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G. Cristine Vieira Gomes1, L. Alamino Viveiro1, C. Quirino Dias1, J. Maria Ribeiro Bacha1, J.E. Pompeu1
1University of Sao Paulo, Department of Physical Therapy, Speech, and Occupational Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
Background: Falls can cause serious physical and psychological consequences including injuries, hospitalizations, decrease in mobility, fear of falling, restricted activity, functional decline and death. It is well known that the main risk factors for falls are related to changes in cognition, mobility, difficulties in walking and loss of balance.
Purpose: To determine the risk factors for falls in older adults who live in nursing home.
Methods: A longitudinal study was carried out through a prospective cohort with a follow-up period of 12 months. Nonprofit and Particular Nursing Homes (NH) were selected in the city of Sao Paulo. The assessments (initial and 12 months) consisted of: (1) data collection from medical records, (2) frailty criteria according to Fried et al.; (3) cognition through the Mini-Mental State Examination test; (4) postural control through Berg Balance Scale and Mini-Balance Evaluation Systems (MiniBESTest), (5) functionality through the Katz Index, (6) mobility by Timed Up and Go test. Normality and homogeneity tests were performed through the Kolmogorov-Smirnov and Levene test, respectively. We have performed an Univariate and Multiple Linear Regression using the STATA software for clinical and demographic variables.
Results: 84 older adults who live in nursing home, mean age of 81.82 years (± 8.69) participated in the study. A univariate analysis between the dependent variable “retrospective fall” and independents variables showed association between age over 80 years (OR = 5.45; 95% CI 1.05 - 28.23; p = 0.043), marital status (loss of spouse) (OR = 3.78; 95% CI 1.51 - 9.49; p = 0.005), education over 7.5 years of study (OR = 2.65; 95% CI 1.09 - 6.40; p = 0.030); Philanthropic NR (OR = 0.24; 95% CI 0.09 - 0.63; p = 0.004), frail residents (OR = 2.69; 95% CI 1.06 - 6.84; p = 0.037); older adults partially dependents (OR = 7.11; 95% CI 2.60 - 19.42; p = 0.000) and older adults dependents (OR = 6.59; 95% CI 1.11 - 39.10; p = 0.038), decreased cognition (OR = 2.67; 95% CI 1.10 - 6.49; p = 0.029); decreased hand grip strength (OR = 3.25; 95% CI 1.32 - 8.01; p = 0.010), decreased walking speed (OR = 0.10; 95% CI 0.02 -0.50; p = 0.005) and low score in the MiniBESTest (OR = 6.42; 95% CI 2.46 - 16.71; p = 0.000). However, in the multivariate analysis, there was association between the independent variables with functional dependence (OR = 8.66; 95% CI 1.60 - 46.89; p = 0.012) and low score in the MiniBESTest (OR = 7.30; 95% CI 1.35 - 39.25; p = 0.020).
Conclusion(s): The main risk factors for falls in older adults who live in nursing home are related to functional dependence and postural control.
Implications: Our results suggest that it is important to include the assessment of postural control and functional status in the Long-term care institutions with the aim of detecting the elderly with high risk of falls to preventing and reducing the number of falls.
Funding, acknowledgements: This study was funded by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES).
Keywords: institutionalized elderly, nursing homes, falls
Topic: Older people
Did this work require ethics approval? Yes
Institution: University of Sao Paulo
Committee: School of Medicine of the University of Sao Paulo
Ethics number: 53540716.3.0000.0065
All authors, affiliations and abstracts have been published as submitted.
