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African Health Sciences
Makerere University Medical School
ISSN: 1680-6905 EISSN: 1680-6905
Vol. 17, No. 3, 2017, pp. 912-922
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Bioline Code: hs17111
Full paper language: English
Document type: Study
Document available free of charge
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African Health Sciences, Vol. 17, No. 3, 2017, pp. 912-922
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Methodological challenges in a study on falls in an older population of Cape Town, South Africa.
Kalula, Sebastiana Z; Ferreira, Monica; Swingler, George H; Badri, Motasim & Sayer, Avan A
Abstract
Background: Falls are a major cause of disability, morbidity and mortality in older persons, but have been under researched in developing countries. .
Objective: To describe challenges encountered in a community-based study on falls in a multi-ethnic population aged ≥65 years in a low-income setting.
Methods: The study was conducted in four stages: A pilot study (n=105) to establish a sample size for the survey. An equipment validation study (n=118) to use for fall risk determination. A cross-sectional baseline (n=837) and a 12-month follow-up survey (n=632) to establish prevalence and risk factors for falls.
Results: Prevalence rate of 26.4% (95% CI 23.5-29.5%) and risk factors for recurrent falls: previous falls, self-reported poor mobility and dizziness were established. Adaptations to the gold standard prospective fall research study design were employed: 1) to gain access to the study population in three selected suburbs, 2) to perform assessments in a non-standardised setting, 3) to address subjects’ poverty and low literacy levels, and high attrition of subjects and field workers.
Conclusion: Studies on falls in the older population of low- to middle-income countries have methodological challenges. Adaptive strategies used in the Cape Town study and the research experience reported may be instructive for investigators planning similar studies in such settings.
Keywords
Falls; older people; community-based research; low and middle income countries; methodology; study design
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