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Predictors and Prognosis of Inability to Get Up After Falls Among Elderly Persons

Predictors and Prognosis of Inability to Get Up After Falls Among Elderly Persons Objective. —To identify the predictors and prognosis associated with inability to get up after falling. Design. —Cohort study with a mean 21-month follow-up. Setting. —General community. Subjects. —1103 New Haven, Conn, residents aged 72 years and older who were able to follow simple commands and walk unassisted. Main Outcome Measures. —Self-reported inability to get up without help after falls not resulting in serious injury; activity restriction and hospitalization after a fall; death; and placement in a nursing home. Results. —Inability to get up without help was reported after 220 of 596 noninjurious falls. Of 313 noninjured fallers, 148 (47%) reported inability get up after at least one fall. Compared with nonfallers, the risk factors independently associated with inability to get up included the following: an age of at least 80 years (adjusted relative risk [RR], 1.6; 95% confidence interval [Cl], 1.2 to 2.1); depression (RR, 1.5; Cl, 1.1 to 2.0); and poor balance and gait (RR, 2.0; Cl, 1.5 to 2.7). Previous stroke (RR, 1.6; Cl, 1.0 to 2.4) and sedative use (RR, 1.5; Cl, 0.9 to 2.2) did not achieve significance. Among fallers, older age and poor balance and gait were associated marginally with inability to get up. Compared with fallers who were able to get up, fallers who were unable to get up were more likely to suffer lasting decline in activities of daily living (35% vs 26%). Fallers who were unable to get up were more likely to die, to be hospitalized, and to suffer a decline in activities of daily living for at least 3 days, and were less likely to be placed in a nursing home than were fallers who were able to get up, but these trends were not statistically significant. Conclusions. —The risk factors for inability to get up were similar to those for falling, although certain factors imparted a particular risk of inability to get up without help. The frequency of inability to get up and the short- and long-term morbidity associated with this inability suggest the need for preventive and treatment efforts. (JAMA. 1993;269:65-70) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Predictors and Prognosis of Inability to Get Up After Falls Among Elderly Persons

JAMA , Volume 269 (1) – Jan 6, 1993

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Publisher
American Medical Association
Copyright
Copyright © 1993 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.1993.03500010075035
Publisher site
See Article on Publisher Site

Abstract

Objective. —To identify the predictors and prognosis associated with inability to get up after falling. Design. —Cohort study with a mean 21-month follow-up. Setting. —General community. Subjects. —1103 New Haven, Conn, residents aged 72 years and older who were able to follow simple commands and walk unassisted. Main Outcome Measures. —Self-reported inability to get up without help after falls not resulting in serious injury; activity restriction and hospitalization after a fall; death; and placement in a nursing home. Results. —Inability to get up without help was reported after 220 of 596 noninjurious falls. Of 313 noninjured fallers, 148 (47%) reported inability get up after at least one fall. Compared with nonfallers, the risk factors independently associated with inability to get up included the following: an age of at least 80 years (adjusted relative risk [RR], 1.6; 95% confidence interval [Cl], 1.2 to 2.1); depression (RR, 1.5; Cl, 1.1 to 2.0); and poor balance and gait (RR, 2.0; Cl, 1.5 to 2.7). Previous stroke (RR, 1.6; Cl, 1.0 to 2.4) and sedative use (RR, 1.5; Cl, 0.9 to 2.2) did not achieve significance. Among fallers, older age and poor balance and gait were associated marginally with inability to get up. Compared with fallers who were able to get up, fallers who were unable to get up were more likely to suffer lasting decline in activities of daily living (35% vs 26%). Fallers who were unable to get up were more likely to die, to be hospitalized, and to suffer a decline in activities of daily living for at least 3 days, and were less likely to be placed in a nursing home than were fallers who were able to get up, but these trends were not statistically significant. Conclusions. —The risk factors for inability to get up were similar to those for falling, although certain factors imparted a particular risk of inability to get up without help. The frequency of inability to get up and the short- and long-term morbidity associated with this inability suggest the need for preventive and treatment efforts. (JAMA. 1993;269:65-70)

Journal

JAMAAmerican Medical Association

Published: Jan 6, 1993

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