Recurrent falls and risk factors among institutionalized older people.

Lidiane Maria De Brito Macedo Ferreira,Karyna Myrelly Oliveira Bezerra De Figueiredo Ribeiro Ribeiro,José Rodolfo Torres Araújo,Kênio Costa De Lima,Javier Jerez-Roig

doi:10.1590/1413-81232018241.35472016

Lidiane Maria De Brito Macedo Ferreira, Karyna Myrelly Oliveira Bezerra De Figueiredo Ribeiro Ribeiro + Show 3 more

Open Access

https://doi.org/10.1590/1413-81232018241.35472016

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Abstract

Recurrent falls constitute a high risk for morbidity and mortality among older people, especially institutionalized individuals, due to greater frailty and functional decline in this group. The aim of this study was to identify risk factors associated with recurrent falls among institutionalized older persons. A longitudinal cohort study was conducted over a one-year period with a study sample consisting of individuals aged 60 years and over living in 10 Nursing homes (NH) who were able to walk and had preserved cognitive ability. The older persons and carers were asked about the occurrence of falls over the last twelve months. The older persons were considered recurrent fallers if they had had two or more falls during this period. Institutional, sociodemographic and health data was also collected using questionnaires and the residents' medical records. One hundred and thirty individuals were included in the sample out of a total of 364 older people living in the NH. The incidence of recurrent falls was 26.9% (CI95% = 22.4 - 31.5). The results of the chi-square test and logistic regression adopting a significance level of 0.05 showed that fatigue was a risk factor for recurrent falls(p = 0.001; RR = 2.9) and that the use of beta blockers was a protective factor (p = 0.010; RR = 0.1). It was concluded that recurrent falls are common in NH and that fatigue constitutes an important risk factor.

Highlights

Falls among older persons are considered a geriatric syndrome because of their multiple causes and risk factors
Of the 130 older persons assessed under this study, the majority (62.3%) lived in nonprofit Nursing homes (NH), were women (73.1%), had a low level of schooling (28.5% had completed the first stage of primary education and 20.8% were illiterate, meaning that almost half the participants had little schooling), single (45.4%), and did not have children (50.4%)
According to an international study conducted in NH, fall incidence is greatest in the bedroom, with the bedroom and bathroom together accounting for 75% of all locations of fall[26], corroborating the findings of the present study, which showed that the majority of recurrent falls occur in the bedroom

Summary

Introduction

Falls among older persons are considered a geriatric syndrome because of their multiple causes and risk factors. The incidence among older persons living in Nursing homes (NH) is higher, reaching around 40%1, while between 13 and 66%3,4 become recurrent fallers. This difference in incidence can be explained by the frailer nature and greater functional dependency of institutionalized older persons, who are more biologically susceptible to the accumulated affects of disease and/or the use of medications, leading to muscular weakness, confusion, and dizziness[5]. Falls are a serious problem among this age group because they can cause considerable injury, disability, and death.

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