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Objectives: Falls among elderly are a well-recognised public health problem. The purpose of the present study was to explore the relation between dementia, number of depressive symptoms, activities of daily living, setting, and risk of falling., Methods: Data for the analysis came from a cross-sectional study about dementia, depression, and disabilities, carried out 1995/96 in Zurich and Geneva. The random sample stratified, by age and gender consisted of 921 subjects aged 65 and more. The interview was conducted by means of the Canberra interview for the Elderly, extended by short questionnaire. The subject was classified as a faller if the subject and/or the informant had reported a fall within the last 12 months prior to the interview. Logistic-regression analysis was used to determine the independent impact of dementia, depressive symptoms, and ADL-score on risk of falling., Results: The stepwise logistic regression analysis has revealed a statistically significant association between dementia (OR 2.14, 95% CI 1.15-3.96), two resp. three depressive symptoms (OR 1.64, 95% CI 1.04-2.60) as well as four or more depressive symptoms (OR 2.64, 95% CI 1.39-5.02) and the risk of falling. There was no statistically significant relationship between studied risk factors and the risk of being one-time faller. However, we found a strong positive association between dementia (OR 3.92, 95% CI 1.75-8.79), four or more depressive symptoms (OR 3.90, 95% CI 1.55-9.83) and the risk of being recurrent faller. Moreover, residents of nursing homes (OR 8.50, 95% CI 2.18-33.22) and elderly aged 85 or more (OR 2.29, 95% CI 1.08-4.87) were under statistically significant higher risk of sustaining recurrent falls., Conclusions: The results of the present study confirm that dementia and depression substantially increase the risk of falling.

The purpose of the study was to determine the prevalence rate of fallers (PRF%) and fall-related consequences among the elderly according to age, gender and setting. Data derive from a cross-sectional study on dementia, depression and handicaps among the elderly, carried out between 1995 and 1996. Elderly people aged 65 and over living in Zurich or Geneva were considered eligible for the study. By means of the Canberra Interview for the Elderly, 921 subjects' and/or informants' interviews were completed. The subjects were classified as a faller if the subject and/or informant reported a fall in the year prior to the interview. Overall PRF% amounted to 27.8% and was higher to a statistically significant degree among females (30.9%) than males (22.5%). Gender difference in PRF was found only among the non-institutionalized elderly. Age-specific PRF increased significantly with the age of the elderly. However, this increase was observed only among male subjects. 143 subjects (PRF 17.1%) have fallen once and 101 (PRF 9.9%) two or more times. Females showed a substantially higher propensity to recurrent falls (age-adjusted OR 1.86; 95% confidence interval 1.11-3.10). While the risk of suffering two or more falls increased with age, it did not increase among one-time fallers. Residents of nursing homes had significantly higher risk of falling as compared with home-dwelling subjects (age-adjusted OR 2.46; 95% confidence interval 1.04-5.78). Every second fall caused fall-related consequences. 9.1% of all falls led to fall-related fracture. The risk of suffering fall-related consequences depended on neither age nor gender. One third of fallers reported fear of further falling. Falls among the elderly occur often and contribute substantially to morbidity.

Falls are frequent among elderly people, and are a still-underestimated medical problem with respect to causes and consequences. The present epidemiological study describes the experience from a 79-bed nursing home in the city of Zürich, regarding frequency, circumstances and consequences of falls. Over half of residents of the studied nursing home fell at least once during the study period of one year, and one third even suffered 3 or more falls. Dizziness, tripping and slipping were among the reasons given for falling. However, in one third of the cases the person involved was not able to specify the cause of the fall. Every fifth fall to injury or fracture, and every tenth fall to fall-related pain. The fall-related overall morbidity therefore amounted to 35.3%.