Risk factors
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Catogories
Falls are unpinned by a number of different risk factors. These are categorized into four domains:
Biological Risk Factors
Biological factors which are non-modifiable relate to the human such as age, gender and race. These are also associated with the changes due to ageing such as the decline of physical, cognitive and affective capacities and the co-morbidity associated with chronic illnesses. The interaction of biological factors with behavioural and environmental risks increases the risk of falling. For example the loss of muscle strength leads to a loss of function and to a higher level of frailty, which increases the risk of falling due to some environmental hazards.
Behavioural Risk Factors
These factors are associated with a person actions, emotions or daily choices. For example risky behaviour such as the intake of multiple medications, excess alcohol use and sedentary behaviour can be modified through strategic interventions for behavioural change.
Environmental Risk Factors
Environmental factors relate the interplay of the individuals with their environment; these include home hazards and hazardous features in the public environment. Home hazards include narrow steps, slippery surfaces on stairs, loose rugs and poor lighting. In the public environs issues such as cracked or uneven foot paths, poor lighting, short pedestrian light sequences, slippery surfaces etc.
Socioeconomic Risk Factors
These relate primarily to the person’s social conditions and the economic status of the individual which has a direct impact on their access to healthcare. Factors include: low income, low education, poor housing, lack of social interaction, limited access to social health care services particularly in remote rural areas and a lack of community resources.
Intrinsic and Extrinsic Factors
The Michigan Public Health Institute in 2004 report entitled “Comprehensive Fall Prevention For Community-Dwelling Older Adults” divide falls risks into intrinsic “within oneself” and extrinsic factors “outside influences”.
One of their conclusions was that a lack of knowledge among health professionals’ with respect to assessment tools, treatment interventions and effective communication and compliance skills is also an extrinsic risk factor for older adult falls. In successful multifactorial intervention programmes the following specific components are common (against a background of the general diagnosis and management of causes and recognised risk factors): A 1. strength and balance training 2. home hazard assessment and intervention 3. vision assessment and referral 4. medication review with modification/withdrawal. Of these 4 factors technology has a potential role to play in 1 and 2 in terms of reducing the risk factor to significantly lower levels.
References
[1] Michigan Public Health Institute, Comprehensive Fall Prevention For Community-Dwelling Older Adults, 2004, Available http://www.mphi.org/files/Fall%20Prevention%20for%20Community%20Dwelling%20Older%20Adults%202004.pdf
