Risk factors associated with injury attributable to falling among elderly population with history of stroke.

TitleRisk factors associated with injury attributable to falling among elderly population with history of stroke.
Publication TypeJournal Article
Year of Publication2009
AuthorsDivani, AA, Vazquez, G, Barrett, AM, Asadollahi, M, Luft, AR
Date Published2009 Oct
ISSN Number1524-4628
Call Numbernewpubs20091013_Divani_etal.pdf
KeywordsAccidental Falls, Aged, Aged, 80 and over, Aging, Causality, Cohort Studies, Comorbidity, disease progression, Female, Health Status, Humans, Male, Marital Status, Mental Disorders, Movement Disorders, Prevalence, Risk Factors, Risk Reduction Behavior, Sex Distribution, Stroke, Urinary incontinence, Wounds and Injuries

BACKGROUND AND PURPOSE: Stroke survivors are at high risk for falling. Identifying physical, clinical, and social factors that predispose stroke patients to falls may reduce further disability and life-threatening complications, and improve overall quality of life.

METHODS: We used 5 biennial waves (1998-2006) from the Health and Retirement Study to assess risk factors associated with falling accidents and fall-related injuries among stroke survivors. We abstracted demographic data, living status, self-evaluated general health, and comorbid conditions. We analyzed the rate ratio (RR) of falling and the OR of injury within 2 follow-up years using a multivariate random effects model.

RESULTS: We identified 1174 stroke survivors (mean age+/-SD, 74.4+/-7.2 years; 53% female). The 2-year risks of falling, subsequent injury, and broken hip attributable to fall were 46%, 15%, and 2.1% among the subjects, respectively. Factors associated with an increased frequency of falling were living with spouse as compared to living alone (RR, 1.4), poor general health (RR, 1.1), time from first stroke (RR, 1.2), psychiatric problems (RR, 1.7), urinary incontinence (RR, 1.4), pain (RR, 1.4), motor impairment (RR, 1.2), and past frequency of > or = 3 falls (RR, 1.3). Risk factors associated with fall-related injury were female gender (OR, 1.5), poor general health (OR, 1.2), past injury from fall (OR, 3.2), past frequency of > or = 3 falls (OR, 3.1), psychiatric problems (OR, 1.4), urinary incontinence (OR, 1.4), impaired hearing (OR, 1.6), pain (OR, 1.8), motor impairment (OR, 1.3), and presence of multiple strokes (OR, 3.2).

CONCLUSIONS: This study demonstrates the high prevalence of falls and fall-related injuries in stroke survivors, and identifies factors that increase the risk. Modifying these factors may prevent falls, which could lead to improved quality of life and less caregiver burden and cost in this population.

User Guide Notes


Endnote Keywords

Stroke/Falls/Elderly/risk factors

Endnote ID


Alternate JournalStroke
Citation Key7363
PubMed ID19628798
PubMed Central IDPMC2929376
Grant ListK02 NS047099 / NS / NINDS NIH HHS / United States
K02 NS047099-06 / NS / NINDS NIH HHS / United States
R01 NS055808 / NS / NINDS NIH HHS / United States
R01 NS055808-02 / NS / NINDS NIH HHS / United States