SJRI | St. John's Research Institute

Projects

Prevalence, Risk factors, COnsequences and opporTunities for prevention of falls in Elderly with select Chronic condiTions (PROTECT 2): A Mixed Methods Study

Division Clinical Research and Training Year Year of initiation: 2025

Project Lead PI- Dr. Denis Xavier, Co-I: Dr. Atiya Faruqui, Dr. Arvind Kasturi, Dr. Jonita Furtado, Dr. Pretesh R Source of Funding Division of Clinical Research & Training, SJRI

Details

A) Description:

a. Background: The proportion of individuals aged 60 years and above, is growing rapidly in India, due to factors such as increased life expectancy and declining fertility rates. This increasing elderly population requires comprehensive health policies to provide happy and self-reliant lives. Amongst the serious morbidities affecting the elderly population, Fall is the second leading cause of unintentional injury. Fall is defined as “an unexpected event in which the participant comes to rest on the ground, floor or lower level. Mortality attributable to a fall in this age group is estimated to be 684,000 annual deaths world-wide, 80% of which are in low- and middle-income countries (LMIC).

b. Falls in elderly are multifactorial with several extrinsic and intrinsic factors that play a major role in its causation.. Few of the known factors include age-related physiological changes (impaired balance, reduced muscle strength, cognitive decline, chronic conditions like diabetes, hypertension, arthritis); use of FRIDs (Fall Risk Increasing Drugs), and sensory impairments such as poor vision or hearing. Various studies conducted in India have reported a high incidence of falls among the elderly population. These injuries can have serious and wide-ranging consequences, affecting their physical, psychological, and social well-being, which in turn adversely affects their quality of life.

c. In India, while several studies have explored either the risk factors or the consequences of falls among the elderly, there is a lack of studies that have included both of these aspects in a single study. An integrated approach to document both intrinsic and extrinsic risk factors causing a fall injury, along with the physical, psychological, and social consequences of these falls, is essential to develop effective prevention and rehabilitation strategies.

b) Aim/objective:

Among elderly persons (≥60 years) with select chronic diseases attending St. John’s Hospital and its outreach center

For Cross-Sectional study:

To estimate the prevalence of falls in the last one year.
To assess various intrinsic and extrinsic risk factors associated with falls.
To evaluate physical, psychological, social and financial consequences of falls.

For qualitative study:

To understand the reasons for falls from different perspectives
To explore the physical, social, psychological, and financial effects of falls.
To elicit possible ways to prevent falls in this group.

c) Methods

Study design: A Mixed-Methods Study

d) Sample size:

Study will be conducted across ten sites in India, from different geographical region—namely North, South, East, North-East, West and Central India. The site selection will be carried out through an invitation-based approach.

For Cross-sectional study: Participants will be recruited from both Out-Patient Department (OPD) and In-Patient Department (IPD) of select specialties. From each study site, 500 participants will be included into the study to reach an overall number of 5000 participants.
For qualitative study: 10 elderly patients, 5 caregivers, 5 Healthcare professionals and 3 administrators will be interviewed from each site.

e) Study update: We are in the process of submitting the documents to the respective site Ethics Committees. At St. John’s, we have received the approval and will be initiating the study shortly.

Updated on : Sept 2025