Ethnic differences in the frequency and circumstances of falling in older community-dwelling women.
OBJECTIVE
To examine ethnic differences in fall rates and fall circumstances in older community-dwelling Caucasian and African-American women.


METHODS
Prospective analysis of incident falls and a nested retrospective analysis of fall circumstances over 5.7 years.


METHODS
Monongahela Valley, Pennsylvania.


METHODS
A total of 1,821 Caucasian and African-American women (mean age+/-standard deviation 76+/-5) enrolled in the Study of Osteoporotic Fractures and participating in 1993/94. Circumstances of 338 falls were collected on a subsample of 197 women who fell.


METHODS
Fall rates and fall circumstances.


RESULTS
Women reported 4,547 falls in 9,508 person-years, averaging 0.48 falls per woman annually (95% confidence interval (CI)=0.43-0.53). Age-adjusted fall rates were nonsignificantly higher in Caucasians than African Americans (relative risk (RR)=1.30, 95% CI=0.93-1.83%). In women younger than 75, fall rates were similar in Caucasians and African Americans (RR=1.17, P=.46). In women aged 75 and older, fall rates were 50% higher in Caucasians than in African Americans (RR=1.50, 95% CI=0.90-2.49), although this difference was not significant (P=.12). Fall circumstances differed by ethnicity. Caucasian women were significantly more likely than African Americans to fall outdoors versus indoors (odds ratio (OR)=1.6, 95% CI =1.0-2.7) and laterally versus forward (OR=2.0, 95% CI =1.1-3.4) but less likely to fall on the hand/wrist (OR=0.6, 95% CI =0.3-1.0). Ninety-eight percent of individuals falling on their hand/wrist reported that they extended their hand to attempt to break their fall.


CONCLUSIONS
Although the circumstances of falling differed for older Caucasian and African-American women, there were no differences in the frequencies of falling. These findings suggest that ethnic differences in fracture risk in older women may be due in part to the different ways in which older Caucasian and African-American women fall, rather than how often they fall. More information will be needed on fall circumstances to determine whether interventions need to be tailored by ethnic group.
Faulkner
Kimberly A
KA
Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA. kaf24@pitt.edu
Cauley
Jane A
JA
Zmuda
Joseph M
JM
Landsittel
Douglas P
DP
Nevitt
Michael C
MC
Newman
Anne B
AB
Studenski
Stephanie A
SA
Redfern
Mark S
MS
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000203:Activities of Daily Living / Q000145:classification*; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People / Q000706:statistics & numerical data*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D018737:Hand Strength; D006801:Humans; D007537:Isometric Contraction; D015663:Osteoporosis, Postmenopausal / Q000453:epidemiology / Q000208:ethnology*; D010809:Physical Fitness; D012307:Risk Factors; D012931:Social Environment; D044465:White People / Q000706:statistics & numerical data*; D001741:Black or African American