Circunstâncias e consequências das quedas em idosos de Florianópolis. Epi Floripa Idoso 2009*

Abstract

The objective was to investigate the cir-cumstances and consequences of falling and risk factors associated with limitations in performing activities after falling. The study is part of the cross-sectional population based survey, conducted in 2009/2010, which involved 1,705 older adults (60 years and older) living in Florianopolis, SC. From the affirmative answer to the question of whether any falls occurred in the 12 months preceding the study, we investigated the circumstances and consequences of falls through a structured questionnaire. Descriptive analysis and binary logistic regression were used, with significance level of 5%. The prevalence of fall was 19% (14.3% for men and 21.5% for women). Most older adults fell while walking, 43.2% inside their homes. The main cause of falling was stumbling due to irregularities on the ground. 71% of those who fell reported injury, and 14.8% reported limitations in performing activities after the fall. There was a significant association between limitations in performing activities after the occurrence of falls and fractures. Preventing falls should be a public health concern, given that relatively easy changes can reduce the risk of falls.

Prevalence of fear of falling, in a sample of elderly adults in the community

“…Literature reports that older adults with functional decline tend to present low self-efficacy in carrying out daily activities, since they have lower physical and functional performance, and often report fear of falling during their execution. It also reports that elderly persons who restrict their activities due to fear of falling are more prone to sedentary living and social isolation, resulting in a loss of functional capacity and consequently, a fear of falling, creating and perpetuating a vicious cycle of adverse effects 3,6,22,30,31 .…”

“…Several studies have shown that the most frequent site where falls occur was inside the elderly person's own home, especially the bedroom and bathroom 14,23,29,30 . Oliveira et al 31 showed a tendency for increased falls outdoors.…”

Evaluation of risk factors that contribute to falls among the elderly

“…According to a study carried out in the city of Ribeirão Preto by Fabricio et al 4 , 66.00% of falls victims were female, while the average age of the elderly persons surveyed was 76 years and there was an incidence of falls among women of 66.00%. In several other studies, the variable of being a woman increased the occurrence of falls independently and significantly 4,8,15,18,19 . The possible causes to explain this phenomenon may be related to the fact that the absolute number of elderly persons who fell was higher among elderly women, the greater physical frailty of women, the lower amount of lean mass and muscular strength compared to men of the same age 8 , the greater loss of bone mass due to the reduction of estrogen 20 , the greater occurrence of chronic diseases, as well as the greater involvement of women in domestic activities and their longer life expectancy.…”

Characteristics of falls in elderly persons residing in the community: a population-based study

“…Most of the elderly investigated limited their social activities and instrumental activities of daily living. When the elderly fall, there is a tendency to reduce daily activities, either for fear of being exposed to the risk of falling or due to the protective attitudes of family members and caregivers 10 . This reduction can cause immobility and consequent muscular atrophy, facilitating the recidivism of falls.…”

“…Some studies in literature indicate that 75% of the elderly suffer a fall in their own home compared to the elderly who fall outside the home 9 . The room where most falls occur is the bedroom (25.2%), followed by the kitchen (16.8%) and the bathroom (14.5%) 10 . This can be explained by the fact that older people spend much of their time in their homes because it is the safest and most familiar place for them.…”