Epidemiological profile and risk assessment of falls in elderly users of the Family Health Strategy

Authors

DOI:

https://doi.org/10.33448/rsd-v10i12.20277

Keywords:

Aging; Postural balance; Dizziness.

Abstract

This study aims to identify the epidemiological profile and assess the occurrence of dizziness and the risk of falling in elderly people in the municipality of Serra Talhada, Pernambuco, Brazil. Therefore, a quantitative, descriptive and cross-sectional epidemiological study was carried out with elderly people complaining of dizziness and users of the Primary Care network of Serra Talhada, from August 2017 to August 2018. Questionnaires were used on the epidemiological profile, history medical history and dizziness. The risk of falls was assessed using the Timed Up and Go (TUG) test with logistic regression of the dichotomized variable (presence or absence of dependence). 101 individuals were evaluated, predominantly female, brown, with incomplete primary education, married, retired and sedentary. The average age was 71.1. The main comorbidities were Systemic Arterial Hypertension, visual impairment and arthritis. The TUG mean was 15.9 seconds, with no statistically significant relationship with gender, occurrence of dizziness, physical activity or self-perceived health. There was a direct relationship between dependence and age and the presence of diabetes mellitus, and an inverse relationship with the presence of SAH. It was found, through the analysis of the epidemiological profile and the identification of the variables that best contribute to the probabilistic occurrence of dependence according to the TUG criteria, inferring risk factors associated with the fall, allowing a quick and effective approach that could reduce the its occurrence.

Author Biography

Daniela de Araújo Viana Marques, Universidade de Pernambuco

Laboratório de Biotecnologia Aplicada a Doenças Infecto-Parasitárias.

References

Abreu, D. R. D. O. M., Novaes, E. S., Oliveira, R. R. D., Mathias, T. A. D. F., & Marcon, S. S. (2018). Internação e mortalidade por quedas em idosos no Brasil: análise de tendência. Ciencia & saude coletiva, 23, 1131-1141.

Acar, S., Demırbüken, İ., Algun, C., Malkoç, M., & Tekın, N. (2015). Is hypertension a risk factor for poor balance control in elderly adults? Journal of physical therapy science, 27(3), 901-904.

Andrade, I. R., de Almeida Souza, E., da Luz, L. A., & Júnior, E. P. P. (2017). Características e gastos com hospitalizações por quedas em idosos na Bahia.Ansai, J. H., Andrade, L. P. D., Nakagawa, T. H., & Rebelatto, J. R. (2018). Performances on the Timed Up and Go Test and subtasks between fallers and non-fallers in older adults with cognitive impairment. Arquivos de neuro-psiquiatria, 76, 381-386.

Araújo, A. H. D., Patrício, A. C. F. D. A., Ferreira, M. A. M., Rodrigues, B. F. L., Santos, T. D. D., Rodrigues, T. D. D. B., & Silva, R. A. R. D. (2017). Falls in institutionalized older adults: risks, consequences and antecedents. Revista brasileira de enfermagem, 70, 719-725.

Barry, E., Galvin, R., Keogh, C., Horgan, F., & Fahey, T. (2014). Is the Timed Up and Go test a useful predictor of risk of falls in community dwelling older adults: a systematic review and meta-analysis. BMC geriatrics, 14(1), 1-14. https://doi.org/10.1186/1471-2318-14-14

Battisti I. A. D. & Smolski F. M. S. (2020). Curso Avançado em Estatística com R da UFFS. smolski.github.io/livroavancado.

Bischoff, H. A., Stähelin, H. B., Monsch, A. U., Iversen, M. D., Weyh, A., Von Dechend, M., & Theiler, R. (2003). Identifying a cut‐off point for normal mobility: a comparison of the timed ‘up and go’test in community‐dwelling and institutionalised elderly women. Age and ageing, 32(3), 315-320.

Bohannon, R. W. (2006). Reference values for the timed up and go test: a descriptive meta-analysis. Journal of geriatric physical therapy, 29(2), 64-68. https://doi.org/10.1519/00139143-200608000-00004

Bouccara, D., Rubin, F., Bonfils, P., & Lisan, Q. (2018). Vertiges et troubles de l’équilibre: démarche diagnostique [Management of vertigo and dizziness]. La Revue de medecine interne, 39(11), 869–874. https://doi.org/10.1016/j.revmed.2018.02.004

Brown, S. J., Handsaker, J. C., Bowling, F. L., Boulton, A. J., & Reeves, N. D. (2015). Diabetic peripheral neuropathy compromises balance during daily activities. Diabetes care, 38(6), 1116–1122. https://doi.org/10.2337/dc14-1982

Browne, W., & Nair, B. (2019). The Timed Up and Go test. The Medical journal of Australia, 210(1), 13–14.e1. https://doi.org/10.5694/mja2.12045

Chagas, D. L., Rodrigues, A. L. P., Brito, L. C. & Soares, E. S. (2018). Relação entre o equilíbrio corporal e o risco de quedas em idosos de um projeto social de Fortaleza-CE. Revista Brasileira de Prescrição e Fisiologia do Exercício, 12(76):547-555.

Ciorba, A., Bianchini, C., Scanelli, G., Pala, M., Zurlo, A., & Aimoni, C. (2017). The impact of dizziness on quality-of-life in the elderly. European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 274(3), 1245–1250. https://doi.org/10.1007/s00405-016-4222-z

Coelho Junior, H. J., Rodrigues, B., Aguiar, S. D. S., Goncalves, I. D. O., Pires, F. D. O., Asano, R. Y., & Uchida, M. C. (2017). Hypertension and functional capacities in community-dwelling older women: a cross-sectional study. Blood pressure, 26(3), 156-165. https://doi.org/10.1080/08037051.2016.1270163

Coelho-Junior, H. J., Rodrigues, B., de Oliveira Gonçalves, I., Asano, R. Y., Uchida, M. C., & Marzetti, E. (2018). The physical capabilities underlying timed “Up and Go” test are time-dependent in community-dwelling older women. Experimental gerontology, 104, 138-146. https://doi.org/10.1016/j.exger.2018.01.025

Cruz, D. T. D., Ribeiro, L. C., Vieira, M. D. T., Teixeira, M. T. B., Bastos, R. R., & Leite, I. C. G. (2012). Prevalência de quedas e fatores associados em idosos. Revista de saúde pública, 46, 138-146. https://doi.org/10.1590/S0034-89102011005000087

Cuevas-Trisan, R. (2019). Balance problems and fall risks in the elderly. Clinics in geriatric medicine, 35(2), 173-183.https://doi.org/10.1016/j.cger.2019.01.008

Dantas, E. L., de Brito, G. E. G. & Lobato, I. A. F. (2012). Prevalência de quedas em idosos adscritos à Estratégia de Saúde da Família do município de João Pessoa, Paraíba. Rev APS, 15(1):67-75.

de Freitas Mussi, R. F., Mussi, L. M. P. T., Assunção, E. T. C., & Nunes, C. P. (2019). Pesquisa Quantitativa e/ou Qualitativa: distanciamentos, aproximações e possibilidades. Revista Sustinere, 7(2), 414-430.

Dobson A.J. (2002). An introduction to generalized linear models. (2a ed.), Boca Raton: Chapman & Hall.

Doré, A. L., Golightly, Y. M., Mercer, V. S., Shi, X. A., Renner, J. B., Jordan, J. M., & Nelson, A. E. (2015). Lower-extremity osteoarthritis and the risk of falls in a community-based longitudinal study of adults with and without osteoarthritis. Arthritis care & research, 67(5), 633–639. https://doi.org/10.1002/acr.22499

Dutra M. C., Cabral, A. L. L. & Carvalho G. A. (2016). Tradução para o português e validação do teste Timed up and go. Rev. Interfaces, Saúde, Hum Tecnol, 3(9):81-88. https://doi.org/X.430.INSS

Ferreira, C. G., Gazzola, J. M., Cendoroglo, M. S., Dias, V. N. & Ganança, F. F. (2019) Fatores associados ao equilíbrio postural de idosos longevos. Fisioter mov, 32:e003240. https://doi.org/10.1590/1980-5918.032.AO40

Field A. Descobrindo a Estatística usando o SPSS. 2. Artmed; 2011.

Gioacchini, F. M., Albera, R., Re, M., Scarpa, A., Cassandro, C., & Cassandro, E. (2018). Hyperglycemia and diabetes mellitus are related to vestibular organs dysfunction: truth or suggestion? A literature review. Acta diabetologica, 55(12), 1201–1207. https://doi.org/10.1007/s00592-018-1183-2

Hewston, P., & Deshpande, N. (2016). Falls and Balance Impairments in Older Adults with Type 2 Diabetes: Thinking Beyond Diabetic Peripheral Neuropathy. Canadian journal of diabetes, 40(1), 6–9. https://doi.org/10.1016/j.jcjd.2015.08.005

Ibrahim, A., Singh, D., & Shahar, S. (2017). 'Timed Up and Go' test: Age, gender and cognitive impairment stratified normative values of older adults. PloS one, 12(10), e0185641. https://doi.org/10.1371/journal.pone.0185641

Ibrahim, A., Singh, D., Shahar, S., & Omar, M. A. (2017). Timed up and go test combined with self-rated multifactorial questionnaire on falls risk and sociodemographic factors predicts falls among community-dwelling older adults better than the timed up and go test on its own. Journal of multidisciplinary healthcare, 10, 409–416. https://doi.org/10.2147/JMDH.S142520

Instituto Brasileiro de Geografia e Estatística. Censo 2010 [Internet]. IBGE. https://censo2010.ibge.gov.br/

Jahn K. (2019). The Aging Vestibular System: Dizziness and Imbalance in the Elderly. Advances in oto-rhino-laryngology, 82, 143–149. https://doi.org/10.1159/000490283

Kang, L., Chen, X., Han, P., Ma, Y., Jia, L., Fu, L., Yu, H., Wang, L., Hou, L., Yu, X., An, Z., Wang, X., Li, L., Zhang, Y., Zhao, P., & Guo, Q. (2018). A Screening Tool Using Five Risk Factors Was Developed for Fall-Risk Prediction in Chinese Community-Dwelling Elderly Individuals. Rejuvenation research, 21(5), 416–422. https://doi.org/10.1089/rej.2017.2005

Khow, K., & Visvanathan, R. (2017). Falls in the Aging Population. Clinics in geriatric medicine, 33(3), 357–368. https://doi.org/10.1016/j.cger.2017.03.002

Kojima, G., Masud, T., Kendrick, D., Morris, R., Gawler, S., Treml, J., & Iliffe, S. (2015). Does the timed up and go test predict future falls among British community-dwelling older people? Prospective cohort study nested within a randomised controlled trial. BMC geriatrics, 15, 38. https://doi.org/10.1186/s12877-015-0039-7

Kurosawa, C., Shimazu, N., & Yamamoto, S. (2020). Where do healthy older adults take more time during the Timed Up and Go test? Journal of physical therapy science, 32(10), 663–668. https://doi.org/10.1589/jpts.32.663

Laurence, B. D., & Michel, L. (2017). The Fall in Older Adults: Physical and Cognitive Problems. Current aging science, 10(3), 185–200. https://doi.org/10.2174/1874609809666160630124552

Long, J., Cai, T., Huang, X., Zhou, Y., Kuang, J., & Wu, L. (2020). Reference value for the TUGT in healthy older people: A systematic review and meta-analysis. Geriatric Nursing, 41(3), 325-330. https://doi.org/10.1016 / j.gerinurse.2019.11.012

Marchetti, G. F., Whitney, S. L., Redfern, M. S., & Furman, J. M. (2011). Factors associated with balance confidence in older adults with health conditions affecting the balance and vestibular system. Archives of physical medicine and rehabilitation, 92(11), 1884–1891. https://doi.org/10.1016/j.apmr.2011.06.015

Mari, F. R., Alves, G. G., Aerts, D. R. G. D. C., & Camara, S. (2016). O processo de envelhecimento e a saúde: o que pensam as pessoas de meia-idade sobre o tema. Revista Brasileira de Geriatria e Gerontologia, 19, 35-44. https://doi.org/10.1590/1809-9823.2016.14122

Mathias, S., Nayak, U. S., & Isaacs, B. (1986). Balance in elderly patients: the "get-up and go" test. Archives of physical medicine and rehabilitation, 67(6), 387–389.

Moreland, B., Kakara, R., & Henry, A. (2020). Trends in Nonfatal Falls and Fall-Related Injuries Among Adults Aged ≥65 Years - United States, 2012-2018. MMWR. Morbidity and mortality weekly report, 69(27), 875–881. https://doi.org/10.15585/mmwr.mm6927a5

National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Population Health and Public Health Practice, Committee on Public Health Approaches to Reduce Vision Impairment and Promote Eye Health, Welp, A., Woodbury, R. B., McCoy, M. A., & Teutsch, S. M. (Eds.). (2016). Making Eye Health a Population Health Imperative: Vision for Tomorrow. National Academies Press (US).

Oliveira, M. R. D., Inokuti, T. T., Bispo, N. N. D. C., Oliveira, D. A. D. A. P., Oliveira, R. F. D., & Silva, R. A. D. (2015). Elderly individuals with increased risk of falls show postural balance impairment. Fisioterapia em Movimento, 28, 269-276. https://doi.org/10.1590/0103-5150.028.002.AO07

Pavanate, A.A., Hauser, E., Gonçalves, A.K. & Mazo, G.Z. (2018). Avaliação do equilíbrio corporal em idosas praticantes de atividade física segundo a idade. Rev Bras Ciênc Esporte, 40(4):404-409. https://doi.org/10.1016/j.rbce.2018.03.023

Podsiadlo, D., & Richardson, S. (1991). The timed "Up & Go": a test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society, 39(2), 142–148. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x

Pondal, M., & del Ser, T. (2008). Normative data and determinants for the timed "up and go" test in a population-based sample of elderly individuals without gait disturbances. Journal of geriatric physical therapy (2001), 31(2), 57–63. https://doi.org/10.1519/00139143-200831020-00004

Rawlings, J.O., Pantula, S.G. & Dickey, D.A. (1998). Applied Regression Analysis: a research tools. Springer.

Carbonell, F. R., Ocampo, E. M. H., Pascual, J. M. A., Soler, E., Clapera, F., & Panicot, J. E. (2014). Experiencia de una Unidad de Prevención de Caídas de un hospital de cuidados intermedios. Revista Española de Geriatría y Gerontología, 49(2), 69-71. https://doi.org/10.1590/1518-8345.2953-3145

Rodrigues, A., Assef, J. C., & Lima, C. B. (2019). Assessment of risk factors associated with falls among the elderly in a municipality in the state of Paraíba, Brazil. A cross-sectional study. Sao Paulo medical journal = Revista paulista de medicina, 137(5), 430–437. https://doi.org/10.1590/1516-3180.2018.0198120619

Rodrigues, M. M. P., Falcão, R. M. D. M., Veras, R. F. S., Barbosa, K. T. F., de Oliveira, F. M. R. L., Pereira, M. A., ... & dos Santos Oliveira, J. (2017). Timed up and go risk predictor of falls in elderly people residing in the community? International archives of medicine, 10.

Roshdibenam, V., Jogerst, G. J., Butler, N. R., & Baek, S. (2021). Machine Learning Prediction of Fall Risk in Older Adults Using Timed Up and Go Test Kinematics. Sensors (Basel, Switzerland), 21(10), 3481. https://doi.org/10.3390/s21103481

Rubenstein, L. Z., & Josephson, K. R. (2006). Falls and their prevention in elderly people: what does the evidence show?. The Medical clinics of North America, 90(5), 807–824. https://doi.org/10.1016/j.mcna.2006.05.013

Santos, R. K. M., Maciel, A. C. C., Britto, H. M. J. S., Lima, J. C. C. & Souza T. O. (2015). Prevalência e fatores associados ao risco de quedas em idosos adscritos a uma Unidade Básica de Saúde do município de Natal, RN, Brasil. Cien Saude Colet, 20(12):3753-3762. https://doi.org/10.1590/1413-812320152012.00662015

Schlick, C., Schniepp, R., Loidl, V., Wuehr, M., Hesselbarth, K., & Jahn, K. (2016). Falls and fear of falling in vertigo and balance disorders: A controlled cross-sectional study. Journal of vestibular research: equilibrium & orientation, 25(5-6), 241–251. https://doi.org/10.3233/VES-150564

Silva, E. M. T. D., Lima, B. F. D., Mantello, É. B., Sousa, A. G. P. D., Diniz, J., & Gazzola, J. M. (2019). Diseases and symptoms associated with changes in postural balance in diabetics: an integrating literature review. Revista CEFAC, 21. https://doi.org/10.1590/1982-0216/201921617318

Sorond, F. A., Cruz-Almeida, Y., Clark, D. J., Viswanathan, A., Scherzer, C. R., De Jager, P., Csiszar, A., Laurienti, P. J., Hausdorff, J. M., Chen, W. G., Ferrucci, L., Rosano, C., Studenski, S. A., Black, S. E., & Lipsitz, L. A. (2015). Aging, the Central Nervous System, and Mobility in Older Adults: Neural Mechanisms of Mobility Impairment. The journals of gerontology. Series A, Biological sciences and medical sciences, 70(12), 1526–1532. https://doi.org/10.1093/gerona/glv130

Stolt, L. R. O. G., Kolisch, D. V., Tanaka, C. & Cardoso, M. R. A. (2020), Schmitt ACB. Increase in fall-related hospitalization, mortality, and lethality among older adults in Brazil. Rev Saude Publica, 54:76. https://doi.org/10.11606/s1518-8787.2020054001691

Suzman, R., Beard, J. R., Boerma, T., & Chatterji, S. (2015). Health in an ageing world--what do we know? Lancet (London, England), 385(9967), 484–486. https://doi.org/10.1016/S0140-6736(14)61597-X2.

Tavares, R. E., Jesus, M. C. P. D., Machado, D. R., Braga, V. A. S., Tocantins, F. R., & Merighi, M. A. B. (2017). Envelhecimento saudável na perspectiva de idosos: uma revisão integrativa. Revista brasileira de geriatria e gerontologia, 20, 878-889. https://doi.org/10.1590/1981-22562017020.170091

Timar, B., Timar, R., Gaiță, L., Oancea, C., Levai, C., & Lungeanu, D. (2016). The Impact of Diabetic Neuropathy on Balance and on the Risk of Falls in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study. PloS one, 11(4), e0154654. https://doi.org/10.1371/journal.pone.0154654

Vanspauwen R. (2018). Tontura e medo de cair em idosos: alguns fatos. The journal of international advanced otology, 14 (1), 1–2. https://doi.org/10.5152/iao.2018.0201815

Vennu, V., & Bindawas, S. M. (2014). Relationship between falls, knee osteoarthritis, and health-related quality of life: data from the Osteoarthritis Initiative study. Clinical interventions in aging, 9, 793–800. https://doi.org/10.2147/CIA.S62207

Waisman G. (2017). Hipertensión arterial en el anciano [Arterial hypertension in the elderly]. Hipertension y riesgo vascular, 34(2), 61–64. https://doi.org/10.1016/j.hipert.2017.03.004

Zalewski C. K. (2015). Aging of the Human Vestibular System. Seminars in hearing, 36(3), 175–196. https://doi.org/10.1055/s-0035-1555120

Published

19/09/2021

How to Cite

SOUZA, L. K. M. de .; PEREIRA, V. M. A. .; AQUINO, A. N. .; ALMEIDA, M. M. de; SERAFIM, J. L. .; GALVÃO, P. V. M. .; MARQUES, D. de A. V. . Epidemiological profile and risk assessment of falls in elderly users of the Family Health Strategy . Research, Society and Development, [S. l.], v. 10, n. 12, p. e262101220277, 2021. DOI: 10.33448/rsd-v10i12.20277. Disponível em: https://www.rsdjournal.org/index.php/rsd/article/view/20277. Acesso em: 19 apr. 2024.

Issue

Section

Health Sciences