Risk factors for falling in community-dwelling older adults: which of them are associated with the recurrence of falls?

BACKGROUND: The aim of the study was to determine which risk factors were associated with the recurrence of falls among community-dwelling older adults. METHODS: Based on a cross-sectional design, 1066 community-dwelling volunteers aged 65 and older were recruited. The use of psychoactive drugs, the number of drugs taken per day, the basic mobility assessed with the Timed Up & Go test (TUG), the maximal isometric voluntary contraction strength of hand, the lower limb proprioception, the distance binocular vision, the fear of falling and the history of falls during the past year were recorded. Subjects were separated into 4 groups based on the number of falls: 0, 1, 2 and >/= 2 falls. RESULTS: Among the 395 (37.1%) fallers, 291 (27.3%) were single fallers and 104 (9.8%) were recurrent fallers (i.e., > 2 falls). The numbers of falls increased significantly with age (Incident Rate Ratio (IRR)=1.03, p < 0.001), female gender (IRR=1.95, p < 0.001), institutionalization (IRR=1.66, p=0.002), number of drugs taken per day (IRR=1.05, p < 0.001), use of psychoactive drugs (IRR=1.29, p=0.009), increased time of TUG Test (IRR=1.02, p < 0.001), use of a walking aid (IRR=1.59, p=0.002), and fear of falling (IRR=3.08, p < 0.001). In addition, a high score at the handgrip test (IRR=0.97, p < 0.001) and distance binocular vision (IRR=0.92, p < 0.001) were associated with a decreased number of falls. After adjustment for potential confounders, only female gender (IRR=1.44, p < 0.001), vision (IRR=0.95, p=0.006) and lower limb proprioception (IRR=0.95, p=0.046), and fear of falling (IRR=2.68, p < 0.001) were still significantly associated with the number of falls. CONCLUSION. The current study shows that female gender, poor vision and lower limb proprioception, and fear of falling were associated with the recurrence of falls