Clinical Risk Factors for Head Impact During Falls in Older Adults: A Prospective Cohort Study in Long-Term Care.
To examine risk factors associated with head impact during falls in older adults in long-term care (LTC).



Two LTC facilities in British Columbia, Canada.



160 LTC residents.



Prospective cohort study.



Between 2007 and 2014, we video captured 520 falls experienced by participants. Each fall video was analyzed to determine whether impact occurred to the head. Using generalized estimating equation models, we examined how head impact was associated with other fall characteristics and health status prior to the fall.



Head impact occurred in 33% of falls. Individuals with mild cognitive impairment were at higher risk for head impact (odds ratio = 2.8; 95% confidence interval, 1.5-5.0) than those with more severe cognitive impairment. Impaired vision was associated with 2.0-fold (1.3-3.0) higher odds of head impact. Women were 2.2 times (1.4-3.3) more likely than men to impact their head during a fall.



Head impact is common during falls in LTC, with less cognitively impaired, female residents who suffered from visual impairment, being most likely to impact their head. Future research should focus on improving our ability to detect neural consequences of head impact and evaluating the effect of interventions for reducing the risk for fall-related head injuries in LTC.
Technology for Injury Prevention in Seniors (TIPS) Program (Drs Yang, Feldman, and Robinovitch and Ms Leung), Department of Biomedical Physiology and Kinesiology (Drs Yang, Mackey, Feldman, and Robinovitch), and School of Engineering Science (Dr Robinovitch), Simon Fraser University, Burnaby, British Columbia, Canada; Centre for Hip Health and Mobility, Robert H. N. Ho Research Centre (Drs Yang, Mackey, Liu-Ambrose, and Robinovitch), and Department of Physical Therapy (Dr Liu-Ambrose), University of British Columbia, Vancouver, British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, Vancouver, British Columbia, Canada (Dr Liu-Ambrose); and Primary Care, Chronic Disease Management & Specialized Seniors, Fraser Health Authority, Surrey, British Columbia, Canada (Ms Leung and Dr Feldman).
Yijian
Y
Yang
Dawn C
DC
Mackey
Teresa
T
Liu-Ambrose
Pet-Ming
PM
Leung
Fabio
F
Feldman
Stephen N
SN
Robinovitch
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D001955:British Columbia / Q000453:epidemiology; D015331:Cohort Studies; D016001:Confidence Intervals; D006259:Craniocerebral Trauma / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D015577:Geriatric Assessment; D006707:Homes for the Aged; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D008134:Long-Term Care; D008297:Male; D009735:Nursing Homes; D016017:Odds Ratio; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D014741:Video Recording