title: Differing risk factors for falls in nursing home and intermediate-care residents who can and cannot stand unaided.
abstract: OBJECTIVE
  To determine fall risk factors in nursing home and intermediate-care residents who can and cannot stand unaided.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Residential elderly care facilities in Sydney, Australia.
  
  
  METHODS
  One thousand people aged 65 to 103 (mean age +/- standard deviation: 85.0 +/- 7.4).
  
  
  METHODS
  Accidental falls.
  
  
  RESULTS
  Fall rates were highest in those with fair standing balance, intermediate in those with the best standing balance, and lowest in those with the worst standing balance. This nonlinear pattern was even more striking when subjects were categorized according to their standing balance and ability to rise from a chair. Using this dual classification, fall rates were highest in those who could rise from a chair but could not stand unaided (81%) and lowest in those who could neither rise from a chair nor stand unaided (48%). In residents who could stand unaided, risk factors included increased age, male sex, higher care classifications, incontinence, psychoactive medication use, previous falls, and slow reaction times. In contrast, quite different risk factors were evident in residents who could not stand unaided, with a number of known fall risk factors (previous stroke, reduced ability to rise from a chair, slow reaction times) being associated with fewer falls. In this group, risk factors were intermediate versus nursing home care, poor health status, psychoactive medication use, Parkinson's disease, previous falls, and being able to get out of a chair.
  
  
  CONCLUSIONS
  The findings indicate that there are different risk factors for falls for people living in residential aged care facilities who can and cannot stand unaided. These findings provide important information for developing fall-prevention strategies and suggest that those who can stand unaided but have multiple falls risk factors constitute the highest priority group for such interventions.
authors.affiliation: Prince of Wales Medical Research Institute, University of New South Wales, New South Wales, Australia. S.Lord@unsw.edu.au
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Lord
authors.forename: Lynn M
authors.initials: LM
authors.lastname: March
authors.forename: Ian D
authors.initials: ID
authors.lastname: Cameron
authors.forename: Robert G
authors.initials: RG
authors.lastname: Cumming
authors.forename: Jennifer
authors.initials: J
authors.lastname: Schwarz
authors.forename: Jane
authors.initials: J
authors.lastname: Zochling
authors.forename: Jian Sheng Charles
authors.initials: JS
authors.lastname: Chen
authors.forename: Jan
authors.initials: J
authors.lastname: Makaroff
authors.forename: Yih Yiow
authors.initials: YY
authors.lastname: Sitoh
authors.forename: Tang Ching
authors.initials: TC
authors.lastname: Lau
authors.forename: Alan
authors.initials: A
authors.lastname: Brnabic
authors.forename: Philip N
authors.initials: PN
authors.lastname: Sambrook
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D040561:Assisted Living Facilities / Q000706:statistics & numerical data; D001315:Australia / Q000453:epidemiology; D015331:Cohort Studies; D003196:Computer Graphics; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009735:Nursing Homes / Q000706:statistics & numerical data; D004856:Postural Balance / Q000502:physiology*; D011446:Prospective Studies; D012112:Residential Facilities / Q000706:statistics & numerical data*; D012307:Risk Factors