Prevalence, characteristics and factors associated with falls among the elderly living at home.

Attempts to determine the underlying causes of falls have come to conflicting conclusions, partly because subject groups studied have not been representative of all elderly people. Two hundred and three randomly selected people of 75 years and over, living at home, were visited and questioned about falls experienced in the previous 12 months, and about factors that might be related to falling. Eighty-six subjects (42.4%) had suffered one or more falls during this time, and of fallers, 49 (59.3%) were injured, 9 of them seriously. Women were slightly more likely to have had falls and were more likely to have suffered injury, but no increase in frequency of falls with age was demonstrated. Only a minority of fallers (43.0%) sought medical attention following their fall. Falls outside the home accounted for 39.5% of falls and these were more likely to be due to simple trips or slips. Analysis of the factors related to falls showed a considerable overlap between fallers and non-fallers. Fallers had significantly greater dependency and cognitive impairment, more physical symptoms, and higher scores for anxiety and depression, but there was no association with postural hypotension, neurological abnormalities, or measurements relating to nutritional state. The factors found to be significant on discriminant analysis were combined to determine a "fall risk score". This type of easily calculated score might be of use to medical and paramedical personnel for assessing the risk of falling among the elderly living at home.

'Silent' pyrexia in the elderly.

Simultaneous oral, rectal and axillary temperatures were measured in 73 elderly patients on a geriatric unit. Axillary and oral temperatures were significantly lower than rectal readings. If oral or axillary temperatures alone had been measured, pyrexia would have been missed in two thirds of patients with a rectal temperature of 37.5 degrees C or more, and about three quarters of those with a rectal temperature of 38 degrees C or more. These findings suggest that oral or axillary temperature measurements are inadequate screening tests for pyrexia in the elderly.