title: Impact of falls on the balance, gait, and activities of daily living functioning in community-dwelling Chinese older adults.
abstract: OBJECTIVE
  The objective of the present study was to investigate the impact of incident falls on the balance, gait, and Activities of Daily Living functioning in community-dwelling older adults.
  
  
  METHODS
  This was a population-based, 1-year prospective cohort study in older adults. We performed baseline assessment of potential predictors, the 1-year occurrence of falls, and then 1-year reassessment of the following outcome measures: the Barthel Index (BI), Lawton's Instrumental Activities of Daily Living (IADL) scale, gait speed, and Tinetti Balance and Gait Evaluation's total mobility score (TMS). At 1 year of follow-up, participants who had declined by > or = 1 standard deviation (SD) below the baseline mean value of each outcome measure were classified as "decliners."
  
  
  RESULTS
  Of the 1517 participants, 93.5% (n = 1419) completed the 1-year follow-up reassessment of BI and IADL. For gait speed and TMS, respectively, 88.2% (n = 1338) and 88.3% (n = 1339) completed the 1-year outcome assessment. Fallers, particularly recurrent fallers, experienced significantly greater 1-year declines in the four functional measures. Multivariate logistic regression analyses showed that an incident fall was a significant independent predictor for decliners in the BI, Lawton's IADL score, gait speed, and TMS after adjustment of all significant confounding factors. The relative risks of an incident fall as an independent predictor for decliners in the BI, IADL score, gait speed, and TMS were 2.4 (95% confidence interval [CI], 1.4-4.0; p =.01), 2.9 (95% CI, 1.7-5.2; p <.001), 2.4 (95% CI, 1.5-3.8; p <.001), and 4.6 (95% CI, 2.7-7.8; p <.001), respectively.
  
  
  CONCLUSIONS
  Incident falls have a significant negative impact on the balance, gait, and Activities of Daily Living functioning in community-dwelling older adults.
authors.affiliation: FRCP, University Department of Medicine, Queen Mary Hospital, The University of Hong Kong, 102 Pokfulam Road, Hong Kong, Hong Kong SAR. lwchu@hkucc.hku.hk
authors.forename: Leung-Wing
authors.initials: LW
authors.lastname: Chu
authors.forename: Alice Y Y
authors.initials: AY
authors.lastname: Chiu
authors.forename: Iris
authors.initials: I
authors.lastname: Chi
mesh_terms: D000058:Accidental Falls; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D006723:Hong Kong; D006801:Humans; D008297:Male; D004856:Postural Balance / Q000502:physiology*; D011446:Prospective Studies; D012111:Residence Characteristics