Prospective study of fall risk assessment among institutionalized elderly in Japan

Abstract

The purpose of the present study was to identify risk factors for falls among institutionalized elderly, using the standardized risk assessment tool developed by Izumi. We examined 746 patients from three types of facilities: rehabilitation wards in four general hospitals, three long-term care facilities, and three nursing homes, for up to three months. The incidence of falls within all facilities was 12.5%. Patterns of relative risks of falling differed among types of facilities. The highest relative risk of fall in long-term care facilities and nursing homes was nurses' prediction, followed by history of fall and altered mentation. In contrast, that in general hospitals was mobility. In long-term care facilities, history of falls (odds 3.68, 95CI: 1.47-9.23) and interaction (history of falls and assistance with toileting) (odds 3.13, 95CI: 1.48-6.64) showed significance on adjusted-odds ratios for fall. History of falls, altered mentation, and assistance with toileting may be used to screen patients at a high risk for fall at admission.

Ocorrência de quedas em idosos residentes em instituições de longa permanência em Pelotas, Rio Grande do Sul, Brasil

“…Estudos internacionais realizados com idosos em instituições de longa permanência apresentaram diferentes freqüências de quedas como nos Estados Unidos 42,9% (34.163 idosos em 437 instituições) 9 e 49% (462 idosos em 56 instituições) 10 , no Canadá 10,6% (14.744 idosos em 71 instituições) 11 , na Austrália 11% (2.005 idosos em 81 instituições) 12 no Japão 12,5% (746 idosos em 10 instituições) 13 , no Chile 24% (453 idosos em 8 instituições) 14 , na Colômbia 36% (116 idosos em uma instituição) 15 e em Cuba 78% (23 idosos em uma instituição) 16 . Do mesmo modo, os estudos brasileiros apresentam 40% (105 idosos em 4 instituições) em São Paulo 17 , 64,6% (312 idosos em um asilo) na Bahia 18 , e o Instituto Nacional de Traumato-Ortopedia (INTO) 19 faz uma estimativa de 50% de quedas de idosos residentes em instituições asilares brasileiras.…”

Usefulness of the Subjective Risk Rating of Specific Tasks for Falls in Frail Elderly People

“…Additionally, there are many frail elderly who cannot perform functional tests used to assess the fall risk. In a previous study, a subjective fall risk assessment based on observations by care staff was developed and its usefulness as a fall risk predictor was examined 5,6) . In this study, we examined the utility of a subjective assessment tool based on observations by care staff for identifying useful measures for screening the fall risk of specifi c tasks in ADL among frail elderly people.…”

“…For intensive intervention to prevent falls, it is necessary to detect those with high risk of falls among frail elderly people 4) . Because there are many frail elderly subjects who cannot perform functional tests, in a previous study, subjective fall risk assessment based on observations by care staff was developed and its usefulness as a fall risk predictor was examined 5,6) . However, the subjective fall risk assessment was not developed to assess multiple fall risks of specific tasks or behaviors in activities of daily living (ADL).…”

Validation of the STRATIFY Falls Risk Assessment Tool in a Japanese Acute Care Hospital Setting

“…Prevention of inpatient falls is performed by a strategy to target patients at high risk for falls determined by a falls risk assessment system (Gates, Fisher, & Cooke, 2008). However, there has been no standard risk assessment tool for falls in Japanese hospitals (Izumi, Makimoto, Kato, & Hiramatsu, 2002). In Japan, each hospital uses its own fall risk assessment system specific for the hospital, and different hospitals use different risk assessment tools for falls.…”