As recognized in the Healthy People 2000 objectives, falls and their sequelae represent common, potentially preventable sources of disability among older persons. The goal of this study, during its initial funding period, was to determine the frequency of, and risk factors for falls, serious injuries, and other fall sequelae. The goal of the study during the renewal period will be to continue these investigations the next step, namely to examine the health, functional, and cost outcomes associated with falls and their sequelae.
The specific aims of this proposal are: l) to determine whether, and to what extent, falls and/or fall sequelae are independent determinants of adverse functional and health outcomes in elderly persons; and 2) to determine the health care costs associated with falling and fall sequelae. The fall sequelae to be studied include injuries, fear of falling, low fall-related efficacy, and inability to get up without help after a fall. The adverse health and functional outcomes include new onset or increased disability in physical performance, basic and instrumental activities of daily living, and advanced physical and social activities as well as increased home services and institutionalization. The proposed study, during the renewal period, is designed to supplement an existing rich dataset on a representative sample of community elderly persons with additional utilization and expenditure data. The 1,103 participants represent a probability sample of non-institutionalized New Haven, Connecticut residents who were at least 72 years of age at time of enrollment in 1989-1990 and are now a mean age of 82.4 (5.2) years old. Data already collected on participants include: 1) three interviews between 1989 and 1993 during which demographic, social, psychological, medical, physical performance, and functional data were ascertained; 2) 3 years of daily surveillance data on occurrence, circumstances, and consequences of falls; and 3) ongoing surveillance for hospitalizations and death. These data will be supplemented with: l) reviews of medical records of all cohort members to ascertain the presence of chronic diseases and occurrence of intervening medical events; 2) medical care expenditure data from HCFA; and 3) nursing home data from the Connecticut Long Term Care Registry. The planned investigations will help determine whether, and to what extent, falls and their sequelae play a role in the increased disability, dependence, and health care costs seen as persons age and whether, in turn, fall and injury prevention programs are likely to impact on the health, functioning, and health care costs of the increasing numbers of elderly persons.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
2R01AG007449-06
Application #
2049756
Study Section
Epidemiology and Disease Control Subcommittee 2 (EDC)
Project Start
1989-05-01
Project End
1997-06-30
Budget Start
1994-08-15
Budget End
1995-06-30
Support Year
6
Fiscal Year
1994
Total Cost
Indirect Cost
Name
Yale University
Department
Internal Medicine/Medicine
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

Showing the most recent 10 out of 26 publications