Fall Risk related Factors in Postmenopausal Women

Jung-Han Lee; Hee Seung Kim

doi:10.7469/kjan.2014.26.5.533

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Lee and Kim: Fall Risk related Factors in Postmenopausal Women

Original Article

Korean J Adult Nurs 2014;26(5):533-542.

Published online: NaN October 2014

DOI: https://doi.org/10.7469/kjan.2014.26.5.533

Fall Risk related Factors in Postmenopausal Women

Jung-Han Lee¹, Hee Seung Kim^2,

^¹Seoul St. Mary‘s Hospital, Seoul

^²College of Nursing, The Catholic University of Korea, Seoul, Korea

Corresponding author: Kim, Hee Seung College of Nursing, The Catholic University of Korea, 222 Banpo-dong, Seocho-gu, Seoul 137-701, Korea. Tel: +82-2-2258-7408, Fax: +82-2-2258-7772, E-mail: hees@catholic.ac.kr

Received 14 March 201429 September 2014 Accepted 10 October 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to understand the risk of falling associated with postmenopausal women and to identify the relationships between this risk and factors such as lifestyle, metabolic syndrome, and bone mineral density.

Methods

The sample was 128 postmenopausal women between 50 and 65 from one menopausal clinic in an urban city. The Risk Assessment for Falls Scale Ⅱ, developed by Glydenvand and Reinboth (1982) and adapted by Park Young-Hye (2003), was modified and used for this study.

Results

The average fall-risk score in postmenopausal women was 7.2 out of 33, the fall-risk score associated with lifestyle was higher in women exposed to stress frequently or who favored spicy or salty foods. The fall-risk score associated with metabolic syndrome was higher in groups with HBP or with a waist circumference of 80cm or greater. The fall-risk score in groups with three or more factors of metabolic syndrome was the highest.

Conclusion

The risk of fall in postmenopausal women was higher in groups with only elementary education, unemployed, reported two or more chronic diseases or reported frequent exposure to stress and for women who preferred spicy or salty foods or exhibited three or more factors of metabolic syndrome.

Keywords: Postmenopausal women, Fall risk, Lifestyle, Metabolic syndrome

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Table 1.

Fall Risk Scores by Characteristics of the Subjects (N=128)

Characteristics	Categories	n (%) or M±SD	RAFS II score	t or F	p
Characteristics	Categories	n (%) or M±SD	M±SD	t or F	p
Age (year)		57.1±4.7
Educational level	Elementary school^a	12 (9.4)	10.9±3.2	7.49	.001
	Middle school	10 (7.8)	8.8±2.9
	High school^b	47 (36.7)	6.9±3.3
	≥College^b	59 (46.1)	6.4±3.1
Spouse	Yes	113 (88.3)	7.1±3.5	0.93	.354
Spouse	No	15 (11.7)	8.0±2.8	0.93	.354
Job	Yes	20 (15.6)	4.6±2.4	4.03	.001
Job	No	108 (84.4)	7.7±3.4	4.03	.001
Living with family	Yes	123 (96.1)	7.2±3.4	-0.71	.514
Living with family	No	5 (3.9)	8.2±3.1	-0.71	.514
Menarche (year)		15.2±1.4
Past history	0^a	64 (55.5)	5.7±3.0	25.53	.001
(number of	1^b	46 (35.9)	8.6±2.8
chronic disease^†)	≥2^c	11 (8.6)	11.4±3.0
Hormone therapy	Yes	64 (50.0)	7.6±3.4	-1.27	.207
	No	64 (50.0)	6.8±3.5	-1.27	.207

Note. a, b, c=Different letters are significantly different.

RAFS=Risk Assessment for Falls Scale;

^† Chronic disease: Hypertension, Diabetes Mellitus, Abdominal obesity, Hypertriglyceridemia, Low HDL (High-density lipoprotein) cholesterol levels in blood.

Table 2.

Fall Risk Factor and Score

Risk factors	Score	Degree of risk factors	n (%)	M±SD
Passed day after discharge	0	No inpatient experience	107 (83.6)	0.2±0.4
	1	More than 15 days	18 (14.1)
	2	From 8 to 14 days	3 (2.3)
	3	Less than 7 days	0 (0.0)
Inpatient	0	None	43 (33.6)	0.7±0.5
	1	Mild-insulting language	80 (62.5)
	2	Moderate screaming, aggressive	5 (3.9)
	3	Severe-needed restraints	0 (0.0)
Depression	0	None	53 (41.4)	0.8±0.8
	1	Fatigue, mild depression	44 (34.4)
	2	Insomnia, anorexia	31 (24.2)
	3	Over 8kg weight loss, ataraxia	0 (0.0)
Anxiety	0	None	81 (63.3)	0.4±0.5
	1	Unstable, insomnia	46 (35.9)
	2	Rapidly speaking, safety demanded	1 (0.8)
	3	Concentrate difficulty	0 (0.0)
Vision	0	Normal	20 (15.6)	1.3±0.7
	1	Wearing glasses	44 (34.4)
	2	Occasionally discomfort	64 (50.0)
	3	Visual disturbance	0 (0.0)
Communication	0	Normal	111 (86.7)	0.1±0.3
	1	Hearing disturbance	17 (13.3)
	2	Speaking disturbance	0 (0.0)
	3	Hearing / speaking disturbance	0 (0.0)
Drug intake	0	None	82 (64.1)	0.5±0.8
	1	Cardiovascular drug	31 (24.2)
	2	Neurological drug	10 (7.8)
	3	Cardiovascular / neurological drug	5 (3.9)
Chronic disease	0	None	50 (39.0)	0.8±0.8
	1	1 type	52 (40.6)
	2	2 types	24 (18.8)
	3	More than 3 types	2 (1.6)
Urinary dysfunction	0	None	60 (46.8)	0.7±0.7
	1	1 type	54 (42.2)
	2	2 types	13 (10.2)
	3	Nocturia, frequancy, urgency	1 (0.8)
Client age (year)	0	Less than 19	0 (0.0)	1.3±0.4
	1	20~60	93 (72.7)
	2	61~74	35 (27.3)
	3	More than 75	0 (0.0)
Fall history	0	None	86 (67.2)	0.4±0.6
	1	Within last 6months	35 (27.3)
	2	Within 1~5 months	6 (4.7)
	3	Last 4 weeks	1 (0.8)
Total score				7.2±3.4
Range				1~33

Note. Each risk factor was scored and M±SD is the average value of total score of 128 people.

Table 3.

Fall Risk Scores by Life Styles (N=128)

Characteristics	Categories	n (%) or M±SD	RAFS II score	t or F	p
Characteristics	Categories	n (%) or M±SD	M±SD	t or F	p
Weight check (frequency/week)		4.5±6.5
Exercise	Yes	98 (76.6)	7.0±3.2	1.14	.260
Exercise	No	30 (23.4)	7.9±4.0		.260
Exercise time (minutes/week)		126.2±13.7			.641
Intake of health supplements^† (number)	0	30 (23.4)	7.5±4.1	0.56
	1	73 (57.0)	6.9±3.4
	2	18 (14.1)	7.9±2.7
	≥3	7 (5.5)	7.9±2.9
Alcohol (glass/week)		0.6±2.0		1.34	.194
	0	110 (85.9)	7.4±3.3
	≥1	18 (14.1)	6.1±3.9
Stress	No^a	24 (18.7)	5.3±3.4	4.80	.010
	Sometimes	22 (17.2)	7.6±3.6
	Frequently^b	82 (64.1)	7.7±3.2
Fried dishes (frequency/week)		1.0±1.1		0.32	.868
	0	50 (39.1)	7.1±3.6
	1	50 (39.1)	7.4±3.2
	2	18 (14.0)	6.9±4.1
	3	8 (6.2)	7.1±2.9
	5	2 (1.6)	9.5±2.1
Meat or animal fat (frequency/week)		1.1±0.9		0.29	.751
	0	24 (18.8)	6.9±3.1
	1	74 (57.8)	7.4±3.7
	≥2	30 (23.4)	7.0±3.1
Instant food (frequency/week)		0.2±0.4		0.57	.577
	0	19 (14.8)	6.8±3.7
	≥1	109 (85.2)	7.4±3.4
Spicy or salty food (frequency/day)		0.2±0.5		-3.05	.003
	0	102 (79.7)	6.8±3.1
	≥1	26 (20.3)	9.0±4.0

Note. a, b=Different letters are significantly different. RAFS=Risk Assessment for Falls Scale;

^† Health supplements: calcium, vitamin, etc.

Table 4.

Fall Risk Scores by Metabolic Syndrome Risk Factors (N=128)

Characteristics	Categories	n (%) or M±SD	RAFS II score	t or F	p
Characteristics	Categories	n (%) or M±SD	M±SD	t or F	p
Blood pressure (mmHg)	≥130/85	54 (42.2)	8.4±3.3	-3.34	.001
Blood pressure (mmHg)	＜130/85	74 (57.8)	6.4±3.3	-3.34	.001
Fasting blood sugar (mg/dL)	≥110	23 (18.0)	7.6±3.5	-0.52	.607
Fasting blood sugar (mg/dL)	＜110	105 (82.0)	7.2±3.4	-0.52	.607
Waist circumstance (cm)		78.2±9.0		-2.06	.041
	≥80	59 (46.1)	7.9±3.6
	＜80	69 (53.9)	6.7±3.2
Triglyceride (mg/dL)		101.4±52.2		-1.85	.066
	≥150	17 (13.3)	8.7±4.4
	＜150	111 (86.7)	7.0±3.2
HDL-cholesterol (mg/dL)		57.2±12.7		-1.00	.322
	＜50	33 (25.8)	7.0±3.4
	≥50	95 (74.2)	7.8±3.6
Metabolic syndrome risk factors (number)	0^a	30 (23.4)	5.9±3.3	6.12	.001
	1^a	44 (34.4)	7.1±3.1
	2^a ^b	25 (19.5)	6.6±3.1
	≥3^b	29 (22.7)	9.3±3.4

Note. a, b=Different letters are significantly different. RAFS=Risk Assessment for Falls Scale.

Table 5.

Fall Risk Scores by Bone Mineral Density (N=128)

Characteristics	Categories	n (%) or M±SD	RAFS II score	t or F	p
Characteristics	Categories	n (%) or M±SD	M±SD	t or F	p
Lumbar		-1.9±0.9		0.66	.516
	Normal	18 (14.0)	7.2±3.3
	Osteopenia	71 (55.5)	7.5±3.7
	Osteoporosis	39 (30.5)	6.7±3.0
Femoral neck		-2.3±0.7		1.41	.248
	Normal	1 (0.8)	12.0±0.0
	Osteopenia	76 (59.4)	7.0±3.5
	Osteoporosis	51 (39.8)	7.5±3.4
Trochanter		-1.6±0.7		0.30	.739
	Normal	24 (18.8)	6.8±3.9
	Osteopenia	90 (70.3)	7.3±3.4
	Osteoporosis	14 (10.9)	7.6±2.5
Ward's triangle		-2.7±0.7		1.04	.358
	Normal	1 (0.8)	12.0±0.0
	Osteopenia	46 (35.9)	7.3±3.8
	Osteoporosis	81 (63.3)	7.1±3.2
Lowest point		-2.8±0.7		0.66	.419
	Osteopenia	38 (29.7)	7.6±3.8
	Osteoporosis	90 (70.3)	7.0±3.3

RAFS=Risk Assessment for Falls Scale.

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