RT Journal Article
SR Electronic
T1 Prevalence of and factors associated with head impact during falls in older adults in long-term care
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP E803
OP E810
DO 10.1503/cmaj.130498
VO 185
IS 17
A1 Schonnop, Rebecca
A1 Yang, Yijian
A1 Feldman, Fabio
A1 Robinson, Erin
A1 Loughin, Marie
A1 Robinovitch, Stephen N.
YR 2013
UL http://www.cmaj.ca/content/185/17/E803.abstract
AB Background: Falls cause more than 60% of head injuries in older adults. Lack of objective evidence on the circumstances of these events is a barrier to prevention. We analyzed video footage to determine the frequency of and risk factors for head impact during falls in older adults in 2 long-term care facilities.Methods: Over 39 months, we captured on video 227 falls involving 133 residents. We used a validated questionnaire to analyze the mechanisms of each fall. We then examined whether the probability for head impact was associated with upper-limb protective responses (hand impact) and fall direction.Results: Head impact occurred in 37% of falls, usually onto a vinyl or linoleum floor. Hand impact occurred in 74% of falls but had no significant effect on the probability of head impact (p = 0.3). An increased probability of head impact was associated with a forward initial fall direction, compared with backward falls (odds ratio [OR] 2.7, 95% confidence interval [CI] 1.3–5.9) or sideways falls (OR 2.8, 95% CI 1.2–6.3). In 36% of sideways falls, residents rotated to land backwards, which reduced the probability of head impact (OR 0.2, 95% CI 0.04–0.8).Interpretation: Head impact was common in observed falls in older adults living in long-term care facilities, particularly in forward falls. Backward rotation during descent appeared to be protective, but hand impact was not. Attention to upper-limb strength and teaching rotational falling techniques (as in martial arts training) may reduce fall-related head injuries in older adults.