Risk factors for recurrent falls in the elderly in long-term institutional care.

All the persons aged 70 years or older and living in long-term institutional care in five rural northern Finnish municipalities (N = 145) were followed up for two years, and all their fall incidents were recorded through diary reporting by the nursing staff and by examining the medical records in hospitals, health centres and nursing homes. The study population was examined halfway through the follow-up period by two nurses, a physiotherapist and a physician. Of the 93 ambulatory subjects, 57% of the men and 56% of the women experienced at least two falls in six months (recurrent falls): 10% of the recurrent falls resulted in a major soft tissue injury and 5% in a fracture. Logistic regression analyses showed the independent risk factors for recurrent falls to be slow walking speed, a change in living conditions during the previous two years, reduced quadriceps strength and existence of an ophthalmic disease. Many of the risk factors are potentially remediable, and they should be minimized by optimizing the care and by improving or maintaining the functional abilities of the elderly.