title: Association of injurious falls with disability outcomes and nursing home admissions in community-living older persons.
abstract: Little is known about the deleterious effects of injurious falls relative to those of other disabling conditions or whether these effects are driven largely by hip fractures. From a cohort of 754 community-living elders of New Haven, Connecticut, we matched 122 hospitalizations for an injurious fall (59 hip-fracture and 63 other fall-related injuries) to 241 non-fall-related hospitalizations. Participants (mean age: 85.7 years) were evaluated monthly for disability in 13 activities and admission to a nursing home from 1998 to 2010. For both hip-fracture and other fall-related injuries, the disability scores were significantly greater during each of the first 6 months after hospitalization than for the non-fall-related admissions, with adjusted risk ratios at 6 months of 1.5 (95% confidence interval (CI): 1.3, 1.7) for hip fracture and 1.4 (95% CI: 1.2, 1.6) for other fall-related injuries. The likelihood of having a long-term nursing home admission was considerably greater after hospitalization for a hip fracture and other fall-related injury than for a non-fall-related reason, with adjusted odds ratios of 3.3 (95% CI: 1.3, 8.3) and 3.2 (95% CI: 1.3, 7.8), respectively. Relative to other conditions leading to hospitalization, hip-fracture and other fall-related injuries are associated with worse disability outcomes and a higher likelihood of long-term nursing home admissions.
authors.affiliation: Department of Internal Medicine,Yale School of Medicine, Adler Geriatric Center, 20 York Street, New Haven, CT 06510, USA. thomas.gill@yale.edu
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Gill
authors.forename: Terrence E
authors.initials: TE
authors.lastname: Murphy
authors.forename: Evelyne A
authors.initials: EA
authors.lastname: Gahbauer
authors.forename: Heather G
authors.initials: HG
authors.lastname: Allore
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000203:Activities of Daily Living; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015331:Cohort Studies; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D011446:Prospective Studies; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000145:classification / Q000453:epidemiology*
keywords: accidental falls; activities of daily living; aged; cohort studies; nursing homes
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