Both deterioration and improvement in activities of daily living are related to falls: a 6-year follow-up of the general elderly population study Good Aging in Skåne

Figures & data

Table 1 Change in activities of daily living (ADL) and the ADL staircase (0 to 10 steps) over the course of 6 years and association to falls at the follow-up assessment

Status in ADL	n	Crude odds ratio, (95% confidence interval)	Adjusted odds ratio (95% confidence interval)*	Adjusted odds ratio (95% confidence interval)†
No change in ADL
Stayed dependent in ADL	295	3.16 (2.18–4.59)	2.51 (1.64–3.84)	2.42 (1.56–3.76)
Stayed independent in ADL (reference)	831	1	1	1
Change in ADL
Became dependent in ADL	266	2.64 (1.78–3.92)	2.02 (1.30–3.14)	1.97 (1.25–3.10)
Toward instrumental ADL dependency	85	1.87 (0.97–3.63)	1.80 (0.85–3.81)	1.58 (0.72–3.48)
Toward personal ADL dependency	181	3.03 (1.96–4.69)	2.26 (1.40–3.63)	2.31 (1.42–3.76)
Became independent in ADL	148	2.32 (1.41–3.81)	2.20 (1.38–3.64)	2.25 (1.35–3.75)
From instrumental ADL dependency	44	3.35 (1.59–7.09)	3.69 (1.73–7.87)	4.13 (1.89–9.00)
From personal ADL dependency	104	1.92 (1.05–3.51)	1.69 (0.91–3.11)	1.66 (0.89–3.10)
Change in ADL staircase
Two to eight step reduction	29	5.43 (2.44–12.09)	4.48 (1.87–10.77)	4.05 (1.62–10.11)
One step reduction	166	1.41 (0.84–2.38)	1.29 (0.75–2.20)	1.25 (0.72–2.15)
Zero (reference)	883	1	1	1
One to three step improvement	122	2.02 (1.19–3.45)	1.87 (1.09–3.21)	1.91 (1.11–3.29)

Notes: Risk for falls calculated with unadjusted logistic regression and adjusted multiple logistic regression analysis.

* Adjusted for age and sex.

† Adjusted for age, sex, heart disease, heart failure with symptoms, and use of fall risk drugs.

Abbreviations: ADL, activities of daily living; n, number.

Table 2 Proportion of fallers and characteristics of groups with risk for falls compared to reference group (staying independent in activities of daily living; n=831)

Characteristics	Stayed independent in activities of daily living, n=831	Became dependent in activities of daily living, n=266		Reduction of two to eight steps in the activities of daily living staircase, n=29		Became independent in activities of daily living, n=148		Became independent from instrumental activities of daily living, n=44
	n (%)	n (%)	P-value	n (%)	P-value	n (%)	P-value	n (%)	P-value
Fallers at follow-up	67 (8.1)	50 (18.8)	<0.001	10 (34.5)	<0.001	25 (16.9)	0.001	10 (22.7)	0.001
Sex
Men	438 (52.7)	108 (40.6)		12 (41.4)		62 (41.9)		28 (63.6)
Women	393 (47.3)	158 (59.4)	0.001	17 (58.6)	0.225	86 (58.1)	0.015	16 (36.4)	0.157
Age
60–79 years	787 (94.7)	180 (67.7)		14 (48.3)		131 (88.5)		42 (95.5)
80–93 years	44 (5.3)	86 (32.3)	<0.001	15 (51.7)	<0.001	17 (11.5)	0.004	2 (4.5)	1.000*
Social and physical factors
Living alone	256 (30.8)	117 (44.0)	<0.001	12 (41.4)	0.216	50 (33.8)	0.472	10 (22.7)	0.256
Use of walking device	8 (1.0)	20 (7.5)	<0.001	5 (17.2)	<0.001*	4 (2.7)	0.093*	1 (2.3)	0.373*
Low physical activity	81 (9.8)	31 (11.9)	0.337	2 (6.9)	1.000*	23 (15.6)	0.035	5 (11.6)	0.605*
Low walking speed	305 (36.9)	166 (63.6)	<0.001	20 (80.0)	<0.001	76 (52.8)	<0.001	23 (52.3)	0.041
Comorbidity
Heart disease	127 (15.3)	60 (22.6)	0.006	8 (27.6)	0.075	33 (22.3)	0.035	15 (34.1)	0.001
Angina	73 (8.8)	36 (13.5)	0.025	4 (13.8)	0.326*	20 (13.5)	0.071	11 (25.0)	<0.001
Myocardial infarction	36 (4.3)	21 (7.9)	0.023	1 (3.4)	1.000*	14 (9.5)	0.009	7 (15.9)	0.001
Arrhythmia	50 (6.0)	29 (10.9)	0.007	6 (20.7)	0.002	9 (6.1)	0.981	3 (6.8)	0.745*
Heart failure with symptoms	11 (1.3)	15 (5.8)	<0.001	0 (0)	1.000*	2 (1.4)	1.000*	2 (4.7)	0.134*
Suspected cognitive impairment (Mini-Mental State Examination scale score <24)	26 (3.2)	28 (10.7)	<0.001	5 (17.2)	0.002*	7 (4.8)	0.317	0 (0)	0.638*
Medications
Use of fall risk drugs	202 (24.3)	105 (39.5)	<0.001	15 (51.7)	0.001	48 (32.4)	0.037	11 (25.0)	0.917
Sedatives/hypnotics	66 (7.9)	50 (18.8)	<0.001	6 (20.7)	0.011	19 (12.8)	0.051	1 (2.3)	0.245*
Neuroleptics	7 (0.8)	1 (0.4)	0.688*	0 (0)	1.000*	2 (1.4)	0.632*	0 (0)	1.000*
Anticholinergics	9 (1.1)	5 (1.9)	0.346*	1 (3.4)	0.316*	7 (4.7)	0.001	0 (0)	1.000*
Antihypertensives	51 (6.1)	16 (6.0)	0.942	3 (10.3)	0.410*	11 (7.4)	0.551	2 (4.5)	1.000*
Diuretics	113 (13.6)	61 (22.9)	<0.001	11 (37.9)	<0.001	28 (18.9)	0.089	10 (22.7)	0.09

Notes: Statistical differences analyzed with Pearson’s chi-squared test, unless stated otherwise.

* Fisher’s exact test. All variables recorded at the baseline assessment except data on falls.

Abbreviation: n, number.

Figure 1 Change in the activities of daily living (ADL) staircase (0–10 steps) over the course of 6 years and association to falls at the follow-up assessment.

Notes: An increased score corresponds to a functional decline. Risk presented in odds ratios (ORs) with 95% confidence interval as whiskers (n=1,200).
Abbreviations: ns, not significant; n, number.