Zohari Zahira, Rahim Azliza, Mat Din Hazwan, Saibul Nurfaizah, Jafri Asiah, Rahim Shafikah, Nasir Faizah, Sallehuddin Hakimah Mohammad
Geriatric Unit, Medical Department, Faculty of Medical and Health Sciences, Universiti Putra Malaysia, Malaysia.
Nursing Unit, Hospital Sultan Abdul Aziz Shah, Universiti Putra Malaysia, Malaysia.
Belitung Nurs J. 2025 Aug 3;11(4):487-495. doi: 10.33546/bnj.3899. eCollection 2025.
Falls among older adults in institutional care are a significant concern due to their serious consequences and are further complicated by staffing constraints. Identification of key risk factors is essential for targeted prevention and closer monitoring.
To identify the fall risk factors among older adults in institutional care and evaluate their relationships with overall fall risk.
This retrospective cross-sectional study analyzed data from 184 residents of a public institutional care home in Selangor, Malaysia. Data were collected from January 2023 to October 2023 through fall risk assessments and medical records. A history of falls over the past 12 months was documented. Fall risk was assessed using the Downton Fall Risk Index (DFRI). Descriptive statistics were used to summarize participant characteristics and the prevalence of falls. Ordinal logistic regression was conducted to identify factors associated with higher fall risk scores.
The study included 184 participants (60.3% male), with the majority aged 70-79 years (45.4%). Common comorbidities were hypertension (50.5%) and diabetes mellitus (28.8%), with sensory impairments such as visual (50.0%) and hearing (32.1%) deficits. Polypharmacy was reported in 23% of participants, and almost a quarter had a history of falls. A high fall risk was observed in 39.7% of cases. Ordinal logistic regression revealed significant predictors of higher fall risk: hypertension (OR 5.93, 95% CI 2.18-16.14), polypharmacy (OR 5.53, 95% CI 2.11-14.47), visual impairment (OR 16.28, 95% CI 3.38-78.41), hearing impairment (OR 17.64, 95% CI 3.50-88.85), cognitive impairment (OR 33.12, 95% CI 4.61-237.88), psychiatric illness (OR 4.76, 95% CI 1.23-18.44), and female sex (OR 2.61, 95% CI 1.19-5.74).
Regular fall risk assessments and tailored intervention plans that address these factors are crucial for reducing falls and improving the quality of life for this vulnerable population. These findings provide practical guidance for healthcare professionals, including nursing staff, in institutional care to prioritize high-risk residents and implement early preventive strategies.
机构照料中的老年人跌倒问题令人严重关切，因其后果严重，且人员配备限制使其进一步复杂化。识别关键风险因素对于有针对性的预防和密切监测至关重要。
识别机构照料中老年人的跌倒风险因素，并评估它们与总体跌倒风险的关系。
这项回顾性横断面研究分析了马来西亚雪兰莪州一家公立机构照料院184名居民的数据。数据于2023年1月至2023年10月通过跌倒风险评估和医疗记录收集。记录了过去12个月内的跌倒史。使用唐顿跌倒风险指数（DFRI）评估跌倒风险。描述性统计用于总结参与者特征和跌倒患病率。进行有序逻辑回归以识别与较高跌倒风险评分相关的因素。
该研究包括184名参与者（60.3%为男性），大多数年龄在70 - 79岁之间（45.4%）。常见合并症为高血压（50.5%）和糖尿病（28.8%），存在视力（50.0%）和听力（32.1%）等感觉障碍。23%的参与者报告使用多种药物，近四分之一有跌倒史。39.7%的病例观察到高跌倒风险。有序逻辑回归显示较高跌倒风险的显著预测因素：高血压（比值比5.93，95%置信区间2.18 - 16.14）、使用多种药物（比值比5.53，95%置信区间2.11 - 14.47）、视力障碍（比值比16.28，95%置信区间3.38 - 78.41）、听力障碍（比值比17.64，95%置信区间3.50 - 88.85）、认知障碍（比值比33.12，95%置信区间4.61 - 237.88）、精神疾病（比值比4.76，95%置信区间1.23 - 18.44）和女性（比值比2.61，95%置信区间1.19 - 5.74）。
定期进行跌倒风险评估并制定针对这些因素的量身定制的干预计划对于减少跌倒和改善这一脆弱人群的生活质量至关重要。这些发现为机构照料中的医护人员（包括护理人员）提供了实用指导，以便对高风险居民进行优先排序并实施早期预防策略。
