Living alone as a red flag sign of falls among older people in rural Taiwan

Background/PurposeFall is a common geriatric syndrome and is associated with physical injuries, fear of falling, limitation of activities of daily living, and increased medical expenditure. Although risk factors of falls have been explored extensively, little is known about the impact of solitary living on falls in the elderly. The main purpose of this study was to evaluate the impact of solitary living on risk of fall among older people who visited the outpatient geriatric services in rural Taiwan.MethodsFrom September 2009 to August 2010, all patients who visited the primary care–based outpatient geriatric services were invited for study. For all participants, comprehensive geriatric assessment was performed by a well-trained research nurse. Common risk factors of falls were collected in addition to solitary living, such as polypharmacy (more than four drugs), visual impairment, hearing impairment, age, gender, and cognitive impairment.ResultsOverall, 173 (mean age = 78.8 ± 6.8 years, men = 73.4%) patients were enrolled, and 42 (24.2%) of them reported falls in the past year. Two-thirds of fall events occurred outdoors and mainly (66.7%) during walking. Two-thirds of falls were associated with injuries, and half of the patients reported reduced activities of daily living because of fear of falling. Compared with nonfallers, fallers were significantly more likely to live alone (28.6% vs. 14%, p = 0.031), but age (79.0 ± 7.2 years vs. 78.8 ± 6.8 years, p = 0.89); gender (66.7% vs. 76.7%, p = 0.197); polypharmacy (47.6% vs. 39.8%, p = 0.378); use of psycotropic agents (4.8% vs. 0.8%, p = 0.096); visual impairment (35.7% vs. 35.7%, p = 0.995); hearing impairment (21.4% vs. 23.4%, p = 0.79); and cognitive impairment (21.4% vs. 12.5%, p = 0.158) were not statistically significant.ConclusionsIn rural Taiwan, solitary living is an important risk factor of falls among patients who visited primary care–based outpatient geriatric services. Further prospective study is needed to evaluate the impact of solitary living on risk of falls, and improvement of outdoor environment is also of great importance to reduce fall-related injuries.