scholarly journals The Se.Ko.Ph. study: a European multicentre study on falls in elderly subjects living in residential homes

2017 ◽  
Vol 3 (1) ◽  
Author(s):  
Aladar Bruno Ianes ◽  
Giorgio Ricci ◽  
For the Se.Ko.Ph. Study Group

The aim was to investigate risk factors for falls in elderly people living in residential nursing homes. An observational, prospective, multicentre study was conducted between March 2010 and March 2011 investigating falls in elderly residents living in residential nursing homes (4 Italian¸ 4 French and 5 German nursing homes). A number of risk factors were assessed as well as details of the fall (dynamics, reasons, location and time of occurrence). Differences were observed between the countries related to different nursing practices. Fallers comprised 36.5% of all residents and approximately 40% were injured as a consequence. Six logistic regression models were created to assess which fallrelated variables had the most impact, and showed subjects with faecal incontinence had a lower risk of falling, while subjects afflicted with dementia and visual impairment showed an increased risk of falling. Higher Tinetti scores were found to be related to an increased fall risk. Falls in the elderly occur due to complex interactions between demographic, physical, behavioural and environmental risk factors. Differences between countries in fall rates were seen, probably due to different medical practices, use of aids and restraints, and characteristics of the populations (<em>i.e.</em> the Italian residents tended to be more cognitively impaired and more impaired in balance and gait compared to the French and German residents). There was evidence that subjects with a better clinical status fall more frequently, whereas non-fallers had a worse clinical status and therefore tended to be more bedridden.

2019 ◽  
Vol 12 ◽  
pp. 117954411988493 ◽  
Author(s):  
Anneli Teder-Braschinsky ◽  
Aare Märtson ◽  
Marika Rosenthal ◽  
Pille Taba

Objectives: Deteriorating functionality and loss of mobility, resulting from Parkinson’s disease, may be worsened by osteoarthritis, which is the most common form of joint disease causing pain and functional impairment. We assessed the association between symptomatic hip or knee osteoarthritis, falls, and the ability to walk among patients with Parkinson’s disease compared to a control group. Methods: A total of 136 patients with Parkinson’s disease in Southern Estonia and 142 controls with an average age of 76.8 and 76.3 years, respectively, were enrolled in a retrospective case-control study. Information on falls and related fractures during the previous year was collected from the patients with Parkinson’s disease and controls. Covariates included gender, age, mobility, duration of Parkinson’s disease, and fractures. Results: Patients with Parkinson’s disease were at an increased risk of falls compared to the control group, and for the higher risk of fractures. Symptomatic knee or hip osteoarthritis was a significant independent predictor of falls in both patients with Parkinson’s disease and controls. The higher risk for fractures during the previous year was demonstrated in symptomatic osteoarthritis. Risk factors for falls included also female gender, use of sleep pills, and the inability to walk 500 m. Conclusions: Symptomatic hip and knee osteoarthritis are risk factors for falls and related fractures among the elderly population with and without Parkinson’s disease. The inability to walk 500 m could be used as a simple predictive factor for the increased risk of falls among elderly populations.


2020 ◽  
Vol 73 (suppl 3) ◽  
Author(s):  
Paulo Henrique Fernandes dos Santos ◽  
Marina Morato Stival ◽  
Luciano Ramos de Lima ◽  
Walterlânia Silva Santos ◽  
Cris Renata Grou Volpe ◽  
...  

ABSTRACT Objective: to evaluate the Nursing Diagnosis (ND) Risk for Falls in elderly subjects in primary health care in the Federal District. Methods: a descriptive, quantitative, cross-sectional study conducted in two basic health units. Data collection included blood collection, nursing consultation and physical evaluation of 156 elderly subjects with chronic diseases. Results: the most prevalent intrinsic risk factors of NANDA-I were visual impairment (73.7%), impaired mobility (70.5%) and history of falls (69.9%); and extrinsic factors were the use of insufficient material in the bathroom (60.3%) and loose carpets (58.3%). The intrinsic factors that increased the risk for falls were the use of assistive devices (OR 3.50; p=0.030), impaired walking (OR 2.84; p=0.019) and cognitive impairment (OR 1.26; p=0.019); and the extrinsic factor was the use of loose rugs (OR 1.59; p=0.041). Conclusion: this ND has proved to be a valuable instrument for the identification of risk factors for falls in elderly subjects in primary care.


2020 ◽  
Vol 4 (2) ◽  
pp. 108
Author(s):  
Vitri Rohima ◽  
Iwan Rusdi ◽  
Evi Karota

ABSTRAKLatar Belakang: Lansia merupakan tahap akhir pertumbuhan kehidupan manusia yang mengalami perubahan fisik maupun psikososial, dan salah satu aspek penting perubahan itu adalah resiko jatuh. Resiko jatuh pada lansia dipengaruhi oleh faktor intrinsik, faktor ekstrinsik, dan faktor situasional. Tujuan: penelitian ini untuk mengetahui hubungan resiko jatuh dengan kejadian jatuh pada klien lansia di Puskesmas Medan Johor. Metode: Penelitian ini merupakan studi deskriptif korelasi terhadap 70 responden lansia. Pengumpulan data dilakukan dengan menggunakan kuisioner faktorfaktor penyebab resiko jatuh dan kejadian resiko jatuh pada klien lansia. Hasil: umumnya klien berusia 60-74 (51%), beragama Islam (81%), dan keluarga tinggal serumah lebih dari 2 orang 84%. Hasil penelitian menunjukkan faktor penyebab resiko jatuh lansia terutama dari faktor situasional 26%, faktor intrinsik 17% dan tidak ada dari faktor ekstrinsik (0%). Berdasarkan kejadian resiko jatuh pada lansia adalah 46% beresiko tinggi, 36% beresiko rendah, dan 18% tidak beresiko. Hasil uji chi square menunjukkan adanya hubungan yang signifikan dari faktor intrinsik p=0,000, faktor ekstrinsik p=0,000 dan faktor situasional p=0,004 terhadap kejadian resiko jatuh. Kesimpulan: faktor-faktor resiko jatuh berhubungan dengan kejadian jatuh pada klien lansia di Puskesmas Medan Johor. Hasil penelitian ini dapat menjadi masukan bagi pelayanan kesehatan khususnya pelayanan asuhan keperawatan untuk meningkatkan edukasi kepada klien lansia dan keluarganya tentang dengan resiko jatuh dan pelayanan kesehatan dapat melakukan pengembangan program kegiatan pencegahan resiko jatuh pada lansia.Kata Kunci: Lansia, resiko jatuh, kejadian resiko jatuhRisk for Full Factor among the Elders in Puskesmas Medan Johor ABSTRACTBackground: Elderly is a process of human life experiencing various physical and psychosocial changes, and one important aspect due to these changes is the risk of falling among the elders. It is influenced by intrinsic, extrinsic, and situational factors. Aim: The purpose of this study was to determine the relationship between the risk of falls and the incidence of falls in elderly clients who visit to the Health Center. Method: This study is a descriptive study of correlation to 70 elderly people at the Puskesmas Medan Johor. The data were collected by using questionnaires of risk factors of fall and risk incidence of falls on the elders. Result: Demographic data are generally the elders aged 60-74 years (51%), Moslem (81%), family live at home more than 2 person (84%). The results of the study showed that the risk factor of falling elderly mainly from situational factor (26%), intrinsic factor (17%) and extrinsic factor (0%). Meanwhile, based on the risk incidence of falling on the elderly clients, the result is high risk (46%), low risk (36%), and no risk of fall (18%). The chi square test shows that there is significant correlation of intrinsic factor p=0.000, extrinsic factor p=0.000 and situational factor p=0.004 to fall risk event. Conclusion: There is a relationship between falling risk factors and the incidence of falls in elderly clients at the Puskesmas Medan Johor. This study provide recommendations for health services, especially nursing care services to provide education to elderly clients and their families related to the risk of falls in the elderly and the health centers can develop prevention programs to reduce the risk of falls in the elderly.Keywords: Elderly, a risk factor for falling, the risk of falling


2018 ◽  
Vol 146 (7-8) ◽  
pp. 396-402
Author(s):  
Suncica Ivanovic ◽  
Sanja Trgovcevic ◽  
Biljana Kocic ◽  
Snezana Todorovic-Tomasevic ◽  
Milica Jeremic-Knezevic ◽  
...  

Introduction/Objective. The aim of this study was to identify the elderly who are at increased risk of falling, as well as the risk factors for falls in the general population. Methods. This cross sectional study included a random sample of 400 people (164 men and 236 women) with the average age of 75.04 (65?94) years selected from the Register of the Primary Health Center in Nis, Serbia. Socio-demographic questionnaire, the Elderly Fall Screening Test, and the Multi-factor Falls Questionnaire were used. Odds ratio (OR) was evaluated and adjusted for gender, age, marital status, education level, and self-assessment of the health state. Results. The risk of falling and risk factors for falls were as follows: age [odds ratio (OR) = 1.129, confidence interval (CI) = 1.067?1.196], health self-assessed as good (OR = 0.365; CI = 0.142?0.938), limitation of activities (OR = 7.189; CI = 3.559?14.522), walking problems (OR = 2.153; CI = 1.046?4.428), osteoporosis (OR = 4.611; CI = 1.231?17.265), female gender (OR = 3.770, CI = 1.648?8.624), vision problems (OR = 2.719; CI = 1.588?108.581), cognitive problems (OR = 4.485; CI = 17.721), arthritis (OR = 6.524; CI = 2.077?20.496), and urination problems (OR = 2.511; CI = 1.083?5.820). Conclusion. Risk factors for falls were the following: age, self-assessment of health state, walking problems, osteoporosis, female gender, vision problems, arthritis, and urination problems.


Author(s):  
Vida Vakili ◽  
Ali Taghipour ◽  
Ehsan Mosa Farkhani ◽  
Hamid Reza Bahrami ◽  
Behnaz Beygi ◽  
...  

Introduction: Falling is one of the most common problems of the elderly people with a multi factorial nature and frequent cases. This study aimed to determine the risk factors of falls in old people covered by Mashhad University of Medical Sciences. Methods: This retrospective case-control study was conducted on 15,600 elderly participants. Data were extracted from Sina Electronic Health Record System (SinaEHR®, Iran). The obtained data were analyzed using STATA through odds ratio formula. Results: Risk factors of falls in the elderly subjects included age, fear of falling, higher body mass index, diabetes, anemia, gastrointestinal problems, hypothyroidism, use of sedatives, and smoking, after adjusting the potentially confounding effects of other variables. Conclusion: The current study provides evidence that patient-related factor such as diabetes, anemia, hypothyroidism and smoking are associated with falls in the elderly. The results of the present research can be used by health policy-makers to reduce fall-related costs of the old people by focusing on care services and high-risk individuals.


2020 ◽  
Vol 62 (2) ◽  
pp. 86-91
Author(s):  
Justyna Pawlak ◽  
Małgorzata Dudkiewicz ◽  
Łukasz Kikowski

Introduction: The progressing aging process and comorbidities worsen the efficiency of the balance system in the elderly, which leads to a weakening of stability and, as a consequence, to falls and injuries. The first ones lead to: worsening of functioning, reduced mobility, an increased risk of disease and mortality, therefore systematic physical activity and shaping the balance using physiotherapy, which can prevent dangerous falls is very important. Aim: Assessment of the therapeutic effect of physiotherapy on minimizing imbalances in geriatric patients. M aterial and Methods: The study group consisted of 46 people, including 32 women (69.6%) and 14 men (30.4%); average age of respondents – 72.5 years. They were patients of the Department of Rehabilitation of Poddębice Health Center, Ltd. The researchers used a self-made questionnaire, body mass to height index (BMI) and the Tinetti Test. Results: Patients with an elevated BMI (89.1%), as well as those taking more than 4 medication (78.3%), have had more falls over the past year (respectively 91.4% and 81.4%). After the use of comprehensive therapy, none of the patients achieved a worse result than before the physiotherapy while 91.3% of the respondents had an increase in the number of points scored in the Tinetti Test. The percentage of patients at high risk of falling reduced from 67.4% to 37%. There was also a decrease in the fear of walking (in 58.7%), falling (in 57.7%) and climbing stairs (in 47.9%). According to 78.3% of respondents, physiotherapy positively affected their independence and quality of life. Conclusions: The use of comprehensive physiotherapy reduces the fear of walking, climbing stairs and falling, which can be a good predictor of prevention. Both polypragmasia and an elevated body mass index (BMI) increase the risk of falling. Comprehensive physiotherapy of geriatric patients helps to improve balance and gait stereotype. Physiotherapy for the elderly helps improve the quality of life, independence, minimize imbalances, and thus reduce the risk of falls. Balance exercises play an important role in preventing falls.


Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
George Howard ◽  
Mary Cushman ◽  
Maciej Banach ◽  
Brett M Kissela ◽  
David C Goff ◽  
...  

Purpose: The importance of stroke research in the elderly is increasing as America is “graying.” For most risk factors for most diseases (including stroke), the magnitude of association with incident events decreases at older ages. Potential changes in the impact of risk factors could be a “true” effect, or could be due to methodological issues such as age-related changes in residual confounding. Methods: REGARDS followed 27,748 stroke-free participants age 45 and over for an average of 5.3 years, during which 715 incident strokes occurred. The association of the “Framingham” risk factors (hypertension [HTN], diabetes, smoking, AFib, LVH and heart disease) with incident stroke risk was assessed in age strata of 45-64 (Young), 65-74 (Middle), and 75+ (Old). For those with and without an “index” risk factor (e.g., HTN), the average number of “other” risk factors was calculated. Results: With the exception of AFib, there was a monotonic decrease in the magnitude of the impact across the age strata, with HTN, diabetes, smoking and LVH even becoming non-significant in the elderly (Figure 1). However, for most factors, the increasing prevalence of other risk factors with age impacts primarily those with the index risk factor absent (Figure 2, example HTN as the “index” risk factor). Discussion: The impact of stroke risk factors substantially declined at older ages. However, this decrease is partially attributable to increases in the prevalence of other risk factors among those without the index risk factor, as there was little change in the prevalence of other risk factors in those with the index risk factor. Hence, the impact of the index risk factor is attenuated by increased risk in the comparison group. If this phenomenon is active with latent risk factors, estimates from multivariable analysis will also decrease with age. A deeper understanding of age-related changes in the impact of risk factors is needed.


2017 ◽  
Vol 11 (12) ◽  
pp. 4895
Author(s):  
Jerry Deyvid Freires Ferreira ◽  
Rafaella Pessoa Moreira ◽  
Tibelle Freitas Maurício ◽  
Paula Alves de Lima ◽  
Tahissa Frota Cavalcante ◽  
...  

RESUMOObjetivos: avaliar as condições de saúde cardiovascular e identificar os fatores de risco modificáveis para doenças cardiovasculares em idosos. Método: estudo quantitativo, transversal e descritivo com 246 idosos. Aplicou-se um formulário com questões abertas, referentes à identificação do paciente, relacionando dados sociodemográficos, fatores de risco e informações sobre as condições de saúde. Para análise dos dados, realizou-se o teste Qui-Quadrado de Pearson. Resultados: 75,7% dos participantes eram mulheres, 94,3% aposentados. O uso de bebidas alcoólicas, fumo ativo e passivo foram referidos, respectivamente, por 8,9%, 11,8% e 18,3% dos entrevistados. A pressão arterial esteve alterada em 58,6% dos idosos na primeira avaliação, 81,8% na segunda e 74,3% na terceira. Conclusão: foi possível traçar o perfil da saúde cardiovascular e dos fatores de risco modificáveis para as doenças cardiovasculares na população idosa, que subsidiarão de base para intervenções voltadas à promoção da saúde e prevenção dos agravos. Descritores: Enfermagem; Idosos; Doenças Cardiovasculares.ABSTRACTObjectives: to evaluate cardiovascular conditions and to identify modifiable risk factors for cardiovascular diseases in the elderly. Method: descriptive, cross-sectional and quantitative study with 246 elderly subjects. A questionnaire with open questions regarding patient identification was applied, relating sociodemographic data, risk factors and information on health conditions. For data analysis, the Pearson Chi-Square test was performed. Results: 75.7% of the participants were women, 94.3% were retired. Alcohol consumption, active and passive smoking were reported, respectively, by 8.9%, 11.8% and 18.3% of respondents. Changes in blood pressure were identified in 58.6% of the elderly in the first evaluation, 81.8% in the second and 74.3% in the third evaluation. Conclusion: it was possible to outline the profile of cardiovascular health status and of modifiable risk factors for cardiovascular diseases in the elderly population, which will support interventions aimed at health promotion and disease prevention. Descriptors: Nursing; Elderly; Cardiovascular Diseases.RESUMENObjetivos: evaluar las condiciones de salud cardiovascular e identificar los factores de riesgo modificables para enfermedades cardiovasculares en ancianos. Método: estudio cuantitativo, transversal y descriptivo con 246 ancianos. Se aplicó un formulario con preguntas abiertas, referentes a la identificación del paciente, relacionando datos sociodemográficos, factores de riesgo e informaciones sobre las condiciones de salud. Para análisis de los datos, se realizo el test Chi-Cuadrado de Pearson. Resultados: 75,7% de los participantes eran mujeres, 94,3% jubialdos. El uso de bebidas alcohólicas, fumador activo y pasivo fueron referidos, respectivamente, por 8,9%, 11,8% y 18,3% de los entrevistados. La presión arterial estuvo alterada en 58,6% de los ancianos en la primera evaluación, 81,8% en la segunda y 74,3% en la tercera. Conclusión: fue posible trazar el perfil de la salud cardiovascular y de los factores de riesgo modificables para las enfermedades cardiovasculares en la población anciana, que subsidiarán de base para intervenciones dirigidas ala promoción de la salud y prevención de los problemas. Descriptores: Enfermería; Los Ancianos; Enfermedades Cardiovasculares.


2006 ◽  
Vol 15 (1) ◽  
pp. 59-70 ◽  
Author(s):  
Mauro Percudani ◽  
Corrado Barbui ◽  
Ida Fortino ◽  
Michele Tansella ◽  
Lorenzo Petrovich

SUMMARYBackground – The patterns of antidepressant and antipsychotìc drag prescribing have rarely been studied in large and geographically defined catchment areas. In the present study we examined the prevalence and distribution of antidepressant and antipsychotic prescribing in Lombardy, a northern Italy region of nine million inhabitants. Methods – This study used the Regional Administrative Database of Lombardy. This database includes all prescriptions reimbursed by the National Health System in the population living in this region. All antidepressant and antipsychotic prescriptions dispensed from the 1st January to the 31st December 2001 were extracted and prevalence data calculated by dividing antidepressant and antipsychotic users by the total number of male and female residents in each age group. In addition, from the Regional database of hospital admissions we extracted all patients aged 65 or above with cerebrovascular-related outcomes for the year 2002. The two databases were linked anonymously with the aim of investigating the relationship between exposure to psychotropics and occurrence of cerebrovascular accidents in the elderly. Results – During the study period 404, 238 individuals were dispensed antidepressants, yielding a prevalence of use of 2.85 (95% CI 2.84, 2.87) per 100 males and 5.92 (95% CI 5.90, 5.94) per 100 females. The prevalence of use progressively rose with age in both sexes, with the highest rates in old and very old individuals. The majority of individuals received a pharmacological treatment with selective-serotonin reuptake inhibitors only, slightly more than 12% received a treatment with tricyclic antidepressants. A total of 86, 187 subjects were dispensed antipsychotic agents, yielding a prevalence of use of 0.87 (95% CI 0.86, 0.88) per 100 males and 1.01 (95% CI 1.00, 1.02) per 100 females. The prevalence of use progressively rose with age in both sexes, with the highest rates in old and very old subjects. Concerning the relationship between exposure to second-generation antipsychotics (SGAs) and occurrence of cerebrovascular (CBV) accidents, the analysis showed a significantly increased risk of CBV events in elderly subjects exposed to SGAs in comparison with those exposed to first-generation antipsychotics (FGAs) (3, 31%, 95% CI 2, 95–3, 69 vs. 2, 37%, 95% CI 2, 19–2, 57). Finally the analysis indicated no differences in the proportion of cerebrovascular events in elderly subjects exposed to TCAs and SSRIs. Conclusions – The very high rates of antidepressant and antipsychotic drug prescribing detected in late life suggest the need of characterising these individuals in terms of medical and psychiatric characteristics, needs and quality of life. It also suggests the need for pragmatic clinical trials, carried out in the general practice, with the aim of assessing whether antidepressants are effective in these conditions. The data provide preliminary epidemiological evidence that exposure to SGAs, in comparison with exposure to FGAs, significantly increased the risk of cerebrovascular accidents in the elderly.Declaration of Interest: none.


2019 ◽  
Author(s):  
Sigrid Burruss ◽  
Lillian Min ◽  
Areti Tillou

The geriatric trauma population continues to grow as life expectancy and unintentional injury increase. Age-related physiologic changes and complex comorbidities may not only lead to injury but also may precipitate a downward spiral. The injury patterns, presentation of life-threatening injury, and response to injury are unique in the elderly trauma population, and dedicated evaluation of elderly trauma patients at a trauma center may be beneficial. Aggressive, early intervention with a focus on geriatric-specific needs and care coordination are an integral part of the management to reduce morbidity and mortality. Much of the unintentional injuries may be preventable with identification of risk factors for falls and fall prevention programs. Frailty measurements may be used to predict morbidity and functional status. Surgeons must become familiar with geriatric-specific issues and how best to treat the geriatric trauma population.  This review contains 3 figures, 2 tables, and 133 references. Key Words: care coordination, elderly, frailty, geriatric, injury, prevention, risk factors, trauma, triage


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