Causes and correlates of recurrent falls in ambulatory frail elderly

Falls are a major cause of injuries and death for nursing home residents. Nearly 50 percent of these residents suffer one or more falls each year, resulting in broken bones as well as other serious complications. Recent studies have identified risk factors for falls, but have not examined the specific causes of falls or of recurrent falls. This study examined the specific causes of recurrent falls in nursing home residents, and characteristics that can be modified to prevent such falls. An evaluation of falls that occurred over a three-year period among residents of two nursing homes was performed. Only data concerning falls in patients who were either independent or partially dependent and ambulatory (able to walk) were analyzed. There were 70 recurrent fallers and 56 nonfallers, with an average age of 87 years. Results showed that fallers were more likely to be females and more likely to be functionally impaired than were nonfallers. Only 10 percent of the reported falls were caused by an environmental hazard. The most common causes of falls were impairment caused by stroke, Parkinsonism, arthritis, visual defects, and hypotension (low blood pressure). Fallers were more likely to be taking antidepressants or analgesics than were nonfallers. Fallers were also more likely to need to push off with their arms when getting up from a chair. Residents who fell took smaller steps when walking and turning, and were slower in doing so. These results indicate that nursing home residents who are more likely to experience recurrent falls can be identified by a number of characteristics. These include sex, types of drugs being taken, and performance on simple tests of mobility such as standing up from a seated position. Identifying likely fallers may lead to the prevention of falls. (Consumer Summary produced by Reliance Medical Information, Inc.)