title: Do elderly people at more severe activity of daily living limitation stages fall more?
abstract: OBJECTIVE
  The aim of this study was to explore how activity of daily living (ADL) stages and the perception of unmet needs for home accessibility features associate with a history of falling.
  
  
  METHODS
  Participants were from a nationally representative sample from the Second Longitudinal Survey of Aging conducted in 1994. The sample included 9250 community-dwelling persons 70 yrs or older. The associations of ADL stage and perception of unmet needs for home accessibility features with a history of falling within the past year (none, once, or multiple times) were explored after accounting for sociodemographic characteristics and comorbidities using a multinomial logistic regression model.
  
  
  RESULTS
  The adjusted relative risk of falling more than once peaked at 4.30 (95% confidence interval, 3.29-5.61) for persons with severe limitation (ADL-III) compared those with no limitation (ADL-0) then declined for those at complete limitation (ADL-IV). The adjusted relative risks of falling once and multiple times were 1.42 (95% confidence interval, 1.07-1.87) and 1.85 (95% confidence interval, 1.44-2.36), respectively, for those lacking home accessibility features.
  
  
  CONCLUSIONS
  Risk of falling appeared greatest for those whose homes lacked accessibility features and peaked at intermediate ADL limitation stages, presumably at a point when people have significant disabilities but sufficient function to remain partially active.
authors.affiliation: Hospital de La Concepción, San Germán, Puerto Rico.
authors.forename: John T
authors.initials: JT
authors.lastname: Henry-Sánchez
authors.forename: Jibby E
authors.initials: JE
authors.lastname: Kurichi
authors.forename: Dawei
authors.initials: D
authors.lastname: Xie
authors.forename: Qiang
authors.initials: Q
authors.lastname: Pan
authors.forename: Margaret G
authors.initials: MG
authors.lastname: Stineman
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001107:Architectural Accessibility; D004185:Disability Evaluation; D005260:Female; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D014481:United States / Q000453:epidemiology