Prevalence and predictors of falls and dizziness in people younger and older than 80 years of age—A longitudinal cohort study (original) (raw)
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2014
Falling in old age may have a large impact on daily life. Falls can lead to injuries, reduced mobility and reduced quality of life. The risk of falls increases with age and frailty level. Dizziness is a strong risk factor for falls, and preventing falls and dizziness in older people is essential. The overall aim of this thesis was to investigate risk factors for falls or dizziness and to explore older people’s experiences of living with chronic dizziness. Furthermore, the aim was to evaluate the effects of a home-based case management intervention on falls in frail older people. The thesis comprised three studies. Study I was a longitudinal cohort study, the Swedish National Study on Aging and Care (SNAC), with 1,402 participants in 10 age cohorts from 60 to 96 years. The study started in 2001 and follow-up was done after 3 and 6 years. The sample was divided into subjects aged 60-78 years and 80-96 years and the prevalence and predictors of falls or dizziness were investigated (Pap...
Aging Clinical and Experimental Research
Background Dizziness is common among older people and falling is a feared complication. Aim The purpose of this study was to investigate the presence of dizziness and its association with falls, walking speed and fear of falling, including sex differences, among 79-year-olds. Secondary purposes were to describe the relationship between dizziness and falls to number of medications and diseases. Method The study consisted of the fifth cohort of Gothenburg’s H70 birth cohort studies. A sample of 662 79-year-olds (404 women, 258 men) were investigated with questions regarding dizziness, previous falls and falls efficacy [estimated according to the falls efficacy scale Swedish version (FES (S))]. Functional tests included self-selected and maximal walking speed over 20 m. Results Dizziness was reported among 51% of the women and by 58% of the men (p = 0.12). Approximately, 40% had fallen during the past 12 months (41% women, 38% of the men, p = 0.48). Dizziness was related to a higher ri...
Dizziness in community-dwelling older adults: a population-based study
Brazilian journal of otorhinolaryngology
Dizziness is a common complaint among older adults. To identify the prevalence of dizziness and its related factors in a sample of community-dwelling older adults. A prospective population-based study with a representative sample of older adults aged 65 years and over. A multidimensional questionnaire and a battery of measures were used for assessing physical function. The prevalence of dizziness was 45%. Vertigo was found in 70.4% of older adults with dizziness and 43.8% of them referred vertigo crises along life. A significant association was found between dizziness and female gender (p=0.004), memory difficulties complaints (p=0.015), bad health perception (p=0.001), depression (p<0.0001), five or more comorbidities (p=0.021), self-reported fatigue (p<0.0001), recurrent falls (p=0.001), excessive sleepiness (p=0.003), fear of falling (p<0.0001), left leg unipedal stance (p=0.002) and Short Performance Physical Battery score (p=0.009). Dizziness is a common complaint amon...
BMC Geriatrics, 2013
Background: Accidental falls in the elderly are a major health problem, despite extensive research on risk factors and prevention. Only a limited number of multifactorial, long-term prospective studies have been performed on risk factors for falls in the general elderly population. The aim of this study was to identify risk factors predicting falls in a general elderly population after three and six years, using a prospective design. Methods: The prevalence of 38 risk factors was recorded at a baseline assessment of 1763 subjects (aged 60-93 years). The incidence of one or more falls was recorded after three and six years. The predicted risk of falling, after exposure to the various risk factors, was analysed in a multiple logistic regression model, adjusted for age and sex, and presented as odds ratios (OR). A principal component analysis (PCA), including the statistical significant factors, was also performed to identify thematic, uncorrelated components associated with falls. Results: The use of neuroleptics (OR 3.30, 95% CI: 1.15-9.43), heart failure with symptoms (OR 1.88, 95% CI: 1.17-3.04) and low walking speed (OR 1.77, 95% CI: 1.28-2.46) were prominent individual risk factors for falls. In the PCA, three main components predicting falls were identified: reduced mobility, OR 2.12 (95% CI 1.54-2.91), heart dysfunction, OR 1.66 (95% CI 1.26-2.20) and functional impairment including nocturia, OR 1.38 (95% CI 1.01-1.88). Conclusions: Three main components predicting falls were identified in a general elderly population after three and six years: reduced mobility, heart dysfunction and functional impairment including nocturia. The use of neuroleptic drugs was also a prominent individual risk factor, although the prevalence was low. Heart failure with symptoms was a significant risk factor for falls and may be of clinical importance as the prevalence of this condition in the elderly is increasing worldwide. There is need for further research on the relation between heart failure and falls in the elderly, as the treatment for this condition is poorly documented in this demographic. The findings of this study may be valuable in the development of intervention programmes aimed at sustainable, long-term reduction of falls in the elderly.
Use of posturography to identify the risk of falling in elderly people with dizziness
Audiology - Communication Research
Purpose the aim of this study is to determine whether posturography, an exam used to investigate the ability to maintain balance under conflicting sensory conditions, can identify the risk of falls in eldery patients with dizziness. Methods to compare the posturographic results of elderly people with falls vs elderly people with no falls, paired by sex, age and dizziness etiology. Results 18 fallers, and, of these, 14 with two or more falls in the last year were compared with 18 elderly people without falls. Comparing subjects without falls vs subjects with at least one fall in the last year, fallers obtain worse scores in conditions of visual dependence. Comparing non fallers with subjects with two or more falls, people with recurrent falls obtain worse score in several conditions: somatosensorial, vestibular, visual conflict, and in the main measure, the composite score. Conclusion posturography appears to be a useful tool to identify those at high risk of recurrent falls.
Falls in very old people: The population-based Umeå 85+ Study in Sweden
Archives of Gerontology and Geriatrics, 2009
Aged, 80 and over Accidental falls Incidence of falls Risk factors Geriatric assessment A B S T R A C T The aim of this study was to describe incidences of falls and fall-related injuries, and to identify predisposing factors for falls in very old people in a prospective population-based follow-up study for falls. The study is part of the Umeå 85+ Study which includes half of the population aged 85, and the total population aged 90 and !95 (À103), in Umeå , Sweden. Of the 253 people interviewed, 220 (87%) were followed up for falls for 6 months, of whom 109 lived in ordinary and 111 in institutional housing. A comprehensive geriatric baseline assessment was made through interviews and testing during home visits. Forty percent of the participants did fall a total 304 times, corresponding to 2.17 falls per Person Year (PY). It occurred 0.83 injuries per PY, including 0.14 fractures per PY. In a Cox regression analysis, the independent explanatory risk factors for time to first fall were dependency in activities of daily living (ADL), thyroid disorders, treatment with selective serotonin reuptake inhibitors (SSRIs) and occurrence of falls in the preceding year. It could be predicted that every seventh participant and every third of the people who did fall would suffer a fracture within 1 year. ADL, thyroid disorders and treatment with SSRIs should be considered in fall prevention programmes. ß
Falls in 84- to 85-year-old people living at home
Accident Analysis & Prevention, 1992
present study is a part of the Swedish longitudinal population study "70-yearold people in Gothenburg". The aim of the present study was to analyse retrospectively incidence, circumstances, and consequences of falls during one year among 741 home-living people aged 84-85. A comparison of social and medical characteristics of failers and non-fallers aged 85 was performed. Information was collected by interviews and clinical examinations. In 1986/1987,732 home-living people (244 men and 488 women), aged 85 gave information about falls during the last year. Three hundred and one (41%). 97 men and 204 women. had fallen at least once durine the iast year, mainly indoors. No sex 'difference was found in incidence. The most dominant triggering causes of falls were stumbling, dizziness, and feebleness. In 80% of the falls an injury occurred, of which every fourth was a fracture. A multivariate regression procedure showed that dizziness, vertigo and unsteadiness, transient ischemic attacks, antidepressant drugs, and poor subjectively experienced health characterized the failers. Mortality rate of those between 85 and 88 years of age showed no association with falls.
Aging Clinical and Experimental Research, 2013
Background and aims The aim of this study was to describe the prevalence of falls in a general older population, especially among the most elderly, and the risk markers associated with falls. Methods This is a cross-sectional study in which 38 fall risk markers were analysed in non-, occasional-and frequent-fallers. The population was 2,865 individuals (aged 60-93), randomly selected from the general population register. The risk of falling was calculated as age-adjusted odds ratios. The relation between the number of risk markers for an individual and falls was also analysed. Results About one in ten reported falling during the past 6 months, 35 % of which were over 90 years old. Twentyone risk markers were significantly related to falls confirming falling as a multifactorial problem. These included a variety of diseases, symptoms, medical and physical functions, lifestyle factors and the taking of certain drugs. The five risk markers with the highest odds ratio in frequent fallers were 'tendency to fall' (37.9), 'low walking speed' (12.8), consumption of 'neuroleptics' (10.9), 'impaired mobility' (10.0) and 'dementia' (5.4). Subjects with more than four and seven risk markers showed a 9-respectively 28-fold increase in the risk of falling, especially among frequent fallers and those aged over 90 years. Conclusion Falls are common in the elderly population and the risk is multifactorial. The results imply that there is an overrepresentation of fallers in a distinct subgroup of the very elderly and those with multiple risk markers. The selfperceived clinical sign 'tendency to fall' seems highly sensitive as indicator of individuals at risk. Several risk markers may be treatable. Fall risk seems to increase in a non-linear, almost exponential way with increasing number of risk markers.
Brazilian Journal of Otorhinolaryngology, 2015
Introduction: Dizziness is among the most common complaints in the elderly population. Objective: To determine the sociodemographic and clinical-functional profiles of institutionalized elderly people related to dizziness. Methods: Cross-sectional prospective study with institutionalized elderly people aged 60 or more years. A questionnaire on sociodemographic and clinical-functional characteristics was applied, and an anamnesis of occurrence of dizziness was held, as well as the Dizziness Handicap Inventory questionnaire. Results: 48.9% of the elderly subjects had dizziness. The mean numbers of diseases and medications associated with dizziness were, respectively, 4.5 diseases and 7.8 medications. We found a significant association between the occurrence of dizziness and diseases of the musculoskeletal system, sub-connective tissue and genitourinary system, as well as the use of medications for the musculoskeletal system. The scores for handicap degree in functional DHI were significantly higher among elderly subjects who needed walking aids, who had suffered falls, and those manifesting anxiety. ଝ Please cite this article as: Rosa TSM, de Moraes AB, dos Santos Filha VAV. The institutionalized elderly: sociodemographic and clinicalfunctional profiles related to dizziness.