Risk factors associated with injury attributable to falling among elderly population with history of stroke.
OBJECTIVE
Stroke survivors are at high risk for falling. Identifying physical, clinical, and social factors that predispose stroke patients to falls may reduce further disability and life-threatening complications, and improve overall quality of life.


METHODS
We used 5 biennial waves (1998-2006) from the Health and Retirement Study to assess risk factors associated with falling accidents and fall-related injuries among stroke survivors. We abstracted demographic data, living status, self-evaluated general health, and comorbid conditions. We analyzed the rate ratio (RR) of falling and the OR of injury within 2 follow-up years using a multivariate random effects model.


RESULTS
We identified 1174 stroke survivors (mean age+/-SD, 74.4+/-7.2 years; 53% female). The 2-year risks of falling, subsequent injury, and broken hip attributable to fall were 46%, 15%, and 2.1% among the subjects, respectively. Factors associated with an increased frequency of falling were living with spouse as compared to living alone (RR, 1.4), poor general health (RR, 1.1), time from first stroke (RR, 1.2), psychiatric problems (RR, 1.7), urinary incontinence (RR, 1.4), pain (RR, 1.4), motor impairment (RR, 1.2), and past frequency of > or = 3 falls (RR, 1.3). Risk factors associated with fall-related injury were female gender (OR, 1.5), poor general health (OR, 1.2), past injury from fall (OR, 3.2), past frequency of > or = 3 falls (OR, 3.1), psychiatric problems (OR, 1.4), urinary incontinence (OR, 1.4), impaired hearing (OR, 1.6), pain (OR, 1.8), motor impairment (OR, 1.3), and presence of multiple strokes (OR, 3.2).


CONCLUSIONS
This study demonstrates the high prevalence of falls and fall-related injuries in stroke survivors, and identifies factors that increase the risk. Modifying these factors may prevent falls, which could lead to improved quality of life and less caregiver burden and cost in this population.
Divani
Afshin A
AA
Minnesota Stroke Initiative, Department of Neurology, University of Minnesota, Minneapolis, MN 55455, USA. divani@umn.edu
Vazquez
Gabriela
G
Barrett
Anna M
AM
Asadollahi
Marjan
M
Luft
Andreas R
AR
D000058:Accidental Falls / Q000401:mortality* / Q000517:prevention & control / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D015984:Causality; D015331:Cohort Studies; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D017533:Marital Status; D001523:Mental Disorders / Q000453:epidemiology; D009069:Movement Disorders / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D040242:Risk Reduction Behavior; D017678:Sex Distribution; D020521:Stroke / Q000453:epidemiology* / Q000503:physiopathology; D014549:Urinary Incontinence / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000517:prevention & control