Clin Osteol 2024; 29(1-2): 12-19

Falls prevention -⁠ identification and intervention of risk factorsReview articles

Greplová Kamila
Všeobecná interní klinika LF MU a FN Brno

Falls and fall-related injuries are common in older adults, have negative effects on functional independence and quality of life and are associated with increased morbidity, mortality and health related costs. World guidelines for falls prevention and management for older adults: a global initiative were published in September 2022, which include an algorithm for fall risk stratification and patient assessment. For older people at high risk of falling, multifactorial falls risk assessment should be performed as a basis for subsequent targeted intervention. Examination should focus on history of fall, physical examination including gait assessment, balance, muscle strength, functional capacity and nutritional status assessment, fracture risk assessment, vision and hearing screening, evaluation of cognitive function, cardiology and neurological examination. According to the identified cause, the thera­peutic options are determined. Preventive measures include the creating of a safe home environment, use of appropriate equipment, rehabilitation, medication review with regard to fall risk increasing drugs (FRIDs) and prevention and treatment of osteoporosis and sarcopenia.

Keywords: falls; falls prevention; multifactorial assessment; older adults; risk stratification

Published: June 11, 2024  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Greplová K. Falls prevention -⁠ identification and intervention of risk factors. Clinical Osteology. 2024;29(1-2):12-19.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Topinková E. Pády a poruchy chůze. In: Topinková E (ed). Geriatrie pro praxi. Galén: Praha 2010 : 44 -⁠ 47. ISBN 978-80-7262-365-6.
    2. Matějovská Kubešová H et al. Pády u geriatrických pacientů. In: Matějovská Kubešová H (ed). Vybrané klinické stavy u seniorů. Mladá fronta: Praha 2015 : 188-197. ISBN 978-80-204-3394-7.
    3. Weber P et al. Pády. In: Weber P (ed). Minimum z klinické gerontologie. IDV PZ: Brno 2000 : 69-75. ISBN 80-7013-314-7.
    4. Jenšovský J. Extraskeletální rizikové faktory pro zlomeniny ve vyšším věku. Clin Osteol 2019; 24(2): 82-85.
    5. Montero-Odasso M, van der Velde N, Martin FC et al. World guidelines for falls prevention and management for older adults: a global initiative. Age Ageing 2022; 51(9): 1-36. Dostupné z DOI: <https://doi.org/10.1093/ageing/afac205>. Go to original source...
    6. Topinková E. Doporučení pro screening a stratifikaci rizika pádu u seniorů z pohledu nových "Celosvětových guidelines pro prevenci a management pádů u starších osob". Geri a Gero 2023; 12(1): 12-17.
    7. Burns ER, Lee R, Hodge SE et al. Validation and comparison of fall screening tools for predicting future falls among older adults. Arch Gerontol Geriatr 2022; 101 : 104713. Dostupné z DOI: <http://dx.doi.org(10.1016/j.archger.2022.104713>. Go to original source...
    8. Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med 1988; 319(26): 1701-1707. Dostupné z DOI: <http://dx.doi.org710.1056/NEJM198812293192604> Go to original source...
    9. Beck Jepsen D, Robinson K, Ogliari G et al. Predicting falls in older adults: an umbrella review of instruments assessing gait, balance, and functional mobility. BMC Geriatr 2022; 22(1): 615. Dostupné z DOI: <http://dx.doi.org710.1186/s12877-022-03271-5>. Go to original source...
    10. Ganz DA, Latham NK. Prevention of Falls in Community-Dwelling Older Adults. N Engl J Med 2020; 382(8):734-743. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMcp1903252 >. Go to original source...
    11. Jepsen B, Robinson K, Ogliari G et al. Predicting falls in older adults: an umbrella review of instruments assessing fait, balance, and functional mobility. BMC Geriatr 2022; 22(1): 615. Dostupné z DOI: <http://dx.doi.org/10.1186/s12877-022-03271-5>. Go to original source...
    12. Berková M, Topinková E, Mádlová P et al. [The "Short Physical Performance Battery" in the Czech Republic -⁠ the pilot and validation study in older persons]. Krátká baterie pro testování fyzické zdatnosti seniorů. Vnitř Lék 2013; 59(4): 256-263. Go to original source...
    13. Topinková E. Mobilita jako klíčový faktor zdravého stárnutí. Geri a Gero 2021; 10(1): 15-22.
    14. Fried LP, Tangen CM, Walston J et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001; 56(3): M146-156. Dostupné z DOI: <http://dx.doi.org/10.1093/gerona/56.3.m146>. Go to original source...
    15. Vaňková H, Topinková E, Hrnčiariková D et al. Vyhodnocení syndromu křehkosti (frailty) u geriatrického pacienta. Klinický doporučený postup výboru České gerontologické a geriatrické společnosti ČLS JEP. Geri a Gero 2023; 12 (1): 5-8.
    16. Rockwood K, Song X, MacKnight C et al. A global clinical measure of fitness and frailty in elderly people. CMAJ 2005; 173(5): 489-495. Dostupné z DOI: <http://dx.doi.org/10.1503/cmaj.050051>. Go to original source...
    17. Gillespie LD, Robertson MC, Gillespie WJ et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev 2012; 2012(9): CD007146. Dostupné z DOI: <http://dx.doi.org/10.1002/14651858.CD007146.pub3>. Go to original source...
    18. Dautzenberg L, Beglinger S, Tsokani S et al. Interventions for preventing falls and fall-related fractures in community-dwelling older adults: A systematic review and network meta-analysis. J Am Geriatr Soc 2021; 69(10): 2973-2984. Dostupné z DOI: <http://dx.doi.org/10.1111/jgs.17375>. Go to original source...
    19. Hopewell S, Adedire O, Copsey BJ et al. Multifactorial and multiple component interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev 2018; 7(7). Dostupné z DOI: <http://dx.doi.org/10.1002/14651858.CD012221>. Go to original source...
    20. Vellas BJ, Wayne SJ, Romero LJ et al. Fear of falling and restriction of mobility in elderly fallers. Age Ageing 1997; 26(3): 189-193. Dostupné z DOI: <http://dx.doi.org/10.1093/ageing/26.3.189>. Go to original source...
    21. Sillner AY, Holle CL, Rudolph JL. The Overlap Between Falls and Delirium in Hospitalized Older Adults: A Systematic Review. Clin Geriatr Med 2019; 35(2): 221-236. Dostupné z DOI: <http://dx.doi.org/10.1016/j.cger.2019.01.004>. Go to original source...
    22. Kanis JA, Cooper C, Rizzoli R et al. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 2019; 30(1): 3-44. Dostupné z DOI: <http://dx.doi.org/10.1007/s00198-018-4704-5>. Go to original source...
    23. Blain H, Masud T, Dargent-Molina P et al. A Comprehensive Fracture Prevention Strategy in Older Adults: The European Union Geriatric Medicine Society (EUGMS) Statement. J Nutr Health Aging 2016; 20(6): 647-652. Dostupné z DOI: <http://dx.doi.org/10.1007/s12603-016-0741-y>. Go to original source...
    24. Trevisan C, Crippa A, Ek S et al. Nutritional Status, Body Mass Index, and the Risk of Falls in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis. J Am Med Dir Assoc 2019; 20(5): 569-582.e7. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jamda.2018.10.027>. Go to original source...
    25. Topinková E, Fialová D. Doporučené nástroje pro revizi medikace a optimalizaci preskripce u geriatrických pacientů. Geri a Gero 2023; 12(3): 112-126.
    26. Seppala LJ, Petrovic M, Ryg J et al. STOPPFall (Screening Tool of Older Persons Prescriptions in older adults with high fall risk). Age Ageing 2021; 50(4): 1189-1199. Dostupné z DOI: <http://dx.doi.org/10.1093/ageing/afaa249>. Go to original source...
    27. Keglovits M, Clemson L, Hu YL et al. A scoping review of fall hazards in the homes of older adults and development of a framework for assessment and intervention. Aust Occup Ther J 2020; 67(5): 470-478. Dostupné z DOI: <http://dx.doi.org/10.1111/1440-1630.12682>. Go to original source...
    28. Berková M, Berka Z. Pády: významná příčina morbidity a mortality seniorů. Vnitř Lék 2018; 64(11): 1076-1083. Go to original source...
    29. Sherrington C, Fairhall N, Kwok W et al. Evidence on physical activity and falls prevention for people aged 65+ years: systematic review to inform the WHO guidelines on physical activity and sedentary behaviour. Int J Behav Nutr Phys Ac 2020; 17(1): 144. Dostupné z DOI: <http://dx.doi.org710.1186/s12966-020-01041-3>. Go to original source...
    30. Sherrington C, Fairhall NJ, Wallbank GK et al. Exercise for preventing falls in older people living in the community. Cochrane Database Syst Rev 2019; 1(1): CD012424. Dostupné z DOI: <http://dx.doi.org710.1002/14651858.CD012424.pub2>. Go to original source...

    Return to the content


    Clinical Osteology

    Madam, Sir,
    please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
    Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

    I declare:

    1. that I have met the above instruction
    2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited

    No
    Yes

    If your statement is not true, please be aware
    that brings the risk of danger to their health or the health of others.