#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Falls: a significant cause of morbidity and mortality in elderly people


Authors: Marie Berková 1;  Zdeněk Berka 2
Authors‘ workplace: LDN FN Královské Vinohrady, Praha 1;  II. interní klinika – gastroenterologická a geriatrická LF UP a FN Olomouc 2
Published in: Vnitř Lék 2018; 64(11): 1076-1083
Category:

Overview

The incidence of falls of older people is increasing. Falls are the most common cause of injuries of older adults. Costs for the treatment of injuries caused by falls are constantly increasing too. In fragile and polymorbid individuals, falls are most often of multifactorial ethiology; age-related frailty, coinciding chronic diseases and interactions with the external environment. The most serious consequences of falls include hip fractures and intracranial injury. The American Geriatric Society recommends an annual falls and instability screening in people ≥ 65 years of age. Multifactorial interventions should be targeted primarily at people with two or more falls or with a history of injury after a fall and at high-risk patients. It includes treatment of diseases that increase the risk of falls, management of podiatric problems, correction of visual deficit, optimization of medication, use of compensatory aids, home environment adaptation and education of older people and their family members. Vitamin D supplementation is recommended for indicated patients. Recently published reports, however, are reserved for its fall reduction effect. The results of rehabilitation studies are not consistent, with the best effect being reported in special programs for older adults. Using 3D technologies to simulate virtual reality can represent a new approach to improve patient adherence to physical activity.

Key words:

falls – multifactorial intervention – older people – prevention – risk factors – screening


Sources
  1. Bergen G, Stevens MR, Burns ER. Falls and fall injuries among adults aged ≥ 65 years – United States, 2014. MMWR Morb Mortal Wkly Rep 2016; 65(37): 993–998. Dostupné z DOI: <http://dx.doi.org/10.15585/mmwr.mm6537a2>.
  2. Burns ER, Stevens JA, Lee R. The direct costs of fatal and non-fatal falls among older adults – United States. J Safety Res 2016; 58: 99–103. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jsr.2016.05.001>.
  3. Tricco AC, Thomas SM, Veroniki AA et al. Comparisons of interventions for preventing falls in older adults: A systematic review and meta-analysis. JAMA 2017; 7; 318(17): 1687–1699. Dostupné z DOI: <http://dx.doi.org/10.1001/jama.2017.15006>.
  4. Charvátová P, Jurásková D. Pád pacienta jako indikátor kvality péče. Lékařské listy 2004. [online]. Dostupné z WWW: http://zdravi.e15.cz/clanek/priloha-lekarske-listy/pad-pacienta-jako-indikator-kvality-pece-163327.
  5. Tinetti ME, Speechley M, Ginter SF. Risk factors for falling among elderly persons living in the community. N Engl J Med 1988; 319(26): 1701–709. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJM198812293192604>.
  6. Jeřábek J. Diagnostika pacienta s akutní závratí. Česk Slov Neurol 2015; 78/111(5): 503–509. Dostupné z DOI: <http://dx.doi.org/10.14735/amcsnn2015503>.
  7. Pendlebury ST, Lovett NG, Smith SC et al. Observational, longitudinal study of delirium in consecutive unselected acute medical admissions: age-specific rates and associated factors, mortality and re-admission. BMJ Open 2015; 5(11): e007808. Dostupné z DOI: <http://dx.doi.org/10.1136/bmjopen-2015–007808>.
  8. Morse J. Enhancing the safety of hospitalization by reducing patient falls. Am J Infect Control 2002; 30(6): 376–380.
  9. Gowing R, Jain MK. Injury patterns and outcomes associated with elderly trauma victims in Kingston, Ontario. Can J Surg 2007; 50(6): 437–444.
  10. Fu TS, Jing R, McFaull SR et al. Recent trends in hospitalization and in-hospital mortality associated with traumatic brain injury in Canada: a nationwide, population-based study. J Trauma Acute Care Surg 2015; 79(3): 449–454.
  11. Chan V, Zagorski B, Parsons D et al. Older adults with acquired brain injury: a population based study. BMC Geriatr 2013; 13: 97. Dostupné z DOI: <http://dx.doi.org/10.1186/1471–2318–13–97>.
  12. Fu TS, Jing R, Fu WW et al. Epidemiological trends of traumatic brain injury identified in the emergency department in a publicly-insured population, 2002–2010. PloS One 2016; 11(1): e0145469. Dostupné z DOI: <http://dx.doi.org/10.1371/journal.pone.0145469>.
  13. Fu WW, Fu TS, Jing R et al. Predictors of falls and mortality among elderly adults with traumatic brain injury: A nationwide, population-based study. PLoS One 2017; 12(4): e0175868. Dostupné z DOI: <http://dx.doi.org/10.1371/journal.pone.0175868>.
  14. Vieira ER, Palmer RC, Chaves PH. Prevention of falls in older people living in the community. BMJ 2016; 353: i1419. Dostupné z DOI: <http://dx.doi.org/10.1136/bmj.i1419>.
  15. Lystad RP, Cameron CM, Mitchell RJ. Mortality risk among older Australians hospitalised with hip fracture: a population-based matched cohort study. Arch Osteoporos 2017; 12(1): 67. Dostupné z DOI: <http://dx.doi.org/10.1007/s11657–017–0359–7>.
  16. Le Manach Y, Collins G, Bhandari M et al. Outcomes after hip fracture surgery compared with elective total hip replacement. JAMA 2015; 314(11): 1159–1166. Dostupné z DOI: <http://dx.doi.org/10.1001/jama.2015.10842>.
  17. Man-Son-Hing M, Nichol G, Lau A et al. Choosing antithrombotic therapy for elderly patients with atrial fibrillation who are at risk for falls. Arch Intern Med 1999; 159(7): 677–685.
  18. Gage BF, Birman-Deych E, Kerzner R et al. Incidence of intracranial hemorrhage in patients with atrial fibrillation who are prone to fall. Am J Med 2005; 118(6): 612–617. Dostupné z DOI: <http://dx.doi.org/10.1016/j.amjmed.2005.02.022>.
  19. Rosand, J, Eckman, MH, Knudsen, KA et al. The effect of warfarin and intensity of anticoagulation on outcome of intracerebral hemorrhage. Arch Intern Med 2004; 164(8): 880–884. Dostupné z DOI: <http://dx.doi.org/10.1001/archinte.164.8.880>.
  20. Okubo Y, Schoene D, Lord SR. Step training improves reaction time, gait and balance and reduces falls in older people: a systematic review and meta-analysis. Br J Sports Med 2017; 51(7): 586–593. Dostupné z DOI: <http://dx.doi.org/10.1136/bjsports-2015–095452>.
  21. Hwang HF, Chen SJ, Lee-Hsieh J et al. Effects of home-based tai chi and lower extremity training and self-practice on falls and functional outcomes in older fallers from the emergency department-a randomized controlled trial. J Am Geriatr Soc 2016; 64(3): 518–525. Dostupné z DOI: <http://dx.doi.org/10.1111/jgs.13952>.
  22. Taylor D, Hale L, Schluter P et al. Effectiveness of tai chi as a community-based falls prevention intervention: a randomized controlled trial. J Am Geriatr Soc 2012; 60(5): 841–848. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1532–5415.2012.03928.x>.
  23. Mirelman A, Rochester L, Maidan I et al. Addition of a non-immersive virtual reality component to treadmill training to reduce fall risk in older adults (V-TIME): a randomised controlled trial. Lancet 2016; 388(10050): 1170–1182. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(16)31325–3>.
  24. Neelemaat F, Lips P, Bosmans JE et al. Short-term oral nutritional intervention with protein and vitamin D decreases falls in malnourished older adults. J Am Geriatr Soc 2012; 60(4): 691–699. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1532–5415.2011.03888.x>.
  25. [American Geriatrics Society Workgroup on Vitamin D Supplementation for Older Adults]. Recommendations abstracted from the American Geriatrics Society Consensus Statement on vitamin D for prevention of falls and their consequences. J Am Geriatr Soc 2014; 62(1): 147–152. Dostupné z DOI: <http://dx.doi.org/10.1111/jgs.12631>.
  26. Moncada LV, Mire LG. Preventing Falls in Older Persons. Am Fam Physician 2017; 96(4): 240–247.
  27. Le Fevre ML, Le Fevre NM. Vitamin D screening and supplementation in community-dwelling adults: common questions and answers. Am Fam Physician 2018; 97(4): 254–260.
  28. Lin KW. Vitamin D screening and supplementation in primary care: Time to curb our enthusiasm. Am Fam Physician 2018; 97(4): 226–227.
  29. Theodoratou E, Tzoulaki I, Zgaga L et al. Vitamin D and multiple health outcomes. BMJ 2014; 348: g2035. Dostupné z DOI: <http://dx.doi.org/10.1136/bmj.g2035>.
  30. Fleming J, Brayne C Cambridge City over-75s Cohort (CC75C) study collaboration. Inability to get up after falling, subsequent time on floor, and summoning help: prospective cohort study in people over 90. BMJ 2008; 337: a2227. Dostupné z DOI: <http://dx.doi.org/10.1136/bmj.a2227>.
Labels
Diabetology Endocrinology Internal medicine

Article was published in

Internal Medicine

Issue 11

2018 Issue 11

Most read in this issue
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#