Circumstances and consequences of falls among the older
					adults in Florianopolis. Epi Floripa Aging 2009*

The objective was to investigate the circumstances and consequences of falling and risk factors associated with limitations in performing activities after falling. The study is part of the cross-sectional population based survey, conducted in 2009/2010, which involved 1,705 older adults (60 years and older) living in Florianopolis, SC. From the affirmative answer to the question of whether any falls occurred in the 12 months preceding the study, we investigated the circumstances and consequences of falls through a structured questionnaire. Descriptive analysis and binary logistic regression were used, with significance level of 5%. The prevalence of fall was 19% (14.3% for men and 21.5% for women). Most older adults fell while walking, 43.2% inside their homes. The main cause of falling was stumbling due to irregularities on the ground. 71% of those who fell reported injury, and 14.8% reported limitations in performing activities after the fall. There was a significant association between limitations in performing activities after the occurrence of falls and fractures. Preventing falls should be a public health concern, given that relatively easy changes can reduce the risk of falls.

Aged; Accidental falls; Cross-sectional studies; Physical exercise; Activities of daily living; Public health.

Authorship

Danielle Ledur Antes

Eleonora d’Orsi

Tânia R. Bertoldo Benedetti

Universidade Federal de Santa Catarina, Programa de Pós-graduação em Educação Física, Florianópolis, SC, BrasilUniversidade Federal de Santa CatarinaBrasilFlorianópolis, SC, BrasilUniversidade Federal de Santa Catarina, Programa de Pós-graduação em Educação Física, Florianópolis, SC, Brasil

Correspondence: Danielle Ledur Antes. Núcleo de Cineantropometria e Desempenho Humano (NuCiDH) – sala 42 – UFSC – Centro de Desportos - Campus Universitário – Trindade, CEP: 88040-900 Florianópolis, SC. E-mail: danielleantes@gmail.com

SCIMAGO INSTITUTIONS RANKINGS

Tables

Tables (4)

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Table 1
Number (n), percentage (%) and confidence intervals (CI) of the circumstances and consequences of falls in 60 or more years old individuals, Florianopolis, SC, 2009/2010.

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Table 2
Table 2 - Number (n), percentage (%) and confidence intervals (CI) of the consequent injury of the fall, loss of consciousness, medical attendance at the scene, saw doctor after the fall, subsequent alteration of medication, restriction of normal daily activities, difficulties in performing activities after the fall, fear of reoccurrence of a fall; in 60 or more years old individuals, Florianopolis, SC, 2009/2010.

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Table 3
Bivariate analyses, crude odds ratio (OR), 95% confidence interval (CI), and p-value of the association between limitations on the performance of daily activities after the fall; and other variables in 60 or more years old individuals. Florianopolis, SC, 2009/2010.

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Table 4
Multiple analyses, crude odds ratio (OR), 95% confidence interval (CI), and p-value of the association between limitations on the performance of daily activities after the fall; and other variables in 60 or more years old individuals. Florianopolis, SC, 2009/2010.

Table 1 Number (n), percentage (%) and confidence intervals (CI) of the circumstances and consequences of falls in 60 or more years old individuals, Florianopolis, SC, 2009/2010.

Variable	n	%	(95%CI)
Number of falls (n=322)
1 fall	181	56.2	(50.8; 61.7)
2 to 5 falls	122	37.9	(32.6; 43.2)
More than 5 falls	19	5.9	(3.3; 8.5)
Period of the day (n=297)
Morning	129	43.4	(37.8.8; 49.1)
Afternoon	120	40.4	(34.8; 46.0)
Evening	48	16.2	(11.9; 20.4)
Place (n=304)
Street near home	56	18.4	(14.0; 22.8)
Garden/courtyard	59	19.4	(14.9; 22.8)
Street far from home	30	9.9	(6.5; 13.2)
Other	28	9.2	(5.9; 12.5)
Inside the home (n=131)	131	43.1	(37.5; 48.7)
Bathroom	19	14.5	(8.4; 20.6)
Kitchen	22	16.8	(10.3; 23.3)
Living-room	19	14.5	(8.4; 20.6)
Laundry room	07	5.3	(1.4; 9.2)
Bedroom	33	25.2	(17.7; 32.7)
Stairs	09	6.9	(2.3; 11.3)
Other	22	16.8	(10.3; 23.3)
Activity at the moment (n=304)
Walking	154	50.7	(45.0; 56.3)
Domestic activity	53	17.4	(13.1; 21.7)
Walking down stairs	22	7.2	(4.3; 10.2)
Taking a shower	13	4.3	(1.9; 6.6)
Climbing stairs	13	4.3	(1.9; 6.6)
Other	49	16.1	(11.9; 20.3)
Needed help standing up (n=304)
Yes	157	51.6	(45.9; 57.2)
No	147	48.4	(42.7; 54.0)
*Time on the ground (n=294)**
≤ 1 minute	222	75.5	(70.6; 80.4)
2 to 14 minutes	49	16.8	(12.4; 20.9)
≥ 15 minutes	23	7.8	(4.7; 10.9)
Circumstance of the fall (n=304)
Felt weak	14	4.6	(2.2; 6.9)
Twisted the ankle	34	11.2	(7.6; 14.7)
Felt dizzy	32	10.5	(7.1; 13.9)
Stumbled	91	29.9	(24.8; 35.1)
Slipped	68	22.4	(17.7; 27.1)
Lost balance	17	5.6	(2.9; 8.2)
Does not know/does not remember	17	5.6	(1.9; 6.6)
Other	35	11.5	(7.9; 15.1)
Factors that caused the fall (n=304)
Rug	10	3.3	(1.3; 5.3)
Inadequate shoe	24	7.9	(4.8; 10.9)
Poor lighting	11	3.6	(1.5; 5.7)
Wet floor	44	14.4	(10.5; 18.4)
Irregularity in the ground	60	19.7	(15.2; 24.2)
Object on the floor	19	6.3	(3.5; 8.9)
Other**	78	25.7	(20.7; 30.6)
No factor	58	19.1	(14.6; 23.5)
Was feeling well (n=301)
Yes	276	91.7	(88.5; 94.8)
No	25	8.3	(5.2; 11.4)
Alcohol intake (n=302)
Yes	06	1.9	(0.4; 3.6)
No	296	98.0	(96.4; 99.6)
New medicine (n=302)
Yes	06	1.9	(0.4; 3.6)
No	296	98.0	(96.4; 99.6)
Interruption in the use of a medicine (n=303)
Yes	08	2.6	(0.8; 4.5)
No	295	97.4	(95.5; 99.2)
Self-medication (n=304)
Yes	01	0.3	(0.00; 0.9)
No	303	99.7	(99.0; 100.3)

*Time in minutes; **Hands were occupied, in a hurry, lack of attention, etc.

Table 2 Table 2 - Number (n), percentage (%) and confidence intervals (CI) of the consequent injury of the fall, loss of consciousness, medical attendance at the scene, saw doctor after the fall, subsequent alteration of medication, restriction of normal daily activities, difficulties in performing activities after the fall, fear of reoccurrence of a fall; in 60 or more years old individuals, Florianopolis, SC, 2009/2010.

Variable	N	%	(95%CI)
Suffered consequences (n=304)
Yes	216	71.0	(65.9; 76.2)
No	88	28.9	(23.8; 34.1)
Main consequences (n=215)
Fracture	28	13.0	(8.5; 17.6)
Sprain	18	8.4	(4.6; 12.1)
Abrasion/scratch	75	34.9	(28.5; 41.3)
Bruise	65	30.2	(24.0; 36.4)
Cut	21	9.8	(5.8; 13.8)
Other	08	3.7	(1.2; 6.3)
Loss of consciousness (n=304)
Yes	13	4.3	(1.9; 6.6)
No	291	95.7	(93.4; 98.0)
Medical assistance on the scene (n=303)
Yes	15	4.9	(2.5; 7.4)
No	288	95.0	(92.6; 97.5)
Saw a doctor after the fall (n=294)
Yes	111	37.8	(32.2; 43.3)
No	183	62.2	(56.7; 67.8)
Modified the medication (n=304)
Yes	26	8.5	(5.4; 11.7)
No	278	91.4	(88.3; 94.6)
Restricted activities after the fall (n=304)
Yes	75	24.7	(19.8; 29.5)
No	229	75.3	(70.4; 80.2)
Limitation to perform activities after the fall (n=304)
No	259	85.2	(81.2; 89.2)
Yes	45	14.8	(10.8; 18.8)
Main activities
Walking inside the home	22	16.3	(9.9; 22.6)
Dressing up	24	17.8	(11.2; 24.3)
Taking a shower	15	11.1	(5.7; 16.5)
Walking outdoors	30	22.2	(15.1; 29.3)
Going to the bathroom on time	6	4.4	(0.9; 7.9)
Taking medication at the right time	4	2.9	(0.1; 5.9)
Cutting toenails	8	5.9	(1.9; 9.9)
Shopping	26	19.3	(12.5; 25.9)
Fear of falling again (n=266)
Yes	152	57.1	(51.2; 63.1)
No	114	42.9	(36.9; 48.8)

Table 3 Bivariate analyses, crude odds ratio (OR), 95% confidence interval (CI), and p-value of the association between limitations on the performance of daily activities after the fall; and other variables in 60 or more years old individuals. Florianopolis, SC, 2009/2010.

Variable	n	Limitation (%)	Crude OR (95%CI)	p-value
Sex				0.147
Male	08	9.6	1.00
Female	37	16.5	1.88 (0.79; 4.46)
Age group				0.862
60 to 69 years	17	13.8	0.98 (0.39; 2.42)
70 to 79 years	20	16.1	1.18 (0.49; 2.81)
80 years or older	08	14.0	1.00
Level of schooling				0.482
≤ 4 years	18	13.1	1.00
≥ 5 years	27	16.6	1.31 (0.61; 2.82)
Per capita income				0.561
Level 1	17	14.12	1.34 (0.63; 2.84)
Level 2	19	18.63	1.86 (0.75; 4.57)
Level 3	09	10.98	1.00
Marital status				0.08
With a partner	19	11.31	1.00
Without a partner	26	19.12	1.85 (0.93; 3.71)
Fear of falling again				0.03*
No	11	9.6	1.00
Yes	28	18.4	2.11 (1.10; 4.07)
Fracture				< 0.001*
No	29	15.5	1.00
Yes	14	50.0	5.45 (2.48; 11.95)
Time on the ground				0.002*
≤ 1 minute	23	10.4	1.00
2 to 14 minutes	09	18.4	1.95 (0.74; 5.10)
≥15 minutes	08	34.8	4.61 (1.84; 11.57)
Loss of consciousness				0.007*
No	39	13.4	1.00
Yes	06	46.2	5.54 (1.61; 19.09)
Number of falls				0.629
1 fall	28	16.1	1.00
2 to 5 falls	14	12.3	0.73 (0.43; 1.23)
6 or more falls	03	18.7	1.20 (0.33; 4.42)

*Statistically significant

Table 4 Multiple analyses, crude odds ratio (OR), 95% confidence interval (CI), and p-value of the association between limitations on the performance of daily activities after the fall; and other variables in 60 or more years old individuals. Florianopolis, SC, 2009/2010.

Variable	n	Limitation (%)	adjusted OR** (95%CI)	p-value
Fear of falling again				0,153
No	11	9,6	1,00
Yes	28	18,4	1,74 (0,81; 3,76)
Fracture				0,003*
No	29	15,5	1,00
Yes	14	50,0	4,24 (1,66; 10,87)
Time on the ground				0,123
≤ 1 minute	23	10,4	1,00
2 to 14 minutes	09	18,4	2,21 (0,69; 6,98)
≥15 minutes	08	34,8	2,15 (0,58; 7,97)
Loss of consciousness				0,226
No	39	13,4	1,00
Yes	06	46,2	3,74 (0,43; 32,30)

*Statistically significant; **Adjusted variables by sex and marital status.

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Circumstances and consequences of falls among the older adults in Florianopolis. Epi Floripa Aging 2009*

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[1] Correspondence: Danielle Ledur Antes. Núcleo de Cineantropometria e Desempenho Humano (NuCiDH) – sala 42 – UFSC – Centro de Desportos - Campus Universitário – Trindade, CEP: 88040-900 Florianópolis, SC. E-mail: danielleantes@gmail.com