Fall history

Twenty-eight percent of respondents had no history of falling, 26% reported a single fall, with the other 46% reporting multiple falls (figure 3.3). The most common number of these multiple falls reported was 2-3 falls. The mean age for the first fall was 60.66 (± 11.25) years.

Achievement of at least 30 minutes of at least moderate intensity physical activity on at least 5 days of the week during each decade of life for fallers and non-fallers can be seen in figure 3.4. As with the males and females, it was apparent that the percentage achieving the recommended levels reduced with increased age category. The only increase in physical activity attainment was for the non-fallers in the 80s, which may be due to the low participant numbers in this category (n = 5). There was no

significant relationship between physical activity recommendation attainment and whether someone had fallen or not (χ²Yates = 3.762, p = 0.052). When the fallers were further split into single fallers and multiple fallers, there was still no significant

28%

26%

30%

10%

6% No falls

1 fall 2-3 falls 4-5 falls

More than 5 falls

Figure 3.3 Number of falls in each category

0 10 20 30 40 50 60 70 80 90 100

20s 30s 40s 50s 60s 70s 80s Lifetime

Decade Participants achieving physical activity recommendations (%)

Non-fallers Fallers

Figure 3.4 Percentage of non-fallers and fallers achieving the recommended amount of physical activity for each decade and across the lifetime

relationship between physical activity attainment and faller type (χ² = 4.591, p = 0.101).

There was a significant relationship between sex and fall status (χ²Yates = 11.311, p = 0.001), with more women having experienced a fall than the expected count. This relationship was also significant with type of fall (χ² = 12.512, p = 0.002), with

women more likely to have experienced multiple falls than expected, and less likely to have not fallen than expected.

Walking outdoors was the most common place to experience a fall or stumble (see figure 3.5), with 154 participants reporting an incidence, followed by walking in icy conditions (also normally as outdoors situation; 75 participants) and walking indoors (71 participants). When data was combined into two groups based on location, respondents reported 188 fall occurrences in the home and 421 fall occurrences outside the home.

The most common type of fall was through a trip (150 participants), followed by a slip (112) and a loss of balance (84). Forty-five participants reported that their falls resulted in no injuries. The most commonly reported injuries were bruises (155 participants) and cuts/grazes (100 participants). The most common serious injuries reported were back pain (39) and a broken wrist (26). Two respondents reported a broken hip. When injury types were split into non-serious (no injury, bruises, grazes) and serious (fractures, sprains, back pain) groups, there were no significant

differences in physical activity levels for the decades leading up to the first fall.

11%

2%

2%

5%

9%

11% 24%

3%

11%

4%

12%

6%

Walking indoors Getting out of bed Getting out of a chair Using the shower/bath Walking up and down stairs Walking outdoors

In the garden

Getting out of a vehicle On a kerb/gutter In a public building In icy conditions Other

Figure 3.5 Activity at the time of a fall

3.2.3 Fear of falling

Table 3.5 contains summary data from completion of the fear of falling section of the LPAFH for the male and female categories. Data identified that 15% (12) males and 32% (75) females reported a fear of falling. Chi-squared analysis showed a

significant difference between males and females reporting a fear of falling (χ²Yates = 7.416, p = 0.006), with more females and fewer males reporting a fear of falling than the expected count.

Table 3.5 FES scores per item for males and females (mean ± SD) * indicates a significant difference

Males Females t-value

Cleaning the house 4.77 ± 0.73 4.48 ± 0.94 2.811*

Getting dressed or undressed 4.81 ± 0.58 4.67 ± 0.84 1.641

Preparing simple meals 4.97± 0.16 4.74 ± 0.83 4.071*

Taking a bath or shower 4.50 ± 0.84 4.23± 1.10 2.267*

Simple shopping 4.88 ± 0.51 4.64 ± 0.87 2.959*

Getting in or out of a chair 4.78 ± 0.64 4.65 ± 0.91 1.369

Going up and down stairs 4.64 ± 0.76 4.23 ± 1.13 3.608*

Walking around the neighbourhood 4.78 ± 0.62 4.41 ± 1.03 3.797*

Reaching into cupboards or closets 4.71 ± 0.65 4.38 ± 1.02 3.304*

Hurrying to answer the door or

phone 4.69 ± 0.69 4.39 ± 1.07 2.799*

Walking in icy conditions 3.55 ± 1.11 2.97 ± 1.32 3.466*

Getting in/ out of a car 4.72 ± 0.62 4.43 ± 1.03 3.003*

Using public transport 4.61 ± 0.78 4.26 ± 1.19 2.959*

Crossing roads 4.67 ± 0.72 4.32 ± 1.06 3.214*

Using front or rear steps at home 4.78 ± 0.60 4.31 ± 1.12 4.665*

Picking up an item from the floor 4.62 ± 0.76 4.52 ± 1.02 0.798

When the fear of falling data was analysed by task, females had a lower mean rating across all items than males (see table 3.5), however the mean confidence rating only dropped below 3 for females in icy conditions. Significant differences were observed between males and females for all items except getting dressed/ undressed, getting in or out of a chair and picking an item up from the floor.

Table 3.6 contains summary data from completion of the fear of falling section of the LPAFH for the active and not active categories. There was no significant relationship between fear of falling and being active based on adherence to physical activity guidelines throughout the lifecourse (χ²Yates = 1.242, p = 0.265). When the fear of falling data was analysed by individual item, however, there was a significant difference between groups for all activities except picking an item from the floor.

Table 3.6. FES scores per item for the active and the not active respondents (mean ± SD) * indicates a significant difference

Active Not Active t-value

Cleaning the house 4.73 ± 0.67 4.48 ± 0.97 -2.555*

Getting dressed or undressed 4.83 ± 0.60 4.65 ± 0.84 -2.072*

Preparing simple meals 4.91± 0.48 4.75 ± 0.81 -2.174*

Taking a bath or shower 4.48 ± 0.86 4.23± 1.11 -2.183*

Simple shopping 4.87 ± 0.47 4.63 ± 0.90 -2.991*

Getting in or out of a chair 4.86 ± 0.46 4.61 ± 0.96 -3.038*

Going up and down stairs 4.58 ± 0.79 4.23 ± 1.14 -3.091*

Walking around the neighbourhood 4.69 ± 0.71 4.43 ± 1.03 -2.561*

Reaching into cupboards or closets 4.67 ± 0.73 4.37 ± 1.02 -2.972*

Hurrying to answer the door or

phone 4.66 ± 0.78 4.39 ± 1.07 -2.514*

Walking in icy conditions 3.35 ± 1.17 3.01 ± 1.33 -2.253*

Getting in/ out of a car 4.71 ± 0.72 4.42 ± 1.03 -2.783*

Using public transport 4.58 ± 0.87 4.25 ± 1.18 -2.668*

Crossing roads 4.58 ± 0.86 4.34 ± 1.04 -2.140*

Using front or rear steps at home 4.63 ± 0.78 4.34 ± 1.11 -2.524*

Picking up an item from the floor 4.67 ± 0.83 4.48 ± 1.01 -1.729

There was a significant relationship between fear of falling and whether an individual had experienced a fall (χ²Yates = 26.246, p < 0.001) with more fallers expressing a fear of falling than the expected count. This was supported by the relationship between fear of falling and type of faller (non faller, single faller, multiple faller) (χ²Yates = 39.011. p < 0.001), with single fallers showing similar fear of falling numbers to the expected count, whilst multiple fallers showed a 59% higher number of respondents who were fearful of falling than expected.

When the task data was analysed, the fallers had a lower mean rating across all items than non-fallers (see table 3.7). The mean confidence rating only dropped below 4 for the non-fallers and 3 for the fallers in icy conditions. For all other items, the rating was above 4 for both groups. Significant differences were observed between fallers

and non-fallers for all items except getting dressed/ undressed, preparing simple meals and picking an item up from the floor.

Table 3.7 FES scores per item for non-fallers and fallers (mean ± SD) * indicates a significant difference

Non-fallers Fallers t-value

Cleaning the house 4.75 ± 0.74 4.48 ± 0.94 -2.695*

Getting dressed or undressed 4.81 ± 0.62 4.66 ± 0.84 -1.786

Preparing simple meals 4.89 ± 0.52 4.77 ± 0.80 -1.506

Taking a bath or shower 4.61 ± 0.77 4.18 ± 1.12 -3.817*

Simple shopping 4.85 ± 0.54 4.65 ± 0.88 -2.418*

Getting in or out of a chair 4.83 ± 0.61 4.63 ± 0.92 -2.145*

Going up and down stairs 4.68 ± 0.80 4.20 ± 1.12 -4.168*

Walking around the neighbourhood 4.80 ± 0.70 4.39 ± 1.01 -4.084*

Reaching into cupboards or closets 4.69 ± 0.69 4.37 ± 1.03 -3.156*

Hurrying to answer the door or

phone 4.74 ± 0.69 4.36 ± 1.08 -3.603*

Walking in icy conditions 3.72 ± 1.18 2.87 ± 1.26 -5.447*

Getting in/ out of a car 4.67 ± 0.79 4.45 ± 1.01 -2.041*

Using public transport 4.64 ± 0.78 4.23 ± 1.20 -3.554*

Crossing roads 4.67 ± 0.71 4.31 ± 1.08 -3.393*

Using front or rear steps at home 4.71 ± 0.73 4.32 ± 1.11 -3.645*

Picking up an item from the floor 4.66 ± 0.76 4.50 ± 1.03 -1.475