Prevalence and Risk Factors of Falls among Elderly Attending Some Primary Healthcare Centers in Suez Governorate

Abstract

World Health Organization defined fall as an event which results in a person coming to rest inadvertently on the ground or floor or other lower level. Falls are a major cause of morbidity and mortality in older individuals. The problem of falls in the elderly population is clearly more than simply a high incidence, because young children and athletes certainly have higher incidences of falls than all but the frailest elderly groups. Rather, it is a combination of a high incidence together with a high susceptibility to injury, because of a high prevalence of clinical diseases (e.g. osteoporosis) and age-related physiological changes (e.g. slowed protective reflexes) that make even a relatively mild fall particularly dangerous. In addition, recovery from fall injury is often delayed in older persons, which in turn increases risk of subsequent falls through deconditioning. The objectives were to determine the prevalence of falls in elderly attending primary healthcare centers and to identify the possible risk factors associated with falls among the participating elderly people. The study was cross-sectional study conducted on 300 elderly people attending family medicine clinics in three primary healthcare centers in Suez Governorate (Alsalam medical center, Mubarak medical center and Alsabbah medical center) with excluded of people who are severely ill, have a psychiatric illness prohibiting participation, refused to participate in the study and people who unable to stand or walk at all. The Data collection tools of the study were an interview questionnaire used including socio-demographic data and history of any fall in the previous 12 months, Fall Risk Assessment Tool (FRAT), Basic and instrumental activities of daily living (ADL and IADL), The Mini Mental Status Examination (MMSE) and Geriatric Depression Scale (GDS) 15 questions. We measured blood pressure, pulse and body mass index and made Hand Grip strength test, Single Leg Stance test and Timed Up and Go Test. Results: Prevalence of falls among the studied populations was 29%. Women fell more frequently than men (accounting for 64.4% and 35.6% of fallers, p = 0.01). Most falls occurred indoors (58.3%). A significant association was found between fall history and age, sex, muscle weakness, depression, urinary incontinence, IHD, visual impairment, fear of falling, use of assistive device, postural hypotension, and polypharmacy.