Strengths and limitations
This is a long-term, prospective cohort study of a relatively
large sample of a general, elderly population,
which can be seen as a strength. A prospective design,
allowing the study of outcome following exposure, ranks
higher in the hierarchy of evidence, than retrospective or
cross-sectional studies [18]. Studying the effect of risk
factors on falls over an extended period may provide
valuable information for future fall-prevention programmes.
As a long-term, persistent reduction of falls are
desirable, an intervention on risk factors identified in
long-term prospective studies, may results in sustainable
reduction of falls in the elderly. Although this is a prospective
study of risk factors for falls, the direct causality
of falls cannot be identified using this epidemiological
approach. The risk factors predicting falls, described in
this study, are rather markers of an increased probability
of a future fall.
Unfortunately, selection bias cannot be ruled out in
this study, despite the fact that home visits were offered
to those who were unable to come to the research