Risk factors for falling in home-dwelling older women with stroke: the Women's Health and Aging Study.
OBJECTIVE
Much of our knowledge of risk factors for falls comes from studies of the general population. The aim of this study was to estimate the risk of falling associated with commonly accepted and stroke-specific factors in a home-dwelling stroke population.


METHODS
This study included an analysis of prospective fall reports in 124 women with confirmed stroke over 1 year. Variables relating to physical and mental health, history of falls, stroke symptoms, self-reported difficulties in activities of daily living, and physical performance tests were collected during home assessments.


RESULTS
Risk factors for falling commonly reported in the general population, including performance tests of balance, incontinence, previous falls, and sedative/hypnotic medications, did not predict falls in multivariate analyses. Frequent balance problems while dressing were the strongest risk factor for falls (odds ratio, 7.0). Residual balance, dizziness, or spinning stroke symptoms were also a strong risk factor for falling (odds ratio, 5.2). Residual motor symptoms were not associated with an increased risk of falling.


CONCLUSIONS
Interventions to reduce the frequency of balance problems during complex tasks may play a significant role in reducing falls in stroke. Clinicians should be aware of the increased risk of falling in women with residual balance, dizziness, or spinning stroke symptoms and recognize that risk assessments developed for use in the general population may not be appropriate for stroke patients.
Lamb
S E
SE
Interdisciplinary Research Centre in Health, School of Health and Social Sciences, Coventry University/Warwick West Midlands Primary Care Network, Coventry, UK. s.lamb@coventry.ac.uk
Ferrucci
L
L
Volapto
S
S
Fried
L P
LP
Guralnik
J M
JM
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000061:Accidents, Home / Q000706:statistics & numerical data*; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D009043:Motor Activity; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D004856:Postural Balance; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D012678:Sensation Disorders / Q000209:etiology*; D020521:Stroke / Q000150:complications* / Q000175:diagnosis; D000071939:Stroke Rehabilitation