Incidence of falls and their effect on mobility of individuals over 65 years of age relative to their place of residence.
BACKGROUND
Nowadays, there are over 300 mln. people aged 65 years or more living in the world. It is estimated that the number will grow to more than 1.5 billion by 2050. The maintenance of physical fitness of the elderly at a level that enables full functional independence for as long as possible should therefore be a priority. Loss of independence leads to long-term medical, social and economic consequences. The problem of falls has only recently been perceived as one of more significant aspects influencing the fitness and independence of individuals over 65. Identifying the scale of the incidence of falls is a prerequisite for initiating prevention activities. The aim of this study was to compare the incidence of falls and their consequences (including fractures and the reduction of physical activity) among persons over 65 years of age living in a big urban area, medium-size and small towns, and rural areas.


METHODS
The study enrolled 235 inhabitants of a big city (over 1 mln. inhabitants-Warsaw), 85 inhabitants of medium-size and small towns (20-60 thousand inhabitants) and 112 inhabitants of villages (up to 3 thousand inhabitants). The subjects were asked to complete an anonymous questionnaire composed of questions concerning the circumstances of a fall, fracture, fear of another fall and a subjective assessment of mobility before and after a fall. The statistical analysis of the data utilised basic statistical parameters and the following tests: the Mann-Whitney U test, the Wilcoxon signed-rank test and the McNemara test.


RESULTS
77% of the inhabitants of towns/cities had suffered a fall, compared to 89% of the inhabitants of villages. The falls most frequently occurred at home and its vicinity (village) and in the street (town/city). Falls had led to fractures in 35-56% of the subjects, depending on the group. Falls led to a significant reduction in mobility--from moderate to low. According to the subjects, this was due to the fear of another fall, an awareness that one was ill and feeling weak, with pain contributing to a smaller extent. Fear of falling occurred significantly more often in the group which had experienced a fall as compared with those with no history of falls. The fear was mainly connected with walking on flat surfaces, climbing stairs, as well as with bending forwards and being in a bathroom.


CONCLUSIONS
1. The incidence of falls in the study group was an important problem concerning approx. 81% of the respondents. 2. Fractures, which occurred in about half of subjects, were a dangerous consequence of falls. 3. A fall significantly reduced mobility of the subjects--from moderate to low. 4. The fear of falling was most frequently indicated as the reason for the reduced mobility.
Białoszewski
Dariusz
D
Division of Rehabilitation, Department of Physiotherapy, 2nd Medical Faculty, Warsaw Medical University, Warsaw. dariusz.bialoszewski@wum.edu.pl
Słupik
Anna
A
Lewczuk
Emilia
E
Gotlib
Joanna
J
Mosiołek
Anna
A
Mierzwińska
Anna
A
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000061:Accidents, Home / Q000706:statistics & numerical data; D000203:Activities of Daily Living; D000368:Aged; D015897:Comorbidity; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology; D006311:Hearing Disorders / Q000453:epidemiology; D006798:Housing / Q000145:classification; D006801:Humans; D015994:Incidence; D008297:Male; D011044:Poland; D012424:Rural Population / Q000706:statistics & numerical data; D012678:Sensation Disorders / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data