Incidence And Risk Factor Analysis Of Falls Among The Elderly In Urban And Rural Communities

Background: In recent years, with the explosion of global population, the ageing population problems appeared gradually. People pay more attention to the health and life quality of old people.There are a variety of factors that affect the elderly, the fall is one of the most important.A incidence and the number of deaths of fall threatened the elderly health and quality of life.Therefore, there is a need to take immediate measures to prevent and control the elderly.Objective: A cross-sectional study was conducted to the epidemiological status of falls in the elderly and explore the related risk factors through questionnaire investigation。Method: Four communities in Yinchuan City and two villages in Qingtongxia City were selected by cluster sampling. All participants over the age of 60 were interviewed in household with a standard questionnaire produced by the ministry of health in China. The interview included general demographic characteristics,disease history, drug use, living habit(smoking, alcohol consumption and physical activity levels), balance disorder situation(balance function measurement and up-go test),activity of daily life(ADL), dementia and depression. The interview included general inquiring questions and field test.Results: The survey lasted from November 2013 to April 2014. The total number of participates was 2059 with average age of 71.6±6.5. There were 272 old people(167 females and 105 males) in the past year with a history of falls, and the incidence of falls was 13.2%. The incidence of falls in females was higher than that in males(15.3% vs.10.9%, P<0.001). It was showed that the occurrence of falls was increased with age. Moreover, the occurrence of falls in rural place was significantly higher than the occurrence of falls in urban place(25% vs.9.2%, P<0.001). 798 participants had balance disorder, and the prevalence of balancedisorder was 38.7%. The prevalence of balance disorder in females was also higher than that in males(41.5% vs.38.7%, P=0.006). Similarly, the prevalence of balance disorder was increased with age.It was showed that 149 old people(54.8%) got injured after a fall. The injuries included soft tissue injury(79.9%), fractures(18.1%), and craniocerebral injury(2%).The risk factors of falls involved internal causes and external causes. Univariate analysis suggested that 16 items were significant risk factors, including gender, age, balance disorder, frequently dwelling place, education level, medications, exercise, stroke, hypertension, visual disturbance, osteoporosis, arthrophlogosis, diabetes, Ventricular dysfunction, spondylodynia, arrhythmia and ADL level. Multivariate analysis indicated that gender, age, frequently dwelling place, stroke, balance disorder, visual disturbance, osteoporosis, arthrophlogosis and long- term medications were risk factors, and high education level and regularly exercise were protective factors to falls in the elderly.Conclusion: The incidence of falls among the elderly in Ningxia was significantly high. This occurrence in females was higher than that in males, and which in in rural place was also higher than that in urban place. The falls possibly resulted from internal causes and external causes, so some effective measures should be taken to prevent these risk factors. Simultaneously, the elderly needed to be educated to prevent falls and encouraged to do physical exercise regularly as possible as they can, for reducing the incidence of falls.