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Fall Risk related Factors in Postmenopausal Women
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Korean J Adult Nurs : Korean Journal of Adult Nursing

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Original Article

Fall Risk related Factors in Postmenopausal Women

Jung-Han Lee1, Hee Seung Kim2
Korean Journal of Adult Nursing 2014;26(5):533-542.
Published online: October 31, 2014

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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: March 14, 2014   • Accepted: October 10, 2014

Copyright © 2014 Korean Society of Adult Nursing

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.

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  • 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.
  • Key Words: Postmenopausal women; Fall risk; Lifestyle; Metabolic syndrome
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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    • Association between Falls and Nutritional Status of Community-Dwelling Elderly People in Korea
      Ah-Ra Jo, Mi-Jeong Park, Byung-Gue Lee, Young-Gyun Seo, Hong-Ji Song, Yu-Jin Paek, Kyung-Hee Park, Hye-Mi Noh
      Korean Journal of Family Medicine.2020; 41(2): 111.     CrossRef
    • Comparison of falls-related physical fitness and fall experience characteristics of the elderly between Ulsan, Korea and Gifu, Japan
      Sohee Shin
      Korean Journal of Sport Science.2017; : 566.     CrossRef

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    Fall Risk related Factors in Postmenopausal Women
    Korean J Adult Nurs. 2014;26(5):533-542.   Published online October 31, 2014
    DOI: https://doi.org/10.7475/kjan.2014.26.5.533
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    Fall Risk related Factors in Postmenopausal Women
    Korean J Adult Nurs. 2014;26(5):533-542.   Published online October 31, 2014
    DOI: https://doi.org/10.7475/kjan.2014.26.5.533
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    Fall Risk related Factors in Postmenopausal Women
    Fall Risk related Factors in Postmenopausal Women

    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.

    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.

    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.

    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.

    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.
    Table 1. Fall Risk Scores by Characteristics of the Subjects (N=128)

    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

    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)

    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)

    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)

    RAFS=Risk Assessment for Falls Scale.

    Table 1.

    Table 2.

    Table 3.

    Table 4.

    Table 5.

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