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© 1996 Oxford University Press

research-article

Physiological Factors and Medications as Predictors of Injurious Falls by Elderly People: A Prospective Population-based Study

KEIJO KOSK1, HEIKKI LUUKINEN1, PEKKA LAIPPALA3 and SIRKKA-LIISA KIVELÄ2

1Department of Public Health Science and General Practice, University of Oulu Aapistie 1, FIN-90220 Oulu, Finland
2Oulu University Hospital, Unit of General Practice Kajaanintie 50, FIN-90220 Oulu, Finland
3Tampere School of Public Health, University of Tampere PB607, FIN-33101 Tampere, Finland

To determine the physiological factors and medications predicting injurious falls among the elderly population, the authors conducted a prospective study in a rural home-dwelling population aged 70 years or over, initially 979 persons (377 men and 602 women), from 1 January 1991 to 31 December 1992, in Northern Finland. The independent risk factors for all falling injuries, falls leading to minor injuries and ones leading to major injuries were determined. In men, the independent risk factors for all injuries were gait disturbances [odds ratio (OR) = 3.5] and the use of digitalis (OR = 2.2), those for minor injuries were gait disturbances (OR = 2.7) and the use of calcium blockers (OR = 3.0), and those for major injuries were the absence of a quadriceps reflex (OR = 4.8), gait disturbances (OR = 2.8) and the use of digitalis (OR = 2.9). In women, the corresponding independent risk factors were short step length (OR = 32.1), the use of calcium blockers (OR = 2.5) and the use of medications for improving peripheral circulation (OR = 3.7) for all injurious falls, path deviation (OR = 2.3), the use of calcium blockers (OR = 2.8) and the use of anti-inflammatory drugs (OR = 2.1) for minor injuries, and foot deformity (OR = 2.0), short step length (OR = 15.8), the use of long-acting benzodiazepines (OR = 4.0) and the use of calcium blockers (OR = 2.4) for major injuries. In order to prevent injurious falls, attention should be given to the prescription of tranquillizers, cardiovascular medications and anti-inflammatory drugs. The walking abilities of elderly people should be maintained and chronic diseases leading to peripheral neuropathy should be treated adequately.

Received May 30, 1995;
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