Risk factors for hospital admission after a fall: a prospective cohort study of community-dwelling older people.

BACKGROUND

Falls in later life that require admission to hospital have well-established consequences for future disability and health. The likelihood and severity of a fall will result from the presence of one or more risk factors. The aim of this study is to examine risk factors identified for their ability to prevent falls and to assess whether they are associated with hospital admission after a fall.

METHODS

Analyses of data from the English Longitudinal Study of Ageing (ELSA), a prospective cohort study. In a sample of 3,783 men and women over 60 years old, a range of potential risk factors measured at wave 4 (demographic, social environment, physical and mental functioning) were examined as predictors of fall-related hospitalisations, identified using International Classification of Diseases, Tenth Revision (ICD-10) code from linked hospital records in the UK. Subdistribution hazard models were used to account for competing risk of death.

RESULTS

Several risk factors identified by previous work were confirmed. Suffering from urinary incontinence (SHR=1.49; 95% CI: 1.14, 1.95) and osteoporosis (SHR=1.48; 95% CI: 1.05, 2.07) which are not commonly considered at an early stage of screening, were found to be associated with hospital admission after a fall. Both low and moderate levels of physical activity were also found to somewhat increase the risk of hospital admission after a fall.

CONCLUSIONS

Several predictors of having a fall, severe enough to require hospital admission, have been confirmed. In particular, urinary incontinence should be considered at an earlier point in the assessment of risk.