Prevalence and Associated Risk Factors of Falls among Rural Community-Dwelling Older People: A Cross-Sectional Study from Southern Sri Lanka

Abstract

Falls may cause devastating consequences in older people. Conducting surveys on falls and factors associated with falls will inform better preventive health practices among older people to improve their quality of life. This study aimed to assess the prevalence and associated risk factors of falls and recurrent falls among rural community-dwelling older people in Southern Sri Lanka. A cross-sectional study was conducted in Nagoda Divisional Secretariat area, Galle, with 300 participants (females=175) aged 65 years and above. An interviewer-administered questionnaire was used to collect the data. To assess the prevalence of falls, participants were asked if they had fallen in the past year, and if so how many times. If any individual reported two or more falls, it was considered a recurrent fall. Biological, behavioral, environmental, and socioeconomic factors were documented as potential risk factors for falls. Multivariate logistic regression was performed with adjusted Odds Ratio (OR). Mean (SD) age was 73 (6.7) years. The prevalence of falls and recurrent falls were reported as 34.3% (95%CI; 29.03-40.04) (n=103) and 9.6% (95%CI; 6.68-13.73) (n=29), respectively. Out of 103 fallers, 37 (35.9%) had sustained injuries, with 40.5% affecting the wrist and 24.3% the hip. The associated factors for falls were age (OR=0.1), gender (OR=3.0), diabetes mellitus (OR=2.7), balance or gait problems (OR=4.2), use of antihypertensive medication (OR=0.2), and use of at least one long-term medication (OR=3.5). Associated factors for recurrent falls were age (OR=0.3), hypertension (OR=3.7), balance or gait problems (OR=3.8), sleep disturbances (OR=2.0), use of antihypertensive medication (OR=0.1), and use of at least one long-term medication (OR=3.4). A high prevalence of falls and low prevalence of recurrent falls among older people were observed. Biological and behavioral factors were reported as associated risk factors. This information is important to inform strategies to prevent falls in older people in Sri Lanka.