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PubMed2001

Sleep complaints and risk factors for excessive daytime sleepiness in adult males in Northern Ireland.

The prevalence of sleep complaints in Northern Ireland is unknown. Sleep disruption can result in excessive daytime sleepiness (EDS), with significant socioeconomic consequences. The aim of this study was to assess the prevalence of sleep complaints and to determine risk factors for EDS in a Northern Irish community. From an urban and rural community of 499,111 people, a random sample of 3391 adult men were sent a questionnaire by mail. Questions were asked regarding sleep, EDS and medical history. There were 2364 completed questionnaires returned (response rate 70%). The mean age of respondents was 46.0 years (range 18--91 years). 26.7% of men were not satisfied with their usual night's sleep and 68% of men woke up at least once during the night. Based on pre-defined criteria, 24.6% of the population had insomnia and 19.8% had EDS. The strongest risk factor identified for EDS was a history of snoring loudly (odds ratio 2.62; 95% CI 1.82--3.77). Other risk factors included ankle swelling, feeling sad or depressed stopping sleep, experiencing vivid dreams while falling asleep, waking up feeling unrefreshed and age > 35 years. The prevalence rates of sleep complaints and EDS in this community-based study is high, although this does depend directly on the criteria used to define insomnia and EDS. Recognition of risk factors for EDS may help to identify and treat those affected.

Adolescent↗
PubMed1992

Prevalence of ischemic nephropathy in patients with renal insufficiency.

To estimate its clinically unsuspected prevalence among patients with renal insufficiency, renal duplex sonography (RDS) was used to estimate the presence of critical renal artery stenosis (RAS) in that population. Patients, aged 45 to 75 years, with a serum creatinine of greater than or equal to 2.0 mg% but without dialysis dependence, prior renal transplantation, or prior renal artery surgery were considered for RDS. Fifty-three patients who met criteria for study were randomly selected from the Section of Nephrology clinic files and each patient was contacted both by mail and by telephone. Twenty-five patients agreed to RDS, and renal artery anatomy was determined in 21 patients using standardized RDS techniques. These techniques have demonstrated an overall accuracy of 96 and 97 per cent when compared prospectively to conventional angiography during validity analyses in the authors' center. Results of RDS revealed significant findings in 5 of 21 patients (24%). Three patients demonstrated criteria for ischemic nephropathy (IN): one patient had RAS with contralateral renal artery occlusion confirmed by angiography, while 2 patients demonstrated unilateral RAS. An abdominal aortic aneurysm and unilateral hydronephrosis were discovered in the fourth and fifth patients. Evaluation of patient demographic data and functional parameters as predictors of IN revealed that the duration of renal insufficiency at the time of RDS and extra-renal organ-specific atherosclerotic damage were significantly different between the groups with and without IN. The authors preliminary findings suggest that unsuspected ischemic nephropathy may exist in a significant minority of patients with renal insufficiency.

Age Factors↗
PubMed1996

Interventional cardiology in Europe 1993. Working Group on Coronary Circulation of the European Society of Cardiology.

An annual survey on cardiac interventions in Europe is performed by the working group on Coronary Circulation of the European Society of Cardiology with the help of the national societies of cardiology. A questionnaire about cardiac interventions in 1993 was mailed to a representative of the national societies of 35 members of the European Society of Cardiology. The data collection of coronary interventions was delayed by slow backreporting and from 10 of the 35 national members data were missing or grossly incomplete. They were excluded from the analysis. CORONARY ANGIOGRAPHY: A total of 756,822 coronary angiograms were reported resulting in an incidence of 1146 +/- 1024 per 10(6) inhabitants, ranging from 24 (Romania) to 3499 (Germany). This represents an increase of 12% compared to 1992. Germany (279,882 cases), France (157,237), the United Kingdom (77,000), Italy (44,934) and Spain (37,591) registered 79% of all the coronary angiograms performed. PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY: A total of 183,728 percutaneous transluminal coronary angioplasty cases were reported in 1993, 24% more than in 1992. On average, they accounted for 18 +/- 7% (range 8 (Romania) to 35% (Sweden) of the coronary angiograms. Most of these percutaneous transluminal coronary angioplasties (82%) were confined to a single vessel. In 13% only, percutaneous transluminal coronary angioplasty took place immediately after the diagnostic study. Adjusted per capita. Germany ranks first with 873 percutaneous transluminal coronary angioplasties per 10(6) inhabitants, followed by France (737), Holland (725), Belgium (713), and Switzerland (665). The European mean of percutaneous transluminal coronary angioplasties per 10(6) inhabitants was 270 +/- 279, representing an increase of 14% compared with 1992. A major in-hospital complication was reported in 3.8% of the patients undergoing percutaneous transluminal coronary angioplasty: 0.6% hospital deaths, 1.5% emergency coronary artery bypass grafting, and 1.7% myocardial infarctions. NEW DEVICES: In 1993 stents were implanted in 6444 patients (3.5% of all percutaneous transluminal coronary angioplasty patients), equally distributed between bail-out situations (53%) and elective procedures. The 14 stent implanting countries showed a mean increase in incidence of coronary stenting of 53% compared with 1992. Other interventional devices were applied in 7045 cases, 3.8% of all percutaneous transluminal coronary angioplasty cases. Coronary ultrasound (2194 cases) and coronary angioscopy (380 cases) were performed infrequently. NON-CORONARY INTERVENTIONS: Valvuloplasties were most frequently performed non-coronary interventions European countries performed more than 300 valvuloplasties each in 1993. Most of them were mitral valvuloplasties in southern countries. CONCLUSIONS: Although partial backreporting might conclusions, several findings of this survey are noteworthy for the participating countries: The number of percutaneous taneous transluminal coronary angioplasties is universally increasing. There is an extremely wide range of coronary angiography and percutaneous translumina, coronary angioplasties performed per population. The most common additional procedure is a stent implantation while other new devices are only rarely applied. Mitral valvuloplasty is the most frequently performed non-coronary intervention.

Angioplasty, Balloon, Coronary↗
PubMed1995

Nonsteroidal antiinflammatory drugs and dyspepsia in the elderly.

Upper gastrointestinal tract symptoms are common in the elderly and, despite a paucity of data, nonsteroidal antiinflammatory drugs (NSAIDs) are believed to be important risk factors. We aimed to evaluate the association of NSAIDs with dyspepsia and heartburn in a population-based study. An age- and gender-stratified random sample of Olmsted County, Minnesota, Caucasian residents aged 65 years and older was mailed a valid self-report questionnaire; 74% responded (N = 1375). Age- and gender-adjusted (to 1980 US Caucasian population) prevalence rates for NSAID use, dyspepsia (defined as pain located in the upper abdomen or nausea), and heartburn (defined as retrosternal burning pain) were calculated. Logistic regression analysis was used to estimate the association of dyspepsia and heartburn with potential risk factors adjusting for age and gender. The age- and gender-adjusted annual prevalences (per 100) of aspirin and nonaspirin NSAID use were 60.0 (95% CI 57.2, 62.7) and 26.1 (95% CI 23.6, 28.7), respectively. The annual prevalences of dyspepsia and heartburn were 15.0 (95% CI 12.9, 17.0) and 12.9 (95% CI 10.9, 14.8), respectively. Aspirin was associated with dyspepsia and/or heartburn (OR = 1.6, 95% CI 1.2, 2.2) as were nonaspirin NSAIDs (OR = 1.8, 95% CI 1.3, 2.6), but smoking and alcohol were not significant risk factors. Aspirin and nonaspirin NSAIDs are associated with almost a twofold risk of upper gastrointestinal tract symptoms in elderly community subjects.

Age Distribution↗
PubMed2006

Brief survey: determining brain death in Canadian intensive care units.

PURPOSE: Criteria for brain death were first described in 1968, and Canadian guidelines were published in 1988. However, international inconsistency persists in the process of determining brain death. We sought to determine self-reported practices and processes in the determination of brain death amongst Canadian intensive care unit (ICU) physicians. METHODS: An email survey of members of the Canadian Critical Care Society was undertaken. A survey instrument was developed, then face and content validated prior to distribution. RESULTS: Eighty eight responded (response rate = 49%), including adult and pediatric ICU physicians working in both tertiary referral (academic) and community hospitals. Most respondents admit patients with brain death to their ICUs. However, 9% reported refusing to admit this type of patient for reasons including inappropriate utilization of ICU resources (36%), and lack of either space or staff (32% and 29% of respondents, respectively). Community hospital-based ICU physicians were less likely to report a hospital policy on the determination of brain death (46% vs 78% of physicians in tertiary care hospitals). Nearly all physicians (96%) reported that a revised national standard and checklist for the determination of death would be useful. CONCLUSIONS: Nearly one quarter, and over one half of tertiary care and community hospitals (respectively) in Canada lack an institutional policy on neurological determination of brain death. Canadian ICU physicians are interested in a national standard for the determination of death, and establishment of processes that may improve the clinical determination of death by neurological criteria.

Brain Death↗
PubMed1998

Initial treatment of traumatic dental injuries by dental practitioners.

The aim of this study was to investigate the nature of initial treatment provided by dental practitioners to children aged 1-17 years with various types of traumatic dental injuries at public dental clinics in Tanzania. Questionnaires on initial treatment were mailed to 188 practitioners and returned by 138 (73%). The reported treatments were analyzed in relation to the dental practitioners' qualifications and area of practice. Extraction of injured teeth was frequently reported for 64% of the injuries and prescription of antibiotics was reported by 67%, 48% and 46% of the practitioners for soft tissue injuries, concussion, and alveolar fracture respectively. Practitioners working at the Faculty of Dentistry were less involved in treating dental trauma than those at urban and rural clinics (P = 0.001), while no significant association was found with the level of education of the practitioners. Equal proportions of practitioners, about one-third each, reported correct, unnecessary and wrong treatment options. The quality of the treatments provided could not be explained by background variables. It can be concluded that dental practitioners in Tanzania provide a lot of over-treatment for traumatic dental injuries. Therefore, it is suggested that efforts should be made to improve and standardize treatment methods in Tanzania.

Adolescent↗
PubMed1998

Fractures among children: incidence and impact on daily activities.

OBJECTIVES: The study's objective was to examine incidence of fractures and associated activity restriction among children aged 0-12 years. DESIGN: Injuries were prospectively recorded over the four year period from 1992-95 in a cohort of children aged 0-12 years, representing 193,540 children years. Information about length and extent of activity restriction was collected from parents by a mailed questionnaire for a subsample of 192 children with a fracture. RESULTS: A total of 2477 fractures occurred in the study population (128 per 10,000 children annually). The incidence increased linearly with age, by 14 cases per 10,000 children year for each year of age. Boys and girls showed similar patterns of fracture occurrence. There was a significant difference in length of activity restrictions for different types of fractures. The mean and 95% confidence interval (CI) of activity restricted days for leg fractures were 26 (95% CI 7 to 45) days, for arm fractures, 14 (95% CI 8 to 20) days, and for other fractures, 5 (95% CI 1 to 8) days. Arm fractures represented 66% of the cases and 62% of the activity restricted days; leg fractures 19% of cases and 33% of all activity restricted days; and other fractures 16% of the cases but only 5% of the activity restricted days in this population. CONCLUSION: The incidence of fractures increases in childhood. Different types of fractures among children cause different amounts of activity restriction.

Activities of Daily Living↗
PubMed2005

Peer-delivered smoking counseling for childhood cancer survivors increases rate of cessation: the partnership for health study.

PURPOSE: Cancer survivors smoke at rates that are only slightly lower than the general population. This article reports on the final outcomes of Partnership for Health, a smoking cessation intervention for smokers in the Childhood Cancer Survivors Study (CCSS). METHODS: This study is a randomized control trial with follow-up at 8 and 12 months that involved smokers (n = 796) enrolled onto the CCSS cohort. Participants were randomly assigned to either a self-help or a peer-counseling program that included up to six telephone calls from a trained childhood cancer survivor, tailored and targeted materials, and free nicotine replacement therapy. The intervention was delivered by telephone and postal service mail. RESULTS: The quit rate was significantly higher in the counseling group compared with the self-help group at both the 8-month (16.8% v 8.5%; P < .01) and 12-month follow-ups (15% v 9%; P < or = .01). Controlling for baseline self-efficacy and readiness to change, the intervention group was twice as likely to quit smoking, compared with the self-help group. Smoking cessation rate increased with an increase in the number of counseling calls. The cost of delivering the intervention was approximately 300 dollars per participant. The incremental cost-effectiveness of the intervention compared with controls was 5,371 dollars per additional quit. CONCLUSION: Interventions to prevent future illnesses are of critical importance to childhood cancer survivors. The Partnership for Health intervention resulted in a doubling of smoking cessation quit rates. Because of the seriousness of smoking among childhood cancer survivors, this intervention model may be appropriate as a multicomponent treatment program for survivors who smoke.

Adolescent↗
PubMed1995

Survey of knowledge of infectious disease and infection control practices of dental specialists.

A questionnaire was developed to assess the knowledge of clinical specialists regarding infectious disease as well as their infection control practices. The questionnaire was mailed to 202 dental specialists in British Columbia. Seventy per cent returned completed surveys. Their responses indicate that the mechanisms, route and risk of transmission of the viral pathogens of importance in dental practice are not clearly understood. However, infection control practices closely follow the guidelines set forth by the Canadian Dental Association and the licensing bodies, including immunization for hepatitis B (82 per cent), glove use (in 89 per cent of non-surgical and 95 per cent of surgical procedures), and sterilization/disinfection of dental handpieces (94 per cent). Compliance with infection control guidelines was similar to that reported in the United States, where strict enforcement has been instituted. The majority of dental specialists (84-88 per cent) were either treating or willing to provide treatment to patients with infectious disease. Continuing education in the area of infectious disease is needed to improve dentists' understanding of the risk of transmission to dental providers and patients. This will ensure that compliance with infection control recommendations and appropriate patient care practices continue.

Analysis of Variance↗
PubMed2001

The morbidity, time course and predictive factors for persistent post-thoracotomy pain.

After thoracotomy, patients often suffer from a persistent pain syndrome called post-thoracotomy pain. To elucidate morbidity, time course, and predictive factors for this syndrome, we analyzed follow-up data for 85 post-thoracotomy patients. We used a four-point scale to assess pain: none, slight, moderate and severe. Of 85 patients, 50 reported pain (39 slight, 11 moderate) one day after surgery. A year after surgery, the patients were polled using a simple questionnaire received by the mail. Sixty patients reported persistent pain (34 slight, 14 moderate, 12 severe) a month after surgery, and 35 patients reported persistent pain (33 slight, two moderate) around the time of the poll (1 year after surgery). Although pain deterioration was observed in 40% (34/85) of patients during month 1 after surgery, pain alleviation was seen in 48% (41/85) of patients during months 2-12. Stepwise regression analysis revealed that female gender and pain at postoperative day 1 were predictive for persistent pain both 1 month and 1 year after thoracotomy. Among 35 patients with persistent pain 1 year after surgery, 24 cases reported paresthesia-dysesthesia, and 14 cases reported hypoesthesia. The present data thus suggests that persistent pain is common and often severe 1 month after surgery but is alleviated after 1 year. Clinical time course and symptoms indicate that nerve impairment rather than simple nociceptive impact may be involved in this syndrome.

Aged↗
PubMed1997

Ethics in public health practice: a survey of public health nurses in southern Louisiana.

The present study was designed to help learn more about the ethical interests and concerns of public health nurses employed in state and local health departments. Self-administered postal questionnaires were mailed to 41 public health nurses employed at health units in Region I of the Louisiana Office of Public Health. Basic demographic information was obtained along with information about the workers' previous instruction or training in ethics and the nature of ethical conflicts encountered in their public health practice. Only 38% (15 of 39) of the surveyed nurses had had formal instruction in ethics. Even fewer (7.3%) had received continuing education on ethics. Most of the nurses felt confident in their ability to recognize an ethical conflict or dilemma in the workplace; fewer felt confident in their ability to resolve an ethical conflict or dilemma. A high proportion of the nurses agreed that there is a need for continuing education courses on ethics for public health workers. Nurses who had received formal ethics instruction were more likely to feel confident in their ability to recognize an ethical conflict in their public health practice. Continuing education programs on ethics are needed that are designed to meet the specific needs of front-line public health workers.

Adult↗
PubMed1994

Gender differences in fire fighter job stressors and symptoms of stress.

This study described gender differences in fire fighter appraisal of job stressors and symptoms of stress. A sample of 670 male and 41 female fire fighters responded to an anonymous mail survey consisting of three standardized and investigator-developed questionnaires. Male and female fire fighter respondents were more similar than different on both job stressor and symptoms of stress measures. Five job stressors were ranked the most "bothersome" by both males and females during the last 10 shifts worked. These were: sleep disturbance, wage/benefit concerns, job skill concerns, substandard equipment, and safety concerns. Of these five job stress factors, only one gender difference was noted. Female fire fighters reported significantly higher scores than males on job skill concerns. Job discrimination reported by female respondents was significantly higher than for males (t = 3.51, p < .0001) even though it was not ranked among the five most stressful factors. Partial correlations computed between job stressors and symptoms of stress, while controlling for the number of years as a fire fighter, were of moderately high magnitude for both genders and similar to simple correlations computed. These results suggest that the number of years of service did not account for gender differences reported.

Adult↗
PubMed1995

[The prevalence of the principal cardiovascular risk factors in the population of the Azores].

STUDY OBJECTIVE: to characterize the high mortality rate by ischemic heart disease in Azores, by evaluating the main coronary heart disease risk factors prevalence in the population. DESIGN: sample study referring the population of 5 islands: 37 counties. Aleatory choose in the electoral lists. SETTING: the selected individuals were convocated by mail to show up at the Hospital for evaluation. PATIENTS: 1089 individuals selected by aleatory choose from the electoral lists. INTERVENTIONS: the sample was stratified regarding rural (R) and urban (U), by sex feminine (F) and masculine (M), age 20-40 and 40 to 60 years old. All of them were determined three values of blood pressure, and was taken for exact value the medium of the three, inquired the smoking habits and serum lipids were determined. We considered risk factors (RF); blood pressure > 140/90 mmHg, total cholesterol > 200 mg/dl, HDL cholesterol < 35 mg/dl, triglycerides > 180 mg/dl and smoking habits were stratified in three scores: 1: 1-10, 2: 11-20, and 3: more than 20 cigarettes a day. MAIN RESULTS: total prevalences; HBP 20.4%, smoking habits 33%, total hypercholesterolemia 47.3%, low HDL cholesterol 17.4% and triglycerides 30.5%. CONCLUSIONS: the values found for total cholesterol, triglycerides and smoking habits were high and superior to the national medium and to those found in reference studies. Preventive strategies are pointed out.

Adult↗
PubMed2006

Return to work after ill-health retirement in Scottish NHS staff and teachers.

BACKGROUND: Most major public and private sector pension schemes have provision for ill-health retirement (IHR) for those who become too ill to continue to work before their normal retirement age. AIM: To compare the causes, process and outcomes of IHR in teachers and National Health Service (NHS) staff in Scotland. METHODS: A total of 537 teachers and 863 NHS staff who retired due to ill-health between April 1998 and March 2000 were mailed an IHR questionnaire by the Scottish Public Pensions Agency. RESULTS: The response rate for teachers was 53% and for NHS staff 49%. The most common cause of IHR was musculoskeletal disorders for NHS staff and mental disorders for teachers. Teachers retired at a younger average age than NHS staff. Ninety-two per cent of NHS staff but only 11% of teachers attended occupational health services (OHS) prior to IHR. Eighteen per cent of NHS staff and 9% of teachers were offered part-time work by their current employer in response to their ill-health. Fifteen per cent of NHS staff and 5% of teachers were offered alternative work prior to retirement. Seventeen per cent of NHS staff and 36% of teachers subsequently found employment. Multiple logistic regression analyses showed the following variables as independent predictors of subsequent employment: occupational group, age group, sex, managerial responsibility and cause of IHR. CONCLUSIONS: Return to work after IHR suggests that some IHR could be avoided. Teachers had a higher rate of return to work and much less access to OHS.

Age Distribution↗
PubMed2005

Emergency contraceptive pills: dispensing practices, knowledge and attitudes of South Dakota pharmacists.

CONTEXT: Despite a decision by the Food and Drug Administration to deny over-the-counter status to emergency contraceptive pills, pharmacists play a crucial role in a woman's access to this medication, especially in areas with large rural populations. Pharmacists' knowledge about and attitudes toward emergency contraceptive pills may affect whether pharmacies carry the medication and whether individual pharmacists dispense it. METHODS: In October 2003, all registered pharmacists living and working in South Dakota were mailed a survey to assess their dispensing practices for, knowledge about, and attitudes toward emergency contraceptive pills. Data for 501 respondents were analyzed through chi-square testing and multivariate logistic regression. RESULTS: Fifty-four percent of respondents worked in pharmacies that carried emergency contraceptive pills. Of these, 67% had dispensed the medication in 2003, and 24% were not comfortable providing customer counseling about the method. Thirty-seven percent of all pharmacists did not understand its mechanism of action; 43% and 21%, respectively, incorrectly answered questions about the medication's link to birth defects and health risks. Only 5% correctly answered all three questions. Eighty-four percent of surveyed pharmacists believed that the medication should not be made available over the counter. Multivariate analysis showed that knowledge of emergency contraception and support for over-the-counter status were relatively low among pharmacists working in small communities. CONCLUSIONS: The education of pharmacists about emergency contraceptive pills must be strengthened to ensure that women receive accurate medical information and access to all contraceptive services.

Attitude of Health Personnel↗
PubMedDate not supplied

Effects of nonnutritive sucking habits on occlusal characteristics in the mixed dentition.

PURPOSE: Little is known about the extent to which nonnutritive sucking habits contribute to malocclusion in the mixed dentition. The purpose of this study was to report on the relationship between certain occlusal traits in the mixed dentition and longitudinal sucking behaviors. METHODS: Dental examinations were conducted on 630 children in the mixed dentition who participated in a large, ongoing longitudinal study. Five hundred eighty consented to impressions, and 524 adequate study models were obtained. Of these, 444 also had adequate longitudinal nonnutritive sucking data obtained via mailed questionnaires to parents at 3- to 6-month intervals from birth to 8 years. Sucking behaviors were grouped by predominant type and duration. Study models were hand articulated using wax bites to evaluate the occlusion for the presence of open bite, crossbite, molar relationship, and excessive overjet. Bivariate statistical analyses related presence of these malocclusions to sucking duration and type. RESULTS: Fifty-five percent of the children had malocclusions (anterior open bite, posterior crossbite, bilateral Class II molar relationship, or overjet >4 mm). Class II molar relationship was most common (30%). Overall, anterior open bite and posterior crossbite was associated with habits of 36 months or more. Sustained pacifier habits, including those of 24 to 47 months, were associated with anterior open bite and Class II molar relationships, while digit habits were associated with anterior open bite when sustained for 60 months or longer. CONCLUSIONS: Malocclusions are quite prevalent in the mixed dentition, and anterior open bite and posterior crossbite may be preventable by modifying nonnutritive sucking behaviors.

Chi-Square Distribution↗
PubMed1999

A survey of 2,851 patients with hemochromatosis: symptoms and response to treatment.

PURPOSE: Hemochromatosis is a genetic disorder of iron absorption that affects 5 per 1,000 persons and is associated with reduced health and quality of life. We sought to determine the type and frequency of symptoms that patients experienced before the diagnosis and the treatments that they received. METHODS: We mailed a questionnaire to 3,562 patients with hemochromatosis who were located using patient advocacy groups, physicians, blood centers, newsletters, and the Internet. RESULTS: Of the 2,851 respondents, 99% were white and 62% were men. Circumstances that led to diagnosis of hemochromatosis included symptoms (35%), an abnormal laboratory test (45%), and diagnosis of a family member with hemochromatosis (20%). The mean (+/- SD) age of symptom onset was 41 +/- 14 years. Symptoms had been present for an average of 10 +/- 10 years before the diagnosis was made. Among the 58% of patients with symptoms, 65% had physician-diagnosed arthritis and 52% had liver disease. The most common and troublesome symptoms were extreme fatigue (46%), arthralgia (44%), and loss of libido (26%). Physician instructions to patients included treatment with phlebotomy (90%), testing family members (75%), and avoiding iron supplements (65%). CONCLUSIONS: The diagnosis of hemochromatosis in most patients was delayed. Physician education is needed to increase the detection of patients with the disease and to improve its management.

Adolescent↗
PubMed1999

Impact of gait problems and falls on functioning in independent living persons of 55 years and over: a community survey.

In a cross-sectional, population-based study among community-dwelling persons of 55 years and over the incidence of falls, risk indicators for falls, specifically age, and the impact of gait problems, falls and other risk factors on functioning was determined. A randomly age-stratified sample (n = 655) was taken from all independent living persons of 55 years and over (n = 2269) and registered in a primary health care centre. They received a mail questionnaire concerning demographic data, history of falls and injuries due to falls, physical and mental health status, gait problems, functional status, including social activities. The response rate was 62% (n = 405). Of the subjects aged 55 years and of those aged 65 years and over, 25% and 31% respectively fell at least once in the previous year. Half of the people reporting falls fell more than once. Serious injury occurred in 9% of the fallers, with 4% fractures. There is a significant association between falling and age and, even more clearly, between gait problems and age. The main risk factors of single and recurrent falls were female gender, physical health status and gait problems. Logistic regression analysis reveals that the main determinants of falling in general are gait problems and female gender and, of recurrent falling female gender, physical complaints and gait problems. Falls have some negative effect on functioning, i.e. mobility range and social activities, but this is overshadowed by mental status indicators and gait problems.

Accidental Falls↗