Circunstâncias e conseqüências de quedas em idosos com vestibulopatia crônica

Abstract

Aim: To investigate the circumstances and consequences of falls in the chronically dizzy elderly and to correlate them with the number of falls (one/two and more). Method: Transversal descriptive analytic study with 64 patients aged 65 or over, with history of falls and diagnostic of chronic vestibular dysfunction. We performed a descriptive analysis and Qui-Square test (&#61537;<0.05). Results: The sample was constituted by a female majority (76.6%) with a mean age of 73.62±5.69 years. The vestibular examination showed peripheral vestibulopathy in 81.5% of the cases and the most prevalent diagnostic hypothesis were benign paroxysmal positional vertigo (43.8%) and metabolic inner ear disease (42.2%). Recurrent falls were seen in 35 elderly (53.1%). In relation to the last fall, 39.1% of the patients had fallen in their homes, 51.6% of them occurred during the morning, 51.6% with some propulsion mechanism, 53.1% when walking, 25.0% caused by dizziness and 23.4% by stumbling. Activity restriction was significantly greater in patients that have already had two and more falls, when compared with those who had fallen only once (p=0.031). We found a significant association between the number of falls and their causes (p<0.001). Falls that have happened by slipping were more frequent in the elderly that reported one fall (p=0.0265) and falls that had happened because of dizziness were more frequent in the elderly that complained of two or more falls (p=0.0012). Conclusions: Fear and tendency to fall are referred by the majority of chronically dizzy elderly. Fall are more frequent in the morning, in the home and during walking. The propulsion direction is mentioned by half of the elderly and the most common cause for falls are dizziness and stumbling. The number of falls is significantly associated with activity restrictions after the last fall and with the causes for falling (slipping and dizziness).

A influência de fatores comportamentais e ambientais domésticos nas quedas em idosos

“…8 Ampliando este quadro, outro estudo com 64 idosos vestibulopatas em São Paulo verificou que no ambiente interno do domicílio o espaço mais apontado foi o banheiro, referido em 38,1% das quedas relatadas. 7 Por sua vez, foram observados em outra pesquisa os seguintes resultados: quarto 36,36%; quintal 22,73%; sala 13,64%; banheiro 9,08%; cozinha 4,55%.…”

“…Riscos estão presentes em atos rotineiros como sentar ou levantar de camas ou cadeiras; tropeçar em objetos da casa, ou revestimentos do assoalho (tapetes, carpetes e soleiras de portas) e escorregar em superfícies molhadas, ou descendo escadas. Ganança et al 7 apontaram as principais tarefas realizadas pelos idosos durante a ocorrência das quedas: deambulação 53,1%; descer/subir escadas 10,9%; transferência postural 9,4%; e 6,3% banho. Outro estudo de investigação da história de quedas realizado num hospital terciá-rio revelou resultados semelhantes: deambulação 37,5%; banho 20%; levantar da cama 17,5%; caminhar na rua 15%; e outras menos citadas 10%.…”

Vertigo and dizziness in elderly patients with neurological disorders

“…In healthy elderly people, however, these disorders are less frequent when compared with those with vascular, metabolic or degenerative diseases, or with neurological conditions that affect the central vestibular pathways (1) . Vestibular disorders in elderly patients are clinically important, and have drawn attention of many investigators (2)(3)(4)(5)(6)(7)(8)(9) .…”

Resultados do Balance Rehabilitation Unit na Vertigem Posicional Paroxística Benigna

“…Elderly patients with vestibular dysfunction can have SLA reduction and that of the ankle and hip reactive strategies which can cause functional disability and the risk of falls. [25][26][27] It was not possible to notice significant COP changes on situation 1 (stable surface and eyes open), in other words, somatosensory and visual information present. In our study, this finding corroborates those from other authors, in which patients with vestibular disorders use, especially, visual and/or proprioceptive clues in order to maintain body balance 23,27 .…”