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ABSTRACT
Recognizing the importance of identifying subjects at risk of falling, w e
conducted a 9-month prospective study of the incidence of and risk factors for falls
among 518 ambulant, community-dwelling elderly men and w o m e n aged 70 or above
in Hong Kong from January 1994 to March 1995. Following an initial telephone
interview, subjects were telephoned monthly for 9 months to ascertain the incidence
of nonsyncopal falls and their consequences.
113 (21.8%) subjects fell during the follow-up period; 85 (16.4%) subjects fell
once, 28 (5%) subjects fell two or more times. The incidence rate for falls was 29.5
per 1,000 valid person months.
88.1% of falls resulted in no or minor injury.
Multivariate logistic regression analysis showed that the following risk factors were
statistically and independently associated with fallers with one or more falls: living
alone (RR, 2.05; C.I. 1.05-3.99); a history of falls (RR, 1.92; C.I. 1.12-3.29); old
fracture (RR, 1.98; C.I 1.10-3.56); arthritis (RR, 1.97; C.I. 1.27-3.07) and hospital
admission in the previous 18 months for three or more times (RR, 4.27;C.I.1.2214.93). Four out of the five independent risk factors identified for fallers with one or
more falls were independent risk factors for fallers with two or more falls. The risk
factors for fallers with one fall were different from fallers with two or more falls.
They include dissatisfaction with finance (RR, 2.19; C.I. 1.10-4.34); medical
consultation for 10-19 times (RR, 2.38;C.I.1.10-5.13), arthritis (RR, 1.67;C.I.1.012.78) and being female (RR, 1.55;C.I.0.95-2.54). Compared to fallers with one or
more falls, the risk factors for fallers with major injuries were similar but less. The
inclusion or exclusion of fall history in the final model did not alter much the relative
risks of risk factors associated with the outcome measures. The proportion of fallers
with one or more falls increase from 10.7% in those with no independent risk factor to
41.7% in those with three or more independent risk factors. This is the first
prospective study on falls in the community based Chinese elderly cohort. The
identification of the risk factors or markers for frailty and falls would help in the
recommendation for further research and preventive measures for falls.
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