The Five W's of Falls: Weekly Online Health Survey of Community-Dwelling Older Adults: Analysis of 4 Years Prospective Follow-up

Background: An in-depth examination of prospectively collected falls details may facilitate more effective falls prevention. Who was involved? What happened? Where did the fall take place? When did it happen? Why did it occur? This study aimed to provide previously unavailable details about the circumstances surrounding fall events and their consequences. Method: A retrospective analysis of falls prospectively self-reported by older adults via an online weekly health form over 4 years. Results: We collected 371 falls during the 4 year time period from 120 clinically characterized fallers (74% women, mean age 83.3 years). Most of the 371 falls occurred indoors (62%) and in well-lit areas (81%). Bedrooms were the most common places for in-home falls. Commonly observed precipitating factors included loss of balance, slipping or tripping. Almost one-Third (31%) of falls were defined as injurious whereas 22% resulted in a change in the walking ability of which 26% led to the use of a cane or walker. Among falls that did not give rise to any formal health care intervention, 8% resulted in a modification of walking ability. Conclusions: A relatively high rate of fall-related injuries compared to the existing literature was observed. Online weekly surveys and the richness of details provided through these data capture method allowed us to identify falls that did not result in health care utilization but did result in decreased mobility. This finding suggests why some falls classified in the literature as noninjurious may nevertheless increase the risk of loss of autonomy and undesired outcomes.