SLIDE 1
Variation in falling and fall risk among community-dwelling
- lder citizens in 12 European countries
Variation in falling and fall risk among community-dwelling older - - PowerPoint PPT Presentation
Variation in falling and fall risk among community-dwelling older - - PowerPoint PPT Presentation
Variation in falling and fall risk among community-dwelling older citizens in 12 European countries Carmen Franse Department of Public Health Erasmus MC Rotterdam, The Netherlands CONFLICT OF INTEREST DISCLOSURE I have no potential conflict of
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SLIDE 3
Falls: an introduction
Burden health
- 30% community-dwelling elderly >65y fall yearly
- 90% hip fractures attributed to falls
Burden resources
- In 2000, direct costs hip fractures Europe over €24 billion
- In 2050, costs expected to double
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Falls: an introduction
- No studies on international variation in falling and fall risk
– Important to inform policy – Prioritize right fall prevention programmes
- Composition of fall-risk factors in populations could explain
variation – Socio-demographic – Intrinsic – Extrinsic
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Research questions
- 1. Are there between-country differences in fall rate?
- 2. Are there between-country differences in prevalence of socio-
demographic and intrinsic fall risk characteristics
- 3. Do these differences account for possible differences in fall
rate?
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Methods
- Data: Survey of Health, Ageing and Retirement in
Europe (SHARE), wave 4&5 (2010-2013)
- Population: 18,596 community-dwelling men and women aged
≥ 65 years from 12 European countries
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Measurements
- At baseline: Fall risk factors
– Socio-demographics (age, sex, education, living alone) – Mobility limitations, ADL, dizziness, depression, self- perceived health, vision, cognitive function
- At 2-year follow-up: Falling
– Question: “For the past six months at least, have you been bothered by any of the health conditions on this card?”
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Results 1: Are there between-country differences in fall rate? 2 4 6 8 10 12 14 16 18 % within past 6 months
Falling by country
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Results 2: Are there between-country differences in terms of intrinsic fall characteristics?
10 20 30 40 50 60 70 80 Proportion, %
Intrinsic fall risk factors by country
Low health Mobility limitation(s) ADL limitation(s) Dizziness Impaired vision Depression Impaired cognition
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0,5 1 1,5 2 2,5 3
Falls by country, unadjusted (OR)
0,5 1 1,5 2 2,5 3
Falls by country, adjusted for socio-demographics (aOR)
Results 3: Do these differences account for possible differences in falls? 0,5 1 1,5 2 2,5 3
Falls by country, adjusted for intrinsic fall risk factors (aOR)
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Discussion/Conclusion
- Fall incidence varies between European countries
– Higher in Belgium, France, Spain, Estonia, Czech Republic
- Explained by:
– Differences main intrinsic fall risk factors – Not by socio-demographic composition
- Other explanations: home hazards, risk behaviour
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Discussion/Conclusion
- Limitations
– self-reported data – 25% persons lost to follow-up between baseline & follow-up
- Strengths
– first cross-national comparative study falling – Nationally representative samples – Able to capture many intrinsic risk factors
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Thank you!
- Co-authors and collaborators: Hein Raat, Judith
Rietjens, Ed van Beeck, Francesco Mattace Raseo, Lex Burdorf, Amy van Grieken, Agnes van der Heide, Ida Korfage
- SHARE research team and participants
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Do you have any questions?
c.franse@erasmusmc.nl Franse CB, Rietjens JA, Burdorf A, et al. A prospective study on the variation in falling and fall risk among community-dwelling older citizens in 12 European countries BMJ Open 2017;7:e015827.