The prognosis of falls in elderly people living at home

Background: there are few longitudinal studies of the prognosis of falling at home. Objective: to determine outcomes in older people who fall once and more than once. Design: longitudinal prospective cohort study. Setting: primary care in the UK. Subjects: 1815 subjects over 75 who had a standardized and validated health check. Method: annual interviews over 4 years. Practice records were used to establish death and admission to institutions. Results: risk; of death was increased at 1 year [odds ratio (OR) 2.6, 95% confidence interval (CI) 1.4-4.7] and 3 pears (OR 1.9, 95% CI 1.2-3.0) for recurrent fallers but not single fallers (OR 0.9, 95% CI 0.5-1.6 at 1 year; OR 0.97, 95% CI 0.7-1.4 at 3 years), Risk of admission to long-term care over I year was markedly increased both for single fallers (OR 3.8, 95% CI 1.8-8.3) and recurrent fallers (OR 4.5, 95% CI 1.7-12). Functional decline was not related to faller status, the latter being very variable from one year to the next. Conclusions: the stronger relationship between falling and admission to long-term care rather than mortality supports the hypothesis that the perceived risks for those who fall only once are exaggerated.