Yaşlılarda Düşmenin Değerlendirilmesi: Huzursuz Bacak Sendromu ile Düşmeler Arasında İlişki Var mı?

Öz

Amaç: Düşme riski yaşlı hastalarda ileri yaşa eşlik eden komorbid hastalıklar nedeni ile yüksektir. Sensörimotor bir bozukluk olan huzursuz bacak sendromu (HBS) parestezi ve motor semptomlar ile karakterize olup uyku bozukluklarına yol açar. Bu çalışmanın amacı geriatrik hastalarda huzursuz bacak sendromunun düşmeler üzerine etkisini ve düşmelerle ilişkili diğer risk faktörlerini araştırmaktır.

Materyal ve Metot: Çalışmamız kesitsel olup, 65 yaş ve üzeri hastaları kapsamaktadır. HBS tanısı Uluslararası Huzursuz Bacak Sendromu Çalışma Grubu, 2012 kriterlerine göre konulmuştur. Hastalar kapsamlı geriatrik muayene ile değerlendirilmiştir. HBS, geriatrik problemler ve düşmeler arasındaki ilişki binominal lojistik regresyon ile analiz edilmiştir.

Bulgular: Çalışmaya toplam 70 hasta alınmıştır. Hastaların otuz yedisi kadın olup, %44.3’ü yaşlı bakım evinde kalmaktadır. Huzursuz bacak sendromu oranı %15.7’dir. Bir önceki yılda düşme oranı %24.3’tür. Komorbidite ve polifarmasi oranları sırasıyla %37.1 ve % 65.7’dir. Çalışmaya katılanların %21.4’ü günlük yaşam aktivelerinde (GYA) bağımlı bulunmuşken; %40’ında kalk ve yürü testi pozitiftir. Depresyon ve kognitif bozukluk tarama testleri sırasıyla %47.1 ve %38.6’sında pozitiftir. Huzursuz bacak sendromu, kalk ve yürü testi ile düşmeler arasındaki ilişki istatiksel olarak anlamlı bulunmuştur (p=0.041, OR=6.59 ve p=0.046, OR=6.31).

Sonuç: Çalışmamız huzursuz bacak sendromunun yaşlı hastalarda düşmeler için bir risk faktörü olduğunu göstermiştir. Bu çalışma klinisyenlerin huzursuz bacak sendromunun bir düşme riski olabileceği konusundaki duyarlılığını arttıracaktır. Yaşlı hastalarda düşmelere sebep olan risk faktörleri araştırılıp, modifiye edilirken huzursuz bacak sendromu da göz önünde bulundurulmalıdır. Ayrıca düşme ve pozitif kalk ve yürü testi ilişkisi de anlamlı bulunmuştur. Bu bağlamda kalk ve yürü testi düşme değerlendirmesinin önemli bir parçası olarak ele alınmalıdır.

Anahtar Kelimeler

• Huzursuz Bacak Sendromu,Düşme,Geriyatrik Değerlendirme,Komorbidite

Assessment of Falls in Older People: Is There any Association Between Restless Leg Syndrome and Falls?

Abstract

Objectives: The fall risk increases in the elderly due to comorbidities and age. Restless legs syndrome (RLS) might be a potential risk factor since it is a sensorimotor disorder. It is associated with paresthesias and motor restlessness which may cause sleep problems. The aim of this study is to evaluate the effect of restless legs syndrome on falls among geriatric patients and identify the other risk factors for falls.

Materials and Methods: This is a cross sectional study including patients 65 years and older. The diagnosis of RLS was established with 2012 International Restless Legs Syndrome Study Group criteria. Patients were evaluated with comprehensive geriatric assessment. The association between falls and RLS and geriatric conditions was evaluated with binominal logistic regression analysis.

Results: There were total 70 patients in the study. 44.3% of patients were living in the assisted living facility. There were 37 females. The rate of restless legs syndrome was shown 15.7%. The number of falls in the last one year was 24.3%. The rate of comorbidity and polypharmacy was 37.1% and 65.7% respectively. 21.4% patients were dependent on activities of daily living (ADL) and 40% had positive timed up and go (TUG) test. Possible depression and cognitive impairment rate was found 47.1% and 38.6 respectively. The association between falls and RLS and positive TUG test was found statistically significant (p=0.041, OR=6.59 and p=0.046, OR=6.31).

Conclusion: Our study revealed that RLS is a risk factor for falls in elderly. It is essential to address and modify the underlying risk factors including RLS in older patients. This finding would increase the awareness of physicians about RLS as a risk factor for falls. Also the association between falls and positive TUG test has been found statistically significant. Our study suggests that performing TUG test should be an essential part of fall evaluation.

Keywords

• Restless Leg Syndrome,Falls,Geriatric Assessment,Comorbidity

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