Fall risk assessment in very old males and females living in nursing homes

BACKGROUND: Several studies identified muscle weakness, history of falls, gait deficit and balance deficit as the most common risk factors for falls. AIMS: To determine risk factors of fall in older males and females living in nursing homes and to compare characteristics of fallers and non fallers. METHODS: This is a cross-sectional study with a convenience sample of 40 nursing home elderly (13 males and 27 females), mean age 86.35, of which 17 (6 males and 11 females) fell at least once in the previous year and 23 (7 males and 16 females) had not fallen. Each participant filled a self-assessment questionnaire (general health questions and selected questions from the SF-36). An objective evaluation was performed with measurements of blood pressure and heartrate (supine and standing), lower extremity strength and power (dominate side only) by Biodex isokinetic dynamometry, dynamic postural stability by Biodex balance system (5 s trials at level 8) and gait assessment (6 min walk test at comfortable speed) by gait treadmill Biodex. RESULTS: The fallen males decreased significantly knee flexion peak torque (p=0.08), ankle plantarflexion peak torque and average power (p=0.05), compared with the not fallen group. The fallen females decreased significantly knee extension peak torque and average power (p<0.05), walking speed (p<0.005) and cadence (p<0.01), compared with the not fallen group. CONCLUSIONS: This study shows that the fallen males had greater deficits of ankle plantar-flexion strength and power, while fallen females had greater deficits of knee extension strength and power and less walking speed.