Risk Factors For Falls In Older People: A Cross-sectional Analysis Based On The Dongfeng-tongji Cohort Study

Objectives The objective of this study was to understand the prevalence of falls and investigate the possible risk factors for falls in Chinese elderly people.Methods Based on the Dongfeng-Tongji Cohort Study, we conducted a cross-sectional study of a sample of 15256 males and 11642 females aged 60 and older. Each participant completed a face-to-face questionnaire, a medical examination and a laboratory test. At least one fall(vs. no falls) in the past year was self-reported and regarded as a dependent variable.Multivariate logistic regression models were applied to investigate the possible risk factors for falls in Chinese elderly people, including the socio-demographic information(sex, age, ethnics,education level, marital status), lifestyle behaviors(smoking status, drinking status, physical activity, sleep quality), and history of chronic diseases(obesity, hypertension, diabetes mellitus,coronary heart disease, myocardial infarction, stroke).Results The overall rate of falls in the study population was 17.6%, and higher in females than males(21.7% vs. 14.5%, c2=238.74, P<0.001). Compared with males aged 60~65, males aged 65~70(OR=1.15, 95% CI: 1.01-1.31), 70~75(OR=1.36, 95% CI: 1.17-1.59) and older than75(OR=1.76, 95% CI: 1.51-2.06) had a significantly higher risk of falls. Compared with females aged 60~65, the ORs and 95% CI of falls for females aged 65~70, 70~75 and older than 75 were(OR=1.14, 95% CI: 1.02-1.29),(OR=1.24, 95% CI: 1.09-1.42) and(OR=1.46, 95% CI:1.28-1.67). Compared with females with level of elementary or below education, females with level of junior high school(OR=1.23, 95% CI: 1.10-1.37), senior high school(OR=1.43, 95% CI:1.26-1.63) and college or above(OR=1.67, 95% CI: 1.40-1.99) education had a significantly higher risk of falls. Compared with male nonsmokers, cigarette abstinence was associated with increased risk of falls(OR=1.14, 95% CI: 1.00-1.29). Compared with nondrinkers, male current(OR=1.26, 95% CI: 1.12-1.41) and former(OR=1.58, 95% CI: 1.35-1.84) drinkers both had elevated risk of falls; the ORs and 95% CI of falls for female current and former drinkers were(OR=1.34, 95% CI: 1.14-1.58) and(OR=2.41, 95% CI: 1.68-3.45). Compared with individuals with good sleep quality, fair(OR=1.37, 95% CI: 1.23-1.54), poor(OR=2.02, 95% CI: 1.71-2.38)and very poor(OR=2.47, 95% CI: 1.75-3.47) sleep quality were related to higher risk of falls in males; the ORs and 95% CI of falls for females were(OR=1.30, 95% CI: 1.17-1.46),(OR=1.76,95% CI: 1.53-2.02) and(OR=2.06, 95% CI: 1.62-2.61). Compared with males with a BMI of18.5~23.9, males with a BMI of 28 or higher had 1.33 times(95% CI: 1.13-1.56) risk of falls.Diabetes mellitus was related to higher risk of falls(OR=1.14, 95% CI: 1.02-1.29 for males and OR=1.15, 95% CI: 1.04-1.28 for females). Coronary heart disease was related to elevated risk of falls(OR=1.15, 95% CI: 1.01-1.31 for males and OR=1.27, 95% CI: 1.14-1.42 for females).Stroke was associated with increased risk of falls(OR=2.42, 95% CI: 2.06-2.85 for males and OR=1.72, 95% CI: 1.42-2.08 for females). There was no significant association between race,marital status, regular physical activity, hypertension, myocardial infarction and fall risk in the elderly.Conclusions The prevalence of falls was 17.6%. Age, alcohol drinking, poorer sleep quality,diabetes mellitus, coronary heart disease and stroke were risk factors for both older males and females. Obesity was associated with increased risk of falls in males. These findings suggested that older people should establish and maintain healthy behaviors and a scientific lifestyle, take a good control on the weight, and receive effective treatments for their chronic diseases and complications.