Predictors of falls in a multiethnic population of older rural adults with diabetes.
BACKGROUND
Falls are a recognized danger for older adults with diabetes. Persons in rural communities with diabetes may face additional risks from falling due to environmental and activity differences.


METHODS
Data were obtained in a cross-sectional survey of a stratified random sample of 691 community-dwelling adults (42.7% white, 31.4% African American, and 25.9% Native American) at least 65 years old with two or more Medicare claims for diabetes in 1998-2000, living in two rural counties in North Carolina. Falls data were self-reported for the previous year. Demographic data, foot-related symptoms, diabetes medications, and other health characteristics were reported.


RESULTS
Three hundred two persons (43.7%) reported falling at least once, including 171 (26.2%) who experienced two or more (frequent) falls. Frequent fallers were more likely to be male (odds ratio [OR] = 1.76; 95% confidence interval [CI] = 1.17, 2.66), report tingling or numbness in feet (OR = 1.75; 95% CI = 1.13, 2.70), have had a stroke (OR = 1.81; 95% CI = 1.19, 2.76), have longer duration of diabetes (OR = 1.21; 95% CI = 1.00, 1.47), have lower physical functioning (OR = 0.97; 95% CI = 0.96, 0.99) and mobility (OR = 0.89; 95% CI = 0.82, 0.96), and take a greater number of prescription medications (OR = 1.07; 95% CI = 1.01, 1.13).


CONCLUSIONS
For rural older adults with diabetes, falls history should be screened to identify those at risk. Further research should investigate unique environmental factors contributing to falls for rural elderly persons.
Quandt
Sara A
SA
Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1063, USA. squandt@wfubmc.edu
Stafford
Jeanette M
JM
Bell
Ronny A
RA
Smith
Shannon L
SL
Snively
Beverly M
BM
Arcury
Thomas A
TA
D000058:Accidental Falls / Q000706:statistics & numerical data*; D001741:Black or African American; D000368:Aged; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000208:ethnology*; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007198:Indians, North American; D008297:Male; D009657:North Carolina; D012307:Risk Factors; D012423:Rural Health; D012959:Socioeconomic Factors; D044465:White People