Falls and EQ-5D rated quality of life in community-dwelling seniors with concurrent chronic diseases: a cross-sectional study

Long-term Consequences of Noninjurious and Injurious Falls on Well-being in Older Women

BACKGROUND

The physical and mental health consequences of falls are known to influence well-being in the short term. The aim was to investigate the long-term consequences of noninjurious and injurious falls on well-being in older women over 12 years.

METHODS

A total of 10,277 participants (aged 73-78 years, 98.8% community-dwelling) returned the 1999 survey of the Australian Longitudinal Study on Women's Health. Follow-up surveys were completed at 3-year intervals. Surveys included questions about falls and related injuries in the past year. Scores on the health-related quality of life Short Form-36 subscales (range 0-100) were used to compare well-being between noninjurious fallers, injurious fallers, and nonfallers using linear mixed modeling with adjustment for confounders. Scores in the years before and after the first fall since enrolment were graphically depicted with time relative to the first fall since enrolment. For this purpose, nonfallers were matched with noninjurious and injurious fallers based on pattern of surveys returned, chronic conditions, and age to assign them a fictitious "time-of-first-fall."

RESULTS

Over 12 years, there were 22.5% noninjurious fallers, 30.1% injurious fallers, and 47.5% nonfallers. Compared with nonfallers, noninjurious and injurious fallers scored significantly lower on six and seven of the eight domains at the time of the reported fall, respectively. Significant differences were apparent 12 years before the injurious fall for the subscales role physical, bodily pain, and general health. A drop in scores after the reported injurious fall was seen for role physical, bodily pain, and social functioning.

CONCLUSIONS

Among older women, a gap in well-being emerges years before the first reported fall, which may be driven by underlying risk factors rather than the fall itself.

Gender differences in physical activity patterns among older adults who fall

OBJECTIVE

This study describes gender differences in the level and pattern of physical activity in groups of older adults who were frequent fallers, intermittent fallers, or non-fallers.

METHODS

Interviews were conducted with adults aged 50 years and older (N=1834) at senior centers across Pennsylvania from 2010 to 2011. Self-reported falls and validated measures of physical activity were collected at baseline and at 6- and 12-month follow-up assessments.

RESULTS

Complete follow-up data were available for 1487 participants. Men who fell frequently decreased in recreational/leisure activity and household/yard work compared to the intermittent fallers and non-fallers. This association remained even when controlling for baseline health status. All women-regardless of fall group-engaged in similar levels of recreational/leisure activity and household/yard work over time. For both men and women, frequent fallers also showed a greater decrease in walking activities compared to intermittent fallers and non-fallers.

DISCUSSION

Frequent falling among older adults is associated with declines in common leisure, household, and walking activities. The effect of falling frequency on physical activity appears to affect men and women differently, generating the hypothesis that interventions to promote physical activity among fallers need to be gender specific.