Comparison of Risk Factors for Falls in the Old and the Oldest Old Admitted to the Emergency Department

Abstract

Background: Falls can cause a wide range of consequences from a simple injury to life-threatening situations. As falls are a major cause of mortality and morbidity in older adults, it is important to identify risk factors. Our aim was to evaluate fall risk factors in geriatric patients presenting to the emergency department with fall and to evaluate the variability of fall risk factors in the group below and above 85 years of age (oldest old). Materials and Methods: A total of 132 geriatric patients admitted to the emergency department of a univer-sity hospital due to falls were retrospectively analysed. Demographic characteristics and chronic diseases of patients, number of drugs, previous fall history, unintentional weight loss, depressive symptoms, anaemia, urinary incontinence, fear of falling, orthostatic hypotension were recorded. Edmonton frail scale, clock-draw-ing test and geriatric depression scale score was also evaluated. Results: The mean age of our study population was 80.5 ±8.3. While 80 (60.6%) of the patients were below 85 years of age, 52 (39.4%) were aged 85 years and older. 62 (47%) of the patients were frail and orthostatic hypotension was found in 10 (7.6%) of the patients. Fear of falling was observed in 67 (50.8%) patients. Polypharmacy was present in 62 (47%) patients. Frequency of diabetes mellitus, frailty, fear of falling, walking aid usage and the need for a regular caregiver were significantly higher and clock-drawing test score was lower in the oldest old group (p<0.05, for all). Conclusions: Falls are common in older patients. Our study clearly revealed the frequency of fall risk factors in the geriatric population admitted to the emergency department. The frequency of frailty was higher in the oldest old (over 85 years old) who presented with falls, and fear of falling was found in these patients even if there was no previous history of falling. Necessary precautions should be taken considering the negative con-sequences of falls.

Keywords

• Fall
• Geriatric
• Emergency department
• Risk factor
• Oldest old

Acil Servise Başvuran Yaşlı ve İleri Yaşlılarda Düşme Risk Faktörlerinin Karşılaştırılması

Abstract

Amaç: Düşmeler, basit bir yaralanmadan hayatı tehdit eden durumlara kadar geniş bir yelpazede sonuçlara neden olabilir. Düşmeler yaşlı yetişkinlerde önemli bir mortalite ve morbidite nedeni olduğundan, risk faktör-lerinin belirlenmesi önemlidir. Amacımız acil servise düşme ile başvuran geriatrik hastalarda düşme risk fak-törlerini değerlendirmek ve 85 yaş altı ve üstü grupta düşme risk faktörlerinin değişkenliğini değerlendirmektir. Materyal ve Metod: Bir üniversite hastanesi acil servisine düşme nedeniyle başvuran 132 geriatrik hasta geriye dönük olarak incelendi. Hastaların demografik özellikleri ve kronik hastalıkları, ilaç sayısı, düşme öyküsü, istemsiz kilo kaybı, depresif semptomlar, anemi, düşme korkusu, ortostatik hipotansiyon varlığı kaydedildi. Ed-monton kırılganlık ölçeği, saat çizme testi ve geriatrik depresyon ölçeği skorları da değerlendirildi. Bulgular: Çalışma popülasyonumuzun yaş ortalaması 80.5 ±8.3 idi. Hastaların 80'i (%60,6) 85 yaş altında iken, 52'si (%39,4) 85 yaş ve üzerindeydi. Hastaların 62'si (%47) kırılgandı, 10’unda (%7.6) ortostatik hipotansiyon vardı. Düşme korkusu 67 (%50,8) hastada gözlenmiştir. 62 (%47) hastada polifarmasi mevcuttu. Diabetes melli-tus sıklığı, kırılganlık, düşme korkusu, yürümeye yardımcı cihaz kullanımı ve düzenli bakıcı ihtiyacı 85 yaş üstü grupta anlamlı olarak daha yüksek, saat çizme test skoru daha düşüktü (hepsi için p<0.05. Sonuç: Yaşlı hastalarda düşmeler yaygındır. Çalışmamız acil servise düşme ile başvuran yaşlılarda düşme risk faktörlerinin sıklığını açıkça ortaya koymuştur. Düşme ile başvuran ileri yaş hastalarda (85 yaş üzeri) kırılganlık sıklığı daha yüksek olup, bu hastalarda daha önce düşme öyküsü olmasa bile düşme korkusu saptanmıştır. Düşmelerin olumsuz sonuçları göz önünde bulundurularak gerekli önlemler alınmalıdır.

Keywords

• fall
• geriatric
• emergency department
• risk factor

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