A two-year longitudinal study of falls in 482 community-dwelling elderly adults.

BACKGROUND: Falls are a common occurrence in elderly persons, including relatively healthy, community-dwelling men and women. A significant percentage of falls result in soft-tissue injuries. Although some risk factors for falls have been identified, more research is needed on risk factors for injurious falls. In addition, there is little information from prospective studies on the long-term consequences of falls other than injury.

METHODS: Risk factors and consequences of falls were analyzed in a 24-month prospective study of 482 elderly (mean age 74 +/- 6.7 years) men and women living independently.in the community. Falls and injurious falls were ascertained by telephone and by a bimonthly postcard follow-up. Predictor variables were obtained from a baseline assessment and follow-up questionnaire. Outcomes were defined as rates of falls and injurious falls, circumstances surrounding the fall, and the long-term correlates of falls.

RESULTS: Sixty-one percent of the participants (53.7% of men and 65.7% of women) reported one or more falls during the 2-year follow-up. The crude rates of injurious falls were 11.17 per 1000 person-months in women and 7.23 per 1000 person-months in men. Age, history of fracture, low physical health, and low or high mobility level were risk factors for injurious falls in both sexes. The inability to balance unsupported on one leg was associated with injurious falls in women (rate ratio [RR] = 3.0; 95% confidence interval 1.9-4.7). Self-reported cognitive, physical health, and mobility impairments were greater in female fallers compared to the nonfallers.

CONCLUSIONS: Falls and injurious falls without fracture are frequent events for healthy elderly people and may be associated with morbid changes in cognitive status, physical health, and mobility.