Factores asociados con la aparición de caídas en ancianos institucionalizados: un estudio de cohortes / Risk factors for falls amongst older people living in nursing home. A cohort study

ObjetivoDeterminar los factores asociados con caídas en ancianos institucionalizados.Material y métodosEstudio de cohorte, con una duración de 18 meses. Se incluyeron 203 internos mayores de 65 años con capacidad para la deambulación. Se determinaron edad, sexo, IMC, índices de Barthel, Pfeiffer, Tinetti y FRAT (Falls Risk Assessment Tool), caídas previas, ayudas para deambular, existencia de hipotensión ortostática, delirium en el mes previo, presencia de diferentes enfermedades crónicas (10), número y naturaleza de los fármacos habituales (15). Cada caída fue registrada por la enfermera responsable del paciente. El análisis se realizó mediante regresión logística.ResultadosLa media de edad de los participantes fue de 80,1 años (desviación estándar [DE]=9,1 años), siendo varones el 37,9%. Hubo 35 pérdidas (11,5%/año). Se registró un total de 204 caídas en 99 personas (incidencia acumulada del 48,8% a los 18 meses de seguimiento). Cuarenta y cuatro personas (21,7%) sufrieron caídas repetidas. El análisis de regresión mostró asociación con la presencia de delirium en el mes previo a la inclusión en el estudio (OR: 6,7; intervalo de confianza del 95% [IC95]: 1,6–30,3) y menor IMC (OR: 1,1; IC95: 1,01–1,12), y con la deficiencia visual en el caso de las caídas repetidas (OR: 2,2; IC95: 1,1–4,5).ConclusionesLa incidencia de caídas en ancianos institucionalizados es alta. Se constata asociación con algunas condiciones expresivas de fragilidad como indicadores de riesgo(AU)

ObjectiveTo determine factors associated with falls in institutionalized elderly.Material and methodsA prospective cohort study was carried out, over a 18 months period. We included 203 subjects aged 65 and over who were able to walk. We recorded: age, sex, BMI, Barthel, Pfeiffer, Tinetti and FRAT tests, history of falls during the previous year, walking aids, the existence of orthostatic hypotension, delirium in the previous month, presence of various chronic diseases (10), number and nature of the usual drugs (15). Each fall was recorded by the nurse in charge of the patient. The analysis was carried out using logistic regression.ResultsThe average age of participants was 80.1 (SD=9.1) years, male 37.9%. There were 35 losses (11.5%/year). 204 falls were registered in 99 people (48.8% cumulative incidence at 18 months of follow-up). 44 people (21.7%) suffered repeated falls. Regression analysis showed association with the presence of delirium in the month prior to the inclusion in the study (OR 6.7; CI95% 1.6–30.3) and a smaller BMI (OR 1.1; CI95% 1.01–1.12), and visual impairment in the case of repeated falls (OR 2.2; CI95% 1.1–4.5).ConclusionThe incidence of falls in institutionalized elderly is high. It was found strong association with some conditions of fragility as indicators of risk(AU)

[Risk factors for falls amongst older people living in nursing home. A cohort study]. / Factores asociados con la aparición de caídas en ancianos institucionalizados: un estudio de cohortes.

OBJECTIVE: To determine factors associated with falls in institutionalized elderly. MATERIAL AND METHODS: A prospective cohort study was carried out, over a 18 months period. We included 203 subjects aged 65 and over who were able to walk. We recorded: age, sex, BMI, Barthel, Pfeiffer, Tinetti and FRAT tests, history of falls during the previous year, walking aids, the existence of orthostatic hypotension, delirium in the previous month, presence of various chronic diseases (10), number and nature of the usual drugs (15). Each fall was recorded by the nurse in charge of the patient. The analysis was carried out using logistic regression. RESULTS: The average age of participants was 80.1 (SD=9.1) years, male 37.9%. There were 35 losses (11.5%/year). 204 falls were registered in 99 people (48.8% cumulative incidence at 18 months of follow-up). 44 people (21.7%) suffered repeated falls. Regression analysis showed association with the presence of delirium in the month prior to the inclusion in the study (OR 6.7; CI95% 1.6-30.3) and a smaller BMI (OR 1.1; CI95% 1.01-1.12), and visual impairment in the case of repeated falls (OR 2.2; CI95% 1.1-4.5). CONCLUSION: The incidence of falls in institutionalized elderly is high. It was found strong association with some conditions of fragility as indicators of risk.