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    Reevaluating the implications of recurrent falls in older adults: location changes the inference

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    Authors
    Kelsey, Jennifer L.
    Procter-Gray, Elizabeth
    Berry, Sarah D.
    Hannan, Marian T.
    Kiel, Douglas P.
    Lipsitz, Lewis A.
    Li, Wenjun
    UMass Chan Affiliations
    Department of Medicine, Division of Preventive and Behavioral Medicine
    Document Type
    Journal Article
    Publication Date
    2012-03-01
    Keywords
    Accidental Falls
    Activities of Daily Living
    Aged
    Aged, 80 and over
    Comorbidity
    *Environment
    Female
    Follow-Up Studies
    Health Status Indicators
    Humans
    Interviews as Topic
    Male
    Prospective Studies
    Questionnaires
    Recurrence
    Risk Factors
    Behavioral Disciplines and Activities
    Behavior and Behavior Mechanisms
    Community Health and Preventive Medicine
    Geriatrics
    Preventive Medicine
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    Link to Full Text
    http://dx.doi.org/10.1111/j.1532-5415.2011.03834.x
    Abstract
    OBJECTIVES: To compare characteristics of indoor and outdoor recurrent fallers and explore some implications for clinical practice, in which a fall risk assessment for all recurrent fallers has been recommended. DESIGN: Prospective cohort study. SETTING: Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly of Boston Study, a study of falls etiology in community-dwelling older individuals from randomly sampled households in the Boston, Massachusetts, area. PARTICIPANTS: Seven hundred thirteen women and men, mostly aged 70 and older, with at least 1 year of follow-up. MEASUREMENTS: Data at baseline and from an 18-month follow-up examination were collected by questionnaire and comprehensive clinic examination. During follow-up, participants recorded falls on daily calendars. A telephone interview queried location and circumstances of each fall. RESULTS: One hundred forty-five participants reported recurrent falls (>/=2) during the first year. Those who had fallen only outdoors had good health characteristics, whereas those who had fallen only indoors were generally in poor health. For instance, 25.5% of indoor-only recurrent fallers had gait speeds of slower than 0.6 m/s, compared with 2.9% of outdoor-only recurrent fallers; the respective percentages were 44.7% and 8.8% for Berg balance score less than 48. Recurrent indoor fallers generally had poor health characteristics regardless of their activity at the time of their falls, whereas recurrent outdoor fallers who fell during vigorous activity or walking were especially healthy. A report of any recurrent falls in the first year did not predict number of positive findings on a comprehensive or abbreviated fall risk assessment at the 18-month follow-up examination. CONCLUSION: Characteristics of community-dwelling older people with recurrent indoor and outdoor falls are different. If confirmed, these results suggest that different types of fall risk assessment are needed for specific categories of recurrent fallers. Geriatrics Society.
    Source
    J Am Geriatr Soc. 2012 Mar;60(3):517-24. doi: 10.1111/j.1532-5415.2011.03834.x. Epub 2012 Jan 27. Link to article on publisher's site
    DOI
    10.1111/j.1532-5415.2011.03834.x
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/44822
    PubMed ID
    22283236
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1111/j.1532-5415.2011.03834.x
    Scopus Count
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    Population and Quantitative Health Sciences Publications

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