Citation

Greenberg MR, Nguyen MC, Stello B, Goldberg AR, Barraco RD, Porter BG, Kurt A, Dusza SW, Kane BG. J. Emerg. Med. 2014; 48(1): 108-114.e2.

Affiliation

Department of Emergency Medicine, Lehigh Valley Hospital and Health Network, Allentown, Pennsylvania.

Copyright

(Copyright © 2014, Elsevier Publishing)

DOI

10.1016/j.jemermed.2014.07.037

PMID

25282116

Abstract

BACKGROUND: Falls in the elderly cause serious injury.

OBJECTIVE: We aimed to determine subjects' comfort in discussing fall risk and home safety evaluations.

METHODS: This prospective study surveyed a convenience sample of subjects (≥50 years old) in an emergency department (ED), health fair (HF), and family practice (FP). The survey included the Falls Efficacy Scale and Vulnerable Elders Survey-validated surveys measuring fall concern and functional decline. Other data-environmental living conditions, participant behaviors, fall frequency-were collected. The associations between perceived fall risk and participant characteristics were assessed using descriptive statistics and random-effects logistic regression.

RESULTS: Participants (n = 416, 38% males, 62% females) had a mean age of 67.6 years; 35% were high fall risk. Previous year falls (p = 0.002), use of assistive device (p < 0.001), having at least one alcoholic drink/week (p = 0.043), and poor or fair perceived health status (p < 0.001) were associated with perceived fall risk. HF respondents were more willing than FP respondents to discuss falls (84.9% vs. 73.1%, p = 0.025). The difference was not significant between the HF and ED respondents (84.9% vs. 76.9, p = 0.11). HF subjects were more willing than FP to have a home safety inspection (68.9% vs. 45.9%, p < 0.001). The difference was not significant between the HF and ED respondents (68.9% vs 58.5, p = 0.09).

CONCLUSIONS: Perceived and actual fall risks are highly associated. Most participants are willing to discuss their fall risk and a home safety evaluation. HF subjects were most willing to have these discussions; ED subjects were less willing than HF, but not significantly different from health fair participants. FP participants were significantly less willing to have these discussions than HF participants. This may suggest a meaningful opportunity for fall risk prevention in outpatient settings such as health fairs and the ED.

Language: en