title: Factors associated with falls among older adults living in institutions.
abstract: BACKGROUND
  Falls have enormous impact in older adults. Yet, there is insufficient evidence regarding the effectiveness of preventive interventions in this setting. The objectives were to measure the frequency of falls and associated factors among older people living institutions.
  
  
  METHODS
  Data were obtained from a survey on a probabilistic sample of residents aged ≥65 years, drawn in 1998-99 from institutions of Madrid (Spain). Residents, their caregivers, and facility physicians were interviewed. Fall rates were computed based on the number of physician-reported falls in the preceding 30 days. Adjusted rate ratios were computed using negative binomial regression models, including age, sex, cognitive status, functional dependence, number of diseases, and polypharmacy.
  
  
  RESULTS
  The final sample comprised 733 residents. The fall rate was 2.4 falls per person-year (95% confidence interval [CI], 2.04-2.82). The strongest risk factor was number of diseases, with an adjusted rate ratio (RR) of 1.32 (95% CI, 1.17-1.50) for each additional diagnosis. Other variables associated with falls were: urinary incontinence (RR = 2.56 [95% CI, 1.32-4.94]); antidepressant use (RR = 2.32 [95% CI, 1.22-4.40]); arrhythmias (RR = 2.00 [95% CI, 1.05-3.81]); and polypharmacy (RR = 1.07 [95% CI, 0.95-1.21], for each additional medication). The attributable fraction for number of diseases (with reference to those with ≤ 1 condition) was 84% (95% CI, 45-95%).
  
  
  CONCLUSIONS
  Number of diseases was the main risk factor for falls in this population of institutionalized older adults. Other variables associated with falls, probably more amenable to preventive action, were urinary incontinence, antidepressants, arrhythmias, and polypharmacy.
  The virtual slide(s) for this article can be found here:http://www.diagnosticpathology.diagnomx.eu/vs/3916151157277337.
authors: National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain. jdamian@isciii.es
authors: Javier
authors: J
authors: Damián
authors: Roberto
authors: R
authors: Pastor-Barriuso
authors: Emiliana
authors: E
authors: Valderrama-Gama
authors: Jesús
authors: J
authors: de Pedro-Cuesta
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D005260:Female; D006707:Homes for the Aged / Q000639:trends*; D006801:Humans; D007326:Institutionalization / Q000639:trends*; D008297:Male; D009735:Nursing Homes / Q000639:trends*; D011619:Psychotropic Drugs / Q000009:adverse effects; D012307:Risk Factors; D014549:Urinary Incontinence / Q000453:epidemiology / Q000523:psychology / Q000628:therapy
chemical_list: D011619:Psychotropic Drugs