Determining how and why falls occur in elderly people will help to support development of valid and effective approaches for balance assessment and fall prevention in the long-term care environment.

Determining how and why falls occur in elderly people will help to support development of valid and effective approaches for balance assessment and fall prevention in the long-term care environment.


Prof Stephen N Robinovitch PhD, Fabio Feldman PhD, Yijian Yang MD, Rebecca Schonnop BSc, Pet Ming Lueng MSc, Thiago Sarraf MSc, Joanie Sims-Gould PhD, Marie Loughin MSc


Summary

Background
Falls in elderly people are a major health burden, especially in the long-term care environment. Yet little objective evidence is available for how and why falls occur in this population. We aimed to provide such evidence by analysing real-life falls in long-term care captured on video.

Methods
We did this observational study between April 20, 2007, and June 23, 2010, in two long-term care facilities in British Columbia, Canada. Digital video cameras were installed in common areas (dining rooms, lounges, hallways). When a fall occurred, facility staff completed an incident report and contacted our teams so that we could collect video footage. A team reviewed each fall video with a validated questionnaire that probed the cause of imbalance and activity at the time of falling. We then tested whether differences existed in the proportion of participants falling due to the various causes, and while engaging in various activities, with generalised linear models, repeated measures logistic regression, and log-linear Poisson regression.

Findings
We captured 227 falls from 130 individuals (mean age 78 years, SD 10). The most frequent cause of falling was incorrect weight shifting, which accounted for 41% (93 of 227) of falls, followed by trip or stumble (48, 21%), hit or bump (25, 11%), loss of support (25, 11%), and collapse (24, 11%). Slipping accounted for only 3% (six) of falls. The three activities associated with the highest proportion of falls were forward walking (54 of 227 falls, 24%), standing quietly (29 falls, 13%), and sitting down (28 falls, 12%). Compared with previous reports from the long-term care setting, we identified a higher occurrence of falls during standing and transferring, a lower occurrence during walking, and a larger proportion due to centre-of-mass perturbations than base-of-support perturbations.

Interpretation
By providing insight into the sequences of events that most commonly lead to falls, our results should lead to more valid and effective approaches for balance assessment and fall prevention in long-term care.

Funding
Canadian Institutes for Health Research.


Please click here for a link to the article.

Please click here for more information regarding the Technology for Injury Prevention in Seniors (TIPS) Program.

Please see below for links to media coverage of Dr. Robinovitch's work:

The Globe and Mail - Sheryl Ubelacker - October 17, 2012
Analyzing how and why seniors fall to help prevent injuries
Please click here for full article.

kunm.org – Roman Garcia – October 17, 2012
Loss Of Balance Is Leading Cause Of Elderly Falls
Please click here for full article.

Southasiamail.com – October 21, 2012
Video analysis reveals how and why elderly fall
Please click here for full article.

The Canadian Press - Sheryl Ubelacker - October 17, 2012
Videotaping shows most falls among elderly due to incorrect weight-shifting: study
Please click here for full article.

CBC News – October 17, 2012
Slips in nursing homes not biggest cause of falls, videos show
Please click here for full article.

medpagetoday.com – Todd Neale – October 17, 2012
Weight Transfer Tops Reasons Seniors Fall
Please click here for full article.


Media contacts:

Lisa Carver, VCH Research Communications & Public Affairs
604.875.4111 x 61777 or 604.319.7533 – lisa.carver@vch.ca

Brian Lin, UBC Public Affairs
604.822.2234 or 604.818.5685 – brian.lin@ubc.ca