Mental health and environmental factors associated with falls in the elderly in North India: A naturalistic community study

Abstract Aim To determine the prevalence of falls and to assess its relationship with cognitive deficits, depression, visual impairment and self-reported hearing impairment among the elderly. Methods This was a community-based, cross-sectional study conducted in 52 villages in the Naraingarh and Barara block of Ambala district which involved 468 participants. A pretested predesigned questionnaire was used to collect data regarding demographic profile, falls, and physical morbidities. Geriatric Depression Scale-Hindi, Hindi-mini-mental state examination, Snellen chart, Katz- Activity of Daily Living were used to collect data for depression, cognitive decline, vision and activity of daily living respectively. Results The prevalence of falls was found to be 28.7%. An association was found between falls and slippery floors in the houses, hearing loss, vertigo, hypertension, use of multiple medications, depression and functional disability in univariate analysis. On multivariate regression analysis, slippery floors (OR = 2.28), use of multiple medications (OR = 1.71), hearing loss(OR = 1.83) and presence of depression (OR = 1.62) were found to be independent risk factors with falls. Conclusion There is high prevalence of falls among the elderly and these are commonly related to preventable factors. Appropriate environmental modifications and exercise programs can help reduce the rate of falls as well as injuries related to falls among the elderly.