Sustainable fall prevention across Europe: challenges and opportunities

Velde, Nathalie van der; Seppälä, Lotta J.; Petrovic, Mirko; Ryg, Jesper; Tan, Maw Pin; Montero‐Odasso, Manuel; Martin, Finbarr C.; Masud, Tahir

doi:10.1007/s40520-022-02178-w

Cited by 12 publications

(2 citation statements)

References 16 publications

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“…Hospital discharge and transition to the community setting represent a vulnerable phase in the care pathway of geriatric patients [ 21 ]. Research on approaches on fall prevention implementation and patient experiences of CMM to evaluate the intervention are scarce [ 13 , 19 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of medication management in geriatric patients who have fallen: results of the EMMA mixed-methods study

Clemens,

Iglseder,

Alzner

et al. 2024

Age and Ageing

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Background comprehensive medication management (CMM) can reduce medication-related risks of falling. However, knowledge about inter-individual treatment effects and patient-related barriers remains scarce. Objective to gain in-depth insights into how geriatric patients who have fallen view their medication-related risks of falling and to identify effects and barriers of a CMM in preventing falls. Design complementary mixed-methods pre–post study, based on an embedded quasi-experimental model. Setting geriatric fracture centre. Methods qualitative, semi-structured interviews framed the CMM intervention, including a follow-up period of 12 weeks. Interviews explored themes of falling, medication-related risks, post-discharge acceptability and sustainability of interventions using qualitative content analysis. Optimisation of pharmacotherapy was assessed via changes in the weighted and summated Medication Appropriateness Index (MAI) score, number of fall-risk-increasing drugs (FRID) and potentially inappropriate medications (PIM) according to the Fit fOR The Aged and PRISCUS lists using parametric testing. Results thirty community-dwelling patients aged ≥65 years, taking ≥5 drugs and admitted after an injurious fall were recruited. The MAI was significantly reduced, but number of FRID and PIM remained largely unchanged. Many patients were open to medication reduction/discontinuation, but expressed fear when it came to their personal medication. Psychosocial issues and pain increased the number of indications. Safe alternatives for FRID were frequently not available. Psychosocial burden of living alone, fear, lack of supportive care and insomnia increased after discharge. Conclusion as patients’ individual attitudes towards trauma and medication were not predictable, an individual and longitudinal CMM is required. A standardised approach is not helpful in this population.

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Section: Introductionmentioning

confidence: 99%

Effects of medication management in geriatric patients who have fallen: results of the EMMA mixed-methods study

Clemens,

Iglseder,

Alzner

et al. 2024

Age and Ageing

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“…As quedas representam um elevado custo para os sistemas de saúde, nos Estados Unidos, os gastos totais com saúde atribuíveis a quedas de idoso em 2015 foram mais de US$ 49,5 bilhões 6 , na Inglaterra os custos com quedas estima-se que custem £435 milhões 7 , nos países ocidentais europeus os incidentes com queda têm um impacto nos gastos sociais com saúde igualando 0,85-1,5% da despesa total 8 e no Brasil os custos com internações hospitalares por quedas em idosos registradas pelo Sistema de Informações Hospitalares do Sistema Único de Brazilian Journal of Health Review, Curitiba, v. 6, n. 2, p. 4795-4812, mar./apr., 2023 Saúde (SIH/SUS) no período de 2000 a 2020 corresponderam a R$ 2.315.395.702,75 3 . Além dos substanciais custos destacados, as quedas incorrem em despesas para a família tais como, consultas médicas, medicamentos, reabilitação, além das perdas de rendimentos relacionados às atividades nas quais os indivíduos estariam envolvidos caso não estivessem lesionados.…”

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Correlatos das quedas em pessoas idosas do Amazonas, Brasil

Borges¹,

Silva²,

Gouveia³

2023

Braz. J. Hea. Rev.

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Objetivos: (1) Investigar o grau de associação entre as quedas e fatores modificáveis (i.e., equilíbrio, o nível de atividade física, e fatores de risco para a saúde) e não modificáveis (i.e., idade e gênero), e (2) Investigar a associação entre os fatores modificáveis e as quedas depois de controlados a idade e o gênero. Métodos: Este estudo enquadra-se no projeto “Saúde, Estilo de Vida e Aptidão em Adultos e Adultos Idosos do Amazonas (SEVAAI)”. Esta investigação, com um delineamento transversal, 701 idosos, 268 homens e 433 mulheres, entre os 60 aos 92,8 anos de idade, residentes em três municípios do estado do Amazonas: Apuí, Fonte Boa e Manaus. A atividade física, a qualidade de vida e as variáveis sociodemográficas de saúde foram avaliadas através de questionários validados para a população brasileira (entrevistas face-to-face). Resultados: Verificamos que a ocorrência de quedas na população estudada estava correlacionada significativamente e positivamente com os fatores de risco para a saúde. A idade não apresentou diferenças significativas entre os idosos com quedas (70,35 anos) e idosos sem quedas (70,37 anos). Menores níveis de atividade física e menores scores da escala de Fullerton estavam relacionados com a idade. A análise revelou que depois de controlados por fatores de risco não modificáveis (i.e., a idade e gênero), apenas duas variáveis predizem a ocorrência de quedas: os fatores de risco para saúde e o score da escala de Fullerton. Conclusão: Os participantes que não reportaram quedas apresentaram menos fatores de risco para a saúde, um nível de atividade física superior e melhores scores na escala de Fullerton comparativamente aos participantes que reportaram quedas.

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Intrinsic capacity and recent falls in adults 80 years and older living in the community: results from the ilSIRENTE Study

Cacciatore,

Marzetti,

Calvani

et al. 2024

Aging Clin Exp Res

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Background Falls in older adults significantly impact overall health and healthcare costs. Intrinsic capacity (IC) reflects functional reserve and is an indicator of healthy aging. Aims To explore the association between IC and recent falls (≤ 90 days) in community-dwelling octogenarians from the Aging and Longevity in the Sirente geographic area (IlSIRENTE) study. Methods The Minimum Data Set for Home Care (MDS−HC) and supplementary questionnaires and tests were used to assess the five IC domains: locomotion, cognition, vitality, psychology, and sensory. Scores in each domain were rescaled using the percent of maximum possible score method and averaged to obtain an overall IC score (range 0−100). Results The study included 319 participants (mean age 85.5 ± 4.8 years, 67.1% women). Mean IC score was 80.5 ± 14.2. The optimal IC score cut-off for predicting the two-year risk of incident loss of at least one activity of daily living (ADL) was determined and validated in a subset of 240 individuals without ADL disability at baseline (mean age 84.7 ± 4.4 years, 67.1% women). Participants were then stratified into low (< 77.6) and high (≥ 77.6) IC categories. Those with high IC (63.9%) were younger, more often males, and had lower prevalence of recent falls, disability, multimorbidity, and polypharmacy. Logistic regression models including IC as a continuous variable revealed a significant association between higher IC and lower odds of falls. This association was significant in the unadjusted (odds ratio [OR] 0.96, 95% confidence interval [CI] 0.94–0.98, p < 0.001), age- and sex-adjusted (OR 0.96, 95% CI 0.94–0.98, p < 0.001), and fully adjusted models (OR 0.96, 95% CI 0.93–0.99, p = 0.003). When considering IC as a categorical variable, unadjusted logistic regression showed a strong association between high IC and lower odds of falls (OR 0.31, 95% CI 0.16–0.60, p < 0.001). This association remained significant in both the age- and sex-adjusted (OR 0.30, 95% CI 0.15–0.59, p < 0.001) and fully adjusted models (OR 0.33, 95% CI 0.16–0.82, p = 0.007). The locomotion domain was independently associated with falls in the unadjusted (OR 0.98, 95% CI 0.97–0.99, p < 0.001), age- and sex-adjusted (OR 0.97, 95% CI 0.96–0.99, p < 0.001), and fully adjusted model (OR 0.98, 95% CI 0.96–0.99, p < 0.001). Discussion This is the first study using an MDS−HC-derived instrument to assess IC. Individuals with higher IC were less likely to report recent falls, with locomotion being an independently associated domain. Conclusions Lower IC is linked to increased odds of falls. Interventions to maintain and improve IC, especially the locomotion domain, may reduce fall risk in community-dwelling octogenarians.

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Sustainable fall prevention across Europe: challenges and opportunities

Abstract: Falls and related injuries form a growing health-care prob-* Nathalie van der Velde

Cited by 12 publications

References 16 publications

Effects of medication management in geriatric patients who have fallen: results of the EMMA mixed-methods study

Effects of medication management in geriatric patients who have fallen: results of the EMMA mixed-methods study

Correlatos das quedas em pessoas idosas do Amazonas, Brasil

Intrinsic capacity and recent falls in adults 80 years and older living in the community: results from the ilSIRENTE Study

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