Características de las caídas en el adulto mayor que vive en la comunidad / Characteristics of falls among free living elders

RESUMO

Background: Falls by older adults are a frequent problem among ambulatory patients in primary care. Aim: To describe the prevalence and features of falls among elders consulting to an ambulatory Geriatric Clinic. Patients and methods: Persons aged 60 years or more were surveyed about the number of falls in the preceding six months, the characteristics and consequences of each falls. Biopsychosocial characteristics were recorded and the Tinetti gait and balance test was performed in all patients reporting falls. Results: In 104 (18.2 percent) of 571 clinical consultations, one or more falls were reported. Among patients who fell and provided complete data (n=95), 64 percent reported one fall and 36 percent reported two or more, totaling 156 falls to analyze. The mean age of the patients with falls was 71.8ñ6.8 years. The functional and cognitive status was normal in 73 and 71.6 percent of cases respectively and 38 percent carried out periodical physical activity. Fifty seven percent of falls occurred outside of home, and an extrinsic factor was a precipitating cause in 55 percent of the falls. A post-fall syndrome appeared in 21 percent of cases and 2.6 percent resulted in fractures. Falling two or more times versus one time during the last six months was statistically associated with an age over 75, an absence of periodic physical activity, functional impairments, three or more chronic diseases, neurological diseases and with living alone, among other variables. Conclusions: Falls among elders occur mainly outside of home, in subjects older than 75 years old, functionally dependent and with an important involvement of extrinsic factors. Physical activity, as well as the control of environmental risks, could be protective factors against recurrent falls