Age and Ageing, Vol 28, 121-125, Copyright © 1999 by British Geriatrics Society
IP Donald and CJ Bulpitt
BACKGROUND: there are few longitudinal studies of the prognosis of falling
at home. OBJECTIVE: to determine outcomes in older people who fall once and
more than once. DESIGN: longitudinal prospective cohort study. SETTING:
primary care in the UK. SUBJECTS: 1815 subjects over 75 who had a
standardized and validated health check. METHOD: annual interviews over 4
years. Practice records were used to establish death and admission to
institutions. RESULTS: risk of death was increased at 1 year [odds ratio
(OR) 2.6, 95% confidence interval (CI) 1.4-4.7] and 3 years (OR 1.9, 95% CI
1.2-3.0) for recurrent fallers but not single fallers (OR 0.9, 95% CI
0.5-1.6 at 1 year; OR 0.97, 95% CI 0.7-1.4 at 3 years). Risk of admission
to long-term care over 1 year was markedly increased both for single
fallers (OR 3.8, 95% CI 1.8-8.3) and recurrent fallers (OR 4.5, 95% CI
1.7-12). Functional decline was not related to faller status, the latter
being very variable from one year to the next. CONCLUSIONS: the stronger
relationship between falling and admission to long-term care rather than
mortality supports the hypothesis that the perceived risks for those who
fall only once are exaggerated.
ARTICLES
The prognosis of falls in elderly people living at home
Elderly Care Unit, Gloucestershire Royal Hospital, UK.
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