged. So far, in Poland there have not been any population-based data on the prevalence of falls among the elderly. The aim of this analysis was to assess the prevalence of falls, their circumstances and consequences in the Polish population aged 65 years and older in comparison to younger respondents aged 55-59 years, and the relation of falls to visual and hearing deficits. Mean age of the 4920 elderly subjects (51.6% men) was 79.4±8.7 years. Falls in the past year were reported by 10.4% of the younger and 19.1% of the older subjects. In both groups falls occurred more frequently in women (11.9% vs. 8.7%, p=0.03 in the younger and 22.7% vs. 13.2%, p<0.001 in the older group). In the group of older subjects falls occurred most often during walking (66.7% vs. 50.7% in the group of 55-59 years old), p=0.005), while the younger more often fell while practicing sports (5.48% vs. 0.8% in the group 65+, p<0.001) and risky activities (respectively: 13.7% vs. 4.9%, p=0.002). A similar percentage of younger and older fallers reported one (44.0% and 46.1% respectively) or more falls (56.1% and 53.9%; p=0.6). The percentage of recurrent fallers grew with increasing age (Cc=0.177; p<0.001). The prevalence of injurious falls was similar in the younger and older groups (45.4% and 42.8%, p=0.53). In both genders fall-related injuries were more frequent in younger elderly (65-74 years old) and in subjects 90 years old and older. In the non-standardized analysis and after adjustment for age and gender visual and hearing impairments and its degree were associated with falls but both relations lost statistical significance after adjustment for a set of explanatory variables. Despite somewhat lower estimates, falls in older Poles are no less an important factor influencing overall health than in other populations. The higher prevalence of multiple falls should draw attention of the health-care policy makers. Sensory impairment may add to the risk of falls and should be adequately taken care of, however the priority in the future fall prevention initiative should be given to stronger factors, such as age, type of activity, overall health, cognitive function and functional status.

[1]  W. Berg,et al.  Circumstances and consequences of falls in independent community-dwelling older adults. , 1997, Age and ageing.

[2]  Kozo Nakamura,et al.  Prevalence of falls and the association with knee osteoarthritis and lumbar spondylosis as well as knee and lower back pain in Japanese men and women , 2011, Arthritis care & research.

[3]  C. Swine,et al.  Combined effects of functionally-oriented exercise regimens and nutritional supplementation on both the institutionalised and free-living frail elderly (double-blind, randomised clinical trial) , 2009, BMC public health.

[4]  Christianna S. Williams,et al.  The effect of falls and fall injuries on functioning in community-dwelling older persons. , 1998, The journals of gerontology. Series A, Biological sciences and medical sciences.

[5]  F. Stanaway,et al.  Ethnicity and falls in older men: low rate of falls in Italian-born men in Australia. , 2011, Age and ageing.

[6]  F. Ando,et al.  Frequencies and circumstances of falls in the National Institute for Longevity Sciences, Longitudinal Study of Aging (NILS-LSA). , 2000, Journal of epidemiology.

[7]  Luigi Ferrucci,et al.  Hearing loss and falls among older adults in the United States. , 2012, Archives of internal medicine.

[8]  Jacqueline Merchant,et al.  Sport and Physical Activity , 2007 .

[9]  M. Tinetti,et al.  Risk factors for falls among elderly persons living in the community. , 1988, The New England journal of medicine.

[10]  M. Tinetti,et al.  Prevention of falls among the elderly. , 1989, The New England journal of medicine.

[11]  Leon Flicker,et al.  Falls, injuries from falls, health related quality of life and mortality in older adults with vision and hearing impairment--is there a gender difference? , 2011, Maturitas.

[12]  Christianna S. Williams,et al.  Falls, injuries due to falls, and the risk of admission to a nursing home. , 1997, The New England journal of medicine.

[13]  Stephen R Lord,et al.  Falls Incidence, Risk Factors, and Consequences in Chinese Older People: A Systematic Review , 2011, Journal of the American Geriatrics Society.

[14]  P. Chou,et al.  Visual Impairment and Falls in the Elderly: The Shihpai Eye Study , 2008, Journal of the Chinese Medical Association : JCMA.

[15]  M. Tinetti,et al.  Falls and Injuries in Frail and Vigorous Community Elderly Persons , 1991, Journal of the American Geriatrics Society.

[16]  I. Chi,et al.  Incidence and predictors of falls in the chinese elderly. , 2005, Annals of the Academy of Medicine, Singapore.

[17]  In-Young Yoo Recurrent falls among community-dwelling older Koreans: prevalence and multivariate risk factors. , 2011, Journal of gerontological nursing.

[18]  Associated Factors for Falls among the Community-Dwelling Older People Assessed by Annual Geriatric Health Examinations , 2011, PloS one.

[19]  J. Kaprio,et al.  Hearing as a predictor of falls and postural balance in older female twins. , 2009, The journals of gerontology. Series A, Biological sciences and medical sciences.

[20]  Clare E Guse,et al.  Risk factors for falls and fall-related injuries in adults 85 years of age and older. , 2012, Archives of gerontology and geriatrics.

[21]  Markku Kauppinen,et al.  Poor vision accompanied with other sensory impairments as a predictor of falls in older women. , 2008, Age and ageing.

[22]  S. Lord,et al.  Visual risk factors for falls in older people. , 2006, Journal of the American Geriatrics Society.

[23]  J. Cauley,et al.  Hearing sensitivity and the risk of incident falls and fracture in older women: the study of osteoporotic fractures. , 2004, Annals of epidemiology.

[24]  S. Cummings,et al.  Higher risk of multiple falls among elderly women who lose visual acuity. , 2004, Ophthalmology.

[25]  Jenny Lee,et al.  Development of a simple scoring tool in the primary care setting for prediction of recurrent falls in men and women aged 65 years and over living in the community. , 2009, Journal of clinical nursing.

[26]  P. Lüthje,et al.  Long-term survival after falls among the elderly in institutional care. , 2004, Archives of gerontology and geriatrics.

[27]  S. Studenski,et al.  Ethnic Differences in the Frequency and Circumstances of Falling in Older Community‐Dwelling Women , 2005, Journal of the American Geriatrics Society.

[28]  Tiffany Gill,et al.  A Population-Based Survey of Factors Relating to the Prevalence of Falls in Older People , 2005, Gerontology.

[29]  S. Cummings,et al.  Forgetting Falls , 1988, Journal of the American Geriatrics Society.

[30]  Laura A Talbot,et al.  Falls in young, middle-aged and older community dwelling adults: perceived cause, environmental factors and injury , 2005, BMC public health.

[31]  Y. Gustafson,et al.  Falls in very old people: the population-based Umeå 85+ study in Sweden. , 2009, Archives of gerontology and geriatrics.

[32]  A. Silman,et al.  Falls explain between-center differences in the incidence of limb fracture across Europe. , 2002, Bone.

[33]  H. Menz,et al.  Falls in Older People: Epidemiology of falls and fall-related injuries , 2007 .

[34]  Daniel A. Sterling,et al.  Geriatric falls: injury severity is high and disproportionate to mechanism. , 1998 .

[35]  Ecosse Lamoureux,et al.  The relationship between visual function, duration and main causes of vision loss and falls in older people with low vision , 2010, Graefe's Archive for Clinical and Experimental Ophthalmology.

[36]  The association between various visual function tests and low fragility hip fractures among the elderly: a Malaysian experience. , 2010, Age and ageing.

[37]  Tien Yin Wong,et al.  Visual impairment, causes of vision loss, and falls: the singapore malay eye study. , 2008, Investigative ophthalmology & visual science.

[38]  S. Azen,et al.  Central and peripheral visual impairment and the risk of falls and falls with injury. , 2010, Ophthalmology.

[39]  R. Baloh,et al.  A longitudinal study of gait and balance dysfunction in normal older people. , 2003, Archives of neurology.

[40]  M. Barr,et al.  Prevalence, circumstances and consequences of falls among community-dwelling older people: results of the 2009 NSW Falls Prevention Baseline Survey. , 2011, New South Wales public health bulletin.

[41]  Rumi Kozakai,et al.  [Epidemiology of falls among community-dwelling elderly people]. , 2003, Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics.

[42]  Jerzy Chudek,et al.  Medical, psychological and socioeconomic aspects of aging in Poland Assumptions and objectives of the PolSenior project , 2011, Experimental Gerontology.

[43]  H. Menz,et al.  Falls in Older People: Risk Factors and Strategies for Prevention , 2000 .

[44]  R. Klein,et al.  Performance-based and self-assessed measures of visual function as related to history of falls, hip fractures, and measured gait time. The Beaver Dam Eye Study. , 1998, Ophthalmology.

[45]  T. Weiss,et al.  Predictors of falls among postmenopausal women: results from the National Osteoporosis Risk Assessment (NORA) , 2009, Osteoporosis International.

[46]  Carol Jagger,et al.  Health and disease in 85 year olds: baseline findings from the Newcastle 85+ cohort study , 2009, BMJ : British Medical Journal.

[47]  L. Poujol,et al.  Risk factors for falling in community-dwelling older adults: Which of them are associated with the recurrence of falls? , 2010, The journal of nutrition, health & aging.

[48]  O. Plana-Ripoll,et al.  Risk of falls in 85-year-olds is associated with functional and cognitive status: the Octabaix Study. , 2012, Archives of gerontology and geriatrics.

[49]  J. Painter,et al.  Falls in community-dwelling adults aged 50 years and older: prevalence and contributing factors. , 2009, Journal of allied health.