Using a multifactorial approach to determine fall risk profiles in portuguese older adults.

AIM The aim of this study was to use a multifactorial approach to characterize episodic and recurrent fallers risk profiles in Portuguese older adults. MATERIALS AND METHODS To accomplish the mentioned purpose, 1416 Portuguese older adults above 65 years were tested with three different field measurements: 1) health and falls questionnaire; 2) Physical Activity questionnaire and 3) a set of functional fitness tests. The subjects were divided in three different groups according to fall prevalence: non-fallers, subjects who did not report any falls during the previous year, episodic fallers, those who reported to have fallen only once during the previous year, and recurrent fallers, the ones that fell twice or more times during the previous year. Episodic and Recurrent fallers risk profiles were established using multifactorial logistic regression models in order to avoid confounding effects between the variables. RESULTS The results showed that age was not a risk factor for either episodic or recurrent falling. In addition, health parameters were shown to be the factors distinguishing recurrent from episodic fallers. This may imply that, comparing with episodic falls, recurrent falls are more associated with higher presence of chronic conditions and are less likely to occur due to external factors. Furthermore, being a woman, having fear of falling and lower functional fitness levels were determinant factors for both episodic and recurrent falls. It is also important to note that, although total physical activity was only related with episodic falling, promoting physical activity and exercise may be the easiest and cheapest way to improve functional fitness and health levels and therefore, its role in fall prevention should not be underestimated. CONCLUSIONS The results of this study reinforce the importance of using a multifactorial approach, not only focusing on cognitive-behavioral factors, but also on promoting physical activity and healthy lifestyles, when assessing fall risk or planning an intervention aiming at fall prevention within the older population.