RISK FACTORS AND INTERVENTIONS OUTCOMES ASSOCIATED WITH FALLS AMONG COMMUNITY-DWELLING ELDERLY IN MALAYSIA

Abstract

Introduction Falls occur often because of complex interacting risk factors. As such, identifying the risk factors of falls and providing suitable interventions including lifestyle modification are important in elderly care. Methods This epidemiology study utilized data extracted from the MyFAIT study, a randomized controlled individually tailored multifactorial interventional trial. Community- dwelling elderly aged 65 years and above with a history of falls (fallers) or without a history of falls (non-fallers) were recruited. The demographic and clinical data of the fallers and non-fallers were compared. The fallers were then randomized to receive either interventions or standard care and followed up after 12 months. Patients with dementia, major psychiatric illness, non-ambulatory patients or inability to stand were excluded in the intervention trials. The primary outcome variable is the occurrence of falls. Chi-square tests or Fisher Exact tests were used to estimate the association between risk factors and fall history; or interventions and recurrent falls. Logistic regression was used to determine the association of independent variables and the event of falls. A p-value of <0.05 was statistically significant in all tests. Results Data extracted from 483 subjects were analysed. Among them, 268 were fallers and 215 non-fallers. Logistic regression analyses were performed to estimate the effects of influencing factors on the likelihood of having events of falls. Increasing age is found to be associated with an increased risk of falls but higher mean systolic blood pressure iii was associated with a reduced likelihood of falls in the elderly. Elderly who were diagnosed with cataracts have a 1.91-time [Odds Ratios = 1.91 (95% CI 1.10-3.31)] risk to have fall events compared with patients without cataract. In a sub-analysis of individually tailored multifactorial interventions, the results showed that fallers who received 5 types of interventions seem to have a higher risk of recurrent falls [Odd Ratio = 2.07 (95% CI 0.89-4.83)] than those receiving less or more than 5 types of interventions, but the risk is not statistically significant. Dizziness conditions (44.7%), osteoporosis (19.9%), and alcohol consumption (14.9%) were commonly found in the elderly with recurrent falls. Conclusion Multiple risk factors such as aging, low systolic blood pressure, and cataract disease were found to be associated with the risk of falls in the elderly. This study also found that dizziness, osteoporosis, and alcohol consumption and are commonly observed in patients with recurrent falls despite the implementation of fall prevention interventions. This study highlights the importance of lifestyle modification during and after the implementation of fall prevention interventions. Keywords: fall prevention interventions, elderly falls, community-dwelling elderly, lifestyle modification