الفهرس 
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Abstract
Summary
As people grow older they are increasingly at risk of
falls and consequent injuries. Falls may be the first
indication of an undetected illness. The prevention of falls
is of major importance because they engender considerable
mortality, morbidity and suffering for older people and
their families, and incurs social costs due to hospital and
nursing home admissions.
As most of falls are associated with one or more
identifiable risk factors and attention to these risk factors
can significantly reduce rates of falls, this study assessed
prevalence and common risk factors of falls using a
substantial number of valid and reliable falls risk screening
tools.
This study is a cross section study conducted to
assess the prevalence and common risk factors of falls
among elderly Egyptian females. The study included 200
elderly females with mean age 66.9 years, recruited from
the geriatrics outpatient clinic in Ain-Shams University
Hospital.
Each participant was subjected to comprehensive
geriatric assessment including full history taking with
detailed history about falls and common risk factors,
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clinical examination, assessment of cognition using minimental
state examination (MMSE), screening for
depression using geriatric depression scale (GDS-15),
assessment of function using ADL & IADL scales and
assessment of falls risk using five valid and reliable falls
risk screening tools.
The study showed that the prevalence of falls among
elderly Egyptian females was 35.5 % with number of falls
ranging from 1-15 fall in the last 12 months and median
number of falls among positive cases with history of falls is
3 times.
As most of falls are associated with one or more
identifiable risk factors, this study showed that falls have
multifactorial risk factors with the strongest associations
were found with cases with cognitive impairment,
depression, functional impairment in ADL and IADL,
balance disorders, gait disorders , arrhythmias, CV disease,
PN, visual impairment, and urinary incontinence, and the
difference between fallers and non fallers was highly
significant statistically.
This study showed that there is no significant
difference statistically between cases with or without
Hypertension, DM, spondylosis, Osteoarthritis, hearing
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impairment, orthostatic hypotension and some other
comorbidity as regards presence of falls.
Inappropriate prescribing is a common problem in
elderly people. Polypharmacy increases the likelihood of
adverse drug reactions including falls. The more the
number of drugs prescribed (≥4), the higher the risk of
falls. This study showed that using of anti depressants,
diuretics and hypnotics drugs among fallers was much
higher than non fallers and the difference was highly
significant statistically.
This study showed that number of chronic diseases,
number of medications, age and gait or balance disorders
are the highest independent risk factors for falls among
studied patients using backward stepwise logistic
regression model.
Regarding the used fall risk assessment tools,an
important finding of this study is the strong and significant
association between risk of falls, number of previous falls
and the score of falls risk screening tools used in this study
as FRAT, TUGT, FRT, OLST and TST. This study showed
that FRAT is the most accurate tool (77.5%) while OLST,
TUGT and TST are more sensitive tools in detection of
falls (their sensitivity 98.5%, 83.1%, and 84.5%
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respectively) but FRT has 86% specificity and low
sensitivity.
Also, this study showed a positive correlation
between number of falls and TUGT, FRAT and a negative
correlation between number of falls and FRT, OLST and
TST.
Using the ROC curve analysis of the studied five
tools for prediction of falls among studied group showed
that the test with the largest area under the curve is FRAT
this mean that FRAT is the best test in detecting falls
among elderly populations.