Selected factors influencing the risk of falls in the elderly

Izabela Wróblewska, Zuzanna Wróblewska, Elżbieta Bujak-Rogala, Stanisław Manulik, Małgorzata Sobieszczańska

Abstract


Introduction: Falls concern 1/3 of people aged >65 years and every second person aged >80, leading to seniors’ disability and dependence on other people’s care. The unmodifiable causes for falls are age, sex, marital status, and place of residence. The modifiable causes include involutional changes in all body systems, multimorbidity, polypharmacy, as well as living and environmental conditions.

Aim: To determine the risk factors of falls in the elderly.
Material and methods: The study involved 220 hospitalized patients aged >65 years who had experienced a fall. An anonymous questionnaire was applied that referred to the medications taken, diagnosed diseases, factors predisposing to falls, and the frequency of falls. The Mini-Mental State Examination was performed to qualify the subjects, and Tinetti test to assess gait and balance.

Results: In the Tinetti scale, 48.2% of the subjects were characterized by a rise in the risk of fall 5-fold higher than average; the risk increase less frequently concerned people undertaking physical activity and those who were younger (65–70 years) (P<0.05). The Tinetti test analysis revealed a statistically significant relation (P˂0.05) between brain stroke, Parkinson’s disease, orthostatic hypotonia, gait disorders, and falls. The decrease in the number of falls was influenced neither by dizziness, declared by 70.4% of the patients (P=0.092), nor by the number of medications taken (P=0.072). It was influenced, however, by the usage of orthopedic equipment (P˂0.001).

Conclusion: The risk of falls in the elderly rises with age. Physical activity decreases the risk; it is increased, though, by gait and balance disorders, Parkinson’s disease, past brain stroke, and orthostatic hypotonia.

Keywords


elderly; falls; risk factors; quality of life

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References


Protas EJ, Wang CY, Harris C. Usefulness of an individualized balance and gait intervention programme based on the problem-oriented assessment of mobility in nursing home residents. Disability and Rehabilitation 2001; 23(5): 192–198.

Brunader R, Retke J. Dizziness, fainting, falls in the elderly. In: Rosenthal T, Naughton B, Williams M, editors. Geriatrics.

Lublin: Czelej. 2009; p. 179–195.

Osiński W. Gerokinesiology. Learning and Practicing Physical Activity in the Elderly. Warszawa: PZWL 2013.

Choy NL, Brauer S, Nitz J. Linking stability to demographics, strength and sensory system function in women over 40 to support pre-emptive preventive intervention. Climacteric 2008; 11(2): 144–145.

Borzym A. Falls in old age – reasons, consequences, prophylaxis. Polish Journal of Geriatric Psychiatry. 2009; 6(2): 81–88.

Pijnappels M, van der Burg PJ, Reeves ND, Dieën JH. Identification of elderly fallers by muscle strength measures. European Journal of Applied Physiology 2008; 102(5): 585–592.

Bishop NA, Lu T, Yanker BA. Neural mechanisms of ageing and cognitive decline. Nature 2010; 464(7288): 529–535.

Minaker KL. Common clinical sequelae of aging. In: Goldman L, Schafer AI, editors. Goldman’s Cecil Medicine, 24th ed. Philadelphia, PA: Elsevier Saunders; 2011; p. 104–109.

Kocowski T, Paplicki M. Selected clinical aspects in geriatrics. In: Fal A, Witczak I, Kuriata-Kościelniak E, editors. Geriatric Care in Poland. Warszawa: CeDeWu; 2016; p. 98–100.

Szot P, Golec J, Szczygieł E. Overview of selected functional tests used in assessment of the risk of falls in older persons. Polish Gerontology 2008; 16(1): 12–17.

Skalska A, Wizner B, Klich-Rączka A, Piotrowicz K, Grodzicki T. Falls and their consequences in the elderly population in Poland. Proximal femoral fractures and hip joint endoprosthesoplasty. In: Mossakowska M, Więcek A, Błędowski P, editors. Medical, Psychological, Sociological, and Economic Aspects of Aging in Poland. Poznań: Termedia Wydawnictwa Medyczne; 2012; p. 275–294.

Norris JA, Marsh AP, Smith IJ, Kohut RI, Miller ME. Ability of static and statistical mechanics posturographic measures to distinguish between age and fall risk. Journal of Biomechanics 2005; 38(6): 1263–1272.

Abrahamová D, Hlavacka F. Age-related changes of human balance during quiet stance. Physiological Research 2008; 57(6): 957–964.

Masui T, Hasegawa Y, Matsuyama Y, Sakano S, Kawasaki M, Suzuki S. Gender differences in platform measures of balance in rural community-dwelling elders. Archives of Gerontology and Geriatrics 2005; 41(2): 201–209.

Otremba I. Epidemiology, etiology, and complications of falls in patients treated in geriatric wards. Nursing Problems 2013; 21(4): 471–475.

de Noronha Ribeiro Daniel F, de Souza Vale RG, Giani TS, Bacellar S, Escobar T, Stoutenberg M. et al. Correlation between static balance and functional autonomy in elderly women. Archives of Gerontology and Geriatrics 2011; 52(1): 111–114.

Elphick HL, Mankad K, Madan S, Parker C, Liddle BJ. The determinants of successful in-hospital rehabilitation in people aged 90 years and older. Gerontology.2007; 53(2): 116–120.

Kim S, Nussbaum MA, Madigan ML. Direct parameterization of postural stability during quiet upright stance: effects of age and altered sensory conditions. Journal of Biomechanics 2008; 41(2): 406–411.

Du Pasquier RA, Blanc Y, Sinnreich M, Landis T, Burkhard P, Vingerhoets FJ. The effect of aging on postural stability: a cross sectional and longitudinal study. Clinical Neurophysiology 2003; 33(5): 213–218.

Fujita T, Nakamura S, Ohue M, Fujii Y, Miyauchi A, Takagi Y. et al. Effect of age on body sway assessed by computerized posturography. Journal of Bone and Mineral Metabolism 2005; 23(2): 152–156.

Merlo A, Zemp D, Zanda E, Rocchi S, Meroni F, Tettamanti M. et al. Postural stability and history of falls in cognitively able older adults: The Canton Ticino study. Gait and Posture 2012; 36(4): 662–666.

Kołodziejczyk P. Falls in the elderly – consequences and prophylaxis. Contemporary Gerontology 2014; 2(1): 45–48.

Marcus RL, Addison O, Kidde JP, Dibble LE, Lastayo PC. Skeletal muscle fat infiltration: impact of age, inactivity, and exercise. Journal of Nutrition Health and Aging 2010; 14(5): 362–366.

Kaneda K, Sato D, Wakabayashi H, Hanai A, Nomura T. A comparison of the effects of different water exercise programs on balance ability in elderly people. Journal of Aging and Physical Activity 2008; 16(4): 381–392.

Costello E, Edelstein JE. Update on falls prevention for community-dwelling older adults: review of single and multifactorial intervention programs. Rehabilitation Medicine 2009; 13: 33–51.

Qiu F, Cole MH, Davids KW, Henning EM, Silburn PA, Netscher H. et al. Enhanced somatosensory information decreases postural sway in older people. Gait and Posture 2012; 35(4): 630–635.

Ramstrand N, Thuesen AH, Nielsen DB, Rusaw D. Effects of an unstable shoe construction on balance in women aged over 50 years. Clinical Biomechanics 2010; 25(5): 455–460.

Szczerbińska K, Topór-Mądry R. The characteristics of falls based on the prospective registration in nursing homes. Medical Review 2011; 68(9): 576–584.

Wood BH, Bilclough JA, Bowron A, Walker RW. Incidence and prediction of falls in Parkinson’s disease: a prospective multidisciplinary study. Journal of Neurology, Neurosurgery, and Psychiatry 2002; 72(6): 721–725.

Stolze H, Klebe S, Zechlin C, Baecker C, Friege L, Deuschl G. Falls in frequent neurological diseases – prevalence, risk factors and aetiology. Journal of Neurology 2004; 251(1): 79–84.

Ivers RQ, Cumming RG, Mitchell P, Simpson JM, Peduto AJ. Visual risk factors for hip fracture in older people. Journal of the American Geriatrics Society 2003; 51(3): 356–363.

Ivers RQ, Norton R, Cumming RG, Butler M, Campbell AJ. Visual impairment and risk of hip fracture. American Journal of Epidemiology 2000; 152(7): 633–639.

Foss AJ, Harwood RH, Osborn F, Gregson RM, Zaman A, Masud T. Falls and health status in elderly women following second eye cataract surgery: a randomised controlled trial. Age and Ageing 2006; 35(1): 66–71.

Salvi SM, Akhtar S, Currie Z. Ageing changes in the eye. Postgraduate Medical Journal 2006; 82(971): 581–587.

Nevitt MC, Cummings SR, Hudes ES. Risk factors for injurious falls: a prospective study. Journal of Gerontology 1991; 46(5): 164–170.

Pothula VB, Chew F, Lesser TH, Sharma AK. Falls and vestibular impairment. Clinical Otolaryngology 2004; 29(2): 179–182.

Whitney SL, Hudak MT, Marchetti GF. The activities-specific balance confidence scale and the dizziness handicap inventory: a comparison. Journal of Vestibular Research 1999; 9(4):253–259.

Jansen S, Kenny RA, de Rooij SE, van der Velde N. Self-reported cardiovascular conditions are associated with falls and syncope in community-dwelling older adults. Age and Ageing 2015; 44(3): 525–529.

Gupta V, Lipsitz LA. Orthostatic hypotension in the elderly: diagnosis and treatment. American Journal of Medicine 2007; 120(10): 841–847.

Sturnieks DL, St George R, Lord SR. Balance disorders in the elderly. Clinical Neurophysiology 2008; 38(6): 467–478.

Bateni H. Changes in balance in older adults based on use of physical therapy vs the Wii Fit gaming system: a preliminary study. Physiotherapy 2012; 98(3): 211–216.

Nobili A, Garattini S, Mannucci PM. Multiple diseases and polypharmacy in the elderly: challenges for the internist of the third millennium. Journal of Comorbidity 2011; 1(1): 28–44.

Darowski A, Chambers SA, Chambers DJ. Antidepressants and falls in the elderly. Drugs and Aging 2009; 26(5): 381–394.

Woolcott JC, Richardson KJ, Wiens MO, Patel B, Marin J, Khan KM. et al. Meta-analysis of the impact of 9 medication classes on falls in elderly persons. Archives of Internal Medicine 2009; 169(21): 1952–1960.

Woolf AD, Akesson K. Preventing fractures in elderly people. BMJ 2003; 327(7406): 89–95.

Ojo F, Al Snih S, Ray LA, Raji MA, Markides KS. History of fractures as predictor of subsequent hip and nonhip fractures among older Mexican Americans. Journal of the National Medical Association 2007; 99(4): 412–418.




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