risk factors for falls
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Etiology
- weakness (4.9)*
- balance deficit (3.2)
- gait deficit (3.0)
- vision deficit (2.8)
- glaucoma, cataracts, & age-related macular degeneration[9]
- mobility limitation (2.5)
- cognitive deficit (2.4)
- activities of daily living limitation (2.0)
- hypotension
- postural hypotension (1.9)
- systolic blood pressure < 100 mm Hg
- chronic musculoskeletal pain[7]
- factors associated with fall risk
- multiple sites of pain
- high pain severity
- greater functional impairment
- possible mechanisms
- joint pathology
- neuromuscular dysfunction
- interference with cognitive function
- factors associated with fall risk
- medications
- psychotropic drugs top the list
- sedative/hypnotics
- antipsychotics (any or all)
- risperidone (produces parkinsonism)[5]
- antidepressants[3]
- tricyclic antidepressants (2.0)
- selective serotonin reuptake inhibitors (2.0)
- 4 or more medications[6]
- diuretics*
- class 1a antiarrhythmic agents
- antihypertensive agents[5]
- Alzheimer agents
- psychotropic drugs top the list
- anemia[4]
- enironmental risks
- loose rugs, poor lighting, lack of hand rails
- risk of a fall at home is greatest in the 2 weeks immediately following hospitalization[3]
* Relative risk in parenthesis
* history of a fall within the past year is the most predictive factor for falls in the elderly (GRS9)[3]
Notes
- World Guidelines for Falls Prevention & Management's risk stratification algorithm in predicting falls with sensitivity score of 34% & specificity of 90% for predicting one or more falls with 24 months[10]
More general terms
Additional terms
References
- ↑ Sepulveda GRECC guidelines
- ↑ Rubenstein LZ et al Falls in the nursing home. Ann Intern Med 121:442, 1994 PMID: https://www.ncbi.nlm.nih.gov/pubmed/8053619
- ↑ Jump up to: 3.0 3.1 3.2 3.3 Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004; 7th edition 2010
Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016 - ↑ Jump up to: 4.0 4.1 Internal Medicine World Report 2006; 21(2) Penninx BW, Pluijm SM, Lips P, Woodman R, Miedema K, Guralnik JM, Deeg DJ. Late-life anemia is associated with increased risk of recurrent falls. J Am Geriatr Soc. 2005 Dec;53(12):2106-11. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16398894
- ↑ Jump up to: 5.0 5.1 5.2 van der Velde N, van den Meiracker AH, Pols HA, Stricker BH, van der Cammen TJ. Withdrawal of fall-risk-increasing drugs in older persons: effect on tilt-table test outcomes. J Am Geriatr Soc. 2007 May;55(5):734-9. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17493193
- ↑ Jump up to: 6.0 6.1 Medical Knowledge Self Assessment Program (MKSAP) 14, American College of Physicians, Philadelphia 2006
- ↑ Jump up to: 7.0 7.1 Leveille SG et al. Chronic musculoskeletal pain and the occurrence of falls in an older population. JAMA 2009 Nov 25; 302:2214. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19934422
- ↑ Rafiq M, McGovern A, Jones S et al Falls in the elderly were predicted opportunistically using a decision tree and systematically using a database-driven screening tool. J Clin Epidemiol. 2014 Aug;67(8):877-86. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24786593
- ↑ Jump up to: 9.0 9.1 Tsang JY et al. Risk of falls and fractures in individuals with cataract, age-related macular degeneration, or glaucoma. JAMA Ophthalmol 2023 Dec 28; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38153708 https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2813168
- ↑ Jump up to: 10.0 10.1 Ragusa FS, Di Bella G, Dominguez LJ, The role of the World Guidelines for Falls Prevention and Management's risk stratification algorithm in predicting falls: a retrospective analysis of the Osteoarthritis Initiative. Age Ageing. 2024 Aug 6;53(8):afae187. PMID: https://www.ncbi.nlm.nih.gov/pubmed/39171386