Falls Flashcards
WHO definition of fall
A fall is defined as an event which results in a person coming to rest inadvertently on the ground, or floor, or other lower level.
How does ageing affect postural control?
Sensory: proprioceptive sensitivity loss, vestibular impairment from loss of labyrinthine hair cells, vestibular ganglion cell loss, hearing loss
CNS: Neuronal loss, depletion of neurotransmitters in basal ganglia
MSK: activation of proximal muscles prior to distal, delayed muscle activation, reduced power, increased muscle adiposity
BP: age related decline in baroreflex sensitivity to hypotensive stimuli
What percentage of people fall each year who are:
- age >65
- age >80
- residential aged care facility
- with a previous fall in the last year
- 30-40%
- 50%
- 50%
- 60%
What percentage of falls occur inside the home?
What percentage of falls occur at night?
Are falls more common in men or women?
70%
20%
Women
What are the risk factors for falling? (12)
age female sex history of falls lower limb weakness cognitive impairment balance problems psychotropic drug use arthritis history of stroke orthostatic hypotension dizziness anaemia
What medications are most associated with falls?
Antidepressants OR 1.68 Neuroleptics and antipsychotics OR 1.59 Benzodiazepines OR 1.57 Sedatives and hypnotics OR 1.47 Antihypertensives OR 1.24 NSAIDs OR 1.21 Diuretics OR 1.07 B blockers OR 1.01 Narcotics OR 0.96
Timed up and go test:
- what is it
- what is the cut-off for increased risk of falls
- What is a normal value
- Sit to stand, walk 3m then turn around and sit back down
- > 13.5 seconds
- <10 seconds
Interventions for preventing falls
- exercise program (e.g Tai Chi)
- Replace VitD if deficient
- Gradual withdrawal of psychotropics
- Cardiac pacing for those with carotid sinus hypersensitivity
- OT led home safety review
- Podiatry review in those with disabling foot pain
