Falls in older adults: a practical approach

ABSTRACT

Background: Falls are a major problem in public health since they are an important cause of morbidity and mortality. To evaluate the risk of fall and prescribe preventive interventions may be a challenging task. Objectives: The objectives of this study are to summarize the most relevant information on the topic “falls in the elderly” and to give a critical view and practical clinical approach on this topic. Methods: In March 2022, a search of Pubmed database was performed, using the terms “fall elderly”, fall prevention”, “fall risk”, with the following parameters: five years, review, systematic review, meta-analysis, practice guidelines. Results: There are several risk factors for falls that can be grouped in different areas (psychosocial, demographic, medical, medication, behavioral, environmental). The clinical evaluation of an older adult prone to falls must include identification of risk factors through history and examination and identification of risk of falls through an assessment tool such as gait velocity, functional reach test, timed up and go, Berg balance test, and miniBEST test. Fall prevention strategies can be single or multiple, and physical activity is the most cited. Technology can be used to detect and prevent falls. Conclusion:  A systematic approach to the older patient in risk of falls is feasible and may impact fall prevention.

RESUMO

Antecedentes: As quedas são um grande problema de saúde pública, uma vez que são uma importante causa de morbidade e mortalidade. A avaliação do risco de queda e a prescrição de intervenções preventivas podem ser tarefas desafiadoras. Objetivo: Estudo visa sintetizar as informações mais relevantes sobre o tema “quedas em idosos” e apresentar uma visão crítica e uma abordagem da prática clínica neste tema. Métodos: Em março de 2022, foi feita uma revisão bibliográfica no Pubmed, utilizando-se os termos “fall elder”, fall prevention”, “fall risk”, com os seguintes parâmetros s: 5 anos, revisão, revisão sistemática, meta-análise, diretrizes práticas. Resultados: Há inúmeros fatores de risco para quedas que podem ser agrupados em diferentes domínios (psicossocial, demográfico, condições clínicas, uso de medicamentos, comportamental, ambiental). A avaliação clínica de um idoso propenso a queda deve incluir a identificação de fatores de risco por meio da história e exame físico e identificação do risco de queda por meio de um instrumento de avaliação como velocidade da marcha, teste de alcance funcional, timed up and go, teste de equilíbrio de Berg, escala miniBEST. As estratégias de prevenção de quedas podem ser únicas ou múltiplas, sendo a atividade física a mais citada. Tecnologias podem ser usadas para detectar e prevenir quedas. Conclusão: Uma abordagem sistemática ao paciente idoso em risco de queda é possível, deve ser realizada e pode impactar na prevenção de quedas.

Keywords:

Accidental Falls - Aged

Palavras-chave

Acidentes por Quedas - Idoso

Authors’ contributions:

CBP, AMKK: literature review and preparation of the manuscript

Publication History

Received: 15 March 2022

Accepted: 29 April 2022

Article published online:
06 February 2023

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