RT Journal Article
SR Electronic
T1 A prospective study on the variation in falling and fall risk among community-dwelling older citizens in 12 European countries
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e015827
DO 10.1136/bmjopen-2017-015827
VO 7
IS 6
A1 Carmen B Franse
A1 Judith AC Rietjens
A1 Alex Burdorf
A1 Amy van Grieken
A1 Ida J Korfage
A1 Agnes van der Heide
A1 Francesco Mattace Raso
A1 Ed van Beeck
A1 Hein Raat
YR 2017
UL http://bmjopen.bmj.com/content/7/6/e015827.abstract
AB Objectives The rate of falling among older citizens appears to vary across different countries, but the underlying aspects causing this variation are unexplained. We aim to describe between-country variation in falling and explore whether intrinsic fall risk factors can explain possible variation.Design Prospective study on data from the cross-national Survey of Health, Ageing and Retirement in Europe (SHARE).Setting Twelve European countries (Austria, Belgium, Czech Republic, Denmark, Estonia, France, Germany, Italy, The Netherlands, Spain, Sweden, Switzerland).Participants Community-dwelling persons aged ≥65 years (n=18 596).Measurements Socio-demographic factors (age, gender, education level and living situation) and intrinsic fall risk factors (less than good self-rated health (SRH), mobility limitations, limitations with activities of daily living (ADL), dizziness, impaired vision, depression and impaired cognition) were assessed in a baseline interview. Falling was assessed 2 years later by asking whether the participant had fallen within the 6 months prior to the follow-up interview.Results There was significant between-country variation in the rate of falling (varying from 7.9% in Switzerland to 16.2% in the Czech Republic). The prevalence of intrinsic fall risk factors varied twofold to fourfold between countries. Associations between factors age ≥80 years, less than good SRH, mobility limitations, ADL limitations, dizziness and depression, and falling were different between countries (p<0.05). Between-country differences in falling largely persisted after adjusting for socio-demographic differences but strongly attenuated after adjusting for differences in intrinsic fall risk factors.Conclusion There is considerable variation in the rate of falling between European countries, which can largely be explained by between-country variation in the prevalence of intrinsic fall risk factors. There are also country-specific variations in the association between these intrinsic risk factors and falling. These findings emphasise the importance of addressing intrinsic fall risk in (inter)national fall-prevention strategies, while highlighting country-specific priorities.