Prevalence of fall and associated risk factors in elderly in Urban field practice area of , Bengaluru: a cross sectional study

Introduction

According to the population census in India 2011, the percentage of older adults above the age of 60 is 8.6% of the total population and this population is likely to increase to 198 million in 2030¹ .This segment of the population faces multiple problems. Medical and psychological problems are considered to be disabling for the elderly population. Falls are considered one of the more serious problems among all age groups² . Fall is defined as an event which results in a person coming to rest or at another lower level³ . Age is one of the key risk factors for falls. Older people have the highest risk of death or serious injury arising from a fall and the risk increases with age³ . Demographic transition in India has led to an absolute increase in older adult population, which in turn increases the demand on the health care system to add the quality of life (QOL) to the years lived. Falls and its consequences are major public health problem because falls have been identified as the second leading cause of unintentional injury, morbidity, accounting for 11% unintentional injury mortality rate globally.⁴ From the reported 424,000 fall related deaths in 2017 globally, one fifth of them took place in India.⁵ The consequence of fall can either lead into non-traumatic or traumatic injuries which may vary from no injuries, bruises, and lacerations to dislocations, fractures, and head injuries and in some cases, it may even be fatal.

Materials and methods

A Community based Cross-sectional study was conducted among aged 60 years and above residing in urban field practice area of BMCRI, in the month of August to November 2019. Informed consent was obtained from the study participants & confidentiality was assured with regards to their participation. Institutional Ethics Committee approval was obtained. Sample size of 303 was obtained based on study Prevalence, Risk Factors, Circumstances for fall and Level of Functional Independence among Geriatric Population - A descriptive Study conducted in Maharashtra by Pichai P6 . The houses of these elderly people were visited and data like socio-demographic factors, history of fall in last one year and its associated risk factors was collected using pre-tested structured Performa by interview technique. Elderly who have given consent were included. Elderly who were bed ridden, having intellectual disability, road traffic accident victims & seriously ill were excluded in study.

Statistical analysis

Data analysis: Data was entered in MS Excel & coded. Analysis was done using statistical software SPSS version 20 .0. Results were expressed in terms of percentages, tables and graphs using appropriate statistical test

Results

Mean age of the study participants was 66.6±8.6 years. About 82.6% of study population were in the age group of 60 to 69 years. About 55.4% were male, 55.4% were illiterate. Mean BMI of the study participants was 25.7+4.2 kg/m2 (Table No .1).32.2% people had History of fall within last 1 year, about 72.4% had fallen once in last one year, (Figure 1 & 2) 56.1% of people had history of fall at outdoor & 23.4% required medications for incident of fall. Study showed significant association between gait abnormalities, visual abnormalities, practice of regular exercise & history of fall in last 24 hours. (Table 2) About 35 % had dizziness as a cause of fall, 25% had gait abnormalities, 12 % gave history of uneven floor, slippery surface as cause of fall, (Figure No.3).

Discussion

Mean age in present study was 66.6±8.6 years, 82.6% elders are in age group of 60 to 69 years. This finding is approximately same as study, prevalence, risk factors, and circumstances for fall & level of functional independence among geriatric population in Maharashtra by Pichai P whereas the mean age was 69±6.94 years in study prevalence & Risk factors for falls among elderly people living in long term care homes by Dhargave P. The prevalence of fall in present study was 32.2% in last 1 year. where as in study by Pichai P was 24.98%.however various studies conducted in India reported the prevalence vary from 14 to 53%.

Present study showed there was significant association between history of fall and gait abnormalities, vision abnormalities, practice of regular exercise, dizziness, gait abnormalities, uneven floor. Whereas study prevalence & Risk factors for falls among elderly people living in long term care homes by Dhargave P showed significant association between History of fall and poor vision ,use of multiple medications, chronic disease, use of walking aids, vertigo & balance problems. In study, prevalence, risk factors, circumstances for fall & level of functional independence among geriatric population in Maharashtra by Pichai P et al said there was significant association between history of fall and Socioeconomic status, sedentary lifestyle, and chronic disease.

Conclusion

The study showed fall as a significant health problem faced by elders and provides insight into the influencing risk factors and circumstances for falls. Factors such as, gait abnormalities, visual abnormalities, sedentary life style demonstrated a significant association with fall. An identified risk factor can help in effective, comprehensive geriatric assessment to facilitate in adopting multidimensional treatment strategies.