BACKGROUND: Falls cause more than 60% of head injuries in older adults. Lack of objective evidence on the circumstances of these events is a barrier to prevention. We analyzed video footage to determine the frequency of and risk factors for head impact during falls in older adults in 2 long-term care facilities. METHODS: Over 39 months, we captured on video 227 falls involving 133 residents. We used a validated questionnaire to analyze the mechanisms of each fall. We then examined whether the probability for head impact was associated with upper-limb protective responses (hand impact) and fall direction. RESULTS: Head impact occurred in 37% of falls, usually onto a vinyl or linoleum floor. Hand impact occurred in 74% of falls but had no significant effect on the probability of head impact (p = 0.3). An increased probability of head impact was associated with a forward initial fall direction, compared with backward falls (odds ratio [OR] 2.7, 95% confidence interval [CI] 1.3-5.9) or sideways falls (OR 2.8, 95% CI 1.2-6.3). In 36% of sideways falls, residents rotated to land backwards, which reduced the probability of head impact (OR 0.2, 95% CI 0.04-0.8). INTERPRETATION: Head impact was common in observed falls in older adults living in long-term care facilities, particularly in forward falls. Backward rotation during descent appeared to be protective, but hand impact was not. Attention to upper-limb strength and teaching rotational falling techniques (as in martial arts training) may reduce fall-related head injuries in older adults.
BACKGROUND: Falls cause more than 60% of head injuries in older adults. Lack of objective evidence on the circumstances of these events is a barrier to prevention. We analyzed video footage to determine the frequency of and risk factors for head impact during falls in older adults in 2 long-term care facilities. METHODS: Over 39 months, we captured on video 227 falls involving 133 residents. We used a validated questionnaire to analyze the mechanisms of each fall. We then examined whether the probability for head impact was associated with upper-limb protective responses (hand impact) and fall direction. RESULTS: Head impact occurred in 37% of falls, usually onto a vinyl or linoleum floor. Hand impact occurred in 74% of falls but had no significant effect on the probability of head impact (p = 0.3). An increased probability of head impact was associated with a forward initial fall direction, compared with backward falls (odds ratio [OR] 2.7, 95% confidence interval [CI] 1.3-5.9) or sideways falls (OR 2.8, 95% CI 1.2-6.3). In 36% of sideways falls, residents rotated to land backwards, which reduced the probability of head impact (OR 0.2, 95% CI 0.04-0.8). INTERPRETATION: Head impact was common in observed falls in older adults living in long-term care facilities, particularly in forward falls. Backward rotation during descent appeared to be protective, but hand impact was not. Attention to upper-limb strength and teaching rotational falling techniques (as in martial arts training) may reduce fall-related head injuries in older adults.
Authors: Stephen N Robinovitch; Sarah C Normandin; Paula Stotz; Jessica D Maurer Journal: J Gerontol A Biol Sci Med Sci Date: 2005-12 Impact factor: 6.053
Authors: Meena M Sran; Paula J Stotz; Sarah C Normandin; Stephen N Robinovitch Journal: J Gerontol A Biol Sci Med Sci Date: 2009-10-27 Impact factor: 6.053
Authors: Yijian Yang; Kimberley S van Schooten; Vicki Komisar; Heather A McKay; Joanie Sims-Gould; Debbie Cheong; Stephen N Robinovitch Journal: Int J Environ Res Public Health Date: 2022-04-29 Impact factor: 4.614
Authors: Jeremy R Crenshaw; Kathie A Bernhardt; Sara J Achenbach; Elizabeth J Atkinson; Sundeep Khosla; Kenton R Kaufman; Shreyasee Amin Journal: Arch Gerontol Geriatr Date: 2017-07-21 Impact factor: 3.250
Authors: Ruth Y Akinlosotu; Nesreen Alissa; Shari R Waldstein; Robert A Creath; George F Wittenberg; Kelly P Westlake Journal: Exp Gerontol Date: 2021-07-24 Impact factor: 4.032
Authors: Andreas Ejupi; Yves J Gschwind; Matthew Brodie; Wolfgang L Zagler; Stephen R Lord; Kim Delbaere Journal: Eur Rev Aging Phys Act Date: 2016-01-30 Impact factor: 3.878
Authors: José Daniel Jiménez-García; Antonio Martínez-Amat; Fidel Hita-Contreras; Raquel Fábrega-Cuadros; Francisco Álvarez-Salvago; Agustín Aibar-Almazán Journal: Int J Environ Res Public Health Date: 2021-05-31 Impact factor: 3.390