Stroke as a risk factor for falls

 Stroke is one of the most commonly cited risk factor for falls [82]. Hyndman et al.

determined stroke as a risk factor for falls in a cross-sectional, observational study [170].

Half of the 41 community dwelling stroke survivors sustained a post-stroke fall and 10

had fallen more than once. Additional risk factors for those deemed "repeated fallers"

included: post-stroke mobility deficits, upper extremity ability, and declines in ADLs and

IADLs. Byers and colleagues studied acute stroke survivors and concluded post-stroke

fall risk factors included a history of falls, impaired decision making ability, restlessness,

generalized weakness, and abnormal hematocrit levels [81]. Jorgensen et al. determined

the risk of falling was at least twice as high for those post-stroke in a case-control study

[82]. Forster and Young found those post-stroke who fell in the hospital were twice as

likely to fall after being discharged home [79].

 Yates and colleagues indicated that those post-stroke are at increased risk for

falling [78]. They investigated the effect of accumulated impairments on the risk of

falling in community-dwelling stroke survivors. Of 280 participants, 51% sustained a fall

between 1 and 6 months post-stroke. Accumulated post-stroke impairments were

characterized as motor, motor and sensory, or motor and sensory and visual. Fall rates for

those with accumulated deficits were compared to those without any of the impairments.

Results from a multiple logistic regression indicated that the risk of falling increased with

motor impairment and motor and sensory impairments. Interestingly, those with motor

and sensory and visual impairments had decreased falls risk. This was most likely due to

increased severity of the stroke, decreased balance, and therefore overall decreased

mobility. The authors concluded that the community-dwelling post-stroke population

demonstrate a higher risk of falling.