BACKGROUND: falls incidence in home resident elderly people varies from 30% to 40%. Falls induce loss of self-sufficiency and increase mortality and morbidity. OBJECTIVES: to evaluate falls incidence and risk factors in a group of general practice elderly patients. DESIGN: prospective cohort study with 1 year follow-up. METHODS: 18 practitioners visited their elderly patients (>75 years) for a baseline assessment. Information on current pathologies and previous falls in the last six months was collected. Functional status was evaluated using: Short Portable Mental State Questionnaire, Geriatric Depression Scale, Activities of Daily Living, Instrumental Activities of Daily Living. Total mobility Tinetti score was measured in a subgroup of elderly. Falls were monitored through 2 phone-interviews at 6 and 12 months. Data were analyzed through logistic regression. RESULTS: 1168 elderly were visited and 800 were enrolled in the study. Twenty-eight percent of the elderly fell in the whole period. Sixty percent of falls were not reported to the practitioner. Independent predictors for falls were ADL score (ADL<5: OR 1.90; 95% CI 1.05-3.45), falls occurred in the 6 months previous to the follow-up period (OR 1.62; 95% CI 1.03-2.54) and the interaction term among this factor and the follow-up period (OR 2.39; 95% CI 1.22-4.72). Tinetti score was significantly associated to falls only in univariate analysis. CONCLUSIONS: Practitioners can play a key-role in identifying at-risk subjects and managing prevention interventions. Falls monitoring and a continuous practice of comprehensive geriatric assessment should be encouraged.
BACKGROUND: falls incidence in home resident elderly people varies from 30% to 40%. Falls induce loss of self-sufficiency and increase mortality and morbidity. OBJECTIVES: to evaluate falls incidence and risk factors in a group of general practice elderly patients. DESIGN: prospective cohort study with 1 year follow-up. METHODS: 18 practitioners visited their elderly patients (>75 years) for a baseline assessment. Information on current pathologies and previous falls in the last six months was collected. Functional status was evaluated using: Short Portable Mental State Questionnaire, Geriatric Depression Scale, Activities of Daily Living, Instrumental Activities of Daily Living. Total mobility Tinetti score was measured in a subgroup of elderly. Falls were monitored through 2 phone-interviews at 6 and 12 months. Data were analyzed through logistic regression. RESULTS: 1168 elderly were visited and 800 were enrolled in the study. Twenty-eight percent of the elderly fell in the whole period. Sixty percent of falls were not reported to the practitioner. Independent predictors for falls were ADL score (ADL<5: OR 1.90; 95% CI 1.05-3.45), falls occurred in the 6 months previous to the follow-up period (OR 1.62; 95% CI 1.03-2.54) and the interaction term among this factor and the follow-up period (OR 2.39; 95% CI 1.22-4.72). Tinetti score was significantly associated to falls only in univariate analysis. CONCLUSIONS: Practitioners can play a key-role in identifying at-risk subjects and managing prevention interventions. Falls monitoring and a continuous practice of comprehensive geriatric assessment should be encouraged.