Falls among older adults: characteristics of fallers, predictors of falls, and the impact of falls on health care and long-term care utilization

UnrestrictedThis dissertation profiles the characteristics of community-dwelling older adults who fall (hereafter, fallers); investigates predictors of falls by frequency of falls and by race/ethnicity; and examines the extent to which fallers talk about their falls with health care professionals, and the consequences of falls on subsequent health care and long-term care (LTC) utilization.; By using nationally representative samples of the U.S. population, the results demonstrate that fallers were more likely to be older, be female, be non-Hispanic White, live alone, have poorer health characteristics, have poorer socioeconomic characteristics, and have more supportive features at home compared to their nonfaller counterparts. With respect to the predictors of falls, the findings show that being female, having functional limitations, and having certain diseases/chronic conditions were significant predictors of falls for both one-time and multiple-time fallers. In addition, the study found that being non-Hispanic African American or Hispanic decreased the likelihood of experiencing a fall, and the relative magnitude of predictors of a fall varied slightly across racial/ethnic groups.; With respect to the extent to which fallers talk about their falls with health care providers, less than half of the fallers in this study talked about them with health care providers, and those who did were more likely to be older, to be female, to be unmarried, to live in a metropolitan area, to have poorer health, and to have higher numbers of falls and injurious falls compared to those who did not talk about their falls. In terms of the consequences of falls on health care and LTC utilization, falls in 2004 were significantly associated with higher health care and LTC utilization in 2004. However, falls in 2002 were generally not associated with service utilization in 2004, whereas injurious falls in 2002 had a significant positive association with higher number of physician visits in 2004.; Given that falls among older adults are sentinel events, and in light of the significant impact falls have on health care and LTC utilization, effective and targeted fall prevention programs are needed to prevent and reduce falls among older adults by ameliorating and modifying risk factors for falls