title: Risk factors for injurious falls leading to hospitalization or death in a cohort of 19,500 adults.
abstract: Falls are the most common cause of nonfatal injuries and a major cause of injury death. In order to identify risk factors for injuries from falls, 19,518 persons aged 20-92 years from four regions of Finland were examined and followed up from between 1973 and 1977 to 1984 for 8 to 11 years by identifying hospital admissions or deaths due to fall injuries. During 187,405 person-years, 628 injuries from falls were documented. The risk for injuries from falls was significantly and independently of other factors associated with alcohol intake in all age and sex groups. After adjustment for all the other risk determinants, the relative risks (RR) (95% confidence intervals (CI)) in persons with monthly ethanol intake of 100-499 g, 500-999 g, and > or = 1,000 g were 1.43 (1.13-1.82), 2.32 (1.71-3.17), and 3.05 (2.05-4.55), respectively, compared with abstainers. Body mass index (kg/m2) > or = 30 was associated with an increased risk among women aged < 45 years (RR = 2.8, 95% CI 1.28-5.89), whereas in persons aged > or = 65 years it seemed to be a protective factor both among men (RR = 0.3, 95% CI 0.06-1.19) and women (RR = 0.5, 95% CI 0.30-0.76). Also single marital status, smoking, heavy physical activity during leisure time, use of psychopharmacologic agents, diabetes mellitus, and cardiovascular diseases other than stroke were found to carry independent predictive significance in at least one subgroup of sex and age. In conclusion, alcohol consumption, relative weight, and use of psychopharmacologic agents were seen to be the most relevant risk determinants. Intervention trials based on the predictive factors and on high-risk groups are needed.
authors.affiliation: Department of Occupational Medicine, Institute of Occupational Health, Helsinki, Finland.
authors.forename: A
authors.initials: A
authors.lastname: Malmivaara
authors.forename: M
authors.initials: M
authors.lastname: Heliövaara
authors.forename: P
authors.initials: P
authors.lastname: Knekt
authors.forename: A
authors.initials: A
authors.lastname: Reunanen
authors.forename: A
authors.initials: A
authors.lastname: Aromaa
mesh_terms: D000058:Accidental Falls / Q000401:mortality*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005387:Finland / Q000453:epidemiology; D006304:Health Status; D006760:Hospitalization; D006801:Humans; D008019:Life Style; D015993:Life Tables; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires