Socio-Demographic and Lifestyle Factors Associated With Falls among Older People Living in Gatanga Sub-County, Murang’a County, Central Kenya

Abstract

Falls are associated with up to 60 percent of injuries sustained by older people above 65 years of whom a third fall every year worldwide. Many factors are known to contribute to falls. Varying environmental, socio-cultural, socio-demographic characteristics and increasing cases of injuries reported among older people necessitate further research in specific communities. In Kenya, there is no policy on falls prevention among older people yet there is limited data on the incidence, and associated factors among community-dwelling older individuals. This thesis highlights the findings of evaluating falls and related factors among older individuals residing in the Gatanga Sub-County. The study was cross-sectional and conducted with 420 older individuals aged 65 years and above residing in Gatanga Sub-County to determine the prevalence of falls and factors promoting or inhibiting their occurrence. Face-to-face interviews were conducted with the 420 individuals in their homes. Overall, 42.1% of older individuals sustained a fall in the preceding year. Of these, 45.3% were female, while 34.5% were male. Recurrent falls were 34.9%, while 79.5% had fallen outdoors and 79.6% had fallen during the daytime. After falling, 92.1% became afraid of falling, 49.7% sustained an injury, 40.5% abandoned their daily activities, 34.9% lost autonomy, and 31.6% went to the hospital. Other complications included immobilization (29.9%), fractures (23.1%), skin bruises (19.4%), confusion (13.4%), head injury (12.1%), and blackout (10.2%).From the study, it was clear that the most important risk factors for falls included being female (p<0.001), feeling dizzy (0.015), having a history of syncope (0.016), unsteadiness in gait (0.007), and being disabled or frail (0.007). Among women, experiencing dizziness (<0.001), unsteadiness in gait (0.039) and being disabled or frail (0.038) were the most significant risk factors for falls. Among men, alcohol consumption (0.003) was the most important risk factor for their fall.In conclusion, this study demonstrated that falls were a significant cause of morbidity among older persons living in Gatanga, Sub-County and possibly Kenya at large. Therefore, there is an urgent need to address falls in a broad, multifaceted way to mitigate the problem and improve the livelihoods of older individuals. Thus, there is a need to develop a national falls prevention policy to promote awareness of falls, mobilize resources for falls prevention, and encourage research on falls to understand environmental and individual factors that increase the likelihood of falls. Identifying evidence-based interventions to mitigate falls events would also help. Specific activities will involve developing culturally acceptable evidence-based fall prevention methods and building awareness among the community and hospital-based healthcare workers and older people and their caregivers. Improving access to healthcare services among older persons will also reduce morbidity due to falls.