Factors contributing to falls and the effect of a multipronged approach on the incidence of falls in the older person in an outpatient setting in South India

Abstract

Background: A fall is an important predictor of morbidity and mortality in an older adult. Objectives: The aim of this study was to enumerate the various factors contributing to falls and assess the effect of a multipronged approach on the incidence of falls in older individuals who are at a risk of falls. Methodology: In this prospective interventional trial, we recruited sixty subjects, who presented to the Geriatrics Outpatient department of a tertiary care hospital in South India. Using the Stop elderly accidents, deaths, and injuries protocol, we included subjects who presented with a history of fall in the year preceding the study, those with fear of fall and those who felt unsteady while standing or walking. These subjects were subjected to a detailed assessment and an individualized multipronged interventional program was initiated. The subjects were followed up telephonically after 1 and 3 months to assess compliance and the details of incident fall (if any). Results: At baseline, 48.3% had fallen in the year prior to enrolment, of whom 16.7% were recurrent fallers. Various contributory factors for falls were identified - including older age, polypharmacy, sedatives, and anticholinergic drugs. Following a multipronged intervention, 3.6% and 5.3% of the subjects reported falls after 1 and 3 months, respectively. Subjective improvement was reported by 80% and 78.2% of the subjects at 1 and 3 months' follow-up and the compliance with exercises during the follow-up period was good (73%). Conclusion: Identifying the subjects at risk for falls and implementing a tailored approach contributed to a reduction in the incidence of falls.

Keywords

• falls
• fear of fall
• gait speed
• older people