Chronic fall risk among aged individuals with type 2 diabetes.

Falls in the elderly are common and a frequent source of injury. Chronic fall risk factors were evaluated in aging individuals with type 2 diabetes from two different settings--an urban day care center (age range: 57 to 83 years) and a rural community center (age range: 62 to 97 years). Six fall-related risk factors were studied: client history/subjective assessment of fall history, daily medication intake, number of medical diagnoses, balance (Tinetti Balance and Gait Tool), lower extremity protective sensation (Semmes-Weinstein monofilament testing), and relaxed gait velocity (timed functional walk test). Both groups demonstrated a high risk for chronic falling with a mean of 4.8 and 4.0 risk factors present in individuals from the urban day care center and the rural community center, respectively. No differences between clients in the two centers with respect to number of medications and comorbidities were found. In both groups, > 50% of individuals reported a history of falling. Loss of protective sensation was detected in 100% of the individuals from the urban day care center compared to 67% in the rural community center. Similarly, 40% of the individuals from the urban day care center demonstrated impaired balance as compared to 29% from the rural community center. A similar ratio of impaired balance to loss of lower extremity protective sensation was demonstrated across the two groups. These data indicate a potential relationship between loss of protective sensation and impaired balance. These findings also indicate that individuals in urban and rural community settings share similar risk factors for chronic falling.