Intrinsic and Extrinsic Factors Associated with Falls in the Elderly

Sonia Patricia de Santillana Hernández; Luis Eduardo Alvarado Moctezuma; Gustavo Rodrigo Medina Beltrán; Gricelda Gómez Ortega; Rosa María Cortés Gonzálezzuela Espinoza; Sonia Patricia de Santillana Hernández; Luis Eduardo Alvarado Moctezuma; Gustavo Rodrigo Medina Beltrán; Gricelda Gómez Ortega; Rosa María Cortés González

2002, Number 6

Rev Med Inst Mex Seguro Soc 2002; 40 (6)

Intrinsic and Extrinsic Factors Associated with Falls in the Elderly

Santillana HSP, Alvarado MLE, Medina BGR, Gómez OG, Cortés GERM, Santillana HSP, Alvarado MLE, Medina BGR, Gómez OG, Cortés GRM

Full text

How to cite this article

Language: Spanish
References: 18
Page: 489-493
PDF size: 118.43 Kb.

ABSTRACT

Objective: To identify associated factors in falls of the elderly. Design: Cross-sectional. Materials and Methods: Identification data of schedule was applied to patients of 60 years of age and older without cognitive deterioration, who came to the emergency room at the Dr. Victorio de la Fuente Narváez Traumatology Hospital in Mexico due to injuries from falls. We registered general data of patients in whom, previous pa-thologies, injured structures, lesion type, site of fall, disabilities, and pharmaceutical consumption were related. Results: 924 patients were studied with average (standard deviation) age of 74.44 ± 9.64 years, and most opposing pathologies were cardiovascular, metabolic, and musculoskeletal. They presented disability to walk and visual disability in 57 and 82 %, respectively. The most frequent reported lesions were ecchymosis (97 %), bruises (99.5 %), and non-exposed fractures (87 %). The injured structures were hip 50%, head and face 24%, hand 10 %, shoulder 9%, and ankle 9%. The majority of mishap falls occurred at home (62 %) and in the public thoroughfare (26 %). In associated factors, the individual was found to have previously fallen and to be › 80 years OR 1.6, and to have pluripathology OR 2.76, hyperten-sion OR 2.09, disability to walk OR 3.83, visual disability OR 1.96, and polypharmacy OR 3.04. Conclusions: In general, the results confirm what has been informed in the world literature, but two protection factors have bee observed: to live accompanied and the usage of prescription glasses.

REFERENCES

1. Lázaro-del-Nogal M. Evaluación del anciano con caídas de repetición. Grupo de Trabajo de Caídas de la Sociedad Española de Geriatría y Geron-tología. España: Editora Montserrat Lázaro del Nogal; 1998.
2. Blake AJ, Morgan K, Bendall MJ, Dalloso H, Ebrahim SBJ, Arie THD, et al. Falls by elderly people at home: prevalence and associated factors. Age Ageing 1988;17:365-372.
3. Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the com-munity. N Engl J Med 1988;319(26):1701-1707.
4. Campbell AJ, Borrie MJ, Spears GS, Jackson SL, Brown JS, Fitzgerald JL. Circumstances and consequences of falls experienced by a community populations 70 years and over during a prospective study. Age Ageing 1990;19:136-141.
5. Wickham C, Cooper C, Margetts M, Barker JP. Muscle strength, activity, housing and the risk of falls in elderly people. Age Ageing 1989;18:47-51.
6. Tinetti ME, Speechley M. Prevention of falls among the elderly. N Engl J Med 1989;320(16): 1055-1059.
7. Rubenstein LZ, Robbins AS, Josephson KR, Schulman BL, Osterweil D. The value of assessing falls in an elderly population. Ann Intern Med 1990;113(4):308-316.
8. O’Loughlin JL, Robitaille Y, Boivin JF, Suissa S. Incidence of risk factors for falls and injurious falls among the community-dwelling elderly. Am J Epidemiol 1993;137(3):342-354.
9. Tinetti ME, Liu WL, Claus EB. Predictors and prognosis of inability to get up after falls among elderly persons. JAMA 1993;269(1):65-70.
Tibbitts GM. Patients who fall: How to predict and prevent injuries. Geriatrics 1996;51(9):21-31.
Cumming RG, Miller JP, Kelsey JL, Davis P, Arken CL, Birge SJ, et al. Medications and multiple falls in elderly people: The St Louis OASIS Study. Age Ageing 1991;20:455-461.
Tideiksaar R. Preventing falls: How to identify risk factors and reduce complications. Geriatrics 1996; 51(2):43-53.
Robbins AS, Rubenstein LZ, Josephson KR, Schulman BL, Osterweil D, Fine G. Predictors of falls among elderly people. Arch Intern Med 1989;149:1628-1633.
Thapa PB, Gideon P, Cost TW, Milam AB, Ray WA. Antidepressants and the risk of falls among nursing home residents. N Engl J Med 1998;339 (13):875-882.
Campbell AJ, Robertson MC, Gardner MM, Norton RN, Buchner DM. Psychotropic medication with- drawal and a home-based exercise program to prevent falls: A randomized, controlled trial. JAGS 1999;47: 850-853.
Myers AH, Baker SP, Van Natta ML, Abbey H, Robinson EG. Risk factors associates with falls and injuries among elderly institutionalized persons. Am J Epidemiol 1991;133(11):1179-1190.
Clark RD, Lord SR, Webster IW. Clinical para-meters associated with falls in an elderly population. Gerontology 1993;39:117-123.
Folstein MF, Folstein SE. Mini-mental state, a practical method for grading the cognitive state of patients for the clinician. J Psychiat Res 1975;12: 189-198.