Analysis of Fall Risk Factors in an Aging Population Living in Long-Term Care Institutions in SPAIN: A Retrospective Cohort Study
Abstract
:1. Introduction
2. Methods
2.1. Measures
2.1.1. Outcome Variable
2.1.2. Sociodemographic Factors
2.1.3. Balance and Walking Ability
2.1.4. Cognitive Impairment
2.1.5. Functional Independence
2.1.6. Medication
2.1.7. Fall Prevention Interventions
2.2. Procedure
2.3. Data Analysis
3. Results
3.1. Sample Characteristics
3.2. Associations with Past Year Fall and Fall Risk
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Descriptive Outcomes | Subgroups Mean (SD)/Proportions (%) | |||
---|---|---|---|---|
Total Sample (n = 2849) | Non-Faller (n = 1559, 54.7) | Faller 1 (n = 1290, 45.3) | p-Value | |
Gender | ||||
Male | 902 (31.7) | 530 (34) | 372 (28.8) | 0.003 |
Female | 1947 (68.3) | 1029 (66) | 918 (71.2) | |
Age (Mean, SD) | 85.21 (6.6) | 84.76 (6.8) | 85.76 (6.4) | <0.001 |
70–84 years | 1189 (41.7) | 688 (44.1) | 501 (38.8) | |
≥85 years | 1660 (58.3) | 871 (55.9) | 789 (61.2) | |
Institucionalization period | 3.38 (2.8) | 3.52 (3.1) | 3.20 (2.6) | 0.002 |
(Mean, SD) | ||||
1–4 years | 2124 (74.6) | 1138 (73) | 986 (76.4) | |
≥5 years | 725 (25.4) | 421 (27) | 304 (23.6) | |
Tinetti Scale (Mean, SD) | 21.26 (5.7) | 21.68 (5.9) | 20.75 (5.4) | <0.001 |
High risk of falls (1–18) | 747 (26.2) | 357 (22.9) | 390 (30.2) | |
Risk of falls (19–24) | 1104 (38.8) | 580 (37.2) | 524 (40.6) | |
No risk of falls (>24) | 998 (35) | 622 (39.9) | 376 (29.1) | |
MMSE Scale (Mean, SD) | 19.16 (6.9) | 20.04 (6.8) | 18.10 (6.9) | <0.001 |
Severe impairment (<9) | 280 (9.8) | 123 (7.9) | 157 (12.2) | |
Moderate impairment (10–18) | 950 (33.3) | 467 (30) | 483 (37.4) | |
Mild impairment (19–23) | 755 (26.5) | 434 (27.8) | 321 (24.9) | |
Normal (24–30) | 864 (30.3) | 535 (34.3) | 329 (25.5) | |
Barthel Index (Mean, SD) | 75.11 (22.2) | 77.09 (22.6) | 72.72 (21.6) | <0.001 |
Total dependency (0–20) | 78 (2.7) | 53 (3.4) | 25 (1.9) | |
Severe dependency (21–60) | 631 (22.1) | 282 (18.1) | 349 (27.1) | |
Moderate dependency (61–90) | 1376 (48.3) | 731 (46.9) | 645 (50) | |
Slight dependency (91–99) | 396 (13.9) | 272 (17.4) | 124 (9.6) | |
Independent (100) | 368 (12.9) | 221 (14.1) | 147 (11.4) | |
Number of drugs (Mean, SD) | 8.07 (3.6) | 7.93 (3.6) | 8.25 (3.5) | 0.019 |
1–4 drugs | 415 (14.6) | 246 (15.8) | 169 (13.1) | |
≥5 drugs | 2434 (85.4) | 1313 (84.2) | 1121 (86.9) | |
Physical therapy intervention | 1908 (67) | 1011 (64.8) | 897 (69.5) | 0.008 |
1–3 therapies | 1161 (40.8) | 606 (59.9) | 555 (61.9) | |
≥4 therapies | 747 (26.2) | 405 (40.1) | 342 (38.1) | |
Incidence of falls last 12 months (Mean, SD) | 3.10 (3.1) |
Faller | ||
---|---|---|
Univariate OR (95% CI; p-Value) | Multivariate OR (95% CI; p-Value) | |
Gender | - | |
Male | Ref. | |
Female | 1.271 (1.083, 1.491; p = 0.003) | |
Age | - | |
70–84 years | Ref. | |
≥85 years | 1.317 (1.063, 1.632; p = 0.012) | |
Institucionalization period | - | |
1–4 years | Ref. | |
≥5 years | 0.833 (0.703, 0.988; p = 0.036) | |
Tinetti Scale | ||
High risk of falls (1–18) | 1.807 (1.491, 2.190; p < 0.000) | 1.597 (1.280, 1.991; p < 0.001) |
Risk of falls (19–24) | 1.495 (1.256, 1.779; p < 0.000) | 1.362 (1.134, 1.635; p = 0.001) |
No risk of falls (> 24) | Ref. | Ref. |
MMSE Scale | ||
Severe impairment (<9) | 2.076 (1.580, 2.727; p < 0.000) | 1.992 (1.472, 2.695; p < 0.001) |
Moderate impairment (10–18) | 1.682 (1.395, 2.028; p < 0.000) | 1.507 (1.231, 1.845; p < 0.001) |
Mild impairment (19–23) | 1.203 (0.986, 1. 468; p = 0.069) | 1.130 (0.921, 1.386; p = 0.243) |
Normal (24–30) | Ref. | Ref. |
Barthel Index | ||
Total dependency (0–20) | 0.709 (0.422, 1.192; p = 0.709) | 0.343 (0.193, 0.611; p < 0.001) |
Severe dependency (21–60) | 1.861 (1.433, 2.416; p < 0.000) | 1.135 (0.839, 1.536; p = 0.410) |
Moderate dependency (61–90) | 1.327 (1.050, 1.676; p = 0.018) | 1.037 (0.809, 1.330; p = 0.774) |
Slight dependency (91–99) | 0.685 (0.509, 0.923; p = 0.013) | 0.657 (0.487, 0.888; p = 0.006) |
Independent (100) | Ref. | Ref. |
Number of drugs | ||
1–4 drugs | Ref. | Ref. |
≥5 drugs | 1.243 (1.006, 1.535; p = 0.044) | 1.291 (1.039, 1.604; p = 0.021) |
Physical therapy intervention | - | |
Yes | Ref. | |
No | 0.808 (0.690, 0.946; p = 0.008) |
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Díaz, L.B.; Casuso-Holgado, M.J.; Labajos-Manzanares, M.T.; Barón-López, F.J.; Pinero-Pinto, E.; Romero-Galisteo, R.P.; Moreno-Morales, N. Analysis of Fall Risk Factors in an Aging Population Living in Long-Term Care Institutions in SPAIN: A Retrospective Cohort Study. Int. J. Environ. Res. Public Health 2020, 17, 7234. https://doi.org/10.3390/ijerph17197234
Díaz LB, Casuso-Holgado MJ, Labajos-Manzanares MT, Barón-López FJ, Pinero-Pinto E, Romero-Galisteo RP, Moreno-Morales N. Analysis of Fall Risk Factors in an Aging Population Living in Long-Term Care Institutions in SPAIN: A Retrospective Cohort Study. International Journal of Environmental Research and Public Health. 2020; 17(19):7234. https://doi.org/10.3390/ijerph17197234
Chicago/Turabian StyleDíaz, Lourdes Bujalance, María Jesús Casuso-Holgado, María Teresa Labajos-Manzanares, Francisco Javier Barón-López, Elena Pinero-Pinto, Rita Pilar Romero-Galisteo, and Noelia Moreno-Morales. 2020. "Analysis of Fall Risk Factors in an Aging Population Living in Long-Term Care Institutions in SPAIN: A Retrospective Cohort Study" International Journal of Environmental Research and Public Health 17, no. 19: 7234. https://doi.org/10.3390/ijerph17197234