ABSTRACT
Introduction: This is the first prospective longitudinal study carried out in a Chinese elderly population with the objective of identifying the incidence and predictors of falls. Materials and Methods: This is a population-based cohort study in Hong Kong with 1517 ambulatory elderly Chinese recruited using a multi-stage sampling method. Baseline data on demographic, co-morbid diseases, drugs, Activities of Daily Living (ADL) [Barthel Index and Lawton’s Instrumental Activities of Daily Living (IADL)], Geriatric Depression Scale (GDS-15), cognitive assessment by the Abbreviated Mental Test (AMT), fear of falling, self-perceived mobility problem, hand grip strength, lower limb power, balance and gait tests were performed. Every subject was followed up for 1 year. Results: Four hundred and one falls occurred in 294 fallers (19.3%) over 1 year of follow-up. The prevalence of falls and recurrent falls were 19.3% and 4.75%, respectively. The incidences of falls (i.e., the fall events) were 220, 324 and 270 per 1000 person-years for men, women and both gender, respectively. The independent predictors of falls were previous history of falls, advancing age, Parkinson’s disease, knee extension power and gait speed. The independent predictors of recurrent falls were previous history of falls, self-perceived mobility problem, the knee extension strength and the Total Mobility Score of the Tinetti Balance and Gait Evaluation. Conclusions: The incidence of falls in the Chinese elderly was 270 per 1000 person-years. History of falls, old age, Parkinson’s disease, decreased lower limb power and impairment in balance and gait function were important independent predictors of falls or recurrent falls in the Chinese elderly. Effective fall prevention programmes targeted at improving these risk factors for falls should be developed for the Chinese elderly in Hong Kong and Asia
Falls are common events in the elderly. Previous Western studies have shown that up to one third of community-dwelling older adults will fall each year. The incidences of falls in community-based older populations have been reported to vary between 224 and 809 per 1000 person-years in the UK, Finland, New Zealand, United States and Sweden.1-13 The variation may be due to several reasons including recall bias related to the ascertainment of falls in retrospective studies1-3,5,10,12 and the age and race of the study subjects.1-13 A retrospective cross-sectional study on falls in Hong Kong showed a prevalence rate of 18% over the past year. This is lower in comparison with studies carried out in UK, US and Europe.14 For the incidence of falls in the Chinese elderly, there has been no previous prospective follow-up study
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