Cost of falls in old age: a systematic review

Heinrich, Sven; Rapp, Kilian; Rißmann, Ulrich; Becker, Clemens; König, HH

doi:10.1007/s00198-009-1100-1

Cited by 447 publications

(307 citation statements)

References 53 publications

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“…5 Patients with opioid use disorders have a higher risk of overdose death-both suicide and non-suicide-when taking benzodiazepines. 6,7,35 Senior patients are particularly vulnerable, because benzodiazepines are associated with falls, [36][37][38][39] hip fractures, 12 delirium, 10,11 disability, 13 dementia, 14,15 and motor vehicle accidents. 40 Osteoporosis has been linked to fractures alongside benzodiazepine prescriptions in The referent for odds ratios for diagnoses and other prescriptions is patients who did not have that diagnosis or prescription patients at risk of falls, although no direct relationship between osteoporosis and benzodiazepine prescriptions has been described.…”

Section: Discussionmentioning

confidence: 99%

Benzodiazepines are Prescribed More Frequently to Patients Already at Risk for Benzodiazepine-Related Adverse Events in Primary Care

et al. 2016

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BACKGROUND: Benzodiazepine use is associated with adverse drug events and higher mortality. Known risk factors for benzodiazepine-related adverse events include lung disease, substance use, and vulnerability to fracture. OBJECTIVE: To determine whether benzodiazepine prescribing is associated with risk factors for adverse outcomes. DESIGN: Longitudinal cohort study between July 1, 2011, and June 30, 2012. PARTICIPANTS: Patients who visited hospital-and community-based practices in a primary care practicebased research network. MAIN MEASURES:Odds ratio of having a target medical diagnosis for patients who received standard and highdose benzodiazepine prescriptions; rates per 100 patients for outpatient and emergency department visits and hospitalizations. KEY RESULTS: Among 65,912 patients, clinicians prescribed at least one benzodiazepine to 15 % (9821). Of benzodiazepine recipients, 5 % received high doses. Compared to non-recipients, benzodiazepine recipients were more likely to have diagnoses of depression (OR, 2.7; 95 % CI, 2.6-2.9), substance abuse (OR, 2.2; 95 % CI, 1.9-2.5), tobacco use (OR, 1.7; 95 % CI, 1.5-1.8), osteoporosis (OR, 1.6; 95 % CI, 1.5-1.7), chronic obstructive pulmonary disease (OR, 1.6; 95 % CI, 1.5-1.7), alcohol abuse (OR, 1.5; 95 % CI, 1.3-1.7), sleep apnea (OR, 1.5; 95 % CI, 1.3-1.6), and asthma (OR, 1.5; 95 % CI, 1.4-1.5). Compared to low-dose benzodiazepine recipients, high-dose benzodiazepine recipients were even more likely to have certain medical diagnoses: substance abuse (OR, 7.5; 95 % CI, 5.5-10.1), alcohol abuse (OR, 3.2; 95 % CI, 2.2-4.5), tobacco use (OR, 2.7; 95 % CI, 2.1-3.5), and chronic obstructive pulmonary disease (OR, 1.5; 95 % CI, 1.2-1.9).Benzodiazepine recipients had more primary care visits per 100 patients (408 vs. 323), specialist outpatient visits (815 vs. 578), emergency department visits (47 vs. 29), and hospitalizations (26 vs. 15; p < .001 for all comparisons). CONCLUSIONS: Clinicians prescribed benzodiazepines and high-dose benzodiazepines more frequently to patients at higher risk for benzodiazepine-related adverse events. Benzodiazepine prescribing was associated with increased healthcare utilization.

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Section: Discussionmentioning

confidence: 99%

Benzodiazepines are Prescribed More Frequently to Patients Already at Risk for Benzodiazepine-Related Adverse Events in Primary Care

et al. 2016

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“…Falls are a serious public health problem, which can lead older people to immobility, hospitalization, and death, as well as generate fear of falling and decrease functional capacity 21 . According to an estimation, falls generate an annual cost around 1% of all health expenses in occidental countries 22 . Therefore, investigating methods to reduce the risk of falling is extremely important for this population and for public health.…”

Section: Discussionmentioning

confidence: 99%

Melhora do equilíbrio postural em mulheres idosas com o uso de informação sensorial adicional

2017

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RESUMO O processo natural do envelhecimento humano apresenta alterações morfológicas e fisiológicas, como alterações de equilíbrio e da marcha, aumentando o risco de cair. Alguns estudos investigaram a utilização da informação sensorial na melhora do equilíbrio corporal utilizando o toque suave em uma superfície rígida e estacionária, verificando uma redução significativa da oscilação corporal. Avaliou-se os efeitos da informação sensorial adicional durante a marcha em mulheres idosas. Foram avaliadas 30 mulheres com 60 anos ou mais. A adição da informação sensorial foi feita por uma bandagem infrapatelar. As participantes realizaram os testes propostos pelo Dynamic Gait Index (DGI), pelo Timed Up and Go (TUG) e pelo Teste de Caminhada de 10 Metros (TC10m), com e sem a bandagem infrapatelar. As comparações dos dados foram realizadas com o teste t pareado e o teste de Wilcoxon, com p≤0,05. Houve diferença significativa na comparação do TUG (sem bandagem: 10,13±2,1; com bandagem: 9,71±2,1, p=0,0007) e no DGI (sem bandagem: 20,65±2,1; com bandagem: 22,1±2,1, p=0,002). Não houve diferença significativa no uso da bandagem no TC10m. Os resultados mostraram que o uso da informação sensorial adicional gerada pela bandagem infrapatelar promoveu melhora da mobilidade funcional e do desempenho físico em mulheres idosas.

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“…40 % der Verletzungen erklären sich durch extrinsische Stürze, knapp ein Viertel der Stürze ereignen sich in der näheren häuslichen Umgebung, der Rest in entfernterem Terrain außerhalb der Wohnung (Nikolaus, 2013 (Icks et al, 2008). Etwa 25 -75 % der Patienten/-innen mit sturzbedingter Hüftfraktur erreichen nicht mehr das Mobilitätsniveau, das sie vor der Fraktur hatten und 20 -30 % der Patienten/-innen sterben innerhalb eines Jahres nach dem Ereignis (Magaziner, Simonsick, Kashner, Hebel, & Kenzora, 1990 (Heinrich et al, 2010). Stürze ohne ernste Verletzungsfolgen werden sowohl von älteren Menschen als auch von dem medizinischen Fachpersonal oftmals bagatellisiert, sodass präventive Maßnahmen versäumt oder zu spät eingeleitet werden, was wiederum Folgekosten für das Gesundheitswesen nach sich zieht (Zecevic, Salmoni, Speechley, & Vandervoort, 2006).…”

Section: Folgen Für Die Gesellschaftunclassified

Potential analysis for research on occupational therapy-led physical exercise programmes and home environment adaptation programmes to prevent falls for elderly people living at home / Potenzialanalyse zu ergotherapeutischen körperlichen Trainingsprogrammen und Wohnraumanpassungen zur Vermeidung von Stürzen bei zu Hause lebenden älteren Menschen

Müller

Lautenschläger

Voigt-Radloff

2016

International Journal of Health Professions

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Background:In Germany, four to five million community-dwelling people aged 65 years or older fall every year. The presented potential analysis evaluates the potential of occupational therapy-led physical exercise programs and home environment adaptations to reduce the frequency of falling and as well as intrinsic and extrinsic risk factors for falling of older people living at home. Methods: The potential analysis was compiled according to a method guideline (p.11-22) available as follows: http://www.cochrane. de/news/leitfaden-f%C3%BCr-gesundheitsfachberufe-mai-2013. The research question of fall prevention was considered as very relevant for health care and specified according to the PICOS-system. A Cochrane review was systematically searched and the body of evidence was assessed using the GRADE-system. In addition, studies after the search period of the Cochrane review were identified using the search strategy of this review. Both the studies within and after the review were assessed regarding their transferability to the German health care context. . However, direct implementation into the German healthcare context is not recommendable. Implication for research: It is recommended (1) to manualise identified home environment adaptation programmes for the German healthcare context and (2) to pilot-test the physical exercise programmes `LiFE` with regard to theoretical framework, acceptance, applicability and feasibility and to examine both interventions as part of a feasibility study. If this trial results in a feasible treatment programme well accepted by patients and their treating occupational therapists, a large-scaled randomized clinical trial in terms of comparative effectiveness research may follow. Abstract

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Cost of falls in old age: a systematic review

Abstract: Falls are a relevant economic burden to society. Efforts should be directed to economic evaluations of fall-prevention programmes aiming at reducing fall-related fractures, which contribute substantially to fall-related costs.

Cited by 447 publications

References 53 publications

Benzodiazepines are Prescribed More Frequently to Patients Already at Risk for Benzodiazepine-Related Adverse Events in Primary Care

Benzodiazepines are Prescribed More Frequently to Patients Already at Risk for Benzodiazepine-Related Adverse Events in Primary Care

Melhora do equilíbrio postural em mulheres idosas com o uso de informação sensorial adicional

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