Premium
Predicting Falls: The Role of Mobility and Nonphysical Factors
Author(s) -
Studenski Stephanie,
Duncan Pamela W.,
Chandler Julie,
Samsa Greg,
Prescott Barbara,
Hogue Carol,
Bearon Lucille B.
Publication year - 1994
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1994.tb01755.x
Subject(s) - medicine , confidence interval , prospective cohort study , relative risk , injury prevention , poison control , risk assessment , ambulatory , physical therapy , gerontology , medical emergency , computer security , computer science
Objective Our purpose was to test a four‐domain predictive model of recurrent falls developed for this study. In this model, limited mobility is considered a necessary but not sufficient element in risk of recurrent falls. Three other domains, attitudinal, social, and environmental, are proposed to influence fall risk only in persons with impaired mobility. Design Prospective cohort study. Setting Veterans Affairs Ambulatory Care Service serving rural and urban central North Carolina. Subjects Male Veterans aged 70 or older ( n = 306) were monitored prospectively for falls. At baseline, 159 screened as high‐risk mobility status and 147 as low‐risk mobility status. Measurements The primary outcome was recurrent falls. The mobility screen used for risk assignment defined immobile as unable to sit without support for 60 seconds, mobile and stable as meeting criteria for normal ambulation and stair climbing, and mobile but unstable as those who met neither of the above criteria. The high‐risk subjects were further assessed in their homes for mobility in more detail, attitude toward risk, social supports, and environmental status. Other data included demographics, functional status, diagnoses, and medications. Results Recurrent falls occurred in 37 (23.3%) high‐risk subjects and seven (4.8%) low‐risk subjects (relative risk = 4.8, confidence interval 2.5 to 9.6, P < 0.001). Within the high‐risk group, the probability of recurrent falls was significantly affected by degree of impaired mobility ( P < 0.001), attitude toward risk ( P = 0.005), and environment score ( P = 0.03). Conclusions A simple mobility screen can identify elders at increased risk for recurrent falls. Risk within this group is further modified by risk‐taking behavior and environment.