Kate Doyle, Caoimhe McGarvey, Siobhan Scarlett, Frank Moriarty, Amanda Lavan, Rose-Anne Kenny, Robert Briggs
The incidence of falls among community-dwelling older adults is increasing, and the prevalence of falls risk factors is consistently high. This highlights the need to address falls risk factors in national falls prevention policies at population level to reduce the burden of falls and falls-related injuries.
PURPOSE: Multifactorial falls risk assessment incorporates assessment of modifiable falls risk factors, including fall-risk-increasing drugs(FRIDs) identified by Screening Tool of Older Persons Prescriptions in older adults with high fall risk(STOPPFall), orthostatic hypotension(OH) and mobility(measured by Timed-Up-and-Go(TUG)). The aim of this study is to assess the prevalence of these falls risk factors and incidence of falls in a large population-based cohort of community-dwelling older people.
METHODS: Data from The Irish Longitudinal Study on Ageing(TILDA) Waves 1,3,and 6 was used. STOPPFall medications were recorded at each wave. OH was defined as an orthostatic drop in systolic blood pressure ≥20 mmHg(upon standing from sitting) and/or reporting orthostatic unsteadiness. Mobility impairment was defined by TUG ≥12 s. Falls were self-reported.
RESULTS: Participants aged ≥65 years at TILDA Waves 1(2009-2011,n=3507,mean age 73.3, 52.5% female), 3(2014-2015,n=3582,mean age 73.9, 54.2% female) and 6(2021-2023,n=3333,mean age 74.3, 55.3% female) were included. Incidence of all falls on weighted population analysis increased from 22.1% at Wave 1 (approximately 117,665 older people) to 29.8% at Wave 6 (approximately 228,007 people). Prevalence of STOPPFall medication use was high, with over 1 in 4 using one STOPPFall medication and over 1 in 7 using ≥2 STOPPFall medications across each wave. Over 1 in 5 of the population had OH and over 1 in 4 had mobility impairment at each wave.
CONCLUSION: The incidence of falls among community-dwelling older adults is increasing, and the prevalence of falls risk factors is consistently high. This highlights the need to address falls risk factors in national falls prevention policies at population level to reduce the burden of falls and falls-related injuries.