ORIGINAL PAPER
Assessment of the frequency of falls and attendant risk factors, in conjunction with self-perceived quality of life, in elderly residents of nursing facilities in Wroclaw, Poland
More details
Hide details
1
Faculty of Physiotherapy, Wroclaw University of Health and Sport Sciences, Poland
Submission date: 2021-02-12
Acceptance date: 2022-04-05
Publication date: 2023-06-07
Physiother Quart. 2023;31(3):107-113
KEYWORDS
TOPICS
ABSTRACT
Introduction:
An increase in the average life expectancy constitutes one of the greatest achievements of humanity, and at the same time a serious challenge for modern health protection and social care systems. The main aim of the work is to investigate quality of life and risk of falls.
Methods:
Forty-four people (30 women and 14 men) aged 63 to 99 (average: 83.2 ± 7.2) recruited from two local nursing homes participated in the study. To assess the risk of falling FallScreen (physiological profile assessment, Prince of Wales Medical Research Institute) in a shortened version was used. To assess QoL (quality of life), the Polish version of the SF-36 questionnaire in its standard version was used.
Results:
It was indicated that in the year preceding the study, nearly 60% of participants fell; 32% (n = 14) fell once and 27% (n = 12) fell twice or more. Occurrence of chronic diseases and taking at least three medications were reported by more than 80% of seniors. The Results section presents the components of the physical and mental dimensions of the self-assessment of the quality of life of the participants of the study. The average index of quality of life among the studied people was 94.3 points, which is 55.2% of the maximum score.
Conclusions:
The dominating risk factor for falls, as established in the nursing home residents against the Physiological Profile Assessment (PPA) scale, consisted in slower reaction to a stimulus; its average value exceeding by threefold the reference value for healthy individuals of similar age.
REFERENCES (44)
1.
Europe in figures: Eurostat yearbook 2011. Eurostat Statistical Books. Luxembourg: Publications Office of the European Union; 2011.
2.
Bryła M, Burzyńska M, Maniecka-Bryła I. Self-rated quality of life of city dwelling elderly people benefitting from social help: results of a cross-sectional study. Health Qual Life Outcomes. 2013;11:181; doi: 10.1186/1477-7525-11-181.
3.
Ejupi A, Lord SR, Delbaere K. New methods for fall risk prediction. Curr Opin Clin Nutr Metab Care. 2014;17(5):407–411; doi: 10.1097/MCO.0000000000000081.
4.
Hester AL, Wei F. Falls in the community: state of the science. Clin Interv Aging. 2013;8:675–679; doi: 10.2147/CIA.S44996.
5.
Pfortmueller CA, Lindner G, Exadaktylos AK. Reducing fall risk in the elderly: risk factors and fall prevention, a systematic review. Minerva Med. 2014;105(4):275–281.
6.
Gimm GW, Kitsantas P. Falls, depression, and other hospitalization risk factors for adults in residential care facilities. Int J Aging Hum Dev. 2016;83(1):44–62.
7.
Barbosa FA, del Pozo-Cruz B, del Pozo-Cruz J, Alfonso-Rosa RM, Corrales BS, Rogers ME. Factors associated with the risk of falls of nursing home residents aged 80 or older. Rehabil Nurs. 2016;41(1):16–25; doi: 10.1002/rnj.229.
8.
Vlaeyen E, Coussement J, Leysens G, Van der Elst E, Delbaere K, Cambier D, et al. Characteristics and effectiveness of fall prevention programs in nursing homes: a systematic review and meta-analysis of randomized controlled trials. J Am Geriatr Soc. 2015;63(2):211–221; doi: 10.1111/jgs.13254.
9.
Kuczyński M, Ostrowska B. Understanding falls in osteoporosis: the viscoelastic modeling perspective. Gait Posture. 2006;23(1):51–58; doi: 10.1016/j.gaitpost.2004.11.018.
10.
Landi F, Cesari M, Calvani R, Cherubini A, Di Bari M, Bejuit R, et al. The “Sarcopenia and Physical fRailty IN older people: multi-component Treatment strategies” (SPRINTT) randomized controlled trial: design and methods. Aging Clin Exp Res. 2017;29:89–100; doi: 10.1007/s40520-016-0715-2.
11.
Sayilan AA, Kulakaç N, Saltan A. Determining the relationship between postoperative pain and the risk of falls in older adults. Piel Chir Angiol. 2019;4:136–141.
12.
Leś A, Gaworska M. Quality of life and functional fitness of the elderly. Biomed Hum Kinet. 2011;3:57–60; doi.org/10.2478/v10101-011-0013-6.
13.
Kurowska K, Kajut A. Self-assessment of the quality of life of aged people on the example of the Social Welfare House residents [in Polish]. Psychogeriatr Pol. 2011;8(2):55–62.
14.
Smee DJ, Berry HL, Waddington G, Anson J. Association between Berg Balance, Physiological Profile Assessment and physical activity, physical function and body composition: a cross-sectional study. J Frailty Aging. 2016;5(1):20–26; doi: 10.14283/jfa.2015.57.
15.
Barry E, Galvin R, Keogh C, Horgan F, Fahey T. 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 Geriatr. 2014;14:14; doi: 10.1186/1471-2318-14-14.
16.
Lord SR, March LM, Cameron ID, Cumming RG, Schwarz J, Zochling J, et al. Differing risk factors for falls in nursing home and intermediate-care residents who can and cannot stand unaided. J Am Geriatr Soc. 2003;51(11):1645–1650; doi: 10.1046/j.1532-5415.2003.51518.x.
17.
Lord S, Sturnieks D. The physiology of falling: assessment and prevention strategies for older people. J Sci Med Sport. 2005;8(1):35–42; doi: 10.1016/s1440-2440(05)80022-2.
18.
Gunendi Z, Ozyemisci-Taskiran O, Demirsoy N. The effect of 4-week aerobic exercise program on postural balance in postmenopausal women with osteoporosis. Rheumatol Int. 2008;28(12):1217–1222; doi: 10.1007/s00296-008-0651-3.
19.
Berg WP, Alessio HM, Mills EM, Tong C. Circumstances and consequences of falls in independent community-dwelling older adults. Age Ageing. 1997;26(4):261–268; doi: 10.1093/ageing/26.4.261.
20.
Kim J-W, Eom G-M, Kim C-S, Kim D-H, Lee J-H, Park BK, et al. Sex differences in the postural sway characteristics of young and elderly subjects during quiet natural standing. Geriatr Gerontol Int. 2010;10(2):191–198; doi: 10.1111/j.1447-0594.2009.00582.x.
21.
von Heideken Wågert P, Gustafson Y, Lundin-Olsson L. Large variations in walking, standing up from a chair, and balance in women and men over 85 years: an observational study. Aust J Physiother. 2009;55(1):39–45; doi: 10.1016/s0004-9514(09)70059-5.
22.
Büchele G, Becker C, Cameron ID, König H-H, Robinovitch S, Rapp K. Predictors of serious consequences of falls in residential aged care: analysis of more than 70,000 falls from residents of Bavarian nursing homes. J Am Med Dir Assoc. 2014;15(8):559–563; doi: 10.1016/j.jamda.2014.03.015.
23.
Landi F, Liperoti R, Russo A, Giovannini S, Tosato M, Capoluongo E, et al. Sarcopenia as a risk factor for falls in elderly individuals: results from the ilSIRENTE study. Clin Nutr. 2012;31(5):652–658; doi: 10.1016/j.clnu.2012.02.007.
24.
Rożek K, Ołdak K. Assessment of life quality with regard to fitness and physical activity among residents of a nursing home in Wroclaw. Antropomotoryka. 2013;23(63):61–71; doi: 10.5604/17310652.1108402.
25.
Boyé NDA, Mattace-Raso FUS, Van Lieshout EMM, Hartholt KA, Van Beeck EF, Van der Cammen TJM. Physical performance and quality of life in single and recurrent fallers: data from the Improving Medication Prescribing to Reduce Risk of Falls study. Geriatr Gerontol Int. 2015;15(3):350–355; doi: 10.1111/ggi.12287.
26.
Molzahn A, Skevington SM, Kalfoss M, Makaroff KS. The importance of facets of quality of life to older adults: an international investigation. Qual Life Res. 2010;19(2):293–298; doi: 10.1007/s11136-009-9579-7.
27.
Salkeld G, Cameron ID, Cumming RG, Easter S, Seymour J, Kurrle SE, et al. Quality of life related to fear of falling and hip fracture in older women: a time trade off study. BMJ. 2000;320(7231):341–346; doi: 10.1136/bmj.320.7231.341.
28.
Cameron ID, Dyer SM, Panagoda CE, Murray GR, Hill KD, Cumming RG, et al. Interventions for preventing falls in older people in care facilities and hospitals. Cochrane Database Syst Rev. 2018;9:CD005465; doi: 10.1002/14651858.CD005465.pub4.
29.
Ikezoe T, Asakawa Y, Shima H, Ichihashi N. Physical function screening of institutionalized elderly women to predict their risk of falling. Jpn J Phys Fitness Sports Med. 2009;58:489–498; doi: 10.7600/jspfsm.58.489.
30.
Smee DJ, Anson JM, Waddington GS, Berry HL. Association between physical functionality and falls risk in community-living older adults. Curr Gerontol Geriatr Res. 2012;2012:864516; doi: 10.1155/2012/864516.
31.
Smee DJ, Berry HL, Anson JM, Waddington GS. The relationship between subjective falls-risk assessment tools and functional, health-related, and body composition characteristics. J Appl Gerontol. 2017;36(2):156–172; doi: 10.1177/0733464815570669.
32.
Cockayne S, Adamson J, Clarke A, Corbacho B, Fairhurst C, Green L, et al. Cohort randomised controlled trial of a multifaceted podiatry intervention for the prevention of falls in older people (The REFORM Trial). PloS One. 2017;12(1):e0168712; doi: 10.1371/journal.pone.0168712.
33.
Trombetti A, Reid KF, Hars M, Herrmann FR, Pasha E, Phillips EM, et al. Age-associated declines in muscle mass, strength, power, and physical performance: impact on fear of falling and quality of life. Osteoporos Int. 2016;27(2):463–471; doi: 10.1007/s00198-015-3236-5.
34.
Boyd R, Stevens JA. Falls and fear of falling: burden, beliefs and behaviours. Age Ageing. 2009;38(4):423–428; doi: 10.1093/ageing/afp053.
35.
Delbaere K, Close JCT, Heim J, Sachdev PS, Brodaty H, Slavin MJ, et al. A multifactorial approach to understanding fall risk in older people. J Am Geriatr Soc. 2010;58(9):1679–1685; doi: 10.1111/j.1532-5415.2010.03017.x.
36.
Brdak M, Utykański H, Utykańska A. Changes in kinesiophobia at women and man following hospital – based cardiac rehabilitation program [in Polish]. In: Leśny J, Nyćkowiak J (eds.) Badania i rozwój młodych naukowców w Polsce. Nauki medyczne i nauki o zdrowiu [in Polish]. Poznań: Wydawnictwo Młodzi Naukowcy; 2016:49–53.
37.
Lüning Bergsten C, Lundberg M, Lindberg P, Elfving B. Change in kinesiophobia and its relation to activity limitation after multidisciplinary rehabilitation in patients with chronic back pain. Disabil Rehabil. 2012;34(10):852–858; doi: 10.3109/09638288.2011.624247.
38.
Turhan B, Usgu G, Usgu S, Çınar MA, Dinler E, Kocamaz D. Investigation of kinesiophobia, State and Trait Anxiety levels in patients with lower extremity ligament injury or fracture history. Turk J Sports Med. 2019;54(3):175–182.
39.
Monticone M, Ambrosini E, Rocca B, Cazzaniga D, Liquori V, Foti C. Group-based task-oriented exercises aimed at managing kinesiophobia improved disability in chronic low back pain. Eur J Pain. 2016;20(4):541–551; doi: 10.1002/ejp.756.
40.
Howland J, Lachman ME, Peterson EW, Cote J, Kasten L, Jette A. Covariates of fear of falling and associated activity curtailment. Gerontologist. 1998;38(5):549–555; doi: 10.1093/geront/38.5.549.
41.
Borowicz A, Zasadzka E, Gaczkowska A, Gawłowska O, Pawlaczyk M. Assessing gait and balance impairment in elderly residents of nursing homes. J Phys Ther Sci. 2016;28(9):2486–2490; doi: 10.1589/jpts.28.2486.
42.
Costello E, Edelstein JE. Update on falls prevention for community-dwelling older adults: review of single and multifactorial intervention programs. J Rehabil Res Dev. 2008;45(8):1135–1152; doi: 10.1682/JRRD.2007.10.0169.
43.
Seijo-Martinez M, Cancela JM, Ayán C, Varela S, Vila H. Influence of cognitive impairment on fall risk among elderly nursing home residents. Int Psychogeriatr. 2016;28(12):1975–1987; doi: 10.1017/S1041610216001113.
44.
Hanlon JT, Zhao X, Naples JG, Aspinall SL, Perera S, Nace DA, et al. Central nervous system medication burden and serious falls in older nursing home residents. J Am Geriatr Soc. 2017;65(6):1183–1189; doi: 10.1111/jgs.14759.