Consequences of falling in older men and women and risk factors for health service use and functional decline.
OBJECTIVE
(1) to examine consequences of falls in older men and women and (2) to examine risk factors for health service use and functional decline among older fallers.


METHODS
the study was performed within the Longitudinal Aging Study Amsterdam. In 1998/1999, potential risk factors were assessed during the third data collection. In 1999/2000, 204 community-dwelling persons (> or =65 years) who reported at least one fall in the year before the interview, were asked about consequences of their last fall, including physical injury, health service use, treatment and functional decline (i.e. decline in functional status, social and physical activities).


RESULTS
as a consequence of falling, respondents reported physical injury (68.1%), major injury (5.9%), health service use (23.5%), treatment (17.2%), and decline in functional status (35.3%), and social (16.7%) and physical activities (15.2%). Using multivariate logistic regression, specific risk factors for health service use after falling could not be identified. Female gender (OR = 2.8, 95% CI = 1.5-5.1), higher medication use (OR = 1.5, 95% CI = 1.0-2.2) and depressive symptoms (OR = 1.9, 95% CI = 1.3-2.8) were independently associated with functional decline after falling. Depressive symptoms (OR = 2.0, 95% CI = 1.2-3.3) and falls inside (OR = 2.6, 95% CI = 1.1-6.5) were risk factors for decline in social activities, while female gender (OR = 2.7, 95% CI = 1.1-7.0) and depressive symptoms (OR = 1.9, 95% CI = 1.2-3.0) were risk factors for decline in physical activities after falling.


CONCLUSIONS
almost 70% of the respondents suffered physical injury, almost one-quarter used health services and more than one-third suffered functional decline after falling. No risk factors were found for health service use needed after falling. Female gender, higher medication use, depressive symptoms and falls inside were risk factors for functional decline after falling.
Stel
Vianda S
VS
Institute for Research in Extramural Medicine (EMGO Institute) Department of Endocrinology, VU University Medical Center, Amsterdam, The Netherlands.
Smit
Johannes H
JH
Pluijm
Saskia M F
SM
Lips
Paul
P
D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000209:etiology*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009043:Motor Activity; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors; D014947:Wounds and Injuries / Q000209:etiology*