Epidemiological characteristics and factors influencing falls among elderly adults in long-term care facilities in Xiamen, China

Falling in the elderly is an important social issue, especially for those who are in long-term care (LTC) facilities, in addition to being a significant economic burden. This study aims to investigate the epidemiological characteristics and identify the factors influencing falls in LTC residents. We enrolled 260 participants aged 60+ years by multistage sampling across 13 LTC facilities in Xiamen, China, in 2016. Epidemiological characteristics and falls were observed and recorded during a 12-month period using a revised FROP-Com Scale. Multiple logistic regression modeling was performed to determine the factors influencing falls. A total of 218 (83.8%) valid questionnaires were returned. 152 falls (range 1–7, mean 0.7 ± 1.3 falls/person/y) occurred in the previous year, with 69 residents (31.7%) experiencing 1 or more falls. Most participants who fell were female (71%), living in cities (85.5%), had a higher BMI (22.1 ± 4.2), and had a chronic disease (99.9%). Of all falls, 39.1% occurred in the bedroom and 26.1% in the bathroom, 58% during daytime hours between 6:00 am and noon. Thirty-six percent of falls resulted in an injury (e.g., bruises and fractures). The principal reason for falling was due to slipping (23.2%). There were 2 interactions on fall rate between ADL and feet and footwear (OR = 3.120, P<.001; OR = 3.010, P = .007 in Models 1 and 3), and between ADL and cognitive status (OR = 4.401, P<.001; OR = 4.101, P = .005 in Models 2 and 3). Multiple regression analysis indicated that ADL, balance and gait, medical conditions, cognitive status, living environment, feet and footwear and sensory loss were factors influencing falls among elderly adults in LTC facilities. Falls occur frequently and mostly unwitnessed among elderly adults in LTC facilities, highlighting the need for more effective and individualized fall prevention. Fall efficacy enhancing programs for nursing home residents should take degree of self-care, chronic diseases, sensory loss, foot injuries, cognitive impairment, living environment, and gender into account.