Patterns and predictors of falls and their consequences in extreme old age

METHODS: This study added a special investigation of falling in advanced old age to the 2002-2003 follow-up survey of 110 over-90-year-old men and women from the Cambridge City over-75s Cohort, a population-based longitudinal study of ageing. Data collection comprised a standardised nurse-administered questionnaire with cognitive assessment, functional performance testing, quantitative heel ultrasound scans and a year’s prospective monitoring of falls. KEY FINDINGS AND THEIR IMPLICATIONS: The study’s description of a representative population aged over 90 is valuable to service planners preparing for demographic change, revealing high levels of many fall risk factors. Detailed characterisation of functional status showed close agreement between reported disability levels and performance measures. This first population-based survey of skeletal fragility in the tenth decade found quantitative ultrasound measures markedly lower than previous studies with younger old people. Skeletal fragility reflected weight-bearing functional test performance and reported current or past mobility. This first prospective study of falling and adverse sequelae amongst people aged over 90 in a representative population-based sample found falls are even more common than previously reported for very old people a decade younger: 60% fell at least once during follow-up, 45% more than once, with minimal gender differences. Incidence was 277 falls / 100 person-years. Most falls occurred alone, most people were unable to get up after falling, and most did not use available alarms to call help. Findings also showed high levels of injuries including fractures, hospitalisation and long-term care admissions. Fracture risk factors were also associated with skeletal ultrasound measures. Functional tests added no predictive value to reported clinical risk factors.EThOS - Electronic Theses Online ServiceGBUnited Kingdo