Multidimensional risk of falls in elderly
DOI:
https://doi.org/10.5020/18061230.2018.7058Keywords:
Elderly, Accidental Falls, Risk Factors, Community.Abstract
Objective: To identify the multidimensional risk factors for falls, present in a sample of elderly residents in the community. Methods: This is a descriptive, cross-sectional and exploratory study with a sample of 31 elderly people from a Community Care Unit in Lisbon and Tagus Valley Region, Portugal, between October 2016 and February 2017. Scales and instruments of functional evaluation were used in order to assess the risk factors. Descriptive statistics were used. Results: The majority of the sample is 75 years of age or older (67.7%, n=21) and presents more than one fall risk factor in each dimension. It is worth mentioning the walking speed decline, with 58.1% (n=16) of the elderly taking more than 12.6 seconds to perform the Timed Up and Go Test; 54.8% (n=17) being moderately or severely dependent; 48.3% (n=15) without or with little confidence in carrying out the activities; 38.7% (n=12) consumed benzodiazepines and an average of 4.6 medications per day. In the environmental evaluation of the home, researchers note that lighting is only adequate in kitchens. The totality of the elderly has at least one carpet at home; 38.7% (n=12) have one domestic animal inside the house and 61.3% (n=19) have at least one piece of unstable furniture. The safety behaviors are low: 98.6% (n=30) have never been alerted to the risks of falling, 61.3% (n=19) refer not to persevere in choosing the preventive measures. Conclusion: The risk factors for falls identified in the sample are multidimensional. Decreased gait velocity, poor confidence in performing the activities, polypharmacy and non-adoption of safety behaviors by the elderly stand out.Downloads
References
Houry D, Florence C, Baldwin G, Stevens J, McClure R. The CDC Injury Center’s response to the growing public health problem of falls among older adults. Am J Lifestyle Med [Internet]. 2016 [acesso em 2017 Abr 28];10(1):74-7. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/26688674
Smith AA, Silva AO, Rodrigues RAP, Moreira MASP, Nogueira JA, Tura, LFR. Assessment of risk of falls in elderly living at home. Rev Latinoam Enferm [Internet] 2017 [acesso em 2017 Maio 28];25:e2754. Disponível em: http://doi.org/10.1590/1518-8345.0671.2754
Mitchell SE, Aitken SA, Court-Brown CM. The epidemiology of fractures caused by falls down stairs. ISRN Epidemiol [Internet]. 2013 [acesso em 2017 Abr 20]. Disponível em: https://www.hindawi.com/journals/isrn/2013/370340/
Baixinho CL, Dixe MA. Falls in institutions for older adults: characterization of fall occurrences and associated risk factors. Rev Eletrônica Enferm [Internet]. 2015 [acesso em 2017 Abr 28];17(4):1-9. Disponível em: http://dx.doi.org/10.5216/ree.v17i4.31858
Hartholt KA, Polinder S, Van der Cammen TJM, Panneman MJM, Van der Velde N, Van Lieshout EMM, et al. Costs of falls in na ageing population: a nationwide study from the Netherlands (2007-2009). Injury [Internet]. 2012 [acesso em 2017 Maio 28];43(7):1199-203. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/22541759
Martin F. Falls risk factors: assessment and management to prevent falls and fractures. Can J Aging [Internet]. 2011 [acesso em 2017 Maio 15];30(1):33-44. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/24650637
Speechley M. Unintentional falls in older adults: a methodological historical review. Can J Aging [Internet]. 2011 [acesso em 2017 Abr 30];30(1):21-32. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/21356155
Kalula SZ, Scott V, Dowd A, Brodrick K. Falls and fall prevention programmes in developing countries: Environmental scan for the adaptation of the Canadian Falls prevention curriculum for developing countries. J Safety Res [Internet]. 2011 [acesso em 2017 Maio 28];42(6):461-72. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/22152264
Moyer VA, U.S. Preventive Services Task Force. Prevention of falls in community-dwelling older adults: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med [Internet]. 2012 [acesso em 2017 Maio 28];157(3):197-204. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/22868837
Kwan E, Straus SE. Assessment and management of falls in older people. CMAJ [Internet]. 2014 [acesso em 2017 Jun 21];186(16):610-21. Disponível em: http://www.cmaj.ca/content/186/16/E610.full
Sousa LMM, Marques-Vieira CMA, Caldevilla MNGN, Henriques CMAD, Severino SSP, Caldeira SMA. Risco de quedas em idosos residentes na comunidade: revisão sistemática da literatura. Rev Gaúcha Enferm [Internet]. 2016 [acesso em 2017 Jun 8];37(4):e55030. Disponível em: http://www.scielo.br/pdf/rgenf/v37n4/en_0102-6933-rgenf-1983-144720160455030.pdf
Pynoos J, Steinman BA, Nguyen AQ. Environmental assessment and modification as fall-prevention strategies for older adults. Clin Geriatr Med [Internet]. 2010 [acesso em 2017 Maio 27];26(4):633-44. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/20934614
Ungar A, Rafanelli M, Iacomeli I, Brunetti MA, Ceccofiglio A, Tesi F, et al. Fall prevention in the elderly. Clin Cases Miner Bone Metab [Internet]. 2013 [acesso em 2017 Jun 8];10(2):91-5. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3797008/
Gale CR, Cooper C, Sayer AA. Prevalence and risk factors for falls in older men and women: the English longitudinal study of ageing. Age Ageing [Internet]. 2016 [acesso em 2017 Mai 17];45(6):789-94. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/27496938
World Health Organization. ICD – 10 Version: 2016 [acesso em 2017 Jan 08]. Disponível em: http://apps.who.int/classifications/icd10/browse/2016/en
Autoridade Nacional do Medicamento e Produtos de Saúde - Infarmed I. P. Vademecum. [acesso em 2017 Jan 8]. Disponível em: http://www.infarmed.pt/web/infarmed/institucional/documentacao_e_informacao/publicacoes/tematicos/vademecum
Akyol AD. Falls in the elderly: what can be done? Int Nurs Rev [Internet]. 2007 [acesso em 2017 Jun 26];54(2):191-6. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/17492994
Guerreiro M, Silva AP, Botelho M, Leitão O, Castro-Caldas A, Garcia C. Adaptação à população portuguesa da tradução do Mini Mental State Examination (MMSE). Rev Port Neurologia [Internet]. 1994[acesso em 2017 jun 26];1-9.Disponível em:https://www.scienceopen.com/document?vid=97d4329c-9dba-49fe-9df1-db1215f3d4c5
Araújo F, Ribeiro JLP, Oliveira A, Pinto C. Validação do Índice de Barthel numa amostra de idosos não institucionalizados. Rev Port Saúde Pública [Internet]. 2007 [acesso em 2017 Jan 27];25(2):59-66. Disponível em: http://www.ensp.unl.pt/dispositivos-de-apoio/cdi/cdi/sector-de-publicacoes/revista/2000-2008/pdfs/05_02_2007.pdf https://repositorio-aberto.up.pt/handle/10216/15740
Melo CA. Adaptação cultural e validação da escala "falls efficacy scale" de Tinetti. Ifisionline [Internet]. 2011 [acesso em 2017 Jan 28];1(2):33-43 Disponível em: http://comum.rcaap.pt/bitstream/10400.26/8721/1/artigo3_vol1_n2.pdf
American Geriatrics Society, British Geriatrics Society, American Academy of Orthopaedic Surgeons Panel on Falls Prevention. Guideline for the prevention of falls in older persons. J Am Geriatr Soc [Internet]. 2001 [acesso em 2017 Maio 28];49(5):664-72. Disponível em: https://doi.org/10.1046/j.1532-5415.2001.49115.x
Baixinho CL, Dixe MA. Construction and validation of the scale of practices and behaviors of institutionalized elderly to prevent fall. UJPH. 2016 [acesso em 2017 Jan 07]; 4(3):139-43. Disponível em: http://www.hrpub.org/journals/article_info.php?aid=3729
Abdala RP, Barbieri W Junior, Bueno CR Junior, Gomes MM. Gait pattern, prevalence of falls and fear of falling in active and sedentary elderly women. Rev Bras Med Esport [Internet]. 2017 [acesso em 2018 Mar 23];23(1):26-30. Disponível em: http://dx.doi.org/10.1590/1517-869220172301155494
Hunter KF, Voaklander D, Hsu ZY, Moore KN. Lower urinary tract symptoms and falls risk among older women receiving home support: a prospective cohort study. BMC Geriatr [Internet]. 2013 [acesso em 2017 Mai 28]; 13:46. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/23672343
Baixinho CL. Funcionalidade após fractura do colo do fémur. Rev Baiana Enferm [Internet]. 2011 [acesso em 2017 Mai 28];2(3):311-9. Disponível em: https://portalseer.ufba.br/index.php/enfermagem/article/view/5480/4908
Marques-Vieira CMA, Sousa LMM, Severino S, Sousa L, Caldeira S. Cross-cultural validation of the falls efficacy scale international in elderly: systematic literature review. J Clin Gerontol Geriatr [Internet]. 2016 [acesso em 2018 Mar 22];7(3):72-6. Disponível em: http://dx.doi.org/10.1016/j.jcgg.2015.12.002
Santos WH, Santos K. Fear of falling in the elderly and psycotherapic intervention models. Rev HUPE [Internet]. 2014 [acesso em 2018 Mar 22]; 13(2):62-68. Disponível em: http://dx.doi.org/10.12957/rhupe.2014.10121
Fucahori FS, Lopes AR, Correia JJA, Silva CK, Trelha CS. Fear of falling and activity restriction in older adults from the urban community of Londrina: a cross-sectional study. Fisioter Mov [Internet]. 2014 [acesso em 2018 Mar 22];27(3):379-87. Disponível em: https://dx.doi.org/10.1590/0103-5150.027.003.AO08
Chang HT, Chen HC, Chou P. Factors Associated with fear of falling among community-dwelling older adults in the Shih-Pai Study in Taiwan. PloS One [Internet]. 2016 [acesso em 2017 Jun 26];11(3):e0150612. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/26933882
Deandrea S, Bravi F, Turati F, Lucenteforte E, Vecchia C, Negri E. Risk fators for falls in older people in nursing homes and hospitals: a systematic review and meta-analysis. Arch Gerontol Geriatr [Internet]. 2013 [acesso em 2018 Abr 17];56(3):407-15. Disponível em: DOI:10.1016/j.archger.2012.12.006
