Falls among elderly and its relation with their health problems and surrounding environmental factors in Riyadh.

Sir,

I was interested in the article titled, “Falls among elderly and its relation with their health problems and surrounding environmental factors in Riyadh” published in your journal.[1] The main objective of the study was to determine the prevalence of falls in the elderly and identify risk factors associated with them. I appreciate the study since not much research has been done in Saudi Arabia on the falls of elderly people.[2] The authors concluded that 57.7% of the elderly participants in their study had a history of a fall, a percentage which is much higher than reported in other studies. Also important was the significant role the environment played in the falls. A few clarifications are necessary here.

First, the study does not specify the period of time covered in the history of the falls. The validated tool[3] used by the researchers, assess the fall history in the past 3 months. If the current study has also assessed the fall history in the past three months, then it would be inappropriate to compare this study with other studies done in Brazil,[4] Japan,[5] and India,[6] where the history of falls was gathered over a period of 6–12 months. With a change in this duration, the burden of the falls will also differ.

Second, Morse Fall Scale[7] is only used to assess the fall risk of hospitalized elderly patients[8] and not community-based residents for which Berg Balance Scale[9] and other scales can be used. The present study used a single tool to assess the risk of falls in both hospital patients and normal ambulatory patients.

Third, the authors collected data from the study participants by visiting mosques, malls, and hospitals but did not visit the homes of the elderly. They found a significant association between falls and the environmental factors. However, a visit to the homes of the elderly is crucial in drawing conclusions as to whether there are risks as a result of poor lighting at home, certain items are hard to reach, uneven floors, or clutter.

To meet the objectives of the study, the authors could have asked only community-based resident elderly in their homes to participate.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.