Risk isk factors tors for falls ls amon ong g olde der r - - PowerPoint PPT Presentation

Risk isk factors tors for falls ls amon

• ng

g olde der r community

• mmunity-

dweller ellers s in Shenzhen nzhen, , China ina

• Mr. PENG Ke

PhD Candidate | MPH The George Institute for Global Health, Australia The University of Sydney

13th Australasian Injury Prevention and Safety Promotion Conference

23/11/2017 1

Shen enzhen zhen city ty

• First tier city (Shenzhen, Beijing, Shanghai, Guangzhou)
• Urban development level, Economic, Talent attraction

and etc.

Key y Messages ssages

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• What is already known?

The risk factors for being a faller or recurrent fallers among older Chinese people have been determined in previous studies.

• What this study adds?

A history of falls (prior to the past 12 months), presence of at least one chronic disease, walking aid use and living alone were associated with an increased number of falls in older Chinese people.

Backgrou ckground nd and d Objective jective

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• Approximately 30% of American people aged 65 and over fall annually

and around half of these people fall multiple times

• The incidence of falls is relatively lower among older Chinese
• Risk factors for falls were reported to be similar in older Chinese and

Caucasian in previous studies

• To determine the number of falls experienced by older community-

dwellers in Shenzhen, China

• To identify related factors associated with number of falls

Metho thod

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• Cross-sectional study

Multistage random sampling Community-dwellers aged 60 and over Independent ambulation (With walking aids)

• Data collection

Face to face interview by trained health workers using study-specific questionnaire

• Statistical analysis

Descriptive analysis Negative binomial regression model

Res esult ult

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• 1290 (98.5%) of 1310 participants responded
• 138 (10.7%) people had at least one fall in the past year
• 111 people fell once, 17 people fell twice, 10 people fell at least three

times (9 fell 3 times and 1 fell 5 times)

Univ ivariate ariate analy lysi sis

Characteristic 0 fall (n=1152) 1 fall (n=111) 2 falls (n=17) ≥3 falls (n=10) IRR 95% CI p-value Female gender 644 (50%) 83 (6%) 9 (0.7%) 4 (0.3%) 1.35 0.94-1.95 0.1 Age, mean (SD)* 68.2 (6.5) 68.0 (6.5) 69.2 (6.5) 70.7 (6.5) 73.2 (6.2) 1.04 1.02-1.07

0.01

Education illiteracy 69 (5%) 12 (0.9%) 1.08 0.60-1.57 0.70 primary 195 (15%) 22 (2%) 2 (0.2%) 1 (0.1%) Middle 296 (23%) 20 (2%) 3 (0.2%) 1 (0.1%) High 310 (24%) 27 (2%) 8 (0.6%) 2 (0.2%) College+ 283 (22%) 30 (2%) 4 (0.3%) 5 (0.4%) Living alone* 24 (2%) 5 (0.4%) 3 (0.2%) 2.64 1.12-6.22

0.03

Chronic disease* 808 (63%) 93 (7%) 16 (1%) 9 (0.7%) 2.60 1.60-4.21

＜0.01

Medication usage* 580 (45%) 69 (5%) 13 (1%) 6 (0.5%) 1.70 1.18-2.44

＜0.01

Visual impairment* 383 (30%) 54 (4%) 8 (0.6%) 4 (0.3%) 1.65 1.16-2.36

0.01

Hearing loss 173 (13%) 24 (2%) 3 (0.2%) 2 (0.2%) 1.39 0.89-2.19 0.15 Poor subjective body sense perception* 370 (29%) 58 (5%) 11 (0.9%) 6 (0.5%) 2.42 1.70-3.43

＜0.01

Low mood* 276 (21%) 35 (3%) 6 (0.5%) 5 (0.4%) 1.65 1.13-2.41

0.01

Walking aid use* 29 (2%) 10 (0.8%) 3 (0.2%) 4 (0.3%) 5.15 2.84-9.36

＜0.01

Nocturia 267 (21%) 29 (2%) 6 (0.5%) 4 (0.3%) 1.40 0.94-2.07 0.10 Poor self-rated health * 700 (54%) 82 (6%) 12 (0.9%) 7 (0.5%) 1.62 1.10-2.37

0.01

Fall history* 96 (7%) 83 (6%) 13 (1%) 9 (0.7%) 18.89 13.23-26.98

＜0.01

Balance ability, mean (SD)* 1.74 (3.6) 1.51 (3.2) 3.50 (5.5) 3.76 (6.4) 5.70 (4.19) 1.11 1.07-1.15

＜0.01 Table 2. Factors associated with number of falls in the univariate analysis, number (%) unless otherwise indicated

• Note. College+ is at college level and above.

Multi ltivariate variate analy alysi sis

Variable IRR 95%CI p-value Chronic disease 1.85 1.09-3.19 0.02 Fall history 16.51 11.37-23.99 ＜0.01 Table 3. The result of multivariate negative binomial regression Variable IRR 95%CI p-value Living alone 2.46 1.11-5.46 0.03 Chronic disease 1.85 1.05-3.26 0.04 Walking aids use 2.26 1.10-4.66 0.03 Impaired balance 1.05 0.99-1.10 0.06 Table 4. Variables retained in the multivariate negative binomial regression model with fall history removed

Disc iscuss ussion ion

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• Strength: High respondent rate, Randomly selected participants
• Limitation: Recall bias

Risk factors Our study (Number of falls) Morris et al. (Multiple falls) Shi et al. (Recurrent falls) Fall history √ × × Chronic disease √ √ × Living alone √ × × Walking aids use/ poor mobility √ √ × Visual impairment × √ √ impaired balance ×（p=0.06） × √

Conclusi nclusion

• n

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• The factors associated with number of falls in the past year were:

Falls history The presence of at least one chronic disease Walking aid use Living alone

Reference ference

Kwan, M.M.S., Close, J.C., Wong, A.K.W. and Lord, S.R., 2011. Falls incidence, risk factors, and consequences in Chinese older people: a systematic review. Journal of the American Geriatrics Society, 59(3), pp.536-543. Morris, M., Osborne, D., Hill, K., Kendig, H., Lundgren-Lindquist, B., Browning, C. and Reid, J., 2004. Predisposing factors for occasional and multiple falls in older Australians who live at home. Australian journal of physiotherapy, 50(3), pp.153-159. Jing, S.H.I., ZHOU, B.Y., TAO, Y.K., YU, P.L., ZHANG, C.F., QIN, Z.H. and SUN, Z.Q., 2014. Incidence and associated factors for single and recurrent falls among the elderly in an urban community of

• Beijing. Biomedical and Environmental Sciences, 27(12), pp.939-949.

Ackno nowledg wledge

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• Co-authors: Prof Cathie Sherrington

A/Prof Anne Tiedemann

• Dr. Haibin Zhou

Prof Ji Peng

• Affiliated institutes: The School of Public Health, The University of Sydney, Sydney,

Australia Shenzhen Center for Chronic Disease Prevention and Control, Shenzhen, China The George Institute for Global Health, UNSW, Sydney, Australia

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• Email: kpeng@georgeinstitute.org.au
• Research of interest: Falls and fall-related injuries (mainly hip

fracture)

Than ank k you! u! Any y Ques estions? tions?