Prevalence Of And Risk Factors For Falls In Older People In An Urban Community In South Africa

Abstract

Prevalence of and risk factors for falls in older people in an urban

community in South Africa

Sebastiana Zimba Kalula

February 2012

Background. Falls are a major cause of disability and mortality in older people. Little

is known of the extent and gravity of the problem in South Africa.

Methods. A cross-sectional study with a 12-months follow-up was conducted on 837

randomly sampled, ambulant community-dwelling subjects aged ≥ 65 years to

determine the prevalence and incidence of, and risk factors for falls. Data were

collected on socio-demographic characteristics, self-reported health status, comorbid

disease, medications, functioning, physical performance (lower limb power, balance

and gait, hand grip strength), and mental function (memory, concentration,

depression). Prevalence rate of falls was calculated with a 95 per cent confidence interval. Odds ratios and confidence intervals were used to measure effect for predictors of falls at

0.05 level of significance.

Results. Prevalence rates of 26.4 per cent and 21.9 per cent for falls and of 11 per

cent and 6.3 per cent for recurrent falls, were established at baseline and follow-up,

respectively. Rates differed for ethnic groups: at baseline; whites 42.9 per cent,

coloureds 34.4 per cent and black Africans 6.4 per cent (p=0.0005). The incidence

rate was 236, 405.7 and 367 per 1000 person years for men, women and both

genders, respectivelly Independent risk factors for falls were self-reported conditions (poor mobility, poor vision, poor urine control, depression, Parkinson’s disease, foot disorders), self-rated health status, use of antidepressants and anti-inflammatory drugs and the Geriatric Depression Scale score. Ethnicity had the strongest association with fall risk at

baseline in whites (OR 14.94; 95% CI 7.46–29.92 for a fall and OR 21.25; 95% CI

5.54–81.51 for recurrent falls) and coloureds (OR 7.93; 95% CI 4.29–14.65 for a fall

and OR 13.33; 95% CI 3.66 – 48.62 for recurrent falls); at follow-up, history of

previous falls had the strongest association (OR 2.16; 95% CI 1.40–3.33 for a fall

and OR 10.53; 95% CI 4.17–26.56 for recurrent falls). Age, gender, IADLs and timed

Up & Go test were independent predictors of a fall on exclusion of history of a

previous fall from the model.

Conclusion. Effective management of falls and falls prevention intervention for older persons are indicated and recommended.