Yih-Jian Tsai, Section Chief, Division of Adults and Elderly Health

Recent study showed that the prevalence of falls/injurious falls increased with a decreased injury rate of fallers in the elderly in Taiwan. It seems not just a blessing in disguise, but also a reminder of the necessity of early falls prevention for the elderly. With analysis on the Taiwan Longitudinal Study on Ageing (TLSA) data, during 1999 and 2007, the prevalence of falls increased from 18.1% to 22.7%, while the prevalence of injurious falls increased from 6.7% to 7.2%, with a decreased injury rate of fallers from 37.0% to 31.8%. Among 206 injured fallers reported in 1999, 51.2% were attributed to intrinsic causes, with 39.0% to extrinsic causes, and 7.8% claimed by both. 87.6% had single injury, and 12.4% had multiple injuries. In 1999 vs. 2007, the top three body sites of injury were lower limb (37.3% vs. 39.6%), upper limb (25.7% vs. 35.1%), and hip (19.3% vs. 17.3%). Of the injured fallers in 1999 and 2007, the medical care utilization rates were respectively 16.8% and 13.7% for Chinese medicine care, 67.6% and 80.0% for Western medicine care. Those risk factors of injurious falls, identified as statistically significant variables in multi-variate logistic regression analyses, included advanced age, female, IADL dependency and walk aid use, but not for taking sleeping pills or sedative, fair to unclear vision, having two or more chronic conditions, cognitive impairment, and doing exercise, etc.

Although further investigation is needed to verify our study findings, falls prevention program should be tailored to the community-dwelling elderly according to their underlying characteristics and risk factors.