Risk factors for falls and for serious injuries on falling among older Japanese women in Hawaii.
OBJECTIVE
To evaluate if similar constellations of factors underlie the risks of falls and injuries on falling for Japanese women as reported for predominately white populations.


METHODS
A prospective cohort study


METHODS
The island of Oahu


METHODS
The older Japanese women who participated in the Hawaii Osteoporosis Study (mean age = 74 +/- 5 (SD) years).


METHODS
As outcomes: falls and serious injuries on falling. As predictors: anthropometric measurements, measurements of neuromuscular performance, activities of daily living (ADLs), past falls, and other suspected risk factors for falls and serious injuries.


RESULTS
In multivariable models, four subject characteristics were positively associated with having a fall (having a fall in the past year (RR = 2.0 (95% CI, 1.5-2.8)), slow chair stands (RR = 1.4 (95% CI, 1.0-1.9), a short height (RR = 1.5 (95% CI, 1.1-2.1)), difficulties with five or more ADLs (RR = 1.5 (95% CI, 1.1-2.1))). Two subject characteristics were negatively associated with having a fall (ability to perform a full tandem balance with eyes closed (RR = .7 (95% CI, .5-1.0)) and having a long functional reach (RR = .7 (95% CI, .5-1.0))). The RRs represent as nearly as possible comparisons of the upper (or lower) quartile and the remaining quartiles. In multivariable models, long times for chair stands (odds ratio (OR) = 3.0 (95% CI, 1.5-6.1)) and a low BMI (OR = 3.1 (95% CI, 1.5-6.4)) were positively associated with having a serious injury among women who had a fall. Among the same women, taking part in an activity they did frequently (OR = .3 (95% CI, .1-.8)) and slow foot reaction times (OR = .3 (95% CI, .1-.8)) were associated negatively with having a serious injury.


CONCLUSIONS
The results from this Japanese cohort support the conclusion that women at high risk of falling and serious fall injuries can be identified using a questionnaire and simple, performance-based tests of neuromuscular function. The risk factors for falling overlapped, but were distinct from, those for suffering a serious injury once a fall had occurred.
Hawaii Osteoporosis Center, Honolulu, 96814, USA.
J W
JW
Davis
P D
PD
Ross
M C
MC
Nevitt
R D
RD
Wasnich
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000203:Activities of Daily Living; D017677:Age Distribution; D000368:Aged / Q000706:statistics & numerical data*; D000886:Anthropometry; D001213:Asian / Q000706:statistics & numerical data*; D005260:Female; D015577:Geriatric Assessment; D006254:Hawaii; D006801:Humans; D015999:Multivariate Analysis; D004856:Postural Balance; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011597:Psychomotor Performance; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014947:Wounds and Injuries / Q000209:etiology*