Falls Flashcards
Morbidity related to immobilisation?
Hypothermia Dehydration Pressure sores Rhabdomyolysis Venous thromboembolism Bronchopneumonia Muscular de-conditioning
How does a history of falls lead to an increase in risk of falls?
Social isolation -> loss of confidence -> functional decline
What are physiology of ageing factors leading to increased risk of falls?
Vision - smaller pupils, lens thickening -> less light
Central processing and cognition - decreased reaction time
Decreased cardio respiratory fitness
Sarcopenia
Decreased peripheral sensation and propioception -> increased postural sway
What chronic conditions can lead to an increased risk of falls?
Cardiovascular disease / syncope / arrhythmia Cognitive impairment Neurological Vestibular disease Vision problems MSK / gait
Cognitive impairment is likely to increase or decrease risk of fall and why?
Increase
Due to judgment , visual spatial perception, orientation
How can Parkinson’s increase risk of falls?
Shuffling gait
Tremor, rigidity, bradykinesia
Orthostatic hypotension
What issues with vision can increase risk of falls?
Poorer vision
Age specific changes
Cataracts - surgery can decrease risk
Bifocal/ verifocal lenses - alters depth perception
What extrinsic risk factors can increase risk of falls?
Meds
Alcohol environmental hazards
Inappropriate clothing / footwear
Inappropriate walking aids
Drugs that can increase risk of falls?
Benzodiazepines Neuroleptics Anti hypertensives Antidepressants Anticholinergics class 1A antiarrhythmias
Management and interventions to decrease risk of falls?
Strength and balance training - x3 per week for 12 weeks Environmental modifications Footwear and footcare Vision optimisation Patient education and treatment
Exam for falls?
Gait, balance, joints Neuro Cardio - PR, murmurs, lying and standing BP Visual acuity Feet and footwear Incontinence assessment
