Falls are an important health problem for elderly persons because of resulting suffering and functional decline. In our earlier study, 30% of the community elderly subjects fell; 25% of the fallers suffered a serious injury. Serious injury was associated with functional decline-as measured by decreased mobility- independent of number of falls or physical ability.
The aims of the proposed project are: 1) to identify the incidence of, and risk factors for, serious injuries during a fall; and 2) to verify the independent contribution of serious injury to decline in mobility among elderly fallers. The project is a five-year study of the estimated 1,029 eligible members of the Yale Health and Aging Cohort who agree to participate. Hypothesized risk factors for serious injury include factors associated with force of impact of the fall and factors associated with protective responses of the faller. The outcome variables will be serious injury and change in mobility during the study period. Risk and outcome variables will be ascertained during baseline and yearly assessments as well as during followup contacts. Followup contacts include: 1) weekly postcards; 2) immediate telephone calls to ascertain circumstances of fall; and 3) quarterly telephone interviews for all subjects. Each subject will be followed for three years. If, as we postulate, much of the suffering, health care expense, and loss of function associated with falling results from injury, then the factors associated with injury should be identified and targeted in preventive programs. The modifiable risk factors identified in this study will allow the development of targeted, effective preventive programs. This proposal is a revised version of Application AG07449.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
5R01AG007449-05
Application #
3118551
Study Section
Epidemiology and Disease Control Subcommittee 2 (EDC)
Project Start
1989-05-01
Project End
1994-04-30
Budget Start
1993-05-01
Budget End
1994-04-30
Support Year
5
Fiscal Year
1993
Total Cost
Indirect Cost
Name
Yale University
Department
Type
Schools of Medicine
DUNS #
082359691
City
New Haven
State
CT
Country
United States
Zip Code
06520
Murphy, Susan L; Dubin, Joel A; Gill, Thomas M (2003) The development of fear of falling among community-living older women: predisposing factors and subsequent fall events. J Gerontol A Biol Sci Med Sci 58:M943-7
Long, Judith A; Ickovics, Jeannette R; Gill, Thomas M et al. (2002) Social class and mortality in older women. J Clin Epidemiol 55:952-8
Murphy, Susan L; Williams, Christianna S; Gill, Thomas M (2002) Characteristics associated with fear of falling and activity restriction in community-living older persons. J Am Geriatr Soc 50:516-20
Gill, T M; Williams, C S; Tinetti, M E (2000) Environmental hazards and the risk of nonsyncopal falls in the homes of community-living older persons. Med Care 38:1174-83
Gill, T M; Williams, C S; Robison, J T et al. (1999) A population-based study of environmental hazards in the homes of older persons. Am J Public Health 89:553-6
Gill, T M; Williams, C S; Tinetti, M E (1999) The combined effects of baseline vulnerability and acute hospital events on the development of functional dependence among community-living older persons. J Gerontol A Biol Sci Med Sci 54:M377-83
Marottoli, R A; Richardson, E D; Stowe, M H et al. (1998) Development of a test battery to identify older drivers at risk for self-reported adverse driving events. J Am Geriatr Soc 46:562-8
Gill, T M; Robison, J T; Tinetti, M E (1998) Difficulty and dependence: two components of the disability continuum among community-living older persons. Ann Intern Med 128:96-101
Tinetti, M E; Williams, C S (1998) The effect of falls and fall injuries on functioning in community-dwelling older persons. J Gerontol A Biol Sci Med Sci 53:M112-9
Marottoli, R A; Richardson, E D (1998) Confidence in, and self-rating of, driving ability among older drivers. Accid Anal Prev 30:331-6

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