Falls and the outcomes of falls are a serious concern for the elderly, their families, and the healthcare system. The purpose of this study was to examine factors related to fall risk scores and near-falls in a sample of community-dwelling elderly Blacks. Data were collected from 120 male and female patients, age 65 and older, who self-identified as being Black/African American from two outpatient clinics at Mount Sinai Hospital, NYC: the Martha Stewart Center for Living and Internal Medicine Associates (IMA). The study utilized the Elderly Falls Screening Test (EFST), an instrument that generated a fall risk score as the dependent variable. Predictors assessed were comorbidity (Charlson Comorbidity Index), self-rated health (SRH), falls efficacy (Modified Falls Efficacy Scale), and confidence in performing activities of daily living without falling and physical activity (Rapid Assessment of Physical Activity or RAPA). Covariates included demographic data. Controlling for demographics, all predictors were statistically significant for fall risk scores. Using a backward stepwise regression, falls efficacy (beta = -.453, p < .001) and aerobic physical activity together (beta = -2.35, p = .005) constituted the best set of predictors of fall risk score. Those who had lower confidence to do activities of daily living without falling had a higher risk of falling. Those with lower aerobic physical activity levels had a greater risk of falling.
Near-falls is a component of EFST and has not been studied in elderly Blacks. A logistic regression analysis with near-falls as the dependent variable use of an assistive device, gait, physical activity, and time on the observed 5-meter walk (another component of EFST) as predictors and demographics as the covariates, showed that gender and time on the observed 5-meter walk were significant predictors of near-falls (Nagelkerke = .178). In a backward stepwise logistic regression model, only gender and time constituted the best set of significant predictors. Men were 3.675 (p = .022) times more likely to experience a near-fall than women. Participants were 1.414 (p = .001) times more likely to have a near-fall for each unit increase in time (seconds).
New knowledge on falls, fall risk, and near-falls in elderly Blacks can improve standards of care from assessment, planning, implementation, and evaluation of interventions.
|Advisor:||O'Connell, Kathleen, Wallace, Barbara|
|Commitee:||Contento, Isobel, Silverman, Stephen|
|School:||Teachers College, Columbia University|
|Department:||Health and Behavior Studies|
|School Location:||United States -- New York|
|Source:||DAI-B 76/10(E), Dissertation Abstracts International|
|Subjects:||African American Studies, Nursing|
|Keywords:||African americans, Blacks, Community dwelling, Elderly, Falls, Near-falls, Physiology|
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