Falls prevention – identification and intervention of risk factors
Authors:
Greplová Kamila
Authors‘ workplace:
Všeobecná interní klinika LF MU a FN Brno
Published in:
Clinical Osteology 2024; 29(1-2): 12-19
Category:
Overview
Falls and fall-related injuries are common in older adults, have negative effects on functional independence and quality of life and are associated with increased morbidity, mortality and health related costs. World guidelines for falls prevention and management for older adults: a global initiative were published in September 2022, which include an algorithm for fall risk stratification and patient assessment. For older people at high risk of falling, multifactorial falls risk assessment should be performed as a basis for subsequent targeted intervention. Examination should focus on history of fall, physical examination including gait assessment, balance, muscle strength, functional capacity and nutritional status assessment, fracture risk assessment, vision and hearing screening, evaluation of cognitive function, cardiology and neurological examination. According to the identified cause, the therapeutic options are determined. Preventive measures include the creating of a safe home environment, use of appropriate equipment, rehabilitation, medication review with regard to fall risk increasing drugs (FRIDs) and prevention and treatment of osteoporosis and sarcopenia.
Keywords:
falls – falls prevention – multifactorial assessment – older adults – risk stratification
Sources
Topinková E. Pády a poruchy chůze. In: Topinková E (ed). Geriatrie pro praxi. Galén: Praha 2010: 44– 47. ISBN 978–80–7262–365–6.
Matějovská Kubešová H et al. Pády u geriatrických pacientů. In: Matějovská Kubešová H (ed). Vybrané klinické stavy u seniorů. Mladá fronta: Praha 2015: 188–197. ISBN 978–80–204–3394–7.
Weber P et al. Pády. In: Weber P (ed). Minimum z klinické gerontologie. IDV PZ: Brno 2000: 69–75. ISBN 80–7013–314–7.
Jenšovský J. Extraskeletální rizikové faktory pro zlomeniny ve vyšším věku. Clin Osteol 2019; 24(2): 82–85.
Montero-Odasso M, van der Velde N, Martin FC et al. World guidelines for falls prevention and management for older adults: a global initiative. Age Ageing 2022; 51(9): 1–36. Dostupné z DOI: <https://doi.org/10.1093/ageing/afac205>.
Topinková E. Doporučení pro screening a stratifikaci rizika pádu u seniorů z pohledu nových „Celosvětových guidelines pro prevenci a management pádů u starších osob“. Geri a Gero 2023; 12(1): 12–17.
Burns ER, Lee R, Hodge SE et al. Validation and comparison of fall screening tools for predicting future falls among older adults. Arch Gerontol Geriatr 2022; 101: 104713. Dostupné z DOI: <http://dx.doi.org(10.1016/j.archger.2022.104713>.
Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med 1988; 319(26): 1701–1707. Dostupné z DOI: <http://dx.doi.org710.1056/NEJM198812293192604>
Beck Jepsen D, Robinson K, Ogliari G et al. Predicting falls in older adults: an umbrella review of instruments assessing gait, balance, and functional mobility. BMC Geriatr 2022; 22(1): 615. Dostupné z DOI: <http://dx.doi.org710.1186/s12877–022–03271–5>.
Ganz DA, Latham NK. Prevention of Falls in Community-Dwelling Older Adults. N Engl J Med 2020; 382(8):734–743. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMcp1903252 >.
Jepsen B, Robinson K, Ogliari G et al. Predicting falls in older adults: an umbrella review of instruments assessing fait, balance, and functional mobility. BMC Geriatr 2022; 22(1): 615. Dostupné z DOI: <http://dx.doi.org/10.1186/s12877–022–03271–5>.
Berková M, Topinková E, Mádlová P et al. [The „Short Physical Performance Battery“ in the Czech Republic – the pilot and validation study in older persons]. Krátká baterie pro testování fyzické zdatnosti seniorů. Vnitř Lék 2013; 59(4): 256–263.
Topinková E. Mobilita jako klíčový faktor zdravého stárnutí. Geri a Gero 2021; 10(1): 15–22.
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): M146–156. Dostupné z DOI: <http://dx.doi.org/10.1093/gerona/56.3.m146>.
Vaňková H, Topinková E, Hrnčiariková D et al. Vyhodnocení syndromu křehkosti (frailty) u geriatrického pacienta. Klinický doporučený postup výboru České gerontologické a geriatrické společnosti ČLS JEP. Geri a Gero 2023; 12 (1): 5–8.
Rockwood K, Song X, MacKnight C et al. A global clinical measure of fitness and frailty in elderly people. CMAJ 2005; 173(5): 489–495. Dostupné z DOI: <http://dx.doi.org/10.1503/cmaj.050051>.
Gillespie LD, Robertson MC, Gillespie WJ et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev 2012; 2012(9): CD007146. Dostupné z DOI: <http://dx.doi.org/10.1002/14651858.CD007146.pub3>.
Dautzenberg L, Beglinger S, Tsokani S et al. Interventions for preventing falls and fall-related fractures in community-dwelling older adults: A systematic review and network meta-analysis. J Am Geriatr Soc 2021; 69(10): 2973–2984. Dostupné z DOI: <http://dx.doi.org/10.1111/jgs.17375>.
Hopewell S, Adedire O, Copsey BJ et al. Multifactorial and multiple component interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev 2018; 7(7). Dostupné z DOI: <http://dx.doi.org/10.1002/14651858.CD012221>.
Vellas BJ, Wayne SJ, Romero LJ et al. Fear of falling and restriction of mobility in elderly fallers. Age Ageing 1997; 26(3): 189–193. Dostupné z DOI: <http://dx.doi.org/10.1093/ageing/26.3.189>.
Sillner AY, Holle CL, Rudolph JL. The Overlap Between Falls and Delirium in Hospitalized Older Adults: A Systematic Review. Clin Geriatr Med 2019; 35(2): 221–236. Dostupné z DOI: <http://dx.doi.org/10.1016/j.cger.2019.01.004>.
Kanis JA, Cooper C, Rizzoli R et al. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 2019; 30(1): 3–44. Dostupné z DOI: <http://dx.doi.org/10.1007/s00198–018–4704–5>.
Blain H, Masud T, Dargent-Molina P et al. A Comprehensive Fracture Prevention Strategy in Older Adults: The European Union Geriatric Medicine Society (EUGMS) Statement. J Nutr Health Aging 2016; 20(6): 647–652. Dostupné z DOI: <http://dx.doi.org/10.1007/s12603–016–0741-y>.
Trevisan C, Crippa A, Ek S et al. Nutritional Status, Body Mass Index, and the Risk of Falls in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis. J Am Med Dir Assoc 2019; 20(5): 569–582.e7. Dostupné z DOI: <http://dx,.doi.org/10.1016/j.jamda.2018.10.027>.
Topinková E, Fialová D. Doporučené nástroje pro revizi medikace a optimalizaci preskripce u geriatrických pacientů. Geri a Gero 2023; 12(3): 112–126.
Seppala LJ, Petrovic M, Ryg J et al. STOPPFall (Screening Tool of Older Persons Prescriptions in older adults with high fall risk). Age Ageing 2021; 50(4): 1189–1199. Dostupné z DOI: <http://dx.doi.org/10.1093/ageing/afaa249>.
Keglovits M, Clemson L, Hu YL et al. A scoping review of fall hazards in the homes of older adults and development of a framework for assessment and intervention. Aust Occup Ther J 2020; 67(5): 470–478. Dostupné z DOI: <http://dx.doi.org/10.1111/1440–1630.12682>.
Berková M, Berka Z. Pády: významná příčina morbidity a mortality seniorů. Vnitř Lék 2018; 64(11): 1076–1083.
Sherrington C, Fairhall N, Kwok W et al. Evidence on physical activity and falls prevention for people aged 65+ years: systematic review to inform the WHO guidelines on physical activity and sedentary behaviour. Int J Behav Nutr Phys Ac 2020; 17(1): 144. Dostupné z DOI: <http://dx.doi.org710.1186/s12966–020–01041–3>.
Sherrington C, Fairhall NJ, Wallbank GK et al. Exercise for preventing falls in older people living in the community. Cochrane Database Syst Rev 2019; 1(1): CD012424. Dostupné z DOI: <http://dx.doi.org710.1002/14651858.CD012424.pub2>.
Labels
Clinical biochemistry Paediatric gynaecology Paediatric radiology Paediatric rheumatology Endocrinology Gynaecology and obstetrics Internal medicine Orthopaedics General practitioner for adults Radiodiagnostics Rehabilitation Rheumatology Traumatology OsteologyArticle was published in
Clinical Osteology
2024 Issue 1-2
Most read in this issue
- System of coordinated care for osteoporotic patients in the Czech Republic
- Abstract Book: XVth National Conference on Secondary Osteoporosis, Pilsen, 10–11 May 2024
- Acetabuloplasty in therapy of severe dysplasia of the hip: case report
- Falls prevention – identification and intervention of risk factors