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Impact of Falls on the Balance, Gait, and Activities of Daily Living Functioning in Community-Dwelling Chinese Older Adults

¹ Division of Geriatric Medicine, University Department of Medicine, Queen Mary Hospital, The University of Hong Kong.
² Department of Physiotherapy, Queen Mary Hospital, Hong Kong.
³ Sau Po Centre on Ageing, the University of Hong Kong.

Address correspondence to Leung-Wing Chu, FRCP, University Department of Medicine, Queen Mary Hospital, The University of Hong Kong, 102 Pokfulam Road, Hong Kong, Hong Kong SAR. E-mail: lwchu{at}hkucc.hku.hk

Objective. The objective of the present study was to investigate the impact of incident falls on the balance, gait, and Activities of Daily Living functioning in community-dwelling older adults.

Methods. This was a population-based, 1-year prospective cohort study in older adults. We performed baseline assessment of potential predictors, the 1-year occurrence of falls, and then 1-year reassessment of the following outcome measures: the Barthel Index (BI), Lawton's Instrumental Activities of Daily Living (IADL) scale, gait speed, and Tinetti Balance and Gait Evaluation's total mobility score (TMS). At 1 year of follow-up, participants who had declined by 1 standard deviation (SD) below the baseline mean value of each outcome measure were classified as "decliners."

Results. Of the 1517 participants, 93.5% (n = 1419) completed the 1-year follow-up reassessment of BI and IADL. For gait speed and TMS, respectively, 88.2% (n = 1338) and 88.3% (n = 1339) completed the 1-year outcome assessment. Fallers, particularly recurrent fallers, experienced significantly greater 1-year declines in the four functional measures. Multivariate logistic regression analyses showed that an incident fall was a significant independent predictor for decliners in the BI, Lawton's IADL score, gait speed, and TMS after adjustment of all significant confounding factors. The relative risks of an incident fall as an independent predictor for decliners in the BI, IADL score, gait speed, and TMS were 2.4 (95% confidence interval [CI], 1.4–4.0; p =.01), 2.9 (95% CI, 1.7–5.2; p <.001), 2.4 (95% CI, 1.5–3.8; p <.001), and 4.6 (95% CI, 2.7–7.8; p <.001), respectively.

Conclusions. Incident falls have a significant negative impact on the balance, gait, and Activities of Daily Living functioning in community-dwelling older adults.