American Journal of Epidemiology Vol. 136, No. 5: 584-591
Copyright © 1992 by The Johns Hopkins University School of Hygiene and Public Health
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Peripheral Neuromuscular Dysfunction and Falls in an Elderly Cohort
1Division of Epidemiology, Columbia University School of Public Health New York, NY
2Department of Neurology, Neurological Institute-Columbia University New York, NY
Reprint requests to Dr. Gary S. Sorock, 41 Delmar Avenue, Framingham, MA 01701.
In a prospective study of 169 tenants of senior citizen housing in New Jersey in 1986–1987, the relations between tests of peripheral sensory and motor functions in the lower extremities and the rate of first falls were evaluated. The mean age of the cohort was 79.8 years. Fifty-seven persons fell at least once during the follow-up period (mean. 5.6 months). After adjustment for history of stroke, heart failure, emphysema, and use of a walker or cane, rate ratios for first falls were elevated in subjects with reduced toe joint position sense (rate ratio (RR) = 2.2) and sharp-dull discrimination (RR = 2.0), but to a lesser extent for reduced ankle strength (RR = 1.5). Presence of one or more of these three deficits was defined as a peripheral neuromuscular dysfunction and was associated with first falls after adjustment for multiple covariates (RR = 2.4, 95% confidence interval 1.3–4.5). Having two or all three sensory or motor deficits increased the rate of falling 3.9 times (95% confidence interval 2.1–7.0) compared with persons without these deficits. These data suggest that impaired sensory and motor function of the lower extremities plays an important role in falls in the elderly. Am J Epidemiol 1992; 136: 584–91
accidental falls; aged; extremities; peripheral nerves; risk factors
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