Long-term Consequences of Noninjurious and Injurious Falls on Well-being in Older Women

Abstract

Background: The physical and mental health consequences of falls are known to influence well-being in the short term. The aim was to investigate the long-term consequences of noninjurious and injurious falls on well-being in older women over 12 years.

Methods: A total of 10,277 participants (aged 73-78 years, 98.8% community-dwelling) returned the 1999 survey of the Australian Longitudinal Study on Women's Health. Follow-up surveys were completed at 3-year intervals. Surveys included questions about falls and related injuries in the past year. Scores on the health-related quality of life Short Form-36 subscales (range 0-100) were used to compare well-being between noninjurious fallers, injurious fallers, and nonfallers using linear mixed modeling with adjustment for confounders. Scores in the years before and after the first fall since enrolment were graphically depicted with time relative to the first fall since enrolment. For this purpose, nonfallers were matched with noninjurious and injurious fallers based on pattern of surveys returned, chronic conditions, and age to assign them a fictitious "time-of-first-fall."

Results: Over 12 years, there were 22.5% noninjurious fallers, 30.1% injurious fallers, and 47.5% nonfallers. Compared with nonfallers, noninjurious and injurious fallers scored significantly lower on six and seven of the eight domains at the time of the reported fall, respectively. Significant differences were apparent 12 years before the injurious fall for the subscales role physical, bodily pain, and general health. A drop in scores after the reported injurious fall was seen for role physical, bodily pain, and social functioning.

Conclusions: Among older women, a gap in well-being emerges years before the first reported fall, which may be driven by underlying risk factors rather than the fall itself.

Keywords: Accidental falls; Injury; Old age; Quality of life.