A Community-Based Case-Control Study on the Risk of Fall among the Elderly in Rural Kattankulathur Block, Tamil Nadu

Proportion, Pattern, and Predictors of Falls in Older Adults - A Community-based Observational Study in Rural West Bengal

Introduction

In spite of falls being a major public health problem, where most of the falls are preventable, there is a lack of epidemiological investigation among those aged 50 and above, especially in developing countries. Hence, we investigate the proportion, pattern, and predictors of falls in this age group.

Materials and Methods

This cross-sectional community-based study was done in the Uluberia-II block of Howrah district, West Bengal, from February to July 2021. A multistage cluster sampling method was used to meet the sample size. Data were collected with the help of a structured interview schedule. Predictors were estimated by the SPSS version 16 and defined in adjusted odds ratio (AOR) with a 95% confidence interval.

Results

Among 170 study participants, 34.7% (59/170) experienced at least one episode of fall, while 20.6% (35/170) experienced recurrent falls in 12 months. Most (78%; 46/59) falls occurred in the home environment and due to slippage (67.8%; 40/59) on the floor. 84.7% (50/59) sustained any type of injuries, 47.5% (28/59) required either consultation of a physician or medication, and 6.8% (4/59) required hospitalization. Safety Checklist Score measured 75.3% (128/170) had a poor household environment, within that 30.6% (52/170) had a seriously poor household environment, which was an important predictor of falls ([AOR] = 3.59 [1.24-10.38]). Fear of fall (AOR = 6.18 [1.77-21.53]) measured by shortfall efficacy scale and nonformal education (AOR = 5.05 [1.33-19.07]) were also predictors of falls.

Conclusion

Considerable proportion of falls occurred in the past year, which can be preventable by improving modifiable environmental factors and detection of fear of fall in persons at different levels of health-care facilities.

Risk factors for falls among older adults in India: A systematic review and meta‐analysis

Background and Aim

Falls are common among older adults in India. Several primary studies on its risk factors have been conducted in India. However, no systematic review has been conducted on this topic. Thus, the objective of this systematic review was to synthesize the existing evidence on the risk factors for falls among older adults in India.

Methods

JBI and Preferred Reporting Items for Systematic Reviews and Meta‐Analyse guidelines were followed, and two independent reviewers were involved in the process. This review included observational studies conducted among older adults (aged ≥ 60 years) residing in India, reporting any risk factor for falls as exposure and unintentional fall as the outcome. MEDLINE, EMBASE, PsycInfo, CINAHL, and ProQuest Dissertations and Theses were searched until September 24, 2020. Where possible, data were synthesized using random‐effects meta‐analysis.

Results

The literature search yielded 3445 records. Twenty‐two studies met the inclusion criteria of this systematic review, and 19 studies were included in the meta‐analysis. Out of the 22 included studies in the systematic review, 12 (out of 18) cross‐sectional studies, two case–control studies, and two cohort studies met more than 70% criteria in the respective Joanna Briggs Institute (JBI) checklists. Risk factors for falls among older adults in India included sociodemographic factors, environmental factors, lifestyle factors, physical and/or mental health conditions, and medical interventions.

Conclusions

This systematic review and meta‐analysis provided a holistic picture of the problem in India by considering a range of risk factors such as sociodemographic, environmental, lifestyle, physical and/or mental health conditions and medical intervention. These findings could be used to develop falls prevention interventions for older adults in India.

Systematic Review and Meta‐Analysis Registration

The systematic review and meta‐analysis protocol was registered with PROSPERO (registration number‐CRD42020204818).

The effects of social isolation due to COVID‐19 on the fear of movement, falling, and physical activity in older people

Objective

This study investigates the interaction between fear of movement, fall risk, and physical activity levels in ageing individuals who experienced social isolation during the COVID‐19 pandemic.

Methods

In this descriptive and cross‐sectional study, 254 eligible participants used an online background survey. Individuals’ fear of movement was evaluated by the kinesiophobia causes scale, fall risk by the falls efficacy scale, and physical activity levels by the physical activity scale for the ageing.

Results

The fear of movement had a significant positive interaction on fall risk (β = 0.471, R² = 0.495, p < 0.001). The fall risk had a negative effect on physical activity (β = −1.686, R² = 0.161, p < 0.001). The fear of movement and fall risk explained 15.6% of the change in physical activity levels of ageing individuals (p < 0.001).

Conclusions

These results showed a significant interaction between physical activity levels and fear of movement, with a high fall risk in ageing individuals during the pandemic period.

Prevalence and risk factors of fall-related injury among older adults in India: evidence from a cross-sectional observational study

Background

Falls and related injuries in older ages have become a major public health problem. This study aims to identify the prevalence of self-reported fall-related injury and to describe risk factors associated with fall-related injury among older adults in India.

Method

The study used data from the "Building Knowledge Base on Population Ageing in India" (BKPAI), which was carried out in seven major states in India (2011). Bivariate and multivariable logistic regression analyses were conducted to examine the prevalence and risk factors of fall-related injury among older people.

Results

The study found that 3.6% of older adults had a fall-related injury. Older adults with walk difficulty had a significantly higher likelihood of reporting fall-related injuries in comparison to their counterparts [adjusted odds ratio (AOR):1.80; confidence interval (CI): 1.38–2.36]. Older adults who consumed alcohol had significantly higher odds of reporting fall-related injuries than those who did not consume alcohol [AOR: 1.97; CI: 1.31–2.97]. Poor self-rated health was another risk factor for fall-related injury [AOR: 1.24; CI: 1.05–1.61]. Further, older adults with dementia were 2.15 times significantly more likely to report fall-related injuries than older adults with no dementia [AOR: 2.15; CI: 1.03–5.05]. Also, older women compared to men were 98% significantly more likely to report fall-related injury [AOR: 1.98; CI: 1.43–2.75]. The odds of reporting fall-related injury was significantly higher among those who had a secondary level education compared to those with no education [AOR: 1.44; CI: 1.01–2.06].

Conclusions

Walking disabilities, alcohol consumption, poor self-rated health, dementia, and female gender were found to be the risk factors for fall-related injury among older adults. The results highlight the importance of improving physical as well as mental health of older individuals including dementia in terms of reducing the risk of experiencing fall-related injury.

Risk of Fall among Older Adults and its Association with Cognitive Impairment in a Semi-Urban Community

Context:

Fall in older people is a major public health concern. Two-third of the death due to fall are preventable. Risk assessment in older adults therefore is the first step to identify the high-risk group to plan need-based intervention.

Aims:

The aim of the study was to determine the prevalence of risk of fall among older adults and its association with cognitive impairment and sociodemographic characteristics.

Settings and Design:

A cross-sectional study was conducted in the field practice areas of the department of community medicine in a teaching hospital in South Kerala, India.

Subjects and Methods:

A semi-structured questionnaire was used to collect the data. Berg Balance Scale and Mini-Cog Test were used for measuring risk of fall and cognitive impairment.

Statistical Analysis Used:

Descriptive statistics and logistic regression were used for the statistical analysis using SPSS.

Results:

Among the older adults, 45% were at risk of fall, 42.4% in males and 57.6% in females. The risk of fall was found to be significantly associated with cognitive impairment, (odds ratio = 3.89, confidence interval at 95% = 2.06–7.31, P < 0.001). Advanced age, female gender, and unemployed status were significantly associated with the risk of fall.

Conclusions:

The risk of fall prevalence was high and significantly related to cognitive impairment, advanced age, female gender, and occupational status, with more than half of those currently not working having a higher risk. The study would recommend regular follow-up of risk groups for prevention a good percentage of fall and thereby the related injuries.

Falls and visual impairment among elderly residents in 'homes for the aged' in India

We evaluated the prevalence of falls and their association with visual impairment (VI) in elderly residents in 'homes for the aged' in Hyderabad, India. Participants aged ≥ 60 years were recruited from 41 homes, and a comprehensive eye examination was conducted. Interviews were conducted to collect personal and demographic information, systemic health status, fear of falling, depression, and history of falls in the last year. VI categories included low vision (presenting visual acuity worse than 6/18 to 3/60) and blindness (presenting visual acuity worse than 3/60). The data of 1,074 participants were analysed. The mean age was 74.4 years (standard deviation:8.7 years); 63.9% were women, 19.4% had no formal education, 28.1% were diabetic and 56.9% were hypertensive. The annual prevalence of falls was 29.1% (95% CI: 26.4-32.0). Multivariable analysis showed those with VI had significantly higher odds of falls (Odds Ratio:1.47; p = 0.043). The prevalence of falls was higher among those with VI due to uncorrected refractive errors. We found a very high prevalence of falls in elderly individuals living in 'homes for the aged' in Hyderabad, India. Addressing VI can result in fewer falls and contribute to healthy aging in India.