Elderly outpatient profile and predictors of falls
Keywords:
Activities of daily living, Postural balance, Gait, Muscle strength, AgingAbstract
CONTEXT AND OBJECTIVES: Falls are a serious public health problem and are one of the biggest reasons for hospitalization, morbidity and mortality among elderly people. Moreover, few studies on predictors of falls have been conducted in low and middle income countries. The aim here was to identify elderly outpatient profiles according to sociodemographic, clinical, physical and functional variables and correlate them with occurrences of falls among these subjects. DESIGN AND SETTING: Cross-sectional descriptive study forming part of the project “Quality of Life of Frail Elderly People”, carried out in Campinas, Brazil. METHODS: The subjects were 145 elderly individuals (76.3 ± 7.8 years old), of whom 65% were women, who were living in the city of Campinas or nearby and were attended at the geriatric outpatient clinic of a University Hospital. Sociodemographic, clinical, physical and functional data, as well as fall occurrence data, were gathered. Cluster analyses and comparisons between groups were carried out. RESULTS: Cluster analysis identified two distinct groups related to the study variables, and the determinants for this distinction were: gender, marital status, physical performance, handgrip strength and functional independence. These groups were compared according to occurrences of falls over the last year, and significant differences between them were found. CONCLUSIONS: The results showed that greater occurrences of falls were associated with a profile of elderly people comprising female gender, single status, lower muscle strength and physical performance regarding balance and gait, and lower independence in motor tasks for activities of daily living.
Downloads
References
Fabrício SC, Rodrigues RA, da Costa ML Jr. Causas e conseqüências de quedas de idosos atendidos em hospital público [Falls among older adults seen at a São Paulo State public hospital: causes and consequences]. Rev Saúde Pública. 2004;38(1):93-9.
Faulkner KA, Redfern MS, Cauley JA, et al. Multitasking: association between poorer performance and a history of recurrent falls. J Am Geriatr Soc. 2007;55(4):570-6.
Siqueira FV, Facchini LA, Piccini RX, et al. Prevalência de quedas em idosos e fatores associados [Prevalence of falls and associated factors in the elderly]. Rev Saúde Pública. 2007;41(5):749-56.
Lebrão ML, Laurenti R. Saúde, bem-estar e envelhecimento: o estudo SABE no município de São Paulo [Health, well-being and aging: the SABE study in São Paulo, Brazil]. Rev Bras Epidemiol. 2005;8(2):127-41.
Bloem BR, Steijns JA, Smits-Engelsman BC. An update on falls. Curr Opin Neurol. 2003;16(1):15-26.
Saverino A, Benevolo E, Ottonello M, Zsirai E, Sessarego P. Falls in a rehabilitation setting: functional independence and fall risk. Eura Medicophys. 2006;42(3):179-84.
Perracini MR, Ramos LR. Fatores associados a quedas em uma coorte de idosos residentes na comunidade [Fall-related factors in a cohort of elderly community residents]. Rev Saúde Pública. 2002;36(6):709-16.
Bertolucci PH, Brucki SM, Campacci SR, Juliano Y. O mini-exame do estado mental em uma populaçäo geral: impacto da escolaridade [The Mini-Mental State Examination in a general population: impact of educational status]. Arq Neuropsiquiatr. 1994;52(1):1-7.
Guralnik JM, Simonsick EM, Ferrucci L, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49(2):M85-94.
Riberto M, Miyazaki MH, Jorge Filho D, Sakamoto H, Battistella LR. Reprodutibilidade da versão brasileira da medida de independência funcional [Reproductivity brazilian version of functional independence measure]. Acta Fisiátrica. 2001;8(1):45-52.
Riberto M, Miyazaki MH, Jucá SSH, et al. Validação da versão brasileira da Medida de Independência Funcional [Validation of the brazilian version of Functional Independence Measure]. Acta Fisiátrica. 2004;11(2):72-6.
Ottenbacher KJ, Hsu Y, Granger CV, Fiedler RC. The reliability of the functional independence measure: a quantitative review. Arch Phys Med Rehabil. 1996;77(12):1226-32.
Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146-56.
Guimarães JMN, Farinatti PTV. Análise descritiva de variáveis teoricamente associadas ao risco de quedas em mulheres idosas [Descriptive analysis of variables theoretically associated to the risk of falls in elder women]. Rev Bras Med Esporte. 2005;11(5):299-305.
Chang HJ, Lynm C, Glass RM. JAMA patient page. Falls and older adults. JAMA. 2010;303(3):288.
Moreira MD, Costa AR, Rodrigues Felipe L, Caldas CP. The association between nursing diagnoses and the occurrence of falls observed among elderly individuals assisted in an outpatient facility. Rev Lat Am Enfermagem. 2007;15(2):311-7.
Mahoney JE, Shea TA, Przybelski R, et al. Kenosha County falls prevention study: a randomized, controlled trial of an intermediate- intensity, community-based multifactorial falls intervention. J Am Geriatr Soc. 2007;55(4):489-98.
Mancini C, Williamson D, Binkin N, et al. [Epidemiology of falls among the elderly]. Ig Sanita Pubbl. 2005;61(2):117-32.
Gomes GAO, Cintra FA, Diogo MJD, et al. Comparação entre idosos que sofreram quedas segundo desempenho físico e número de ocorrências [Physical performance and number of falls in older adult fallers]. Rev Bras Fisioter. 2009;13(5):430-7.
Sai AJ, Gallagher JC, Smith LM, Logsdon S. Fall predictors in the community dwelling elderly: a cross sectional and prospective cohort study. J Musculoskelet Neuronal Interact. 2010;10(2):142-50.
Koltyn KF. The association between physical activity and quality of life in older women. Womens Health Issues. 2001;11(6):471-80.
Rebelatto JR, Castro AP, Chan A. Quedas em idosos institucionalizados: características gerais, fatores determinantes e relações com a força de preensão manual. [Falls in institutionalized elderly people: general characteristics, determinant factors and relationship with handgrip strength]. Acta Ortop Bras. 2007;15(3):151-4.
Rolland Y, Lauwers-Cances V, Cesari M, et al. Physical performance measures as predictors of mortality in a cohort of community- dwelling older French women. Eur J Epidemiol. 2006;21(2):113-22.
Shechtman O, Mann WC, Justiss MD, Tomita M. Grip strength in the frail elderly. Am J Phys Med Rehabil. 2004;83(11):819-26.
Siqueira FV, Facchini LA, Piccini RX, et al. Prevalência de quedas em idosos e fatores associados [Prevalence of falls and associated factors in the elderly]. Rev Saúde Pública. 2007;41(5):749-56.
Nakano MM. Versão brasileira da Short Physical Performance Battery – SPPB: adaptação cultural e estudo da confiabilidade [thesis]. Campinas: Universidade Estadual de Campinas; 2007.
van Der Velde N, Stricker BH, Pols HA, van der Cammen TJ. Risk of falls after withdrawal of fall-risk-increasing drugs: a prospective cohort study. Br J Clin Pharmacol. 2007;63(2):232-7.
Ruchinskas R. Clinical prediction of falls in the elderly. Am J Phys Rehabil. 2003;82(4):273-8.
