Risk Factors of Fall in Elderly in the Community - ปัจจัยเสี่ยงต่อการหกล้มของผู้สูงอายุในชุมชน

Abstract

           This cross-sectional research was to study the incidence and risk factors of fall in the elderly at tambon Wat Chan, Phitsanulok province. Data on fall during the previous year were taken from 403 elderly randomly selected during 1 March 2004 - 31 January 2005. Information on risk factors was collected from two sources. The first was from personal history taking and the second was from physical examination. Data were analyzed using descriptive statistics such as percentage, average, standard deviation and analytical statistics such as chi-square, Fisher's exact test and logistic regression.

           The annual incidence of fall in elderly was 25.1 percent. The factors significantly related to fall were gender, acute sickness, vertigo, hearing impairment, balance and gait impairment (according to Tinetti balance and gait score), depression, anxiety, using more than 4 items of medicine, unfit shoes, too-long dress, domestic environmental factors such as rugs, wavy or folded-up carpet, too low chair that caused difficulty while getting up, environmental factors outside the house such as damaged footpath, bushes along the path. Other factors included impaired activity of daily living and the arm span exceeding height more than 5 centimetres (indicating general osteoporosis). Fall usually occurred outside the house. Female usually fell down in the morning while male usually fell down in the evening. After fall, most elderly could get up within 5 minutes and most falls left no physical injury but caused mental trauma as they were afraid of repeated accident. Logistic regression analysis indicated 4 main risk factors of fall: balance and gait impairment (by Tinetti balance and gait score), arm span longer than height more than 5 centimetres, gender and environmental factor outside the house (damaged pathway). Amendable risk factors should be improved to reduce fall in elderly.