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A Cross-Sectional Study of the Prevalence, Correlates, and Costs of Falls in Older Home Care Clients ‘At Risk’ for Falling*

Published online by Cambridge University Press:  04 March 2010

Maureen Markle-Reid ,
Gina Browne ,
Amiram Gafni ,
Jacqueline Roberts ,
Robin Weir ,
Lehana Thabane ,
Melody Miles ,
Vida Vaitonis ,
Catherine Hecimovich  and
Pamela Baxter
...Show all authors
Maureen Markle-Reid*
Affiliation:
McMaster University
Gina Browne
Affiliation:
McMaster University
Amiram Gafni
Affiliation:
McMaster University
Jacqueline Roberts
Affiliation:
McMaster University
Robin Weir
Affiliation:
McMaster University
Lehana Thabane
Affiliation:
McMaster University
Melody Miles
Affiliation:
McMaster University
Vida Vaitonis
Affiliation:
McMaster University
Catherine Hecimovich
Affiliation:
McMaster University
Pamela Baxter
Affiliation:
McMaster University
Sandra Henderson
Affiliation:
McMaster University
*
†Correspondence concerning this article should be addressed to / La correspondance concernant cet article doit être adressées à: Maureen Markle-Reid, RN, Ph.D. McMaster University, School of Nursing 1200 Main Street West, HSC 3N28H Hamilton, Ontario L8N 3Z5. (mreid@mcmaster.ca)
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Abstract

This study examined the six-month prevalence, risk factors, and costs of falls in older people using home support services who are at risk of falling. Of the 109 participants, 70.6 per cent reported ≥ one fall in the previous six months, and 27.5 per cent experienced multiple falls. Although there was no statistically significant difference in any fall-related risk factor between fallers (1+ falls) and non-fallers (0 falls), fallers had clinically important trends towards lower levels of physical, social, and psychological functioning. There was no statistically significant difference between fallers and non-fallers in the total per-person costs of use of health services in the previous six months; however, there were significant differences between groups in specific types of health services. The multivariate analysis revealed the presence of five risk factors for falls: neurological disorder (e.g., cognitive impairment, Parkinson’s disease), age ≥ 85 years, environmental hazards, previous slip or trip, and visual impairment.

Résumé

Cette étude a examiné la prévalence pendant 6 mois, à l’aide des services de soutien à domicile, des facteurs de risque et des coûts de chutes de personnes âgées qui sont à risque de chute. Des 109 participants, 70,6 pour cent ont indiqué une chute dans les six mois précédents et 27,5 pour cent ont éprouvé plusieurs chutes. Bien qu’il n’y avait aucune différence statistiquement significative dans n’importe quel facteur de risque lié à la chute parmi ceux qui sont tombés (1+ chutes) et ceux qui ne sont pas tombés (0 chutes), ceux qui sont tombés ont montrés des tendances de plus en plus évidentes de fonctionnement réduit sur le plan physique, social et psychologique. Dans le coût total par personne d’utilisation des services de santé au cours des 6 derniers mois, il n’y avait aucune différence statistiquement significative entre ceux qui sont tombés et ceux qui ne sont pas tombés; toutefois, il y avait des différences significatives entre les groupes dans certains types de services de santé. L’analyse multivariable a révélé la présence de cinq facteurs de risques de chutes: troubles neurologiques (p. ex., diminution cognitive, maladie de Parkinson), l’âge ≥85 ans, risques environnementaux, glissade ou trébuchant précédente et déficience visuelle.

Keywords

chutes accidentalespersonnes agées communautairesprédominancefacteurs de risqueservices d’aide familialepopulation de soins à domicilemaladie chroniquecoûtsétudes transversalesdépistage des risquesaccidental fallscommunity-based seniorsprevalencerisk factorshomemaker serviceshome care populationchronic illnesscostscross-sectional studiesrisk screening
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 29 , Issue 1: Special Issue from the Social and Economic Dimensions of an Aging Population Project (SEDAP) – Caring for an Aging Population: Context, Practice & Policy , March 2010 , pp. 119 - 137
Copyright
Copyright © Canadian Association on Gerontology 2010

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Footnotes

*

We are grateful to the following agencies for funding this project from 2005 to 2008: Canadian Patient Safety Institute (CPSI – Grant Number RFAAA0506164), Community Care Access Centre of Halton, McMaster University System-Linked Research Unit on Health and Social Services Utilization, and Ontario Ministry of Health and Long-Term Care. Maureen Markle-Reid is a Career Scientist, Ontario Ministry of Health and Long-Term Care, Health Research Personnel Development Fund. This research was possible through the ongoing support of the Community Care Access Centre of Halton, Hamilton Niagara Haldimand Brant Community Care Access Centre, Mississauga Halton Community Care Access Centre, Halton Region Health Department, Community Rehab, Ellen Williams, Brant Arts Dispensary, and Dr. Heather H. Keller, Department of Family Relations and Applied Human Nutrition, Macdonald Institute, University of Guelph. We are also grateful to the following individuals: Darlene Lane (project coordination), Leah Macdonald (data entry), Maria Wong (data analysis), and Rachel Harvey (administrative support).

Trial Registration: clinicaltrials.gov identifier: NCT00463658

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