[Risk for falls in the elderly. Role of activities of daily living and of the subjective assessment of health status. A case-control study].

Prevention and treatment of falls in the elderly are today important questions the primary care physicians has to face. It is known that falls are associated with numerous factors related to health status and demographic variables. The role played by the activities of daily living (ADL) and by a negative subjective health rating of one's own health status, and how both could increase the incidence of diseases due to home accidents, is less known. This case-control study carried out in the accident ward of S. Camillo Hospital in Rome, studied 110 elderly patients, who suffered from fractures caused by falls. The main goal was to identify the possible associations among falls, ADL and lower limb mobility, as well as studying the importance of a positive subjective health rating to prevent these accidents. Controls have been selected in other wards of the same hospital and in an out-patient's department. Results show that the risk of falling is associated with previous falls (odds ratio = 3.81), with poor mobility at home (OR = 2.49), outside home (OR = 2.06), out of one's own area (OR = 1.74), and with a negative subjective health rating (OR 3.33). Multivariate analysis has pointed out that a negative subjective health rating keeps being a statistically significant risk factor for falls (OR = 2.86), independently from the objective health conditions of the subject. Such a negative subjective rating often develops itself just as a consequence of a previous fall without injuries.