Multidisciplinary approach to “accidental” falls in the elderly: A case report

Abstract

Falls in the elderly are commonly and often wrongly identified as "accidental". We report a case of an elderly woman admitted to first aid for a trauma due to an accidental fall. Geriatric multidisciplinary evaluation revealed mild cognitive impairment associated with depressive symptoms; both findings made the anamnesis uncertain. Syncope algorithm was applied and "tachy-brady form of sick sinus syndrome" was diagnosed. Differential diagnosis between "accidental" and "apparently accidental" falls in elderly patients is very difficult but a multidisciplinary geriatric evaluation can clarify the correct diagnosis.

The regional ecology of elderly falls in Sweden

“…Fall related fractures caused by slipping, tripping, and stumbling are associated with lower levels of individual income at the county level. These findings are similar to studies showing income trends in fracture rates elsewhere (Trujillo et al 2011;Kannus et al 1999;Tinetti et al 1988;Galizia et al 2008;Luukinen et al 1996). Households with higher incomes have better access to social services including health care services.…”

“…The relationship between fall incidents and ethnical variations has been reported in a number of studies (Cauley 2011;Megyesi et al 2011;Jacobsen et al 1992;Penrod et al 2008;Graham et al 2008;Nguyen-Oghalai et al 2009;Dhanwal et al 2011). The income of the individual may be another important factor suggested by scholars as an implication for fall-related injuries (Kannus et al 1999;Tinetti et al 1988;Galizia et al 2008;Luukinen et al 1996). Trujillo et al (2011) suggest that having a higher income may contribute to better socio-economic conditions such as a healthier diet, and better access to basic social services.…”

“…Internationally, previous studies show that demographic and socio-economic characteristics affect the prevalence of the elderly fall (Andersen 2008;Cakar et al 2011;Cauley 2011;Dhanwal et al 2011;Galizia et al 2008;Graham et al 2008;Haan et al 1987;Hokby et al 2003;Jacobsen et al 1992;Kannus et al 1999;Landi et al 2001;Lopata 1982;Luukinen et al 1996;Megyesi et al 2011;Nguyen-Oghalai et al 2009;Penrod et al 2008;Reimers and Laflamme 2007;Sandberg et al 2012;Tinetti et al 1988;Trujillo et al 2011;Van Rossum et al 2000). Based on this literature, it is suggested that counties that have higher rates of falls are expected to be associated with one or more of these factors: lower proportion of nonSwedes, greater proportion of non-active population, larger share of low income earners, and single individuals.…”

“…Trujillo et al (2011) suggest that having a higher income may contribute to better socio-economic conditions such as a healthier diet, and better access to basic social services. Furthermore, lower income is linked to a higher risk of fall (Trujillo et al 2011;Tinetti et al 1988;Galizia et al 2008;Luukinen et al 1996).…”

Individual income and falls among the elderly in Latin America

“…Multiple risk factors associated with falls in the elderly have been suggested in the published work. One important risk factor possibly associated with falls reported in research in developed nations is individual income 11–14 . There are many reasons as to why higher income may be associated with a decreased probability of falls; an elder with higher income may have better nutrition; different lifestyles (e.g.…”