Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, Ontario.
J Patient Saf. 2009 Jun;5(2):61-6. doi: 10.1097/PTS.0b013e3181a551ed.
Falling constitutes a significant risk to the health and well-being of seniors. Although a number of risk factors have been established within the literature for falling, limited work has differentiated risk factors for 1-time versus recurrent or multiple fallers.
The purpose of this research was to examine 2 relationships: (1) the risk factors for nonfallers versus fallers (1+ falls); and (2) the risk factors for nonfallers/1-time fallers versus multiple fallers (2+ falls). All participants (n = 453) were subjects within 5 different fall intervention programs funded through the Falls Prevention Initiative sponsored by Health Canada and Veterans Affairs Canada. In total, 5 project sites funded in Ontario conducted independent fall intervention programs. At the onset of their programs and at the completion of their programs, each project site assessed all of their subjects or a predetermined number of seniors (if the subject pool was extensive) using 2 instruments, namely the interRAI Community Health Assessment and the Berg Balance Scale, so that comparisons could be made between sites.
Of the 453 individuals, 67% of the sample was classified as nonfallers, with 33% classified as experiencing 1 or more falls. Risk factors significant within the model examining nonfallers versus 1+ fallers included increased medication use and a previous history of falling. For the second analyses, examining 0 falls/1 fall versus recurrent fallers, the following factors were associated with increased risk: medication use, previous history of falling, and compromised activities of daily living (ADL). Fourteen percent of the sample experienced 2+ falls.
It is important to distinguish fallers based on fall status because recurrent or multiple fallers are more likely to benefit from fall prevention efforts. Using a standardized and comprehensive tool such as the interRAI-CHA would assist researchers in making comparisons between different research groups.
跌倒对老年人的健康和福祉构成了重大风险。尽管文献中已经确定了许多跌倒的风险因素，但对于一次性跌倒者与复发性或多次跌倒者的风险因素，研究工作有限。
本研究旨在检验两种关系：（1）非跌倒者与跌倒者（1 次以上跌倒）的风险因素；（2）非跌倒者/1 次跌倒者与多次跌倒者（2 次以上跌倒）的风险因素。所有参与者（n=453）均为加拿大卫生部和加拿大退伍军人事务部资助的五个不同跌倒干预项目的受试者。共有 5 个在安大略省资助的项目地点开展了独立的跌倒干预项目。在项目开始时和项目完成时，每个项目地点都使用 2 种工具评估其所有受试者或预定数量的老年人（如果受试者人数众多），即 interRAI 社区健康评估和 Berg 平衡量表，以便可以在各地点之间进行比较。
在 453 名个体中，67%的样本被归类为非跌倒者，33%的样本被归类为经历过 1 次或多次跌倒。在检查非跌倒者与 1+跌倒者的模型中，有意义的风险因素包括增加药物使用和既往跌倒史。对于第二个分析，检查 0 次跌倒/1 次跌倒与复发性跌倒者，以下因素与风险增加相关：药物使用、既往跌倒史和日常生活活动（ADL）受损。14%的样本经历了 2 次或以上跌倒。
根据跌倒状态区分跌倒者很重要，因为复发性或多次跌倒者更有可能从跌倒预防措施中受益。使用 interRAI-CHA 等标准化和全面的工具将有助于研究人员在不同研究组之间进行比较。
