The MOBILIZE Boston Study: design and methods of a prospective cohort study of novel risk factors for falls in an older population.
BACKGROUND
Falls are the sixth leading cause of death in elderly people in the U.S. Despite progress in understanding risk factors for falls, many suspected risk factors have not been adequately studied. Putative risk factors for falls such as pain, reductions in cerebral blood flow, somatosensory deficits, and foot disorders are poorly understood, in part because they pose measurement challenges, particularly for large observational studies.


METHODS
The MOBILIZE Boston Study (MBS), an NIA-funded Program Project, is a prospective cohort study of a unique set of risk factors for falls in seniors in the Boston area. Using a door-to-door population-based recruitment, we have enrolled 765 persons aged 70 and older. The baseline assessment was conducted in 2 segments: a 3-hour home interview followed within 4 weeks by a 3-hour clinic examination. Measures included pain, cerebral hemodynamics, and foot disorders as well as established fall risk factors. For the falls follow-up, participants return fall calendar postcards to the research center at the end of each month. Reports of falls are followed-up with a telephone interview to assess circumstances and consequences of each fall. A second assessment is performed 18 months following baseline.


RESULTS
Of the 2382 who met all eligibility criteria at the door, 1616 (67.8%) agreed to participate and were referred to the research center for further screening. The primary reason for ineligibility was inability to communicate in English. Results from the first 600 participants showed that participants are largely representative of seniors in the Boston area in terms of age, sex, race and Hispanic ethnicity. The average age of study participants was 77.9 years (s.d. 5.5) and nearly two-thirds were women. The study cohort was 78% white and 17% black. Many participants (39%) reported having fallen at least once in the year before baseline.


CONCLUSIONS
Our results demonstrate the feasibility of conducting comprehensive assessments, including rigorous physiologic measurements, in a diverse population of older adults to study non-traditional risk factors for falls and disability. The MBS will provide an important new data resource for examining novel risk factors for falls and mobility problems in the older population.
Leveille
Suzanne G
SG
Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. sleveill@bidmc.harvard.edu
Kiel
Douglas P
DP
Jones
Richard N
RN
Roman
Anthony
A
Hannan
Marian T
MT
Sorond
Farzaneh A
FA
Kang
Hyun G
HG
Samelson
Elizabeth J
EJ
Gagnon
Margaret
M
Freeman
Marcie
M
Lipsitz
Lewis A
LA
D000058:Accidental Falls; D000203:Activities of Daily Living; D000368:Aged; D001900:Boston; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D007361:Intelligence Tests; D007407:Interviews as Topic; D008297:Male; D010146:Pain / Q000145:classification; D004856:Postural Balance; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires