Journal List > Korean J Adult Nurs > v.26(5) > 1094583

Lee and Kim: Fall Risk related Factors in Postmenopausal Women

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.

REFERENCES

Bone Health and Osteoporosis. 2004. A surgeon general report. Washington: US Department of Health Service.
Choi J. Y.., Han S. H.., Shin A. S.., Shin C. S.., Park S. K.., Cho S. I., et al. 2008. Prevalence and risk factors of osteoporosis and osteopenia in Korean women: Cross-sectional study. Journal of Menopausal Medicine. 14(1):35––49.
Choi K. W.., Park U. A.., Lee I. S.2011. Factors influencing the fear of falling according to gender in frail elderly. Journal of the Korean Gerontological Society. 31(3):539––551.
Fletcher P. C.., Berg K.., Dalby D. M.., Hirdes J. P.2009. Risk factors for falling among community-based seniors. Journal of Patient Safety. 5(2):61––66.
crossref
Glydenvand T.1984. Falls: The construction and validation of the Risk Assessment for Fall Scale Ⅱ (RAFSⅡ). Unpublished master thesis.Iowa City: University of Iowa.
Harling A.., Sompson J. P.2008. A systematic review to determine the effectiveness of Tai Chi in reducing falls and fear of falling in older adults. Physical Therapy Reviews. 13(4):237––248.
crossref
Heinze C.., Dassen T.., Halfens R.., Lohrmann C.2009. Screening the risk of falls: A general or a specific instrument? Journal of Clinical Nursing. 15:350––356.
crossref
Jang G. J.., Jeon E. Y.., Kwon B. H.2010. Differences of prevalence and Associated factors of falls in community-dwelling older people with hypertension. Journal of Korean Academy of Public Health Nursing. 24(2):302––310.
Jung J. W.., Shin H. C.., Park Y. W.., Kim C. H.., Cheong S. Y.., Sung E. J.2004. The relationship between metabolic syndrome, stress and depression-among the 35-64 years old clients of comprehensive medical examination center in one university hospital. Korean Journal of Health Promotion. 4(1):10––16.
Kang T. H.., Park Y. K.., Kim E. H.., Kim S. M.., Oh H. J.2002. Spinal bone mineral density related YSM in Korean menopausal women. Journal of Korean Academic Family Medicine. 23(2):224––232.
Kempen G. I.., van Haastregt J. C.., McKee K. J.., Delbaere K.., Zijlstra G. A.2009. Socio-demographic, health-related and psychosocial correlates of fear of falling and avoidance of activity in community-living older persons who avoid activity due to fear of falling. BMC Public Health, 9, 170.http://dx.doi.org/10.1186/1471-2458-9-170.
Kim C. H.., Kim C.2008. Effectiveness of a community-based exercise intervention of falls and fall risk factors for reducing risks of osteoporotic fracture. The Korean Journal of Measurement and Evaluation in Physical Education and Sport Science. 10(3):81––90.
Kim E. K.., Lee J.., Eom M. R.2008. Falls risk factors of inpatients. Journal of Korean Academy of Nursing. 38(5):676––684. http://dx.doi.org/10.4040/jkan.2008.38.5.676.
crossref
Kim J. M.2009. An analysis of falls in the elderly: A PRECEDE model approach. Unpublished doctoral dissertation, Seoul: Ewha Womans University.
Kim M. S.2009. Prevalence rate of metabolic syndrome and analysis of dietary behaviors for premenopausal and postmenopausal women. Unpublished master's thesis, Seoul: Konkuk University.
Korea National Statistical Office. 2008. Life table. Daejeon: Korea National Statistical Office.
Kuczynski M.., Ostrowska B.2006. Understanding falls in osteoporosis: The viscoelastic modeling perspective. Gait Posture. 23(1):51––58. http://dx.doi.org/10.1016/j.gaitpost.2004.11.018.
Lee I. S.., Ko Y.., Lee K. O.., Yim E. S.2012. Evaluation of the effects of a frailty preventing multi-factorial program concentrated on local communities for high-risk younger and older elderly people. Journal of Korean Academy of Community Health Nursing. 23(2):201––211.
crossref
Lee K. J.., Park H. S.2006. A study on the perceived health status, depression, and activities of daily living for the elderly in urban areas. Korean Journal of Womens Health Nursing. 12(3):221––230.
crossref
Lee O.., Nam H. S.., Kong S. A.., Kim J. W.., Kim C. Z.., Kang H. J.2010. The relationships between physical activity and immanent fall risk factors in the elderly. The Korean Journal of Sports Medicine. 28(2):95––102.
Lee S. W.., Kim M. R.., Kwon D. J.., Kim J. H.., Kim J. H.., You Y. O., et al. 2009. Relationship between metabolic syndrome and bone mineral density in the postmenopausal women. Korean Journal of Obstetrics and Gynecology. 52(8):835––842.
Minister of Health & Welfare. 2001. The Korea Health & Nutrition Examination Survey. Seoul, Minister of Health & Welfare.
National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). 2002. Third report of the NCEP expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation. 106(25):3143––3421.
National Institutes of Health Consensus Conference. 2001. Osteoporosis prevention, diagnosis, and therapy. Journal of American Medical Association. 285:785––795. http://dx.doi.org/10.1001/jama.285.6.785.
Oh E. J.., Joh H. K.., Lee R.., Do H. J.., Oh S. W.., Lym Y. L., et al. 2008. Relations between the dietary habits and components of the metabolic syndrome in premenopausal women. Journal of Korean Academy of Family Medicine. 29(10):746––761.
Park E. K.., Ahn W. H.., Oh H. W.2008. Relationships of hemodynamic variables, dementia, falling related fitness and lower extremity strength in older person with chronic disease. Journal of Sport and Leisure Studies. 34(9):1237––1246.
Park H. S.., Chang R.., Park K. Y.2008. Comparative study on fall related characteristics between single and recurrent falls in community-dwelling older women. Journal of Korean Academic of Adult Nursing. 20(6):905––916.
Park S. H.2008. Relations among metabolic syndrome, dietary behaviors health-related factors, and serum minerals in Korean adult male. Unpublished doctoral dissertation, Soon-chunhyang University, Asan.
Park Y. H.2004. Fall risk assessment in the community-dwelling elderly. Journal of Korean Gerontological Nursing. 6(2):170––178.
Roux C.2001. Can practitioners use the WHO definition for osteoporosis? Joint Bone Spine. 68:10––11. http://dx.doi.org/10.1016/S1297-319X(00)00224-4.
crossref
Roux C.., Priol G.., Fechtenbaum J.., Colet B.., Liu-Leage S.., Audran M.2007. A clinical tool to determine the necessity of spine radiography in postmenopausal women with osteoporosis presenting with back pain. Annals of the Rheumatic Disease. 66:81––85. http://dx.doi.org/10.1136/ard.2006.051474.
crossref
Scheffér A. C.., Schuurmans M. J.., van Dijk N.., van der Hooft T.., de Rooij S. E.2008. Fear of falling: Measurement strategy, prevalence, risk factors and consequences among older persons. Age and Ageing. 37(1):19––24. http://dx.doi.org/10.1093/ageing/afm169.
Yoo I. Y.2011. Recurrent falls among community dwelling older Koreans. Journal of Gerontological Nursing. 37:28––40. http://dx.doi.org/10.3928/00989134-20110503-01.
Zijlstra G. A.., van Haastregt J. C.., van Eijk J. T.., van Rossum E.., Stalenhoef P. A.., Kempen G. I.2007. Prevalence and correlates of fear of falling, and associated avoidance of activity in the general population of community-living older people. Age and Ageing. 36:304––309. http://dx.doi.org/10.1093/ageing/afm021.
crossref

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
M±SD
Age (year)   57.1±4.7      
Educational level Elementary schoola 12 (9.4) 10.9±3.2 7.49 .001
Middle school 10 (7.8) 8.8±2.9
High schoolb 47 (36.7) 6.9±3.3
≥Collegeb 59 (46.1) 6.4±3.1
Spouse Yes 113 (88.3) 7.1±3.5 0.93 .354
No 15 (11.7) 8.0±2.8
Job Yes 20 (15.6) 4.6±2.4 4.03 .001
No 108 (84.4) 7.7±3.4
Living with family Yes 123 (96.1) 7.2±3.4 -0.71 .514
No 5 (3.9) 8.2±3.1
Menarche (year)   15.2±1.4      
Past history 0a 64 (55.5) 5.7±3.0 25.53 .001
(number of 1b 46 (35.9) 8.6±2.8
chronic disease) ≥2c 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

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
M±SD
Weight check (frequency/week)   4.5±6.5      
Exercise Yes 98 (76.6) 7.0±3.2 1.14 .260
No 30 (23.4) 7.9±4.0
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 Noa 24 (18.7) 5.3±3.4 4.80 .010
Sometimes 22 (17.2) 7.6±3.6
Frequentlyb 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
M±SD
Blood pressure (mmHg) ≥130/85 54 (42.2) 8.4±3.3 -3.34 .001
<130/85 74 (57.8) 6.4±3.3
Fasting blood sugar (mg/dL) ≥110 23 (18.0) 7.6±3.5 -0.52 .607
<110 105 (82.0) 7.2±3.4
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) 0a 30 (23.4) 5.9±3.3 6.12 .001
1a 44 (34.4) 7.1±3.1
2a b 25 (19.5) 6.6±3.1
≥3b 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
M±SD
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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