Aging
Falls in the oldest old: prevalence, rate and change in rate over time in The 90+ Study Katherine Colcord* Katherine Colcord Luohua Jiang Claudia Kawas María Corrada
Background: Falls can have serious health consequences, especially in the oldest old (individuals 90 years and older). Yet few studies have examined factors related to falls in this group. We assess fall prevalence, fall rate, and fall rate change over time by sex, living situation, and assistive device. Methods: Participants are from The 90+ Study, a longitudinal study of individuals 90 years and with evaluations every 6 months. Participants, or their informants, are asked how many times they have fallen in the past year (first visit) or since their last visit (follow up visits). We estimated baseline fall prevalence, longitudinal fall rate, and change in rate over time by sex, living situation, and assistive device using generalized linear mixed regression models with Poisson distribution and fixed and time-varying covariates. Results: In 1298 participants (mean age 92.9 years), fall prevalence at baseline was 48.6% (48.5% in men, 49.0% in women). Predicted fall rate for a 93-year-old was lower in women (0.63 falls/py) than in men (0.71 falls/py) (Table). Over time, fall rate remained the same in women and increased in men. Fall rate for those in nursing homes decreased over time in women and remained stable in men. In community dwellers, fall rate increased over time in men using walkers or canes, while, in women, fall rate increased over time only in cane users. Discussion: Individuals 90 years and older had a high rate of falls overall. Individuals in nursing homes may be less active over time or may not report falls consistently, contributing to the decrease in fall rate in this group. Individuals 90 years and older may have difficulty using a cane or may benefit from a more supportive device, contributing to the increase in fall rate in cane users. Conclusions: Examining falls in the oldest old is essential to establishing effective fall screening and prevention in this group.