Proximal Determinants of Falls

Objectives: To study risk factors for falling, we examined risk factors for falls among older people according to the proximal determinants present at the time of the fall. Methods: Data came from MOBILIZE Boston, a prospective cohort study of 765 community-dwelling women and men, mainly aged 70 years or older. Over 4.3 years, 1737 falls were recorded, along with narrative reports describing proximal determinants at the time of the fall. Results: Environmental proximal determinants were the largest contributor to falls. (74%) Elderly with poor mobility and executive function were more likely to fall while performing activities of daily living, specifically while trying to stand and bending over. However, elderly with poor mobility also had lower likelihood of falling to environmental hazards and dual-tasking cognition. In contrast, functional older adults with naturally fast movement speed tend to fall to environmental factors while engaging in complex motor activities.