Risk Factors for Falls among the Community-Dwelling Elderly in Korea

  • Sohng Kyeong-Yae (College of Nursing, The catholic University of Korea) ;
  • Moon Jung-Soon (College of Nursing, The catholic University of Korea) ;
  • Song Hae-Hiang (Department of Biostatistics, College of Medicine, The Catholic University of Korea) ;
  • Lee Kwang-Soo (Department of Neurology, College of Medicine, The Catholic University of Korea) ;
  • Kim Young-Sook (Department of Social Work, Sahm Yook University)
  • Published : 2004.12.01

Abstract

Community-based centres were surveyed to determine the frequency of and risk factors for falls among elderly Koreans. We examined fall-related risk factors, including physiological and physical health, psychosocial functions, self-reported physical capacity and activity, vision, and the use of medication, among 351 elderly people aged 65 years or older, with ambulatory. Forty-two per cent of elderly Korean subjects reported at least one episode of falling in the previous 12 months, $38\%$ of whom had consequences that required either the attention of a physician or hospitalization. Factors significantly associated with an increased risk of falling were a restricted activity during the previous five years (adjusted OR 1.3), use of alternative therapy (adjusted OR 2.7), low knee flexor and extensor-muscle strength (adjusted OR 1.21 and 1.20), and poor balance with closed eyes (adjusted OR 8.32). We conclude that falls among older persons living in the community are common in Korea and that indicator of bad health and frailty or variables directly related to neuromuscular impairment are significant predictors of the risk of falling.

Keywords

References

  1. American Geriatric Society, British Geriatric Society, American Academy of Orthopedic Surgeons Panel on Falls Prevention (2001). Guidelines for the prevention of falls in older persons. J Am Geriat Soc 49, 664-672 https://doi.org/10.1046/j.1532-5415.2001.49115.x
  2. Cho, J. Y. (1998). Functional assessment of the elderly. J Korean Acad Famil Med 19(11), 1197-1206
  3. Cho, J. P., Paik, K. W., Song, H. J., Jung, Y. S., & Moon, H. W. (2001). Prevalence and associated factors of falls in the community elderly. Korean J Prev Med 34(1), 47-54
  4. Davis, A. E. (1995). Hip fractures in the elderly: Surveillance methods and injury control. J Nurs Trauma 2(1), 15-21
  5. Downton, J. H., & Andrews, K. (1991). Prevalence characteristics and factors associated with falls among the elderly living at home. Aging 3, 189-194
  6. Gibson, M. J. (1987). The prevention of falls in later life. Dan Medl Bull 34 (Suppl. 4), 1-24
  7. Hale, W.A., Delaney, M. J., & McGaghie, W. C. (1992). Characteristics and predictors of falls in elderly patients. J Famil Prac 34, 577-581
  8. Hindmarsh, J. J., & Estes E. H. (1989). Falls in older persons. Arch Intern Med 149, 2217-2222 https://doi.org/10.1001/archinte.149.10.2217
  9. Hwang, O. N. (1998). A survey on the factors associated with falls among the elderly. J Korean Adult Nurs 10(2), 337-352
  10. Jin, Y. H. (1997). A new logMar vision chart - Jin's vision chart. J Korean Ophthalm Soc 38 (11), 2036-2044
  11. Josephson K. R., Fabacher, D. A., & Rubenstein, L. Z. (1991). Home safety and fall prevention. Clin Geriatr Med 7(4), 707-31
  12. Kaplan, G., & Baron-Epel, O. (2003). What lies behind the subjective evaluation of health status? Soc Sci & Med 56 (8), 1669-1976
  13. Kee, B. S. (1996). A preliminary study for the standardization of geriatric depression scale form - Korean version. J Korean Neuropsy Assoc 35(2), 298-307
  14. Kendall, F. P. & McCreary, E. K. (1983). Muscle tesingt and function. Baltimore: Williams & Wilkins
  15. Lawton, M. P., & Brody, E. M. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist 9, 179-185
  16. Lee, I.S., Lee, E., Eun, Y., Diana, W., & Basia, B. (1999). A transcultural study for testing models of the treatment-seeking behaviors in patients with rheumatoid arthritis. J Rheum Health 6 (2), 253-277
  17. Mills, E. M. (1994). The effect of low-intensity aerobic exercise on muscle strength, flexibility, and balance among sedentary elderly persons. Nurs Res 43(4), 207-211
  18. Nagasawa, H., Wu, G., Sakamoto, S., Yamamoto, K., & Inatomi, H. (1997). Effects of gual-mu-tong (Caulis aristolochiae manshuriensis) in combination with other natural products on normal and preneoplastic mammary gland growth in mice. Am J Chine Med 25, 79-88 https://doi.org/10.1142/S0192415X97000111
  19. National Statistical Office of Korea (2001). The future estimated population
  20. Nickens, H. (1985). Intrinsic factors in falling among the elderly. Arch Intern Med 145(5), 1089-1093 https://doi.org/10.1001/archinte.1985.00360060157024
  21. Park, J. H., & Kwon, Y. C. (1989). Standardization of Korean version of the Mini-Mental State examination for use in the elderly. Part II: Diagnostic validity. J Korean Neuropsych Assoc 28, 508-513
  22. Rubenstein, L. Z., & Josephson, K. R. (2002). The epidemiology of falls and syncope. Clin Geriatr Med 18(2), 141-158 https://doi.org/10.1016/S0749-0690(02)00002-2
  23. Rubenstein, L. Z., & Powers, C. (1999). Falls and mobility problems: Potential quality indicators and literature review (the ACOVE project). Santa Monica: RAND Corporation
  24. Sohng, K. Y., & Lee, S. Y. (2000). A survey on perceived health status and health promoting lifestyle patterns between Korean elderly and Korean-American elderly. J Korean Acad FundNurs 7(3), 401-414
  25. Speake, D. L., Cowart, M. E., & Pellet, K. (1989). Health perceptions and lifestyles of the elderly. Res Nurs & Health 12, 93-100 https://doi.org/10.1002/nur.4770120206
  26. Tideiksaar, R. (2001). Falls in older persons. Prevention and management. 2nd ed. Baltimore: Health Professions Press
  27. Tinetti, M. E., Mendes de Leon, C. F., Doucette, J. T., & Baker, D. I. (1994). Fear of falling and fall-related efficacy in relationship to functioning among community-living elders. Journal of Gerontology 49, M140-M147
  28. Tinetti, M. E., Speechly, M., & Ginter, S. F. (1988). Risk factors for fall among elderly persons living in the community. N Engl J Med 319, 1701-1709
  29. Tinetti, M. E., Williams, F. T., & Mayewski, R. (1986). A fall risk index for elderly patients based on number of chronic disabilities. Am J Med 80, 429-434 https://doi.org/10.1016/0002-9343(86)90717-5
  30. Vellas, B. J., Garry, P. J., Wayne, S. J., Baumgartner, R. N. & Albarede, J. L. (1992). A comparative study of falls, gait and balance in elderly persons living in North America (Albuquerque, NM, USA) and Europe (Toulouse, France): Methodology and preliminary results. In B. Vellas, M. Toupet, L. Rubinstein, J. L. Albarede, Y. Christen (Eds.), Falls, balance and gait disorders in the elderly (pp. 93-116). Paris: Elsevier
  31. Yesavage, J. A., Brick, T. L., & Rose T. L. (1983). Development and validation of geriatric depression rating scale: a preliminary report. J Psychiatr Res 17, 37-49 https://doi.org/10.1016/0022-3956(82)90033-4