The prognosis of falls in elderly people living at home.
BACKGROUND
there are few longitudinal studies of the prognosis of falling at home.


OBJECTIVE
to determine outcomes in older people who fall once and more than once.


METHODS
longitudinal prospective cohort study.


METHODS
primary care in the UK.


METHODS
1815 subjects over 75 who had a standardized and validated health check.


METHODS
annual interviews over 4 years. Practice records were used to establish death and admission to institutions.


RESULTS
risk of death was increased at 1 year [odds ratio (OR) 2.6, 95% confidence interval (CI) 1.4-4.7] and 3 years (OR 1.9, 95% CI 1.2-3.0) for recurrent fallers but not single fallers (OR 0.9, 95% CI 0.5-1.6 at 1 year; OR 0.97, 95% CI 0.7-1.4 at 3 years). Risk of admission to long-term care over 1 year was markedly increased both for single fallers (OR 3.8, 95% CI 1.8-8.3) and recurrent fallers (OR 4.5, 95% CI 1.7-12). Functional decline was not related to faller status, the latter being very variable from one year to the next.


CONCLUSIONS
the stronger relationship between falling and admission to long-term care rather than mortality supports the hypothesis that the perceived risks for those who fall only once are exaggerated.
Donald
I P
IP
Elderly Care Unit, Gloucestershire Royal Hospital, UK.
Bulpitt
C J
CJ
D000058:Accidental Falls / Q000401:mortality; D000061:Accidents, Home / Q000401:mortality; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D007326:Institutionalization; D008137:Longitudinal Studies; D011379:Prognosis; D011446:Prospective Studies