Risk factors for injuries in New Zealand older adults with complex needs: a national population retrospective study.
Falls-related injuries
Geriatric assessment
Home care
Older adults
interRAI
Journal
BMC geriatrics
ISSN: 1471-2318
Titre abrégé: BMC Geriatr
Pays: England
ID NLM: 100968548
Informations de publication
Date de publication:
04 11 2021
04 11 2021
Historique:
received:
12
10
2020
accepted:
22
10
2021
entrez:
5
11
2021
pubmed:
6
11
2021
medline:
24
11
2021
Statut:
epublish
Résumé
Falls and falls-related injuries are common among older adults. Injuries in older adults lead to poor outcomes and lower quality of life. The objective of our study was to identify factors associated with fall-related injuries among home care clients in New Zealand. The study cohort consisted of 75,484 community-dwelling people aged 65 years or older who underwent an interRAI home care assessment between June 2012 and June 2018 in New Zealand. The injuries included for analysis were fracture of the distal radius, hip fracture, pelvic fracture, proximal humerus fracture, subarachnoid haemorrhage, traumatic subdural haematoma, and vertebral fracture. Unadjusted and adjusted competing risk regression models were used to identify factors associated with fall-related injuries. A total of 7414 (9.8%) people sustained a falls-related injury over the 6-year period, and most injuries sustained were hip fractures (4735 63.9%). The rate of injurious falls was 47 per 1000 person-years. The factors associated with injury were female sex, older age, living alone, Parkinson's disease, stroke/CVA, falls, unsteady gait, tobacco use, and being underweight. Cancer, dyspnoea, high BMI, and a decrease in the amount of food or fluid usually consumed, were associated with a reduced risk of sustaining an injury. After censoring hip fractures the risks associated with other types of injury were sex, age, previous falls, dyspnoea, tobacco use, and BMI. While it is important to reduce the risk of falls, it is especially important to reduce the risk of falls-related injuries. Knowledge of risk factors associated with these types of injuries can help to develop focused intervention programmes and development of a predictive model to identify those who would benefit from intervention programmes.
Sections du résumé
BACKGROUND
Falls and falls-related injuries are common among older adults. Injuries in older adults lead to poor outcomes and lower quality of life. The objective of our study was to identify factors associated with fall-related injuries among home care clients in New Zealand.
METHODS
The study cohort consisted of 75,484 community-dwelling people aged 65 years or older who underwent an interRAI home care assessment between June 2012 and June 2018 in New Zealand. The injuries included for analysis were fracture of the distal radius, hip fracture, pelvic fracture, proximal humerus fracture, subarachnoid haemorrhage, traumatic subdural haematoma, and vertebral fracture. Unadjusted and adjusted competing risk regression models were used to identify factors associated with fall-related injuries.
RESULTS
A total of 7414 (9.8%) people sustained a falls-related injury over the 6-year period, and most injuries sustained were hip fractures (4735 63.9%). The rate of injurious falls was 47 per 1000 person-years. The factors associated with injury were female sex, older age, living alone, Parkinson's disease, stroke/CVA, falls, unsteady gait, tobacco use, and being underweight. Cancer, dyspnoea, high BMI, and a decrease in the amount of food or fluid usually consumed, were associated with a reduced risk of sustaining an injury. After censoring hip fractures the risks associated with other types of injury were sex, age, previous falls, dyspnoea, tobacco use, and BMI.
CONCLUSIONS
While it is important to reduce the risk of falls, it is especially important to reduce the risk of falls-related injuries. Knowledge of risk factors associated with these types of injuries can help to develop focused intervention programmes and development of a predictive model to identify those who would benefit from intervention programmes.
Identifiants
pubmed: 34736406
doi: 10.1186/s12877-021-02576-1
pii: 10.1186/s12877-021-02576-1
pmc: PMC8567659
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
630Subventions
Organisme : NIA NIH HHS
ID : R33 AG0450050
Pays : United States
Organisme : NIA NIH HHS
ID : P30AG021342-16S1
Pays : United States
Informations de copyright
© 2021. The Author(s).
Références
Aging (Milano). 1996 Aug;8(4):282-6
pubmed: 8904959
Gerontologist. 1993 Apr;33(2):200-4
pubmed: 8468012
Mov Disord. 2017 Nov;32(11):1524-1536
pubmed: 29067726
Int J Stroke. 2012 Aug;7(6):482-90
pubmed: 22494388
J Safety Res. 2005;36(4):409-11
pubmed: 16242155
Osteoporos Int. 2005 Nov;16(11):1330-8
pubmed: 15928804
Osteoporos Int. 2008 Oct;19(10):1431-44
pubmed: 18324342
Geriatrics (Basel). 2016 Nov 30;1(4):
pubmed: 31022824
Neurourol Urodyn. 2020 Mar;39(3):945-953
pubmed: 32017231
Lancet. 2005 Nov 26;366(9500):1885-93
pubmed: 16310556
N Z Med J. 1995 Sep 8;108(1007):367-8
pubmed: 7566776
J Am Geriatr Soc. 1994 Mar;42(3):269-74
pubmed: 8120311
J Am Med Dir Assoc. 2017 Jul 1;18(7):588-591
pubmed: 28279604
J Geriatr Oncol. 2015 Jan;6(1):70-83
pubmed: 25454770
J Am Geriatr Soc. 2008 Aug;56(8):1383-9
pubmed: 18808597
J Gerontol A Biol Sci Med Sci. 2002 Nov;57(11):M722-6
pubmed: 12403800
Aust N Z J Public Health. 2016 Aug;40(4):349-55
pubmed: 27197797
N Engl J Med. 1988 Dec 29;319(26):1701-7
pubmed: 3205267
J Rheumatol. 2004 Nov;31(11):2272-9
pubmed: 15517643
JAMA. 1989 May 12;261(18):2663-8
pubmed: 2709546
J Gerontol A Biol Sci Med Sci. 2019 Jun 18;74(7):1127-1133
pubmed: 30084928
Neurourol Urodyn. 2018 Apr;37(4):1336-1343
pubmed: 29130513
Stroke. 2002 Feb;33(2):542-7
pubmed: 11823667
Lancet. 1999 Jan 9;353(9147):93-7
pubmed: 10023893
Aging Clin Exp Res. 2002 Feb;14(1):18-27
pubmed: 12027148
Age Ageing. 2006 Sep;35 Suppl 2:ii55-ii59
pubmed: 16926207
Age Ageing. 1996 Sep;25(5):362-6
pubmed: 8921140
PLoS Med. 2015 Oct 06;12(10):e1001885
pubmed: 26440803
JAMA. 1999 May 26;281(20):1895-9
pubmed: 10349892
Diabetes Care. 2002 Oct;25(10):1749-54
pubmed: 12351472
Eur J Trauma Emerg Surg. 2016 Jun;42(3):317-32
pubmed: 26253883
Osteoporos Int. 2007 Aug;18(8):1109-17
pubmed: 17370100
J Am Med Dir Assoc. 2017 Apr 1;18(4):368.e1-368.e8
pubmed: 28236610
BMJ. 1997 Oct 25;315(7115):1065-9
pubmed: 9366737
J Orthop Trauma. 2012 Sep;26(9):e161-5
pubmed: 22377505
BMC Health Serv Res. 2008 Dec 30;8:277
pubmed: 19115991