Frequency and factors associated with falls in adults aged 55 years or more

Prato, Sabrina Canhada Ferrari; Andrade, Selma Maffei de; Cabrera, Marcos Aparecido Sarria; Dip, Renata Maciulis; Santos, Hellen Geremias dos; Dellaroza, Mara Solange Gomes; Mesas, Arthur Eumann

doi:10.1590/S1518-8787.2017051005409

Brasil

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Original Articles • Rev. Saúde Pública 51 (0) • 2017 • https://doi.org/10.1590/S1518-8787.2017051005409 linkcopy

Frequency and factors associated with falls in adults aged 55 years or more

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE The objective of this study is to analyze the frequency and factors associated with falls in adults aged 55 years or more.

METHODS This is a study inserted into another population-based study with representative sample of persons aged 40 years or more of the urban area in a medium-sized municipality of the State of Paraná, Brazil, in 2011. That study obtained demographic and socioeconomic data and characteristics related to life habits, health conditions, and functional capacity (n = 1,180). In 2012, we selected all persons aged 55 years or more (n = 501). We have estimated grip strength and the occurrence of a fall since the last interview in 80.6% of the adults. The crude and adjusted odds ratios (OR) have been calculated by logistic regression according to a hierarchical model.

RESULTS The rate of fall was 24.3%. After adjustments, we could observe higher chances of falls among women (OR = 3.10; 95%CI 1.79–5.38), among persons aged 65 years or more (OR = 2.39; 95%CI 1.45–3.95), with poor sleep quality (OR = 1.78; 95%CI 1.08–2.93), and with low grip strength (OR = 2.31; 95%CI 1.34–3.97).

CONCLUSIONS Poor sleep quality and low muscle strength can be indicators of increased risk of falls and need assessments and interventions aimed at preventing them.

Middle Aged; Aged; Accidental Falls; Risk Factors; Health Surveys

Variable	Total	Fall (yes)		Not adjusted OR	95%CI	p^a

	N	n	%
Gender
Male	164	24	14.6	1	-
Female	240	74	30.8	2.60	1.56–4.34	< 0.001
Age (years)
55 to 64	206	36	17.5	1	-
≥ 65	198	62	31.3	2.15	1.35–3.44	0.001
Marital status
With partner	271	63	23.2	1	-
Without partner	133	35	26,3	1.18	0.73–1.90	0.449
Race
Black/Brown/Indigenous	135	28	20.7	1	-
White/Yellow	269	70	26.0	1.34	0.82–2.21	0.244
Education level (complete years)^b
0 to 3	88	22	25.0	1	-
4 to 7	136	26	19.1	0.71	0.37–1.35	0.296
≥ 8	179	50	27.9	1.16	0.65–2.08	0.612
Economy class (ABEP)^b
A/B	119	26	21.8	1	-
C	219	54	24.7	1.17	0.69–1.99	0.562
D/E	65	18	27.7	1.37	0.68–2.75	0.375

Variable	Total	Fall (Yes)		Not adjusted OR	95%CI	p^a

	N	n	%
Practice of physical activity
Yes	75	18	24.0	1	-
No	329	80	24.3	1.02	0.57–1.83	0.954
Smoking
No	345	84	24.3	1	-
Yes	59	14	23.7	0.97	0.51–1.85	0.918
Use of psychotropic substances^b
No	271	70	25.8	1	-
Yes	132	28	21.2	0.77	0.47–1.27	0.310
Quality of sleep^c
Good	224	44	19.6	1	-
Poor	157	49	31.2	1.86	1.16–2.98	0.011
Heart failure^d
No	386	96	23.8	1	-
Yes	18	6	33.3	1.60	0.58–4.38	0.362
Diabetes mellitus^d
No	339	83	24.5	1	-
Yes	65	15	23.1	0.93	0.49–1.73	0.809
Depression^d
No	323	69	21.4	1	-
Yes	81	29	35.8	2.05	1.21–3.48	0.007
COPD^d
No	355	87	24.5	1	-
Yes	49	11	22.4	0.89	0.44–1.82	0.753
Neoplasm^d
No	377	88	23.3	1	-
Yes	27	10	37.0	1.93	0.85–4.37	0.114
Hypertension
No	242	54	22.3	1	-
Yes	162	44	27.2	1.30	0.82–2.06	0.265
Obesity^e
No	262	58	22.1	1	-
Yes	133	38	28.6	1.41	0.87–2.27	0.159

Variable	Total	Fall (Yes)		Not adjusted OR	95%CI	p*

	N	n	%
Visual impairment
No	360	89	24.7	1	-
Yes	44	9	20.5	0.78	0.36–1.69	0.534
Hearing impairment
No	354	81	22.9	1	-
Yes	50	17	34.0	1.74	0.92–3.28	0.089
Difficulty of going up/down the stairs
No	256	46	18.0	1	-
Yes	148	52	35.1	2.47	1.55–3.94	< 0.001
ADL
Independent	382	88	23.0	1	-
Dependent	22	10	45.5	2.78	1.16–6.66	0.021
IADL
Independent	274	59	21.5	1	-
Dependent	130	39	30.0	1.56	0.97–2.51	0.065
Grip strength
> 25th percentile	287	53	18.5	1	-
≤ 25th percentile	117	45	38.5	2.76	1.71–4.45	< 0.001

Variable	Total	Fall (yes)		Adjusted OR	95%CI	p^a

	N	n	%
Distal level^a
Gender
Male	153	21	13.7	1	-
Female	219	70	32.0	3.10	1.79–5.38	< 0.001
Age (years)
55 to 64	191	33	17.3	1	-
≥ 65	181	58	32.0	2.39	1.45–3.95	0.001
Intermediate level^b
Quality of sleep
Good	218	42	19.3	1	-
Poor	154	49	31.8	1.78	1.08–2.93	0.023
Proximal level^c
Muscle strength
> 25th percentile	271	51	18.8	1	-
≤ 25th percentile	101	40	39.6	2.31	1.34–3.97	0.003

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[TFN1] ABEP: Associação Brasileira de Empresas de Pesquisa (Brazilian Association of Research Companies).

[TFN2] ^a Wald Chi-square.

[TFN3] ^b Information missing for one interview.