Yaşlı Hastalarda Düşmeler ve Risk Faktörleri

Year 2019, Volume: 4 Issue: 3, 117 - 121, 27.09.2019

Sevil Yılmaz , Leyla Khorshıd

Abstract

Özet
Düşmeler yaşlıları etkileyen yaygın bir problemdir ve önemli bir halk sağlığı sorunudur.
Hastalık Kontrol ve Önleme Merkezleri’ne ve Dünya Sağlık Örgütü raporlarına göre,
65 yaşın üzerindeki üç yetişkinden biri ve 80 yaşın üzerindeki yetişkinlerin yarısı her
yıl düşmektedir. Düşme kaynaklı yaralanma, bakım evlerinde en yaygın beşinci ölüm
nedenidir. Tüm riskleri oluşturan en büyük problemler; ayak ve ayakkabı problemleri,
duyusal veya algısal eksiklikler ve polifarmasi’dir. İlaç kullanımı, düşme ve düşmeyle ilişkili
yaralanmalar için en değiştirilebilir risk faktörlerinden biridir. Düşmeleri önlemek için;
ilaç kullanımının azaltılması, kapsamlı bir anamnez, düzenli kan basıncı kontrolü, tıbbi
durumların yaygınlığındaki farklılıklar göz önünde bulundurulmalıdır. Bu derlemenin
amacı; düşmelere ilişkin demografik ve değiştirilebilir risk faktörleri bilgilerini özetleyen
ilgili literatürün kısa bir özetini sağlamaktır.

Anahtar Kelimeler: Düşme riski, yaşlı, bakım.

Abstract
Falls are a common problem affecting the elderly and a major public health issue.
According to the Centers for Disease Control and Prevention and World Health
Organization reports, one in three adults over the age of 65 and half of the adults
over 80 fall each year. Fall-induced injury is the fifth most common cause of death
in nursing homes. The biggest problems that make up all the risks are foot and shoe
problems, sensory or perceptual deficits, and polypharmacy. Drug use is one of the most
changeable risk factors for falls and related injuries. To prevent falls, reduction of drug
use, acquiring a comprehensive medical history, regular blood pressure control, and
differences in the prevalence of medical conditions should be considered. The purpose
of this review is to provide a brief summary of the relevant literature summarizing
demographic and modifiable risk factors in falls.

Keywords: Fall risk, elderly, care.

Keywords

Düşme riski, yaşlı bakım

References

• Ambrose, A. F., Paul, G., & Hausdorff, J. M. (2013). Risk factors for falls among older adults: A review of the literature. Maturitas, 75(1), 51–61. https://doi.org/10.1016/j.maturitas.2013.02.009
• Aranda-Gallardo, M., Morales Asencio, J. M., Canca-Sanchez, J. C., Mora-Banderas, A. M., Moya-Suarez, A. B., Barrero-Sojo, S. et al. (2013).Instruments for assessing the risk of falls in acute hospitalized patients:A systematic review protocol. Journal of Advanced Nursing, 69(1), 185–193. https://doi.org/10.1111/j.1365-2648.2012.06104.x
• Asadi-pooya, A. A., Nikseresht, A., Yaghoubi, E., & Nei, M. (2012). Physical injuries in patients with epilepsy and their associated risk factors.Seizure. European Journal of Epilepsy, 21(3), 165–168. https://doi.org/10.1016/j.seizure.2011.10.009
• Asiri, F. Y., Alshahrani, A., Aseeri, M. F., Alam, M. M., & Sabri, M. (2018). Fall risks factors among home-based health care patients in the Aseer province :Observational study . Biomedical Research, 29(12), 2640–2645.
• Axmon, A., Sandberg, M., Ahlstrom, G., & Midlov, P. (2018). Fall-risk-increasing drugs and falls requiring health care among older people with intellectual disability in comparison with the general population: A register study. PLoS One, 13(6), e0199218. https://doi.org/10.1371/journal.pone.0199218
• Bell, H. T., Steinsbekk, A., & Granas, A. G. (2015). Factors influencing prescribing of fall-risk-increasing drugs to the elderly: A qualitative study. Scandinavian Journal of Primary Health Care, 33(2), 107–114. https://doi.org/10.3109/02813432.2015.1041829
• Berry, S. D., Placide, S. G., Mostofsky, E., Zhang, Y., Lipsitz, L. A., Mittleman, M. A. et al. (2018). Antipsychotic and Benzodiazepine Drug Changes Affect Acute Falls Risk Differently in the Nursing Home. Journals of Gerontology, 71(2), 273–278. https://doi.org/10.1093/gerona/glv091
• Callis, N. (2016). Falls prevention: Identification of predictive fall risk factors. Applied Nursing Research, 29, 53–58. https://doi.org/10.1016/j.apnr.2015.05.007
• Campanini, I., Mastrangelo, S., Bargellini, A., Bassoli, A., Bosi, G.,Lombardi, F. et al. (2018). Feasibility and predictive performance of the Hendrich Fall Risk Model II in a rehabilitation department :a prospective study. BMC Health Services Research, 1–9. https://doi.org/10.1186/s12913-017-2815-x
• Chang, C. M., Chen, M. J., Tsai, C. Y., Ho, L. H., Hsieh, H. L., Chau, Y. L. et al.(2011). Medical conditions and medications as risk factors of falls in the inpatient older people: A case-control study. International Journal of Geriatric Psychiatry, 26(6), 602–607. https://doi.org/10.1002/gps.2569
• Cimilli, T., Ak, R., Unal, E., Onur, O., & Eroglu, S. (2018). Factors Associated With Multiple Falls Among Elderly Patients Admitted to Emergency Department. International Journal of Gerontology, 11(2), 85–89.https://doi.org/10.1016/j.ijge.2016.05.009
• Costa-Dias, M. J., Oliveira, A. S., Martins, T., Araújo, F., Santos, A. S.,Moreira, C. N. et al. (2014). Medication fall risk in old hospitalized patients: A retrospective study. Nurse Education Today, 34(2), 171–176. https://doi.org/10.1016/j.nedt.2013.05.016
• De Groot, M. H., Van Campen, J. P. C. M., Moek, M. A., Tulner, L. R., Beijnen, J. H., & Lamoth, C. J. C. (2013). The effects of fall-risk-increasing drugs on postural control: A literature review. Drugs and Aging, 30(11), 901–920. https://doi.org/10.1007/s40266-013-0113-9
• Deandrea, S., Negri, E., & Ruggeri, F. (2014). Integrating clinicians’ opinion in the Bayesian meta-analysis of observational studies: The case of risk factors for falls in community-dwelling older people. Epidemiology Biostatistics and Public Health, 11(1), 1–14. https://doi.org/10.2427/8909
• Dillender, M. (2018). What happens when the insurer can say no ? Assessing prior authorization as a tool to prevent high-risk prescriptions and to lower costs. Journal of Public Economics, 165(March 2015), 170–200. https://doi.org/10.1016/j.jpubeco.2018.07.006
• Dunlop, D. D., Manheim, L. M., Sohn, M. W., Liu, X., & Chang, R. W. (2002). Incidence of functional limitation in older adults: The impact of gender, race, and chronic conditions. Archives of Physical Medicine and Rehabilitation, 83(7), 964–971. https://doi.org/10.1053/apmr.2002.32817
• Fernandez, C. R., Dadfar, F., Wong, A., & Brown, S. G. (2015). Use of fall risk increasing drugs in residents of retirement villages : a pilot study of long term care and retirement home residents in Ontario , Canada,1–10. https://doi.org/10.1186/s13104-015-1557-2
• Fortinsky, R. H., Iannuzzi-sucich, Ã. M., Baker, D. I., Gottschalk, M., King, M. B., Brown, Ã. C. J. et al. (2004). Fall-Risk Assessment and Management in Clinical Practice :Views from Healthcare Providers.JAGS, 52, 1522–1526.
• Freeland, K. N., Thompson, A. N., Zhao, Y., Leal, J. E., Mauldin, P. D., & Moran, W. P. (2012). Medication use and associated risk of falling in a geriatric outpatient population. Annals of Pharmacotherapy, 46(9), 1188–1192. https://doi.org/10.1345/aph.1Q689
• Goodwin, V. A., Abdoul, H., Whear, R., Bethel, A., Ukoumunne, O. C., Thompson-Coon, J. et al. (2014). Multiple component interventions for preventing falls and fall-related injuries among older people: systematic review and meta-analysis. BMC geriatrics, 14(1), 8.https://doi.org/10.1186/1471-2318-14-15
• Graham, B. C. (2012). Examining Evidence-Based Interventions to Prevent Inpatient Falls. MEDSURG Nursing, 21(5), 267–270. Tarihinde adresinden erişildi http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=82106527&site=eds-live
• Haasum, Y., Fastbom, J., & Johnell, K. (2016). Use of Fall-Risk Inducing Drugs in Patients Using Anti-Parkinson Drugs ( APD ): A Swedish Register-Based Study, 1–11. https://doi.org/10.1371/journal.pone.0161246
• Hohmann, N., Hohmann, L., & Kruse, M. (2014). The impact of combined use of fall-risk medications and antithrombotics on injury severity and intracranial hemorrhage among older trauma patients. Geriatric Nursing, 35(1), 20–25. https://doi.org/10.1016/j.gerinurse.2013.09.001
• Iinattiniemi, S., Jokelainen, J., & Luukinen, H. (2009). Falls risk among a very old home-dwelling population, (October 2008). https://doi.org/10.1080/02813430802588683
• Ko, A., Van Nguyen, H., Chan, L., Shen, Q., Ding, X. M., Chan, D. L. et al. (2012). Developing a self-reported tool on fall risk based on toileting responses on in-hospital falls. Geriatric Nursing, 33(1),9–16. https://doi.org/10.1016/j.gerinurse.2011.07.012
• Lee, J. Y., & Holbrook, A. (2017). The efficacy of fall-risk-increasing drug ( FRID ) withdrawal for the prevention of falls and fall-related complications : protocol for a systematic review and meta-analysis,1–7. https://doi.org/10.1186/s13643-017-0426-6
• Ma, M. (2017). Medication use and risk of falls among nursing home residents : a retrospective cohort study. Int J Clin Pharm, 408–415. https://doi.org/10.1007/s11096-017-0426-6
• Mamun, K., & Lim, J. K. H. (2009). Association between falls and high-risk medication use in hospitalized Asian elderly patients. Geriatrics and Gerontology International, 9(3), 276–281. https://doi.org/10.1111/j.1447-0594.2009.00533.x
• Maximos, M., Chang, F., & Patel, T. (2017). Risk of falls associated with antiepileptic drug use in ambulatory elderly populations :A systematic review. CPJ/RPC, 150(2), 101–112. https://doi.org/10.1177/1715163517690744
• Mojtaba, M., Alinaghizadeh, H., & Rydwik, E. (2018). Downton Fall Risk Index during hospitalisation is associated with fall-related injuries after discharge : a longitudinal observational study. Journal of Physiotherapy, 64(3), 172–177. https://doi.org/10.1016/j.jphys.2018.05.005
• Nelson, A., Powell-Cope, G., Gavin-Dreschnack, D., Quigley, P., Bulat, T.,Baptiste, A. S. et al. (2004). Technology to promote safe mobility in the elderly. Nursing Clinics of North America, 39(3), 649–671. https://doi.org/10.1016/j.cnur.2004.05.001
• Obayashi, K., Araki, T., Nakamura, K., Kurabayashi, M., Nojima, Y., Hara, K. et al. (2013). Risk of falling and hypnotic drugs: Retrospective study of inpatients. Drugs in R and D, 13(2), 159–164. https://doi.org/10.1007/s40268-013-0019-3
• Olsson Möller, U., Midlöv, P., Kristensson, J., Ekdahl, C., Berglund, J.,& Jakobsson, U. (2013). Prevalence and predictors of falls and dizziness in people younger and older than 80 years of age-A longitudinal cohort study. Archives of Gerontology and Geriatrics, 56(1), 160–168. https://doi.org/10.1016/j.archger.2012.08.013
• Paulozzi, L. J. (2012). Prescription drug overdoses: A review. Journal of Safety Research, 43(4), 283–289. https://doi.org/10.1016/j.jsr.2012.08.009
• Pohl, P., Sandlund, M., Ahlgren, C., Bergvall-Kåreborn, B., Lundin-Olsson, L., & Wikman, A. M. (2015). Fall risk awareness and safety precautions taken by older community-dwelling women and men-a qualitative study using focus group discussions. PLoS ONE,10(3), 1–16. https://doi.org/10.1371/journal.pone.0119630
• Ray, W. A., Thapa, P. B., & Gideon, P. (2000). Benzodiazepines and the Risk of Falls in Nursing Home Residents. JAGS, 682–685.
• Rothberg, M. B., Herzig, S. J., Pekow, P. S., Avrunin, J., Lagu, T., & Lindenauer, P. K. (2013). Association between sedating medications and delirium in older inpatients. Journal of the American Geriatrics Society, 61(6), 923–930. https://doi.org/10.1111/jgs.12253
• Shuto, H., Imakyure, O., Matsumoto, J., Egawa, T., Jiang, Y., Hirakawa, M. et al. (2010). Medication use as a risk factor for inpatient falls in an acute care hospital: A case crossover study. British Journal of Clinical Pharmacology, 69(5), 535–542. https://doi.org/10.1111/j.1365-2125.2010.03613.x
• Spaniolas, K., Cheng, J. D., Gestring, M. L., Sangosanya, A., Stassen, N. A., & Bankey, P. E. (2010). Ground level falls are associated with significant mortality in elderly patients. Journal of Trauma - Injury, Infection and Critical Care, 69(4), 821–824. https://doi.org/10.1097/TA.0b013e3181efc6c6
• Spoelstra, S. L., Given, B. A., & Given, C. W. (2012). Fall prevention in hospitals: An integrative review. Clinical Nursing Research, 21(1), 92–112. https://doi.org/10.1177/1054773811418106
• Stam, H., Harting, T., van der Sluijs, M., Marum, R. van, van der Horst, H., van der Wouden, J. C. et al. (2016). Usual care and management of fall risk increasing drugs in older dizzy patients in Dutch general practice. Scandinavian Journal of Primary Health Care, 34(2), 164–170. https://doi.org/10.3109/02813432.2016.1160634
• Stevens, J. A. (2005). Falls among older adults-risk factors and prevention strategies. Journal of Safety Research, 36(4), 409–411. https://doi.org/10.1016/j.jsr.2005.08.001
• Therese, H., Steinsbekk, A., & Gerd, A. (2017). Elderly users of fall-riskincreasing drug perceptions of fall risk and the relation to their drug use – a qualitative study. Candınavıan Journal of Prımary Health Care, 35(3), 247–255. https://doi.org/https://doi.org/10.1080/02813432.2017.1358438
• Tinetti, M. E., & Christianna S. Williams. (1997). Falls , injurıes due to falls and the risk of admission to a nursing home. The New England Journal of Medicine, 1279–1284.
• Weber, V., White, A., & McIlvried, R. (2008). An electronic medical record (EMR)-based intervention to reduce polypharmacy and falls in an ambulatory rural elderly population. Journal of General Internal Medicine, 23(4), 399–404. https://doi.org/10.1007/s11606-007-0482-z
• Willeboordse, F., Grundeken, L. H., van den Eijkel, L. P., Schellevis, F. G., Elders, P. J. M., & Hugtenburg, J. G. (2016). Information on actual medication use and drug related problems in older patients: questionnaire or interview? International Journal of Clinical Pharmacy, 38(2), 380–387. https://doi.org/10.1007/s11096-016-0258-9
• Wong, A., Phillips, B., & Hill, K. (2012). Comparison of two fall risk assessment tools ( FRATs ) targeting falls prevention in sub-acute care. Archives of Gerontology and Geriatrics, 55(3), 653–659. https://doi.org/10.1016/j.archger.2012.05.003
• Worapanwisit, T., Prabpai, S., & Rosenberg, E. (2018). Correlates of Falls among Community-Dwelling Elderly in Thailand. Hindavi Journal of Aging Research, 1–9. https://doi.org/https://doi.org/10.1155/2018/8546085
• Wu, T. Y., Chie, W. C., Yang, R. Sen, Liu, J. P., Kuo, K. L., Wong, W. K. et al. (2013). Factors associated with falls among community-dwelling older people in Taiwan. Annals of the Academy of Medicine Singapore, 42(7), 320–327.
• Ziere, G., Dieleman, J. P., Hofman, A., Pols, H. A. P., Van Der Cammen, T. J. M., & Stricker, B. H. C. (2006). Polypharmacy and falls in the middle age and elderly population. British Journal of Clinical Pharmacology, 61(2), 218–223. https://doi.org/10.1111/j.1365-2125.2005.02543.x