Incidence and risk factors for falls among community-dwelling elderly subjects on a 1-year follow-up: a prospective cohort study from Ernakulam, Kerala, India

Objectives There is limited knowledge regarding epidemiology and risk of falls among the elderly living in low-income and middle-income countries. In this situation, the current study aims to report the incidence of falls and associated risk factors among free living elderly population from Kerala,...

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Main Authors: Manu Raj, Abish Sudhakar, Conrad Kabali, Divyamol K Sasidharan, Priya Vijayakumar, Sumi Soman, Libin Antony
Format: Article
Language:English
Published: BMJ Publishing Group 2020-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/7/e033691.full
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author Manu Raj
Abish Sudhakar
Conrad Kabali
Divyamol K Sasidharan
Priya Vijayakumar
Sumi Soman
Libin Antony
author_facet Manu Raj
Abish Sudhakar
Conrad Kabali
Divyamol K Sasidharan
Priya Vijayakumar
Sumi Soman
Libin Antony
author_sort Manu Raj
collection DOAJ
description Objectives There is limited knowledge regarding epidemiology and risk of falls among the elderly living in low-income and middle-income countries. In this situation, the current study aims to report the incidence of falls and associated risk factors among free living elderly population from Kerala, India.Design Prospective cohort study with stratified random cluster sampling.Setting The study location was Ernakulam, Kerala, India, and we collected information via house visits using a questionnaire. During the research, the subjects were followed up prospectively for 1 year by phone at intervals of 3 months and missing subjects were contacted by house visits.Participants Community-dwelling elderly above 65 years of age.Results We recruited a total of 1000 participants out of which a total of 201 (20.1%) subjects reported a fall during the follow-up. The incidence rate of falls was 31 (95% CI 27.7 to 34.6) per 100 person-years. Female sex (OR 1.48, 95% CI 1.05 to 2.10, p=0.027), movement disorders including Parkinsonism (OR 2.26, 95% CI 1.00 to 5.05, p=0.048), arthritis (OR 1.48, 95% CI 1.05 to 2.09, p=0.026), dependence in basic activities of daily living (OR, 3.49, 95% CI 2.00 to 6.09, p<0.001), not using antihypertensive medications (OR, 1.53, 95% CI 1.10 to 2.13, p=0.012), living alone during daytime (OR 3.27, 95% CI 1.59 to 6.71, p=0.001) and a history of falls in the previous year (OR, 2.25, 95% CI 1.60 to 3.15, p<0.001) predicted a fall in the following year.Conclusions One in five community-dwelling senior citizen fall annually and one in four who fall are prone to fall again in the following year. Interventions targeting falls among the elderly need to focus on modifiable risk factors such as living alone during daytime, movement disorders, arthritis and dependence on basic activities of daily living.
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spelling doaj-art-878d98ff3fe54939b677258a66e02ee92025-08-20T02:35:54ZengBMJ Publishing GroupBMJ Open2044-60552020-07-0110710.1136/bmjopen-2019-033691Incidence and risk factors for falls among community-dwelling elderly subjects on a 1-year follow-up: a prospective cohort study from Ernakulam, Kerala, IndiaManu Raj0Abish Sudhakar1Conrad Kabali2Divyamol K Sasidharan3Priya Vijayakumar4Sumi Soman5Libin Antony6Health Sciences Research, Amrita Institute of Medical Sciences, Kochi, Kerala, IndiaDepartment of Pediatric Cardiology, Amrita Institute of Medical Sciences, Cochin, Kerala, IndiabiostatisticianGeriatric Medicine, Amrita Institute of Medical Sciences and Research Centre, Cochin, Kerala, IndiaGeriatric Medicine, Amrita Vishwa Vidyapeetham, Kochi, Kerala, IndiaPublic Health Research, Amrita Vishwa Vidyapeetham, Kochi, Kerala, IndiaPublic Health Research, Amrita Vishwa Vidyapeetham, Kochi, Kerala, IndiaObjectives There is limited knowledge regarding epidemiology and risk of falls among the elderly living in low-income and middle-income countries. In this situation, the current study aims to report the incidence of falls and associated risk factors among free living elderly population from Kerala, India.Design Prospective cohort study with stratified random cluster sampling.Setting The study location was Ernakulam, Kerala, India, and we collected information via house visits using a questionnaire. During the research, the subjects were followed up prospectively for 1 year by phone at intervals of 3 months and missing subjects were contacted by house visits.Participants Community-dwelling elderly above 65 years of age.Results We recruited a total of 1000 participants out of which a total of 201 (20.1%) subjects reported a fall during the follow-up. The incidence rate of falls was 31 (95% CI 27.7 to 34.6) per 100 person-years. Female sex (OR 1.48, 95% CI 1.05 to 2.10, p=0.027), movement disorders including Parkinsonism (OR 2.26, 95% CI 1.00 to 5.05, p=0.048), arthritis (OR 1.48, 95% CI 1.05 to 2.09, p=0.026), dependence in basic activities of daily living (OR, 3.49, 95% CI 2.00 to 6.09, p<0.001), not using antihypertensive medications (OR, 1.53, 95% CI 1.10 to 2.13, p=0.012), living alone during daytime (OR 3.27, 95% CI 1.59 to 6.71, p=0.001) and a history of falls in the previous year (OR, 2.25, 95% CI 1.60 to 3.15, p<0.001) predicted a fall in the following year.Conclusions One in five community-dwelling senior citizen fall annually and one in four who fall are prone to fall again in the following year. Interventions targeting falls among the elderly need to focus on modifiable risk factors such as living alone during daytime, movement disorders, arthritis and dependence on basic activities of daily living.https://bmjopen.bmj.com/content/10/7/e033691.full
spellingShingle Manu Raj
Abish Sudhakar
Conrad Kabali
Divyamol K Sasidharan
Priya Vijayakumar
Sumi Soman
Libin Antony
Incidence and risk factors for falls among community-dwelling elderly subjects on a 1-year follow-up: a prospective cohort study from Ernakulam, Kerala, India
BMJ Open
title Incidence and risk factors for falls among community-dwelling elderly subjects on a 1-year follow-up: a prospective cohort study from Ernakulam, Kerala, India
title_full Incidence and risk factors for falls among community-dwelling elderly subjects on a 1-year follow-up: a prospective cohort study from Ernakulam, Kerala, India
title_fullStr Incidence and risk factors for falls among community-dwelling elderly subjects on a 1-year follow-up: a prospective cohort study from Ernakulam, Kerala, India
title_full_unstemmed Incidence and risk factors for falls among community-dwelling elderly subjects on a 1-year follow-up: a prospective cohort study from Ernakulam, Kerala, India
title_short Incidence and risk factors for falls among community-dwelling elderly subjects on a 1-year follow-up: a prospective cohort study from Ernakulam, Kerala, India
title_sort incidence and risk factors for falls among community dwelling elderly subjects on a 1 year follow up a prospective cohort study from ernakulam kerala india
url https://bmjopen.bmj.com/content/10/7/e033691.full
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