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Cave, Rachel. "When whale fall falls." New Scientist 199, no. 2668 (2008): 21. http://dx.doi.org/10.1016/s0262-4079(08)61989-2.
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KALYANAKRISHNAN, SHIVARAM, and AMBARISH GOSWAMI. "LEARNING TO PREDICT HUMANOID FALL." International Journal of Humanoid Robotics 08, no. 02 (2011): 245–73. http://dx.doi.org/10.1142/s0219843611002496.
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Falls are undesirable in humanoid robots, but also inevitable, especially as robots get deployed in physically interactive human environments. We consider the problem of fall prediction: to predict if the balance controller of a robot can prevent a fall from the robot's current state. A trigger from the fall predictor is used to switch the robot from a balance maintenance mode to a fall control mode. It is desirable for the fall predictor to signal imminent falls with sufficient lead time before the actual fall, while minimizing false alarms. Analytical techniques and intuitive rules fail to satisfy these competing objectives on a large robot that is subjected to strong disturbances and exhibits complex dynamics. We contribute a novel approach to engineer fall data such that existing supervised learning methods can be exploited to achieve reliable prediction. Our method provides parameters to control the tradeoff between the false positive rate and the lead time. Several combinations of parameters yield solutions that improve both the false positive rate and the lead time of hand-coded solutions. Learned solutions are decision lists with typical depths of 5–10, in a 16-dimensional feature space. Experiments are carried out in simulation on an ASIMO-like robot.
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Wright, Stephen. "One falls, we all fall." Nursing Standard 24, no. 47 (2010): 26–27. http://dx.doi.org/10.7748/ns.24.47.26.s31.
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Stückemann, Wolfgang. "Editorial. Vom Fall zur Falle." Fachanwalt Arbeitsrecht 22, no. 11 (2018): 353. http://dx.doi.org/10.1515/fa-2018-221101.
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Davis, Kathy. "Trips, falls and fall injuries." Primary Health Care 24, no. 7 (2014): 16. http://dx.doi.org/10.7748/phc.24.7.16.s24.
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Zhang, Duo, Xusheng Zhang, Shengjie Li, et al. "LT-Fall." Proceedings of the ACM on Interactive, Mobile, Wearable and Ubiquitous Technologies 7, no. 1 (2022): 1–24. http://dx.doi.org/10.1145/3580835.
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Falls are the leading cause of fatal injuries to elders in modern society, which has motivated researchers to propose various fall detection technologies. We observe that most of the existing fall detection solutions are diverging from the purpose of fall detection: timely alarming the family members, medical staff or first responders to save the life of the human with severe injury caused by fall. Instead, they focus on detecting the behavior of human falls, which does not necessarily mean a human is in real danger. The real critical situation is when a human cannot get up without assistance and is thus lying on the ground after the fall because of losing consciousness or becoming incapacitated due to severe injury. In this paper, we define a life-threatening fall as a behavior that involves a falling down followed by a long-lie of humans on the ground, and for the first time point out that a fall detection system should focus on detecting life-threatening falls instead of detecting any random falls. Accordingly, we design and implement LT-Fall, a mmWave-based life-threatening fall detection and alarming system. LT-Fall detects and reports both fall and fall-like behaviors in the first stage and then identifies life-threatening falls by continuously monitoring the human status after fall in the second stage. We propose a joint spatio-temporal localization technique to detect and locate the micro-motions of the human, which solves the challenge of mmWave's insufficient spatial resolution when the human is static, i.e., lying on the ground. Extensive evaluation on 15 volunteers demonstrates that compared to the state-of-the-art work (92% precision and 94% recall), LT-Fall achieves zero false alarms as well as a precision of 100% and a recall of 98.8%.
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Kalyanakrishnan, Shivaram, and Ambarish Goswami. "Predicting Falls of a Humanoid Robot through Machine Learning." Proceedings of the AAAI Conference on Artificial Intelligence 24, no. 2 (2010): 1793–98. http://dx.doi.org/10.1609/aaai.v24i2.18815.
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Although falls are undesirable in humanoid robots, they are also inevitable, especially as robots get deployed in physically interactive human environments. We consider the problem of fall prediction, i.e., to predict if a robot's balance controller can prevent a fall from the current state. A trigger from the fall predictor is used to switch the robot from a balance maintenance mode to a fall control mode. Hence, it is desirable for the fall predictor to signal imminent falls with sufficient lead time before the actual fall, while minimizing false alarms. Analytical techniques and intuitive rules fail to satisfy these competing objectives on a large robot that is subjected to strong disturbances and therefore exhibits complex dynamics. Today effective supervised learning tools are available for finding patterns in high-dimensional data. Our paper contributes a novel approach to engineer fall data such that a supervised learning method can be exploited to achieve reliable prediction. Specifically, we introduce parameters to control the tradeoff between the false positive rate and lead time. Several parameter combinations yield solutions that improve both the false positive rate and the lead time of hand-coded solutions. Learned predictors are decision lists with typical depths of 5-10, in a 16-dimensional feature space. Experiments are carried out in simulation on an Asimo-like robot.
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Habib Perez, Olinda D., Samantha Martin, Katherine Chan, Hardeep Singh, Karen K. Yoshida, and Kristin E. Musselman. "A qualitative photo-elicitation study exploring the impact of falls and fall risk on individuals with subacute spinal cord injury." PLOS ONE 17, no. 6 (2022): e0269660. http://dx.doi.org/10.1371/journal.pone.0269660.
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Background Individuals living with chronic spinal cord injury or disease (SCI/D) are at an increased risk of falling. However, little is known about the impact of falls and fall risk in the subacute phase of SCI/D, despite this being a time when fall prevention initiatives are delivered. Hence, we explored the impact of falls and fall risk in individuals with subacute SCI/D as they transitioned from inpatient rehabilitation to community living. Methods This qualitative photo-elicitation study used an inductive thematic analysis. Eight individuals (7 male) undergoing inpatient rehabilitation at a Canadian tertiary rehabilitation hospital due to a new SCI/D participated. Six months following discharge, photo-elicitation interviewing was used to understand the impact of falls and fall risk. Over 7–14 days, participants completed a photo-assignment that involved taking photographs in response to questions, such as what increases/decreases your likelihood of falling? A semi-structured interview followed, in which participants described their photographs and discussed their experiences with falls, fall risk and fall prevention training. Results Four themes were identified. 1) Risk factors and strategies identified through lived experience. Participants discovered their fall risk factors and fall prevention strategies through “trial and error”. 2) Influences on the individual’s perception of their fall risk. Prior experience with falls, including falls experienced by themselves as well as friends and family, influenced their perception of fall risk. 3) Experiencing life differently due to increased fall risk. A high fall risk reduced participation, increased negative emotions and decreased independence and quality of life. 4) Falls training in rehabilitation can be improved. Prior experiences with falls training varied; however, participants expressed a desire for comprehensive and individualized training. Conclusion Although participants’ experiences with falls and fall prevention varied, falls and the risk of falling can have a significant impact on the first year of living with a SCI/D.
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Dinh, Anh, Yang Shi, Daniel Teng, et al. "A Fall and Near-Fall Assessment and Evaluation System." Open Biomedical Engineering Journal 3, no. 1 (2009): 1–7. http://dx.doi.org/10.2174/1874120700903010001.
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The FANFARE (Falls And Near Falls Assessment Research and Evaluation) project has developed a system to fulfill the need for a wearable device to collect data for fall and near-falls analysis. The system consists of a computer and a wireless sensor network to measure, display, and store fall related parameters such as postural activities and heart rate variability. Ease of use and low power are considered in the design. The system was built and tested successfully. Different machine learning algorithms were applied to the stored data for fall and near-fall evaluation. Results indicate that the Naïve Bayes algorithm is the best choice, due to its fast model building and high accuracy in fall detection.
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Fahimnia, Somayeh, Hadi Mirhedayati Roudsari, John Doucette, and Armin Shahrokni. "Falls in Older Patients with Cancer Undergoing Surgery: Prevalence and Association with Geriatric Syndromes and Levels of Disability Assessed in Preoperative Evaluation." Current Gerontology and Geriatrics Research 2018 (2018): 1–7. http://dx.doi.org/10.1155/2018/5713285.
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Falls are common among older adults. However, not much is known about the prevalence of falls among older patients with cancer. In 2015, older patients with cancer referred to Geriatrics service for preoperative evaluation were assessed for fall history, basic and instrumental activities of daily living (ADL and IADL), KPS, and use of assistive device. Of 806 patients, 215 (26.7%) patients reported fall. Incidence of last fall inside and outside home was 54.4% and 45.5%, respectively. Among patients with no falls, 33.6% had KPS ≤ 80 compared to 59.6% with one-time fall and 60.7% with multiple falls (p<0.001). Among IADL, 8.5% of patients with no falls were unable to do shopping compared with 14.7% in one-time fall and 18.8% in multiple fallers (p<0.001). In ADL items, the percentage of patients who were limited a lot in walking outside was 10.7% in no falls, 20.2% in one-time fall, and 27.1% in multiple fallers groups (p<0.001). Only 17.8% of patients with no falls were using canes while 27.7% of patients with one-time fall and 38.8% with multiple falls were using canes (p<0.001). Falls are prevalent among older patients with cancer. Fall history and number of falls are associated with functional status.
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Li, Qiwei, Elias Mpofu, Cheng Yin, and Keith W. Turner. "Perception of Falls and Confidence in Self-Management of Falls among Older Adults." International Journal of Environmental Research and Public Health 16, no. 24 (2019): 5054. http://dx.doi.org/10.3390/ijerph16245054.
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Objectives: Fall preventive programs aim to reduce risks for mortality from fall-related injuries among older adults. However, the covariation between personal perceptions of falls and factors and confidence of self-management in falls (CSMoF) is still under-studied despite its importance to fall prevention. We aimed to investigate the relative contribution of CSMoF in relation to fall risk self-perceptions while controlling for demographics and self-reported health and functioning. Method: Participants were 691 older adults recruited from Area Agency on Aging at Arlington, Texas (females = 76.1%, mean age = 76.23, SD = 6.44, with chronic condition = 79.5%). They completed measures of physical functioning, CSMoF, fall risk perceptions and fear of falls. Results: Regression analyses indicated that fear of fall was the most predictive factor of CSMoF among older persons, accounting for about 25% of the variance. Physical function measures of age, chronic illnesses of metabolism, sensory impairment, and health status were also significant predictors of the CSMoF, but to a lesser extent than fear of falls and fall perceptions. The interaction of perception of falls and fall experience attenuated CSMoF, with physical functioning limitations. Conclusion: The joint effects of perception of falls and fear of falls likely explain CSMoF among older adults more than physical functional indicators. Fall prevention programs for older adults should prioritize to address modifiable subjective factors of fall perceptions, fear of falls, and CSMoF across health and functioning statuses.
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Chiara, Mussi, Galizia Gianluigi, Abete Pasquale, et al. "Unexplained Falls Are Frequent in Patients with Fall-Related Injury Admitted to Orthopaedic Wards: The UFO Study (Unexplained Falls in Older Patients)." Current Gerontology and Geriatrics Research 2013 (2013): 1–6. http://dx.doi.org/10.1155/2013/928603.
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To evaluate the incidence of unexplained falls in elderly patients affected by fall-related fractures admitted to orthopaedic wards, we recruited 246 consecutive patients older than 65 (mean age82±7years, range 65–101). Falls were defined “accidental” (fall explained by a definite accidental cause), “medical” (fall caused directly by a specific medical disease), “dementia-related” (fall in patients affected by moderate-severe dementia), and “unexplained” (nonaccidental falls, not related to a clear medical or drug-induced cause or with no apparent cause). According to the anamnestic features of the event, older patients had a lower tendency to remember the fall. Patients with accidental fall remember more often the event. Unexplained falls were frequent in both groups of age. Accidental falls were more frequent in younger patients, while dementia-related falls were more common in the older ones. Patients with unexplained falls showed a higher number of depressive symptoms. In a multivariate analysis a higher GDS and syncopal spells were independent predictors of unexplained falls. In conclusion, more than one third of all falls in patients hospitalized in orthopaedic wards were unexplained, particularly in patients with depressive symptoms and syncopal spells. The identification of fall causes must be evaluated in older patients with a fall-related injury.
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Tay, Peter Kay Chai, Angelique Chan, Pey June Tan, and Chek Hooi Wong. "Sex Differences in Perceptions toward Falls among Older Adults Living in the Community in Singapore." Journal of Aging and Health 32, no. 10 (2020): 1355–62. http://dx.doi.org/10.1177/0898264320925972.
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Fall prevention strategies informed by understanding sex differences in the perception of falls may be fruitful. Objectives: In the current research, we examined the consequence of having a recent fall episode on sex differences in fall perception based on the postulation that having a recent fall can lead to perceived susceptibility and attenuate male stereotypic perceptions toward falls. Methods and Results: Examining 549 older adults (337 women) living in the community, men reported higher falls efficacy, less negative perception related to the effect of a fall, and lower tendency to restrict activities to prevent falls. These sex differences were observed only among those who did not have a recent fall episode, and no significant sex differences were observed among those who fell. Discussion: The findings suggest that a recent fall episode may underlie sex differences in falls perception. The implications of sex differences in perceptions in falls for healthcare delivery and outcomes are discussed.
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Lam, Freddy M. H., Jason C. S. Leung, and Timothy C. Y. Kwok. "84 Identifying Potential Recurrent Fallers in the Community using Frailty Indicators." Age and Ageing 48, Supplement_4 (2019): iv18—iv27. http://dx.doi.org/10.1093/ageing/afz164.84.
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Abstract Introduction Frailty indicators were proposed to be significant predictors of falls. However, their comparative and additional value to other simple fall predictors has not been evaluated. This study aims to compare the clinical value of three frailty indicators to fall history in predicting recurrent falls in older adults. Methods Four thousand community-dwelling elderly (2000 female) aged 65 years or above were recruited in Hong Kong. The three candidate frailty indicators were the FRAIL scale, the Cardiovascular Health Study Criteria (CHS), and the Study for Osteoporosis and Fracture Criteria (SOF). The comparative predictor was fall history. The area under the receiver operating characteristic curve (AUC) was used to assess their ability to predict recurrent falls in the second year after baseline. Classification and Regression Tree (CART) analysis was used to evaluate the clinical potential of significant predictors on identifying older recurrent fallers in a simulated clinical pathway. Results Fall history is better than all frailty indicators in predicting recurrent falls in men and women (Fall History: AUC: men=0.681; women=0.645; Frailty indicators: AUC≤0.641). Upon adjusting for fall history, FRAIL and SOF remained as significant predictors for women but no frailty indicator remained significant for men. FRAIL could separate older women into two groups with different proportion of recurrent fallers in those with history of recurrent falls (16.0% vs 30.8%), single fall history (9.5% vs 37.5%), and no fall history (3.8% vs 7.5%). SOF provides limited value in people with a single fall history (history of recurrent falls: 16.5% vs 20.6%; single fall history: 10.2% vs 10.9%; no fall history: 3.9% vs 8.6%). Conclusion Adding FRAIL or SOF on top of fall history improves the prediction of recurrent falls in older women but not men. FRAIL could be a useful tool for identifying community-dwelling older women at high risk of recurrent falls.
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Duthie, E., D. Simpson, J. Myers, K. Denson, and S. Denson. "Falls and Prevention of Fall Outcomes." Innovation in Aging 2, suppl_1 (2018): 361. http://dx.doi.org/10.1093/geroni/igy023.1336.
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Singh, Hardeep, Arielle Shibi Rosen, Geoff Bostick, Anita Kaiser, and Kristin E. Musselman. "Exploring the causes and impacts of falls among ambulators with spinal cord injury using photovoice: a mixed-methods study." BMJ Open 10, no. 8 (2020): e039763. http://dx.doi.org/10.1136/bmjopen-2020-039763.
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ObjectivesThis study explored: (1) fall circumstances experienced by ambulators with spinal cord injury (SCI) over a 6-month period, (2) the impacts of falls-related injuries and fall risk and (3) their preferences/recommendations for fall prevention.DesignA sequential explanatory mixed-methods design with two phases.SettingA Canadian SCI rehabilitation hospital and community setting.ParticipantsThirty-three ambulators with SCI participated in phase 1 and eight participants that fell in phase 1 participated in phase 2.MethodsIn phase 1, fall circumstances were tracked using a survey that was completed each time a participant fell during the 6-month tracking period. Phase 2 involved photovoice; participants took photographs of factors that influenced their fall risk and how their fall risk impacted their work/recreational activities. Participants discussed the photographs and topics related to fall prevention in an individual interview and a focus group.ResultsOf the 33 participants, 21 fell in 6 months. Falls commonly occurred in the home while participants were changing positions or walking. Most falls occurred in the morning or afternoon. In phase 2, interviews and focus group discussion revealed three themes: (1) falls are caused by bodily impairments (eg, impaired reactive response during slips and trips and weakness and altered sensation in legs/feet), (2) impacts of fall-related injuries and fall risk (eg, psychosocial effects of fall-related injuries, limiting community participation due to the risk of falling and activity-dependent concern of falling) and (3) approaches to fall prevention (eg, fall prevention strategies used, components of fall prevention and utility of professional fall prevention strategies/interventions).ConclusionsFall prevention interventions/strategies should focus on minimising a person’s fall risk within their home as most falls occurred in the home environment. Ambulators with SCI would benefit from education and awareness about common fall circumstances that they may encounter in their daily lives.
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Kosse, Nienke M., Maartje H. de Groot, Nicolas Vuillerme, Tibor Hortobágyi, and Claudine J. C. Lamoth. "Factors related to the high fall rate in long-term care residents with dementia." International Psychogeriatrics 27, no. 5 (2014): 803–14. http://dx.doi.org/10.1017/s104161021400249x.
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ABSTRACTBackground:Falls in long-term care residents with dementia represent a costly but unresolved safety issue. The aim of the present study was to (1) determine the incidence of falls, fall-related injuries and fall circumstances, and (2) identify the relationship between patient characteristics and fall rate in long-term care residents with dementia.Methods:Twenty long-term care residents with dementia (80 ± 11 years; 60% male) participated. Falls were recorded on a standardized form, concerning fall injuries, time and place of fall and if the fall was witnessed. Patient characteristics (66 variables) were extracted from medical records and classified into the domains: demographics, activities of daily living, mobility, cognition and behavior, vision and hearing, medical conditions and medication use. We used partial least squares (PLS) regression to determine the relationship between patient characteristics and fall rate.Results:A total of 115 falls (5.1 ± 6.7 falls/person/year) occurred over 19 months, with 85% of the residents experiencing a fall, 29% of falls had serious consequences and 28% was witnessed. A combination of impaired mobility, indicators of disinhibited behavior, diabetes, and use of analgesics, beta blockers and psycholeptics were associated with higher fall rates. In contrast, immobility, heart failure, and the inability to communicate were associated with lower fall rates.Conclusions:Falls are frequent and mostly unwitnessed events in long-term care residents with dementia, highlighting the need for more effective and individualized fall prevention. Our analytical approach determined the relationship between a high fall rate and cognitive impairment, related to disinhibited behavior, in combination with mobility disability and fall-risk-increasing-drugs (FRIDs).
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Sakurai, K., N. Yajima, and R. Yanai. "AB0242 RELATIONSHIP BETWEEN FALLS AND FALL RISK MEDICATION IN PATIENTS WITH RHEUMATOID ARTHRITIS." Annals of the Rheumatic Diseases 81, Suppl 1 (2022): 1248.3–1249. http://dx.doi.org/10.1136/annrheumdis-2022-eular.490.
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BackgroundFalls are a serious event that can lead to disability and death. The use of hypnotics, anxiolytics, and antidepressants has been reported drugs associated with higher risk of falls. Rheumatoid arthritis (RA) is associated with a high risk of falls, which is an important issue because it can lead to fractures. Patients with RA have a higher incidence of sleep disorders, depression, and anxiety disorders. They are likely to be prescribed fall risk medications.ObjectivesWe conducted a retrospective study of the incidence of falls in patients with RA, who are more prone to fractures and falls, using fall risk medications, especially hypnotics and anxiolytics, which aimed to determine the relationship between falls and fall risk medications in patients with RA.MethodsThis study is a retrospective cohort study conducted in Showa University Hospital between December 1, 2019 and March 31, 2020. We included of RA patients who visited the outpatient and fulfilled the American College of Rheumatology (ACR) /European League against Rheumatism (EULAR) classification 2010 criteria. The main exposure was the fall risk medication. The fall risk medication group was defined as RA patients who were prescribed fall risk medication (sedative/hypnotic, antidepressants, antipsychotics, and anxiolytic (benzodiazepines) drugs) for all the observational period. The comparison group was defined as RA patients who had never been prescribed any fall risk medications. Outcome measure was the prevalence of fall incidents in the past one year, obtained by using questionnaires to patients. Logistic regression analysis was performed to investigated the relationship between the prevalence of fall incidents and the use of fall-risk medications. The co-variables we selected were as follows: age, sex, stroke, dementia, diabetes and osteoarthritis as covariates.ResultsWe obtained data from 331 patients, of which 303 were included in the analysis. Among the 303 patients, the median age was 67 years (56-75), and 78.5% were women. Of the 303 patients, 45 patients used fall risk medication and 69 patients experienced at least one fall in a year. Of the 45 patients who used fall risk medication, 18 patients experienced at least one fall in a year. Of the 69 patients who experienced falls, 30 patients experienced twice or more falls in a year. Of the 18 patients who used fall risk medication and experienced falls, 9 patients experienced twice or more falls. 4 patients were admitted to the hospital as result of falls, 2 patients used fall risk medication. These results are shown as percentages in Figure 1. The group of fall risk medication was significantly higher than using non fall risk medication. (adjusted odds ratio (AOR) 2.31, 95% Confidence Interval (CI) 1.14-4.68, p=0.02).Figure 1.ConclusionUse of fall risk medications may have increased falls for patients with RA.AcknowledgementsCooperation on data collection: Division of Rheumatology, Department of Medicine, Showa University School of Medicine; Yusuke Miwa, Takeo Isozaki, Kuninobu Wakabayashi, Ryo Takahashi, Sakiko Isojima, Hidekazu Furuya, Nao Ogro, Sho Ishii, Yoko Miura, Mika Hatano, Shinichiro Nishimi, Airi Nishimi, Tomoki Hayashi, Yumeko TaniguchiDisclosure of InterestsNone declared
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Dal Bello-Haas, Vanina P. M., Megan E. O’Connell, and Jake Ursenbach. "Comparison across age groups of causes, circumstances, and consequences of falls among individuals living in Canada: A cross-sectional analysis of participants aged 45 to 85 years from the Canadian Longitudinal Study on Aging." PLOS ONE 19, no. 3 (2024): e0300026. http://dx.doi.org/10.1371/journal.pone.0300026.
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Falls are a leading cause of injury-related deaths and hospitalizations among Canadians. Falls risk has been reported to be increased in individuals who are older and with certain health conditions. It is unclear whether rurality is a risk factor for falls. This study aimed to investigate: 1) fall profiles by age group e.g., 45 to 54 years, 55 to 64 years, 65 to 74 years, 75 to 85 years; and 2) falls profiles of individuals, by age group, living in rural versus urban areas of Canada. Data (N = 51,338) from the Canadian Longitudinal Study on Aging was used to examine the relationship between falls and age, rurality, chronic conditions, need for medical attention, and fall characteristics (manner, location, injury). Self-reported falls within a twelve-month period occurred in only 4.8% (single fall) and 0.8% (multiple falls) of adults. Falls were not related to rural residence or age, but those with memory impairment, multiple sclerosis, as well as other chronic conditions such as mood disorder, anxiety disorder, and hyperthyroidism not often thought to be associated with falls, were also more likely to fall. Older individuals were more likely to fall indoors or fall while standing or walking. In contrast, middle-aged individuals were more likely to fall outdoors or while exercising. Type of injury was not associated with age, but older individuals were more likely to report hospitalization after a fall. This study shows that falls occur with a similar frequency in individuals regardless of age or urban/rural residence. Age was associated with fall location and activity. A more universally applicable multi-facted approach, rather than one solely based on older age considerations, to screening, primary prevention and management may reduce the personal, social, and economic burden of falls and fall-related injuries.
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Burns, Elizabeth, Ramakrishna Kakara, Briana Moreland, and Ankita Henry. "Changes in the Age-Adjusted Rate of Older Adults Dying From a Fall and Reporting a Fall and Fall Injury, 2012–2018." Innovation in Aging 4, Supplement_1 (2020): 774. http://dx.doi.org/10.1093/geroni/igaa057.2798.
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Abstract Falls are a leading cause of injury among older men and women (≥65 years) in the United States. Vital Statistics and Behavioral Risk Factor Surveillance System data were analyzed to determine the age-adjusted fall death rate, the rates of older adults reporting a fall and fall injury, and associated trends. The fall death rate increased 16% from 55.3/100,000 in 2012 to 64.4/100,000 in 2018 (p≤0.05). Like the rates in 2012, the rate of falls reported in 2018 was 713/1000 older adults and the rate of fall injuries reported was 171/1000 older adults. When assessing the rates of older adults reporting a fall or fall injury by sex, the rates among men increased from 2012 to 2016 from 637/1000 to 773/1000 (21% increase, p≤0.05) for falls and from 120/1000 to 153/1000 (28% increase, p≤0.05) for fall injuries. Understanding how these data change over time can inform targeted interventions to reduce falls.
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Jehu, Deborah A., Jennifer C. Davis, Kristin Velsey, Winnie Cheung, and Teresa Liu-Ambrose. "ABILITY OF THE PHYSIOLOGICAL PROFILE ASSESSMENT TO CLASSIFY FALLER TYPE: A PROSPECTIVE COHORT STUDY." Innovation in Aging 3, Supplement_1 (2019): S471. http://dx.doi.org/10.1093/geroni/igz038.1757.
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Abstract Accurately identifying older adults who will experience subsequent falls is important for the provision of secondary fall prevention. The purpose of this study was to determine the accuracy of the Physiological Profile Assessment (PPA) – a valid and reliable fall-risk assessment [1] – in predicting subsequent falls over a 12-month period in older adults who sought for medical attention after an index fall. Seven hundred thirty-seven community-dwelling adults, aged 70 years and older, who were seen at the Vancouver General Hospital Fall Prevention Clinic, completed the PPA at their initial visit. Falls over the subsequent 12 months were tracked prospectively via monthly falls calendars. All individuals received geriatric care at baseline. Binary logistic regressions were performed to determine the accuracy of classifying two prospective faller types: 1) no additional falls; 2) one or more additional fall(s). Baseline PPA, age, and sex were entered as independent variables. During the 12 month observation period, 345 participants had no additional falls (Age:81.3±6.6yrs;Female=251) and 392 fell one or more times (Age:82.3±6.5yrs;Female=230). The classification accuracy was 51.3% for those who had no additional falls and 64.8% for those with one or more additional fall(s) (Overall:58.5%;χ2=29.0;PPA:β=-0.21;Age:β=-0.01;Sex:β=-60). The PPA was not able to accurately differentiate between those who did and did not subsequently fall. Fall-risk assessment sensitivity and specificity should be improved in older adults seeking medical attention following an index fall to inform secondary fall prevention. [1] Lord SR, et al., 2003. Phys Ther.
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Cai, Yurun, Suzanne Leveille, Ling Shi, Ping Chen, and Tongjian You. "CHRONIC PAIN AND CIRCUMSTANCES OF FALLS IN COMMUNITY-LIVING OLDER ADULTS." Innovation in Aging 6, Supplement_1 (2022): 37–38. http://dx.doi.org/10.1093/geroni/igac059.143.
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Abstract Chronic pain is a risk factor contributing to mobility impairment and falls in older adults. Little is known about the patterns of fall circumstances among older adults with pain. This prospective cohort study described frequencies of fall circumstances (i.e., location, activities, and self-reported causes of falls) and examined the relationship between chronic pain and fall circumstances among 765 community-dwelling older adults (mean age=78.1, 63.9% women) in the MOBILIZE Boston Study. Pain severity, fall occurrence, and fall circumstances were recorded using monthly calendar postcards and fall follow-up interviews during a 4-year follow-up. Descriptive analyses summarized frequencies of fall circumstances. Generalized estimating equation (GEE) models examined the relation between monthly pain ratings and circumstances of the first fall in the subsequent month. Among 1,829 falls, 965 (52.8%) falls occurred indoors and 804 (44.0%) falls occurred outdoors, 60 (3.2%) falls with missing location information. Commonly reported activities and causes of falls were walking (915, 50.0%), slips/trips (943, 51.6%), and inappropriate footwear (444, 24.3%). GEE models suggested that compared to fallers without pain, fallers with moderate-to-severe pain had around twice the likelihood of reporting indoor falls (adj.OR=1.93, 95%CI:1.32-2.83), falls in living/dining rooms (adj.OR=2.06, 95%CI:1.27-3.36), and falls due to health problems (adj.OR=2.08, 95%CI:1.16-3.74) or feeling dizzy/faint (adj.OR=2.10, 95%CI:1.08-4.11), but they were less likely to report falls while going down stairs (adj.OR=0.48, 95%CI:0.27-0.87) or falls due to slips/trips (adj.OR=0.67, 95%CI:0.47-0.95) in the subsequent month. Future studies may investigate whether better pain management and tailored fall prevention in elders with chronic pain could lead to fewer falls.
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Wang, Ying, Mengyao Jiang, Mei He, and Meijie Du. "Design and Implementation of an Inpatient Fall Risk Management Information System." JMIR Medical Informatics 12 (January 2, 2024): e46501. http://dx.doi.org/10.2196/46501.
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Background Falls had been identified as one of the nursing-sensitive indicators for nursing care in hospitals. With technological progress, health information systems make it possible for health care professionals to manage patient care better. However, there is a dearth of research on health information systems used to manage inpatient falls. Objective This study aimed to design and implement a novel hospital-based fall risk management information system (FRMIS) to prevent inpatient falls and improve nursing quality. Methods This implementation was conducted at a large academic medical center in central China. We established a nurse-led multidisciplinary fall prevention team in January 2016. The hospital’s fall risk management problems were summarized by interviewing fall-related stakeholders, observing fall prevention workflow and post–fall care process, and investigating patients' satisfaction. The FRMIS was developed using an iterative design process, involving collaboration among health care professionals, software developers, and system architects. We used process indicators and outcome indicators to evaluate the implementation effect. Results The FRMIS includes a fall risk assessment platform, a fall risk warning platform, a fall preventive strategies platform, fall incident reporting, and a tracking improvement platform. Since the implementation of the FRMIS, the inpatient fall rate was significantly lower than that before implementation (P<.05). In addition, the percentage of major fall-related injuries was significantly lower than that before implementation. The implementation rate of fall-related process indicators and the reporting rate of high risk of falls were significantly different before and after system implementation (P<.05). Conclusions The FRMIS provides support to nursing staff in preventing falls among hospitalized patients while facilitating process control for nursing managers.
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Buckner, Tekekee, and Daisy Sherry. "Improving falls in nursing homes: a post-fall huddle quality improvement project." International Journal of Advanced Nursing Studies 8, no. 2 (2019): 33. http://dx.doi.org/10.14419/ijans.v8i2.27533.
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Falls are one of the most common preventable health problems in adults 65 years and older (AHRQ, 2013). A fall in this population can have a devastating effect often leading to a significant change in morbidity or death. Adults in assisting living, nursing homes, and skilled facilities (SNF) have an increased risk of falling and having a subsequent fall due to an acute illness, weakness, or confusion. This makes individualizing a plan of care to prevent a secondary fall and identifying the root cause of falls within a facility imperative.In our agency, the fall rate is nearly triple that of the national benchmark. To address this problem, a Post-Fall Huddle project was implemented. The literature recommends and supports the practice of a post-fall assessment program in fall reduction to identify intrinsic and extrinsic fall risk etiologies. There was found to be a reduction in the absolute values of recurrent patient falls per quarterly reporting after the implementation of the post-fall huddle. The results also provided pertinent data that can be used for recommendations in future fall prevention for the SNF
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Ng, Cheah Ping, Devinder Kaur Ajit Singh, Maw Pin Tan, and Saravana Kumar. "127 Older Adults' Knowledge and Perceptions of Falls: A Mixed Methods Study." Age and Ageing 48, Supplement_4 (2019): iv28—iv33. http://dx.doi.org/10.1093/ageing/afz164.127.
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Abstract Introduction Falls is a global issue due to its devastating consequences and costs associated with fall injuries in older adults. There is limited information regarding knowledge and perceptions about falls among older individuals in Malaysia. The aim of this study was to assess knowledge and perceptions of falls among older adults. Methods A total of twenty-five (n=25) community dwelling older adults were invited to participate in this study (age range 61-83, median=73). Focus group discussions were conducted to explore older adults’ perceptions on falls, while the Fall Risk Assessment Questionnaire (FRAQ) was used to assess their knowledge on falls. Results Three themes emerged from the qualitative data, which were ‘Ageing and its association with falls’, ‘Reactions to a fall’ and ‘Knowledge of fall interventions’. The quantitative results showed that more than half of the participants considered themselves at the risk of falls (n=15, 60%). Older adults had better knowledge on behavioral and environmental (percentage of errors: 19.4%; 35.2%) compared to medical and medication related fall risk factors (percentage of errors: 55.2%; 57.33%). Discussion Older adults had both positive and negative views on ageing and falls. Some of the fall prevention strategies highlighted were in line with evidence-based recommendations. However, majority exhibit fall prevention behaviors that were largely based on their personal experiences. Older adults lacked the knowledge on medical related fall risk factors as these require understanding of various medical conditions and the related medications. Conclusion Education intervention emphasizing on ageing, medical and medication related fall risk factors should now be evaluated.
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Zhou, Yuanjin, Clara Berridge, Nancy Hooyman, and Elizabeth Phelan. "CARE PARTNERS’ ENGAGEMENT IN PREVENTING FALLS FOR COMMUNITY-DWELLING OLDER PEOPLE WITH DEMENTIA." Innovation in Aging 7, Supplement_1 (2023): 87. http://dx.doi.org/10.1093/geroni/igad104.0280.
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Abstract Care partners adopt various behaviors to manage fall risk for community-dwelling older people with dementia (cd-OPWD). It is unknown if these behaviors reduce falls for cd-OPWD at different levels of fall risk. We linked the data from the 2015 and 2016 National Health and Aging Trends Study (NHATS) and the 2015 National Study of Caregiving (NSOC) (cd-OPWD n=365, 89% aged 75+) to explore this question. The outcome was no fall, one fall, and multiple falls in 2016. We used the same variable in 2015 to indicate fall risk at baseline. We identified 28 items from NSOC to represent dementia care partners’ fall risk management (FRM) behaviors based on existing literature and expert review. Using exploratory factor analysis, we identified five categories of FRM behaviors: mobility and safety assistance, health management, accommodations, medical services coordination, and social services coordination. We performed multinomial logistic regression to investigate associations between care partners’ FRM behaviors in 2015 and cd-OPWD’ falls in 2016 stratified by cd-OPWD’s history of falls in 2015, adjusting for selected covariates. For cd-OPWD who had no fall in 2015, mobility and safety assistance was associated with a higher risk of having one fall in 2016; for those who had one fall in 2015, medical services coordination was associated with a lower risk of multiple falls; for those who had multiple falls in 2015, social services coordination was associated with a lower risk of multiple falls. Future research may target care partners’ different FRM behaviors based on cd-OPWD’s history of falls.
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Dessy, Vivi Armany, Harmayetty Harmayetty, and Ika Yuni Widyawati. "Elderly Fall Risk Assessment (Elderly) Scale using Hendrich Falls Fall and Morse Scale." Jurnal Ners 8, no. 1 (2017): 107–17. http://dx.doi.org/10.20473/jn.v8i1.3885.
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Introduction: Incidence of falls in elderly become a serious problem for patients hospitalised with limited activity. There was now the patients instruments to measure risk of fall for elderly patients. The aimed of the study was to examine the differences of risk fall to the elderly by using instrument Hendrich Falls Scale (HFS) and Morse Falls Scale (MFS).Methods: A comparative-longitudinal design was used in this study. The population were elderly patients in the treatment room D2 and D3 Adi Husada’s Hospital. There were 20 elderlys as a respondents which taken by using purposive sampling technique. Dependent variable was the value of measuring the risk of falling and independent variable was the instrument of HFS and MFS. Data were analyzed by using Wilcoxon Signed Rank Test with significance level α≤0.05.Result: The results showed that HFS’s instrument compared with MFS in the fi rst day are equally sensitive on the presented 100%, second day: 80%, third day: 31.3%, fourth day: 20%. HFS specificity of MFS on first day compared only 64% than MFS was 100%. The statistical results tests on the both scale of assessment indicated that there were differences the value on first day p=0.180, second day p=0.58, third and fourth day p=0.001.Conclusion: The use of MFS was more sensitive than HSF for detection of elderly patients with falling risk. The conclution of this results MFS’s instrument was more sensitive to assess elderly with risk of fall because MFS,s points more detailed assessment. It is recommended that elderly patients with falling risk need to assess by using MFS. Further research to focus on the risk of fall assessment using HFS and MFS categories.
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Lee, Justin, Ahmed Negm, Ryan Peters, Eric K. C. Wong, and Anne Holbrook. "Deprescribing fall-risk increasing drugs (FRIDs) for the prevention of falls and fall-related complications: a systematic review and meta-analysis." BMJ Open 11, no. 2 (2021): e035978. http://dx.doi.org/10.1136/bmjopen-2019-035978.
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ObjectivesPrevention of falls and fall-related injuries is a priority due to the substantial health and financial burden of falls on patients and healthcare systems. Deprescribing medications known as ‘fall-risk increasing drugs’ (FRIDs) is a common strategy to prevent falls. We conducted a systematic review to determine its efficacy for the prevention of falls and fall-related complications.DesignSystematic review and meta-analysis.Data sourcesMEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL and grey literature from inception to 1 August 2020.Eligibility criteria for selecting studiesRandomised controlled trials of FRID withdrawal compared with usual care evaluating the rate of falls, incidence of falls, fall-related injuries, fall-related fractures, fall-related hospitalisations or adverse effects related to the intervention in adults aged ≥65 years.Data extraction and synthesisTwo reviewers independently performed citation screening, data abstraction, risk of bias assessment and certainty of evidence grading. Random-effects models were used for meta-analyses.ResultsFive trials involving 1305 participants met eligibility criteria. Deprescribing FRIDs did not change the rate of falls (rate ratio (RaR) 0.98, 95% CI 0.63 to 1.51), the incidence of falls (risk difference 0.01, 95% CI −0.06 to 0.09; relative risk 1.04, 95% CI 0.86 to 1.26) or rate of fall-related injuries (RaR 0.89, 95% CI 0.57 to 1.39) over a follow-up period of 6–12 months. No trials evaluated the impact of deprescribing FRIDs on fall-related fractures or hospitalisations.ConclusionThere is a paucity of robust high-quality evidence to support or refute that a FRID deprescribing strategy alone is effective at preventing falls or fall-related injury in older adults. Although there may be other reasons to deprescribe FRIDs, our systematic review found that it may result in little to no difference in the rate or risk of falls as a sole falls reduction strategy.PROSPERO registration numberCRD42016040203.
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Vivrette, Rebecca L., Laurence Z. Rubenstein, Jennifer L. Martin, Karen R. Josephson, and B. Josea Kramer. "Development of a Fall-Risk Self-Assessment for Community-Dwelling Seniors." Journal of Aging and Physical Activity 19, no. 1 (2011): 16–29. http://dx.doi.org/10.1123/japa.19.1.16.
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Objective:To determine seniors’ beliefs about falls and design a fall-risk self-assessment and educational materials to promote early identification of evidence-based fall risks and encourage prevention behaviors.Methods:Focus groups with community-dwelling seniors, conducted in two phases to identify perceptions about fall risks and risk reduction and to assess face validity of the fall-risk self-assessment and acceptability of educational materials.Results:Lay perception of fall risks was in general concordance with evidence-based research. Maintaining independence and positive tone were perceived as key motivators for fall prevention. Seniors intended to use information in the educational tool to stimulate discussions about falls with health care providers.Implications:An evidence-based, educational fall-risk self-assessment acceptable to older adults can build on existing lay knowledge about fall risks and perception that falls are a relevant problem and can educate seniors about their specific risks and how to minimize them.
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Mark, Janice A. "HOW TO STEADI YOUR PATIENTS WITH THE COORDINATED CARE PLAN TO PREVENT OLDER ADULT FALLS AND EVALUATION GUIDE." Innovation in Aging 3, Supplement_1 (2019): S857—S858. http://dx.doi.org/10.1093/geroni/igz038.3152.
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Abstract Falls are common, costly, and the leading cause of fatal and nonfatal injuries for older Americans. Reports show that fall death rates are increasing. Healthcare providers play an important role in fall prevention but few talk to their patients about falls. This lack of communication demonstrates the need for more physician-initiated fall prevention. The Centers for Disease Control and Prevention (CDC) created the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) initiative to help providers talk to their patients about falls. Specifically, CDC’s new STEADI-based fall prevention program, the Coordinated Care Plan to Prevent Older Adult Falls (CCP) and Evaluation Guide for Older Adult Clinical Fall Prevention Programs can assist healthcare providers in integrating and evaluating new fall prevention programs that screen older adults for fall risk, assess patients’ modifiable fall risk factors, and implement evidenced-based fall prevention interventions (e.g., medication management, physical therapy). The CCP offers guidance for incorporating a STEADI-based fall prevention program including how to engage leadership, integrate with existing clinic workflow and electronic health records, and strategies on how to obtain reimbursement for fall prevention. The Evaluation Plan offers details on how to engage stakeholders, collect data, interpret findings and how to share results for maximum impact. Both documents were based on lessons learned from successful implementation of STEADI-based programs in primary care. A STEADI-based program in New York found fewer fall-related hospitalizations among at-risk patients who received a fall prevention care plan compared to at-risk patients who did not receive a care plan.
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Kelekar, Uma, Debasree Das Gupta, Jewel Shepherd, and Anupam Sule. "Risk Factors of Fall-Related Emergency Department Visits by Fall Location of Older Adults in the US." Western Journal of Emergency Medicine 22, no. 4 (2021): 988–99. http://dx.doi.org/10.5811/westjem.2021.2.49307.
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Introduction: Prior evidence indicates that predictors of older adult falls vary by indoor-outdoor location of the falls. While a subset of United States’ studies reports this finding using primary data from a single geographic area, other secondary analyses of falls across the country do not distinguish between the two fall locations. Consequently, evidence at the national level on risk factors specific to indoor vs outdoor falls is lacking. Methods: Using the 2017 Nationwide Emergency Department Sample (NEDS) data, we conducted a multivariable analysis of fall-related emergency department (ED) visits disaggregated by indoor vs outdoor fall locations of adults 65 years and older (N = 6,720,937) in the US. Results: Results are compatible with findings from previous primary studies. While women (relative risk [RR] = 1.43, 95% confidence interval [CI], 1.42-1.44) were more likely to report indoor falls, men were more likely to present with an outdoor fall. Visits for indoor falls were highest among those 85 years and older (RR = 2.35, 95% CI, 2.33-2.37) with outdoor fall visits highest among those 84 years and younger. Additionally, the probabilities associated with an indoor fall in the presence of chronic conditions were consistently much higher when compared to an outdoor fall. We also found that residence in metropolitan areas increased the likelihood of an indoor elderly fall compared to higher outdoor fall visits from seniors in non-core rural areas, but both indoor and outdoor fall visits were higher among older adults in higher income ZIP codes. Conclusion: Our findings highlight the contrasting risk profile for elderly ED patients who report indoor vs outdoor falls when compared to the elderly reporting no falls. In conjunction, we highlight implications from three perspectives: a population health standpoint for EDs working with their primary care and community care colleagues; an ED administrative vantage point; and from an individual emergency clinician’s point of view.
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Adam, Claire E., Annette L. Fitzpatrick, Cindy S. Leary, Sindana D. Ilango, Elizabeth A. Phelan, and Erin O. Semmens. "The impact of falls on activities of daily living in older adults: A retrospective cohort analysis." PLOS ONE 19, no. 1 (2024): e0294017. http://dx.doi.org/10.1371/journal.pone.0294017.
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Background Falls contribute to impairments in activities of daily living (ADLs), resulting in significant declines in the quality of life, safety, and functioning of older adults. Understanding the magnitude and duration of the effect of falls on ADLs, as well as identifying the characteristics of older adults more likely to have post-fall ADL impairment is critical to inform fall prevention and post-fall intervention. The purpose of this study is to 1) Quantify the association between falls and post-fall ADL impairment and 2) Model trajectories of ADL impairment pre- and post-fall to estimate the long-term impact of falls and identify characteristics of older adults most likely to have impairment. Method Study participants were from the Ginkgo Evaluation of Memory Study, a randomized controlled trial in older adults (age 75+) in the United States. Self-reported incident falls and ADL scores were ascertained every 6 months over a 7-year study period. We used Cox proportional hazards analyses (n = 2091) to quantify the association between falls and ADL impairment and latent class trajectory modeling (n = 748) to visualize trajectories of ADL impairment pre-and post-fall. Results Falls reported in the previous 6 months were associated with impairment in ADLs (HR: 1.42; 95% CI 1.32, 1.52) in fully adjusted models. Based on trajectory modeling (n = 748), 19% (n = 139) of participants had increased, persistent ADL impairment after falling. Participants who were female, lived in a neighborhood with higher deprivation, or experienced polypharmacy were more likely to have ADL impairment post-fall. Conclusions Falls are associated with increased ADL impairment, and this impairment can persist over time. It is crucial that all older adults, and particularly those at higher risk of post-fall ADL impairment have access to comprehensive fall risk assessment and evidence-based fall prevention interventions, to help mitigate the negative impacts on ADL function.
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Tarbert, Rebecca J. "Multi-Factorial Management of Fall Risk in the Home Setting With Use of Innovative Technology: A Case Study." International Journal of Studies in Nursing 5, no. 4 (2020): 12. http://dx.doi.org/10.20849/ijsn.v5i4.830.
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Fall risk and fall injury risk are a raising concern for older adults living in the home and community environment. Injuries from falls account for reduced independence in the form of limitations of performance of activities of daily living, significant dependency for ambulation and For up to 50% of those who suffer a hip fracture from a fall, will not be able to return to their prior level of living. Serious fall injuries create a necessity to move into a setting where increased levels of care are provided. The ability to remain in the most desired setting of their own home is a critical part of successfully aging in place. According to the Centers of Disease Control, 36 million older adults in the United States suffered a fall in 2018 with 8 million reported injuries. With the expansion of the older adult population, these numbers are anticipated to inflate up to 52 million falls with 12 million reported fall injuries by the year 2030. Several countries have adopted fall risk mitigation programs for fall risk identification in primary care and community provision of fall management strategies. Traditional methods of fall risk management follow the American Geriatrics Society’s and British Geriatrics Society’s Clinical Practice Guideline. Though great strides are taken to intervene on the modifiable risk factors for falls, the risk of falls for many individuals remains. Introduction of new and innovative technologies can offer increased safety and ability to participate in functional mobility for those most at risk of falls and fall injuries.
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Bisson, Etienne J., Elizabeth W. Peterson, and Marcia Finlayson. "Frequency of and Factors Associated with a Proxy for Critical Falls Among People Aging with Multiple Sclerosis." International Journal of MS Care 19, no. 2 (2017): 59–65. http://dx.doi.org/10.7224/1537-2073.2015-053.
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Background: Critical falls, defined in the literature as involving an inability to get up after the fall, have been associated with morbidity and mortality in older adults but have not been examined in people with multiple sclerosis (MS). To highlight the importance of the critical fall concept in MS, this exploratory study sought to identify the frequency of and factors associated with a proxy for critical falls in people with MS. Methods: Of 354 adults with MS 55 years and older interviewed, 327 reported a story about their most recent fall that included information about fall-related experiences, including whether they received help to get up after a fall. We used this information as a proxy for critical falls in a logistic regression analysis. Results: A total of 177 individuals (54.1%) received help to get up after their most recent fall. Logistic regression analysis revealed six factors associated with this proxy for critical falls: fall leading to a fracture (OR = 4.21), leg weakness (OR = 3.12), living with others (OR = 2.48), female sex (OR = 1.96), balance or mobility problems (OR = 1.90), and longer disease duration (OR = 1.04). Conclusions: Receiving help after a fall is common for people aging with MS, suggesting that critical falls need to be further studied. Findings support the need for fall management education that includes action planning for proper assistance and balance and strength training to increase the ability to get up safely after a fall.
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Farup, Per G., Knut Hestad, and Knut Engedal. "Predictors of Fall-Related Injuries in Fallers—A Study in Persons with Cognitive Impairment." Geriatrics 10, no. 3 (2025): 74. https://doi.org/10.3390/geriatrics10030074.
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Background/Objectives: Old age and cognitive impairment/dementia are risk factors for falling and fall-related injuries. We have, in a previous study in persons with cognitive impairment, shown that falls were associated with frailty, reduced physical fitness, and cognitive reduction. Falls were independent of the disorders causing the impaired functions. Because most falls are innocent, knowledge of predictors of fall-related injuries seems more clinically relevant than the predictors of falls. Predictors of falls and fall-related injuries are not necessarily identical. The aim of this follow-up study to our previous one in the same population was to explore predictors of fall-related injuries in fallers and compare these predictors with those of falls. Methods: This study and our previous study used data from the “The Norwegian Registry of Persons Assessed for Cognitive Symptoms” (NorCog), a Norwegian research and quality registry with a biobank. The registry included consecutive home-dwelling persons referred to Norwegian specialist healthcare units for assessment of cognitive decline. This study included 3774 persons from our previous study who experienced falls last year and compared persons with and without a fall-related injury. A fall-related injury was defined as admittance to a hospital for the injury. Results: The annual incidence of fall-related injuries in the fallers was 884/3774 (23.4%). Female sex, older age, lower BMI, in need of public health service and walking assistance, and low Hb and Ca were independent predictors of fall-related injuries, indicating reduced physical fitness and state of health and a high burden of comorbidity. Injuries were not associated with the degree of cognitive impairment or the dementia diagnosis. Conclusions: In home-dwelling persons with impaired cognitive functions and falls, fall-related injuries were associated with reduced physical fitness and state of health. In contrast to predictors of falls, neither the degree of cognitive impairment nor the dementia diagnosis was associated with fall-related injuries. The difference is comprehensible. Persons with cognitive impairment or dementia might have reduced power of judgment and be inattentive, unconcerned and careless, which increases the fall incidence but not the risk of injury once falling. Prevention of fall-related injuries should focus on relieving comorbidities, improving physical fitness and general health rather than on cognitive improvement.
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Low, Chin Yeong, Marhanis Salihah Omar, Hazlina Mahadzir, and Mei Kuen Yin. "141 Fall-Risk Increasing Drugs use in Elderly with Fall-Related Fractures." Age and Ageing 48, Supplement_4 (2019): iv34—iv39. http://dx.doi.org/10.1093/ageing/afz164.141.
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Abstract Introduction Elderly populations are at the highest risk of fatal falls and fracture is one of the fall-related injuries which results in high morbidity and mortality. A group of drugs have been identified as the fall risk increasing drugs (FRIDs) and listed as one of the modifiable extrinsic risk factors for falls. This study aimed to determine the use of FRIDs in fall-related fractures among elderly patients. Method Patients aged 65 years and above admitted to a tertiary teaching hospital due to falls were included. Falls were identified through a case-mix system using the ICD-10 codes of W01 and W18 (fall at the same level). Patient medical records were reviewed retrospectively and drugs use before the falls were analysed. Results Among the patients included (n=124), majority of them had fall-related fractures (83.1%) and hip fractures were among the highest type of fractures (67%). The older old (≥ 80 years) had recorded a significant higher incidence of hip fractures compared to the younger individuals (p=0.009). About 75% of the patients with fall-related fractures had recorded use of at least one FRID before the admission. The younger individuals had significantly higher use of FRIDs compared to the older old, particularly the anti-hypertensive drugs (p=0.017). Most of them (&gt;80%) still received FRIDs at discharge and deprescribing was commenced in less than one quarter of the patients. Furthermore, 32.6% of them had either an addition of new FRIDs or increased of the FRIDs dose at discharge. Conclusion In conclusion, fracture was the major reason of admissions among the elderly with falls. The older old recorded higher incidence of fall-related hip fractures. There was high usage of FRIDs before and after fall-related fractures. Deprescribing was not widely practiced in the elderly after the fall incidence.
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Alsaad, Saad Mohammad, Mshari Alabdulwahed, Nabeel Mohammed Rabea, Shabana Tharkar, and Abdulaziz A. Alodhayani. "Knowledge, Attitudes, and Practices of Nurses toward Risk Factors and Prevention of Falls in Older Adult Patients in a Large-Sized Tertiary Care Setting." Healthcare 12, no. 4 (2024): 472. http://dx.doi.org/10.3390/healthcare12040472.
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The objective was to assess the knowledge, attitudes, and practices of nurses toward the prevention of falls in older hospitalized patients. A cross-sectional study employing a 54-item questionnaire was conducted on 370 nurses at a tertiary care referral center. The mean age of the study population was 36.3 ± 7.7 years, with the majority being females (282; 76.8%). Most of them had attended fall prevention training (335; 90.5%). More than 98% knew fall prevention policies and safety goals, according to their response to a fall and risk assessment, but were less aware of the risk factors of falls, such as recurrent falls (61%), depression (44%), and lower-extremity numbness (40.5%). Similarly, 99% had positive attitudes toward risk assessment, fall prevention intervention, and response to a fall. Around 55% thought they were responsible for patients’ falls, and 96% felt the need to undergo more training on fall prevention. Furthermore, 92% strictly followed fall prevention policies and 85.4% followed the color-coding system for high-risk patients. Despite the preventive measures in place, 33% encountered patient falls, and 82.2% experienced unwitnessed patient fall incidents in their units. Although the nurses had higher levels of knowledge about the policies, they lacked information on the risk factors. There is a significant scope that warrants great attention concerning the adherence to guidelines and the provision of fall prevention training programs, with a focus on the intrinsic causative factors of falls.
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Lim, Myeong Jun, Jin Ho Cho, Young Sun Cho, and Tae Seong Kim. "Directional Human Fall Recognition Using a Pair of Accelerometer and Gyroscope Sensors." Applied Mechanics and Materials 135-136 (October 2011): 449–54. http://dx.doi.org/10.4028/www.scientific.net/amm.135-136.449.
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Human fall in the elderly population is one of the major causes of injury or bone fracture: it can be a cause of various injuries (e.g., fracture, concussion, and joint inflammation). It also could be a possible cause of death in a severe case. To detect human fall, various fall detection algorithms have been devised. Most fall detection algorithms rely on signals from a single accelerometer or gyroscope and use a threshold-based method to detect the human fall. However, these algorithms need careful adjustment of a threshold for each subject and cannot detect the direction of falls. In this study, we propose a novel fall recognition algorithm using a pair of a tri-axial accelerometer and a tri-axial gyroscope. Our fall recognition algorithm utilizes a set of augmented features including autoregressive (AR) modeling coefficients of signals, signal magnitude area (SMA), and gradients of angles from the sensors. After Linear Discriminant Analysis (LDA) of the augmented features, an Artificial Neural Nets (ANNs) is utilized to recognize four directional human falls: namely forward fall, backward fall, right-side fall, and left-side fall. Our recognition results show the mean recognition rate of 95.8%. Our proposed fall recognition technique should be useful in the investigation of fall-related injuries and possibly in the prevention of falls for the elderly.
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Krauss, Melissa J., Sheila L. Nguyen, Wm Claiborne Dunagan, et al. "Circumstances of Patient Falls and Injuries In 9 Hospitals In a Midwestern Healthcare System." Infection Control & Hospital Epidemiology 28, no. 05 (2007): 544–50. http://dx.doi.org/10.1086/513725.
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Objective.Preventing hospital falls and injuries requires knowledge of fall and injury circumstances. Our objectives were to determine whether reported fall circumstances differ among hospitals and to identify predictors of fall-related injury.Design.Retrospective cohort study. Adverse event data on falls were compared according to hospital characteristics. Logistic regression was used to determine adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for risk factors for fall-related injury.Setting.Nine hospitals in a Midwestern healthcare system.Patients.Inpatients who fell during 2001-2003.Results.The 9 hospitals reported 8,974 falls that occurred in patient care areas, involving 7,082 patients; 7,082 falls were included in our analysis. Assisted falls (which accounted for 13.3% of falls in the academic hospital and 9.8% of falls in the nonacademic hospitals;P&lt;.001) and serious fall-related injuries (which accounted for 3.7% of fall-related injuries in the academic hospital and 2.2% of fall-related injuries in the nonacademic hospitals;P&lt;.001) differed by hospital type. In multivariate analysis for the academic hospital, increased age (aOR, 1.006 [95% CI, 1.000-1.012]), falls in locations other than patient rooms (aOR, 1.53 [95% CI, 1.03-2.27]), and unassisted falls (aOR, 1.70 [95% CI, 1.23-2.36]) were associated with increased injury risk. Altered mental status was associated with a decreased injury risk (aOR, 0.72 [95% CI, 0.58-0.89]). In multivariate analysis for the nonacademic hospitals, increased age (aOR, 1.007 [95% CI, 1.002-1.013]), falls in the bathroom (aOR, 1.46 [95% CI, 1.06-2.01]), and unassisted falls (aOR, 1.83 [95% CI, 1.37-2.43]) were associated with injury. Female sex (aOR, 0.83 [95% CI, 0.71-0.97]) was associated with a decreased risk of injury.Conclusion.Some fall characteristics differed by hospital type. Further research is necessary to determine whether differences reflect true differences or merely differences in reporting practices. Fall prevention programs should target falls involving older patients, unassisted falls, and falls that occur in the patient's bathroom and in patient care areas outside of the patient's room to reduce injuries.
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Jeon, Gye Rok, Young Jae Kim, Ah Young Jeon, et al. "Effective Falls Detection Method Using Two Tri-Axial Accelerometers." Advanced Materials Research 647 (January 2013): 854–60. http://dx.doi.org/10.4028/www.scientific.net/amr.647.854.
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Falls detection systems have been developed in recent years because falls are detrimental events that can have a devastating effect on health of the elderly population. Current fall detecting methods mainly employ accelerometer to discriminate falls from activities of daily living (ADL). However, this makes it difficult to distinguish real falls from certain fall-like activities such as jogging and jumping. In this paper, an accurate fall detection system was implemented using two tri-axial accelerometers. By attaching the accelerometers on the chest and the abdomen, our system can effectively differentiate between falls and non-fall events.The Diff_Z and Sum_diff_Z parameter resulted in falls detection rate of 100%, respectively.
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Alexander, Bradley, Benjamin B. Cage, Elise M. Greco, et al. "Incidence and Risk Factors of Preoperative and Postoperative Falls for Patients with Chronic Foot Pathologies: An Institutional Prospective Study." Foot & Ankle Orthopaedics 5, no. 4 (2020): 2473011420S0009. http://dx.doi.org/10.1177/2473011420s00099.
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Category: Other; Hindfoot; Lesser Toes; Midfoot/Forefoot Introduction/Purpose: Individuals with chronic foot pathologies often have an increased fall risk due to decreased power, deformity, or neuropathy. If patients do fall they can suffer injuries leading to emergency room visits, hospital admission, and surgery. Additionally, falls can increase the severity of their existing condition. This leads to an increase cost burden on the healthcare field and can ultimately decrease the quality of life for the patient. It is important to identify which foot pathologies are associated with the highest fall risk preoperatively and postoperatively. This study analyzes preoperative and postoperative fall data for patients with a variety of common forefoot, midfoot, and hindfoot pathologies. Methods: Over the course of 2019 70 patients had preoperative and 2-week and 6-week postoperative fall data collected in clinic prior to and after surgery. These patients were subdivided into three cohorts based on the location of foot pathology. This included 25 patients for forefoot, 20 patients for midfoot and 20 patients for hindfoot. We had patients complete several surveys that pertained to previous fall history, fall risks, fall history after surgery, current medical status, and use of an assistant device. The John’s Hopkins Fall Risk Assessment tool and the survey pertaining to fall risk from the national council on aging were validated surveys that were completed. Results: Patients that suffered from a hindfoot pathology had the highest risk of suffering a fall preoperatively. Of the 25 patients in the hindfoot cohort 36% experienced at least one fall in the 12 months prior to surgery. Patients with forefoot and hindfoot pathologies experienced the most falls prior to surgery (0.64 and 0.60 respectively). Postoperatively patients with midfoot pathologies had the highest frequency of falls with 35% experiencing at least one fall within the 2-week period after surgery. The midfoot cohort also experience the most falls postoperatively averaging 0.50 falls. Preoperatively all patients completed a John’s Hopkins fall risk assessment and the scores for forefoot midfoot and hindfoot were 6.32, 4.70, 6.96 respectively. With a score of over 6 indicating moderate fall risk. Conclusion: This information can help to identify which patients undergoing surgery for chronic foot pathologies are at the highest risk for preoperative and postoperative falls. Our study suggests that individuals with hindfoot pathologies are at greatest risk for preoperative falls and patients with midfoot pathologies have the greatest risk for postoperative falls. This study can help to guide patient management and decrease fall risk by understanding which patients are most susceptible. We are currently undertaking a prospective study looking at how preoperative mobility device training can reduce postoperative fall risk. [Table: see text]
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Jurišković, Mladen, and Martina Smrekar. "An Overview of Fall Prevention Strategies Among Adult Patients in Hospital Settings." Croatian nursing journal 4, no. 2 (2020): 205–17. http://dx.doi.org/10.24141/2/4/2/7.
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Falls present a major challenge for health care systems: they correlate with poor patient outcomes, extend the length of hospitalization, and increase overall medical expenditure. According to existing literature, risk factors for the occurrence of falls include the male gender, urinary incontinence, muscle weakness, agitation or confusion, and dementia. Studies have shown that the combined practice of identifying risk factors and implementing appropriate fall prevention interventions leads to a reduction in the incidence of falls among hospital patients. As the largest group of health professionals committed to providing high-quality care, nurses play an important role in preventing falls among patient populations. In order to prevent falls and maintain patient safety, it is important to identify the most effective strategies for fall prevention. This study presents an overview of previously published strategies and intervention practices on fall prevention in hospital settings around the world. The most common interventions include fall risk assessment, environment/equipment modifications, patient education/family education on fall prevention interventions, staff education on fall reporting and fall prevention, fall risk alerts, medication management, physical fitness of patients, assistance with transfer and toileting and effective team communication and leadership. Ultimately, it is incumbent upon nurses, other health-care professionals and the entire hospital system to develop effective strategies in order to prevent falls among hospitalised patients.
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Kim, Mi Hyun, Chang Hee Go, Jung Min Lee, Ji-Young Kang, and Jae-Young Lim. "53 The Development and Education of Fall Prevention Program Through the Multidisciplinary Approach." Age and Ageing 48, Supplement_4 (2019): iv13—iv17. http://dx.doi.org/10.1093/ageing/afz164.53.
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Abstract Introduction To reduce the rate of falls in the rehabilitation ward, fall prevention program was developed and educated for physical and occupational therapists, which increased the attitude towards falls and knowledge towards fall prevention activities. Method Participants of this study include 17 therapists currently employed at a university-affiliated hospital located in Gyeongg-do, South Korea. Systematic protocol for fall prevention with the emphasis in the roles of rehabilitation teams was developed. This standardized protocol consists of educating therapists with adequate assistive device use, safe ambulation techniques, and client-centered transfer techniques. The therapists then record the paitent's status related to fall prevention and or risks, which is then shared with other medical professionals including registered nurses and medical doctors. Paper-based questionnaires regarding 9 questions on attitude towards falls and 12 questions on knowledge towards fall prevention activities were done by the participants after the education of systematic protocol. The rate of falls was then compared with the change of attitudes in participants. Rate of falls was calculated by dividing the number of fall by the patient bed days and multiplying by 1000. Result After the education of fall prevention program, the mean score of attitude towards falls significantly increased (t=-3.99, p=0.001). The mean score of knowledge towards fall prevention activities significantly increased (t=-4.79, p&lt;0.001). The rate of falls decreased from 4.2 to 1.4. The effectiveness of systematic protocol regarding therapists' change in attitude and the resulting change in rate of falls was mainly seen in patients' ward. The decline in rate of falls was observed when patients transferred from bed to wheelchair. Conclusion In order to effectively convey the fall prevention education program, the multidisciplinary approach showed promising results in this study. Implications for future research include translation of this program to the community, such as long term care facility.
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Karthigayan, Aruna, Noor Azleen Ahmad Tarmizi, Elizabeth Gar Mit Chong, Rizah Mazzuin, Weng Keong Yau, and Fatt Soon Lee. "13 Characteristics, Circumstances, and Clinical Outcomes of Inpatient Falls in the Medical Department, Hospital Kuala Lumpur (HKL)." Age and Ageing 48, Supplement_4 (2019): iv4—iv5. http://dx.doi.org/10.1093/ageing/afz164.13.
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Abstract Introduction Falls among hospital inpatients are common, generally ranging from 2.3 to 7 falls per 1000 patient bed days1. Around 30% of falls as inpatient are injurious2. Falls are associated with a longer length of stay in hospital and greater utilization of healthcare facilities3. Objective The goal of this study is to describe patient characteristics, circumstances of fall and clinical outcomes after inpatient fall Methodology This is a retrospective, descriptive study of all patients admitted to the Medical Department in year 2017 who sustained an inpatient fall. The data was obtained from the database of the Falls Team HKL. Results 162 patients, with an average age of (61.82±15.50) years were included in this study. Of these, 103(63.58%) were male and 74(45.68%) were ≥65 years. 120(74.1%) were walking unaided prior to admission. 146(90.1%) patients were admitted with an acute medical illness and 13(8.0%) with an acute fall. Median time to first fall was 5(IQR 3-8) days after admission. 160(98.77%) falls occurred in the ward. 79(48.77%) falls occurred between 9:00pm to 6:59am. 75(46.3%) patients fell near their bed and 56(34.6%) fell in the toilet. 47(29.01%) had an injurious fall; 32(19.7%) had minor injury, 9(5.6%) had moderate injury and 6(3.7%) had severe injury. Patients with injurious falls were more likely to have “Direct Impact to Head” during fall [OR; 12.73 (95%CI 5.62 – 28.82)]. They were also more likely to have a Head CT after fall [(OR; 6.41 (95%CI 3.02 – 13.62)]. 18(11.1%) patients died during hospitalisation. Median time to death was 9(IQR 4-16.25) days after fall. 144(88.9%) patients were discharged alive at median 6(IQR 3.75 – 9.25) days after fall. Upon discharge, only 49(30.2%) patients were walking unaided. Conclusion Inpatient falls affects patients of all age groups, regardless of gender. Our data shows that Inpatient falls can cause increased morbidity due to falls related injuries; however, there is no difference in age, gender, length of stay or death as inpatient between patients with injurious and non-injurious falls.
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Schwickert, Lars, Jochen Klenk, Wiebren Zijlstra, et al. "Reading from the Black Box: What Sensors Tell Us about Resting and Recovery after Real-World Falls." Gerontology 64, no. 1 (2017): 90–95. http://dx.doi.org/10.1159/000478092.
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Background: Lying on the floor for a long time after falls, regardless of whether an injury results, remains an unsolved health care problem. In order to develop efficient and acceptable fall detection and reaction approaches, it is relevant to improve the understanding of the circumstances and the characteristics of post-impact responses and the return or failure to return to pre-fall activities. Falls are seldom observed by others; until now, the knowledge about movement kinematics during falls and following impact have been anecdotal. Objective: This study aimed to analyse characteristics of the on-ground and recovery phases after real-world falls. The aim was to compare self-recovered falls (defined as returns to standing from the floor) and non-recovered falls with long lies. Methods and Participants: Data from subjects in different settings and of different populations with high fall risk were included. Real-world falls collected by inertial sensors worn on the lower back were taken from the FARSEEING database if reliable information was available from fall reports and sensor signals. Trunk pitch angle and acceleration were analysed to describe different patterns of recovery movements while standing up from the floor after the impact of a fall. Results: Falls with successful recovery, where an upright posture was regained, were different from non-recovered falls in terms of resting duration (median 10.5 vs. 34.5 s, p = 0.045). A resting duration longer than 24.5 s (area under the curve = 0.796) after the fall impact was a predictor for the inability to recover to standing. Successful recovery to standing showed lower cumulative angular pitch movement than attempted recovery in fallers that did not return to a standing position (median = 76°, interquartile range 24-170° vs. median = 308°, interquartile range 30-1,209°, p = 0.06). Conclusion: Fall signals with and without successful returns to standing showed different patterns during the phase on the ground. Characteristics of real-world falls provided through inertial sensors are relevant to improve the classification and the sensing of falls. The findings are also important for redesigning emergency response processes after falls in order to better support individuals in case of an unrecovered fall. This is crucial for preventing long lies and other fall-related incidents that require an automated fall alarm.
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Klenk, Jochen, Lars Schwickert, Luca Palmerini, et al. "The FARSEEING real-world fall repository: a large-scale collaborative database to collect and share sensor signals from real-world falls." European Review of Aging and Physical Activity 13, no. 1 (2016): 8. https://doi.org/10.1186/s11556-016-0168-9.
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<strong>Background: </strong>Real-world fall events objectively measured by body-worn sensors can improve the understanding of fall events in older people. However, these events are rare and hence challenging to capture. Therefore, the FARSEEING (FAll Repository for the design of Smart and sElf-adaptive Environments prolonging Independent livinG) consortium and associated partners started to build up a meta-database of real-world falls.<strong>Results: </strong>Between January 2012 and December 2015 more than 300 real-world fall events have been recorded. This is currently the largest collection of real-world fall data recorded with inertial sensors. A signal processing and fall verification procedure has been developed and applied to the data. Since the end of 2015, 208 verified real-world fall events are available for analyses. The fall events have been recorded within several studies, with different methods, and in different populations. All sensor signals include at least accelerometer measurements and 58 % additionally include gyroscope and magnetometer measurements. The collection of data is ongoing and open to further partners contributing with fall signals. The FARSEEING consortium also aims to share the collected real-world falls data with other researchers on request.<strong>Conclusions: </strong>The FARSEEING meta-database will help to improve the understanding of falls and enable new approaches in fall risk assessment, fall prevention, and fall detection in both aging and disease.
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Francis-Coad, Jacqueline, Anne-Marie Hill, Angela Jacques, et al. "Association Between Characteristics of Injurious Falls and Fall Preventive Interventions in Acute Medical and Surgical Units." Journals of Gerontology: Series A 75, no. 10 (2020): e152-e158. http://dx.doi.org/10.1093/gerona/glaa032.
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Abstract Background Hospital falls remain common and approximately 30% of falls in hospital result in injury. The aims of the study were the following: (i) to identify the association between fall interventions present at the time of the injurious fall and injurious faller characteristics and (ii) to identify the association between fall preventive interventions present at the time of the injurious fall and the injurious fall circumstances. Methods Secondary data analysis of deidentified case series of injurious falls across 24 acute medical/surgical units in the United States. Variables of interest were falls prevention interventions (physical therapy, bed alarm, physical restraint, room change, or a sitter) in place at the time of fall. Data were analyzed using logistic regression and hazard ratios. Results There were 1,033 patients with an injurious fall, occurrence peaked between Day 1 and Day 4, with 46.8% of injurious falls having occurred by Day 3 of admission. Injurious fallers with a recorded mental state change 24 hours prior to the fall were more likely to have a bed alarm provided (adjusted odds ratio [OR] 2.56, 95% confidence interval [CI] 1.61, 4.08) and receive a physical restraint as fall prevention interventions (adjusted OR 6.36, 95% CI 4.35, 9.30). Injurious fallers restrained fell later (stay Day 6) than those without a restraint (stay Day 4) (p = .007) and had significantly longer lengths of stay (13 days vs 9 days). Conclusions On medical/surgical units, injurious falls occur early following admission suggesting interventions should be commenced immediately. Injurious fallers who had a physical restraint as an intervention had longer lengths of stay.
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Fernandes, Sonal Sophia, Jyothi Seema Moras, Alvita Lurdin Saldanha, and Shyni Cardoza. "A study on fall incidences affecting patient’s safety in a multispecialty hospital." International Journal Of Community Medicine And Public Health 12, no. 2 (2025): 871–75. https://doi.org/10.18203/2394-6040.ijcmph20250321.
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Background: Falls in healthcare settings are a significant concern, resulting in fear, pain, injuries, extended hospital stays, patient discomfort, and diminished quality of life. Several risk factors for falls have been identified, including age, gender, medications, mental status, chronic conditions, and environmental factors. This study aimed to determine fall risk-related activity patterns in patients during hospitalization and identify and describe the incidences of falls, circumstances of falls, and fall-related injuries. Methods: A retrospective, time-bound study was conducted, collecting data from fall incidence reports, patient medical records, and nursing department data using a mixed-methods approach (quantitative data) over a 9-month period (January 2023 to September 2023). The study included all fall patients from January 2023 to September 2023, with a total of 12,673 inpatients and 11 reported fall incidences. Results: The study found that the age group 61-80 years had the highest fall risk incidences, with most falls occurring at night due to patients not wanting to disturb relatives or call nurses for assistance. Additionally, a lack of education regarding fall risk from nurses to patients and relatives was observed, and in some cases, relatives were not present, and nurses were unaware of the patient’s solitude. Conclusions: Fall interventions should be linked to each etiologic factor, and accidental falls can be prevented by ensuring a safe environment. Healthcare and nursing teams play a crucial role in fall prevention, interacting with patients the most, and proper training and autonomy are essential for implementing and assessing individualized preventative measures using information technology systems and tools.
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Kehrer-Dunlap, Abigail, Rebecca Bollinger, Audrey Keleman, Beau Ances, and Susan Stark. "CHARACTERIZING THE CIRCUMSTANCES OF FALLS AMONG COMMUITY-DWELLING OLDER ADULTS." Innovation in Aging 8, Supplement_1 (2024): 1045. https://doi.org/10.1093/geroni/igae098.3362.
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Abstract Falls are the leading cause of injury, institutionalization, and injury-related mortality among older adults. As the older adult population is expected to grow exponentially in the next decade, the cost and consequences of falls will continue to rise. While promising fall prevention interventions exist, the death rate due to falls continues to climb. Limited population health effectiveness of these interventions may be attributable to a poor understanding of contributing factors to falls, such as the environmental and contextual circumstances in which falls occur. The objective of this study was to characterize the circumstances of falls among community-dwelling older adults. We completed monthly, prospective fall monitoring with 350 cognitively normal (Clinical Dementia Rating=0) older adults for up to four years. Standardized interviews were conducted to gather the circumstances of all reported falls, including the location, time of day, and activity at the time of the fall. We qualitatively analyzed fall interviews to determine the reason for the fall and factors of limited or divided attention preceding the fall. There were a total of 1,133 falls reported by 212 (61%) participants. The majority of falls occurred outdoors (53%), in the afternoon (45%), while walking or running (50%), and due to tripping over or catching feet on an object (37%). Additionally, 37% of falls occurred during instances of limited or divided attention. Taken together, these findings provide a greater understanding of the circumstances of older adult falls that may inform future classifications of types of falls and lead to tailored fall prevention approaches.
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Jones, Megan, Sally Paulson, Joshua Gills, et al. "The Effects of Mild Cognitive Impairment on Fall Severity in Older Adults." Innovation in Aging 5, Supplement_1 (2021): 698. http://dx.doi.org/10.1093/geroni/igab046.2617.
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Abstract Falls affect more than 30% of older adults and are one of the leading causes of injury, hospitalization, and mortality in this populations. Mild cognitive impairment (MCI) is one of the risk factors for falls in older adults. The purpose of this study is to determine if older adults with MCI have increased fall severity than older adults without MCI. Participants (n: 81: age: 79 ± 6) completed a Montreal Cognitive Assessment (MoCA) and a Hopkins Falls Grading Scale, a tool used to grade the severity of falls on a scale of 1-4 (1 = loss of balance without fall; 4 = fall requiring hospital admission). Participants were categorized as having MCI (score &lt;26: N: 44: age: 81 ± 6.4) or non-MCI (score ≥26: n: 37: age: 77 ± 6). Groups were analyzed using a one-way ANOVA in SPSS to compare the severity of falls within the previous 12 months. There were no differences between groups for fall grade 1 (p =.22) or fall grade 2 (p =.45). There was a significant difference between groups for fall grade 3 (p =.04) and fall grade 4 (p =.05) with the MCI group having more of these falls compared to the non-MCI group. Older adults with MCI had a higher number of falls requiring medical attention than older adults without MCI. Although falls are a risk in all older adults, those with MCI may be at higher risk of more injurious falls than older adults without MCI.