الفهرس 
Falls among the ElderlyOnly 14 pages are availabe for public view
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Abstract
As people grow older they are increasingly at risk of falls and consequent injuries. Falls may be the first indication of an undetected illness. The prevention of falls is of major importance because they engender considerable mortality, morbidity and suffering for older people and their families, and incurs social costs due to hospital and nursing home admissions.
As most of falls are associated with one or more identifiable risk factors and attention to these risk factors can significantly reduce rates of falls, this study assessed prevalence and common risk factors of falls using a substantial number of valid and reliable falls risk screening tools.
This study is a cross section study conducted to assess the prevalence and common risk factors of falls among elderly Egyptian females. The study included 200 elderly females with mean age 66.9 years, recruited from the geriatrics outpatient clinic in Ain-Shams University Hospital.
Each participant was subjected to comprehensive geriatric assessment including full history taking with detailed history about falls and common risk factors, clinical examination, assessment of cognition using mini-mental state examination (MMSE), screening for depression using geriatric depression scale (GDS-15), assessment of function using ADL & IADL scales and assessment of falls risk using five valid and reliable falls risk screening tools.
The study showed that the prevalence of falls among elderly Egyptian females was 35.5 % with number of falls ranging from 1-15 fall in the last 12 months and median number of falls among positive cases with history of falls is 3 times.
As most of falls are associated with one or more identifiable risk factors, this study showed that falls have multifactorial risk factors with the strongest associations were found with cases with cognitive impairment, depression, functional impairment in ADL and IADL, balance disorders, gait disorders , arrhythmias, CV disease, PN, visual impairment, and urinary incontinence, and the difference between fallers and non fallers was highly significant statistically.
This study showed that there is no significant difference statistically between cases with or without Hypertension, DM, spondylosis, Osteoarthritis, hearing impairment, orthostatic hypotension and some other comorbidity as regards presence of falls.
Inappropriate prescribing is a common problem in elderly people. Polypharmacy increases the likelihood of adverse drug reactions including falls. The more the number of drugs prescribed (≥4), the higher the risk of falls. This study showed that using of anti depressants, diuretics and hypnotics drugs among fallers was much higher than non fallers and the difference was highly significant statistically.
This study showed that number of chronic diseases, number of medications, age and gait or balance disorders are the highest independent risk factors for falls among studied patients using backward stepwise logistic regression model.
Regarding the used fall risk assessment tools,an important finding of this study is the strong and significant association between risk of falls, number of previous falls and the score of falls risk screening tools used in this study as FRAT, TUGT, FRT, OLST and TST. This study showed that FRAT is the most accurate tool (77.5%) while OLST, TUGT and TST are more sensitive tools in detection of falls (their sensitivity 98.5%, 83.1%, and 84.5% respectively) but FRT has 86% specificity and low sensitivity.
Also, this study showed a positive correlation between number of falls and TUGT, FRAT and a negative correlation between number of falls and FRT, OLST and TST.
Using the ROC curve analysis of the studied five tools for prediction of falls among studied group showed that the test with the largest area under the curve is FRAT this mean that FRAT is the best test in detecting falls among elderly populations