Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
권호 표지
DOI QR코드

DOI QR Code

Analyses of Studies on the Intervention programs for the Prevention of Falls in Elderly with Dementia

치매노인의 낙상예방을 위한 중재 프로그램에 대한 국내·외 논문 분석

  • Received : 2018.03.27
  • Accepted : 2018.06.01
  • Published : 2018.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

The purpose of this study was to determine the status of interventional studies to prevent falling in elderly with dementia and to determine the contents and effectiveness of intervention programs to prevent falling. Existing reports published between January 1, 2000 and December 31, 2016 were searched electronically using the RISS, National Library, KISS, PubMed, and CINAHL database with the keywords dementia, Alzheimer's or Alzheimer's disease, falling, and prevention of falling. After checking the original sources of the articles, 13 articles were included in the review. Therapeutic interventions used in the articles included exercise therapy (8, 61.5%), physiotherapy and occupational therapy (2, 15.4%), complementary therapies (2, 15.4%), and music therapy (1, 7.7%). As a result of the qualitative evaluation of the papers using a checklist of the Scottish Intercollegiate Guideline Network, two studies scored 9 out of 10 points, five studies scored 8 out of 10, and six studies scored 7 out of 10. Intervention sessions were conducted for 55 minutes, on average, for a total of 37 sessions. This study found that exercise, music therapy, physical and occupational therapy, and rhythmic motion therapy were effective in preventing falling in the elderly with dementia. In the future, these findings are expected to be used as a basis for the development of a preventive intervention program for nurses in a clinical setting.

이 연구의 목적은 치매노인의 낙상을 예방하기 위한 중재연구의 현황을 파악하고 낙상예방을 위한 중재 프로그램의 내용과 효과를 알아보는 것이다. 문헌 검색은 치매, 알쯔하이머, 알츠하이머, 낙상, 낙상예방을 검색어로 하여 한국교육학술정보원(http://www.riss4u.net), 국회도서관, 한국학술정보(http://kiss. kstudy.com)와 pubMed, CINAHL을 통해 2000년 1월부터 2016년 12월까지 발표된 연구 논문을 검색하였다. 전자 자료를 검색한 후 연구자가 원본을 확인하여 선별한 13편의 논문을 최종 분석 하였다. 연구에 적용된 중재분야는 운동 치료(8편, 61.5%), 물리 치료와 작업 치료(2편, 15.4%), 보완대체요법(2편, 15.4%), 음악 치료(1편, 7.7%)이었다. Scottish Intercollegiate Guideline Network의 체크 리스트로 논문의 질적 평가를 실시하였다. 논문의 질적 평가 결과 10점 만점에 9점인 연구가 2편, 8점인 연구가 5편, 7점인 연구가 6편이었다. 낙상예방 중재내용을 분석한 결과 중재시간은 1회당 평균 55분을 시행하였고 중재 총 시행 횟수는 평균 37회이었다. 분석한 연구 결과에 의하면 운동 치료(타이치 포함), 음악 치료, 물리 치료와 작업 치료, 율동 동작 치료 등이 치매노인의 낙상예방에 효과가 있는 것으로 나타났다. 향후 이 결과를 활용하여 임상 현장에서 간호사에 의한 낙상예방 중재 프로그램 개발에 근거 자료로 활용하기를 기대한다.

Keywords

References

  1. Ministry of Health and Welfare, The second (2013-2015) National dementia manage comprehensive plan. Retrieved August 2, 2012, from http://blog.naver.com/PostView.nhn?blogId=rlaqudgjs883&logNo=90148849829
  2. Number of elderly with dementia by year, http://info.khidi.or.kr/board/view?pageNum=1&rowCnt=10&menuId=MENU00286&maxIndex=99999999999999&minIndex=99999999999999&schType=0&schText=&categoryId=&continent=&country=&upDown=0&boardStyle=&no1=0&linkId=125414. 2018.3.13
  3. L. M. Allan, C. G. Ballard, E. N. Rowan, R. A. Kenny, Incidence and prediction of falls in dementia: a prospective study in older people, PLoS One, vol. 4, no. 5, pp. e5521, 2009. DOI: https://doi.org/10.1371/journal.pone.0005521
  4. J. Swanenburg, E. D. de Bruin, D. Uebelhart, T. Mulder, Falls prediction in elderly people: a 1-year prospective study, Gait and Posture, vol. 31, no. 3, pp. 317-321, 2010. DOI: https://doi.org/10.1016/j.gaitpost.2009.11.013
  5. L. Rubenstein, K. Josephson, Falls and their prevention in elderly people: What does the evidence show?, The Medical Clinics of North America, vol. 90, no. 5, pp. 807-824, 2006. DOI: https://doi.org/10.1016/j.mcna.2006.05.013
  6. Korea geriatric disease society, geriatric medicine (2nd), Seoul, medicine publisher, 2005.
  7. N. M. Kosse, M. H. de Groot, N. Vuillerme, T. Hortobagyi, C. J. Lamoth. Factors related to the high fall rate in long-term care residents with dementia, International Psychogeriatrics, vol. 27, no. 5, pp. 803-814. 2015. DOI: https://doi.org/10.1017/S104161021400249X
  8. S. Sadigh, A. Reimers, R. Andersson, L. Laflamme, Falls and fall-related injuries among the elderly: a survey of residential-care facilities in a Swedish municipality, Journal of Community Health, vol. 29, no. 2, pp. 129-140, 2004. DOI: https://doi.org/10.1023/B:JOHE.0000016717.22032.03
  9. P. P. Barry, Iatrogenic disorders in the elderly; preventive techniques, Geriatrics, vol. 41, no. 9, pp. 42-47. 1986.
  10. E. J. Choi, Y. S. Lee, E. J. Yang, J. H. Kim, Y. H. Kim, H. A. Park, Characteristics and Risk Factors for Falls in Tertiary Hospital Inpatients, Journal of Korean Academy of Nursing, vol. 47, no. 3, pp. 420-430, 2017. DOI: https://doi.org/10.4040/jkan.2017.47.3.420
  11. H. Park. The perception of interior design factor related to risk of falls among elderly, Korean Institute of Interior Design Journal, 25, pp. 130-134, 2000.
  12. J. Hu, Q. Xia, Y. Jiang, P. Zhou, Y. Li, Risk factors of indoor fall injuries in community-dwelling older women: a prospective cohort study, Archives of Gerontology and Geriatrics, vol. 60, no. 2, pp. 259-264. 2015. DOI: https://doi.org/10.1016/j.archger.2014.12.006
  13. M. J. Kang, H. Rim, S. S. Kim, The Epidemiologic Survey Committee in the Korean Ophthalmological Society, Visual Acuity and Falls in South Korea: Korean National Health and Nutrition Examination Survey 2008-2012, Journal of Korean Ophthalmological Society, vol. 57, no. 9, pp. 1451-1459, 2016. DOI: https://doi.org/10.3341/jkos.2016.57.9.1451
  14. J. D. Moreland, J. A. Richardson, C. H. Goldsmith, C. M. Clase, Muscle weakness and falls in older adults, Journal of the American Geriatrics Society, vol. 52, no. 7, pp. 1121-1129, 2004. DOI: https://doi.org/10.1111/j.1532-5415.2004.52310.x
  15. M. Kim, Factors Associated with Falls in the Elderly : Based on 2014 the Korean Elderly Survey. Journal of Contents Association, vol. 17, no. 6, pp. 479-489, 2017.
  16. R. Korpelainen, J. Korpelainen, J. Heikkinen, K. Vaananen, S. Keinanen-Kiukaanniemi. Lifelong risk factors for osteoporosis and fractures in elderly women with low body mass index, Bone, vol. 39, no. 2, pp. 385-391, 2006. DOI: https://doi.org/10.1016/j.bone.2006.01.143
  17. V. D. Voort, P. P. Geusens, G. J. Dinant. Risk factors for osteoporosis related to their outcome. Osteoporosis International, vol. 12, no. 8, pp. 630-638, 2001. DOI: https://doi.org/10.1007/s001980170062
  18. Y. H. Park, J. S. Moon, Home environmental hazards of falling accident in the elderly, Journal of korean society for health education and promotion, vol. 22, no. 4, pp. 203-213, 2005.
  19. Y. Lajoie, S. P. Gallagher. Predicting falls within the elderly community, Archives of Gerontology & Geriatrics, vol. 38, no. 1, pp. 11-26. 2004. DOI: https://doi.org/10.1016/S0167-4943(03)00082-7
  20. K. L. Mukamal, M. A. Mittleman, W. T. Longstreth, A. B. Newman, L. P. Fried, D. S. Siscovick. Self-reported alcohol consumption and falls in older adults, Journal of the American Geriatrics Society, vol. 52, no. 7, pp. 1174-1179, 2004. DOI: https://doi.org/10.1111/j.1532-5415.2004.52318.x
  21. S. M. Friedman, B. Munoz, S. K. West, G. S. Rubin, L. P. Fried. Falls and fear of falling, Journal of the American Geriatrics Society, vol. 50, no. 8, pp. 1329-1335, 2002. DOI: https://doi.org/10.1046/j.1532-5415.2002.50352.x
  22. C. Tudor-Locke, A. M. Myers, C. S. Jacob, J. Jones, D-A. Lazowski, N. A. Ecclestone. Development and formative evaluation of the centre for activity and ageing's home support exercise program for frail older adults, Journal of Ageing & Physical Activity, vol. 8, no. 1, pp. 59-75, 2000. DOI: https://doi.org/10.1123/japa.8.1.59
  23. I. Y. Yoo. Effects of Fall Prevention Program applying HSEP on Physical Balance and Gait, Leg Strength, Fear of Falling and Falls Efficacy of Community-dwelling Elderly, Journal of the Korean Gerontological Society, vol. 29, no. 1, pp. 259-273, 2009.
  24. M. C. Kim, C. S. Ahn, Y. S. Kim. The effect of exercise program for falls prevention on balance and quality of life in the elderly women, Journal of the Korean Society of Physical Medicine, vol. 5, no. 2, pp. 245-254, 2010.
  25. B. J. Jeoung. A review of exercise program for fall prevention in the elderly, The journal of korean society of aerobic exercise, vol. 12, no. 1, pp. 1-9, 2008.
  26. National Health Insurance Corporation. Symposium associated with health care expenditure for the elderly. Retrieved August 31, 2015, from http://m.healthmedia.co.kr/news/articleView.html?idxno=52291
  27. Scottish Intercollegiate Guidelines Network (SIGN)(2013, April26). Methodology checklist 2: Randomized controlled trials. Retrieved May 09, 2013, from www.sign.ac.uk/methodology/checklists.html
  28. S. H. Jeong. "Systematic review of the literatures on music intervention for neurological patients in korea", Journal of Korean Biological Nursing Science, vol. 15, no. 2, pp. 65-73, 2013. DOI: http://dx.doi.org/10.7586/jkbns.2013.15.2.65
  29. L. Yao, B. J. Giordani, D. L. Algase, M. You, N. B. Alexander. Fall Risk-Relevant Functional Mobility Outcomes in Dementia Following Dyadic Tai Chi Exercise, Western Journal of Nursing Research, vol. 35, no. 3, pp. 281-296. 2012. DOI: http://dx.doi.org/10.1177/01939459124433191-Dy
  30. J. Wesson, L. Clemson, H. Brodaty, S. Lord, M. Taylor, L. Gitlin, J. Close. A feasibility study and pilot randomized trial of a tailored prevention program to reduce falls in older people with mild dementia. Wesson et al. BMC Geriatrics, vol. 13, no. 1, pp. 89-101, 2013. DOI: http://doi.org/10.1186/1471-2318-13-892-fe
  31. K. H. Pitkala, M. M. Poysti, M. L. Laakkonen, R. S. Tilvis, N. Savikko, H. Kautiainen, T. E. Strandberg. Effects of the Finnish Alzheimer Disease Exercise Trial (FINALEX), JAMA Internal Medicine, vol. 173, no. 10, pp. 894-901, 2013. DOI: https://doi.org/10.1001/jamainternmed.2013.359
  32. T. Zieschang, M. Schwenk, P. Oster, K. Hauer. Sustainability of Motor Training Effects in Older People with Dementia, Journal of Alzheimer's Disease, vol. 34, no. 1, pp. 191-202, 2013. DOI: http://dx.doi.org/10.3233/JAD-1208146-mo
  33. C. Toulotte, C. Fabre, B. Dangremont, G. Lensel, A. Thevenon. Effects of physical training on the physical capacity of frail, demented patients with a history of falling: a randomized controlled trial, Age and Ageing, vol. 32, no. 1, pp. 67-73, 2003. DOI: https://doi.org/10.1093/ageing/32.1.67
  34. E. Rosendahl, Y. Gustafson, E. Nordin, L. Lundin-olsson, L. Nyberg. A randomizes controlled trial of fall prevention by a high-intensity functional exercise program for older people living in residential care facilities, Aging clinical and experimental research, vol. 20, no. 1, pp. 67-75, 2008. DOI: https://doi.org/10.1007/BF03324750
  35. Y. Rolland, F. Pillard, A. Klapouszczak, E. Reynish, D. Thomas, S. Andrieu, D. Riviere, B. Vellas. Exercise Program for Nursing Home Residents with Alzheimer's Disease: A 1-Year Randomized, Controlled Trial, The American Geriatrics Society, vol. 55, no. 2, pp. 158-165, 2007 DOI: http://dx.doi.org/10.1111/j.1532-5415.2007.01035.x10-ex
  36. S. W. Jung, G. H. Ra, S. G. Woo. Effectiveness verification of improve dementia in 8 weeks complex exercise. Athletic event, 2, vol. 014, no. 5, pp. 67-74, 2014.
  37. J. H. Choi. The effect of the dual task program based on neurologic music therapy techniques on preventing fall so folder adults with early-stage dementia. Myongji University master thesis, 2012.
  38. J. S. Park. The Effect of Physical Activity Program on Cognitive Function, Physical Function, Quality of Life and Depression in the Elderly with Dementia. Sahmyook University master thesis, 2010.
  39. Y. S. Yeom. An effect of 8weeks of exercise therapy on cognitive function and daily life performance ability of the aged with severe dementia. Kyung Hee University master thesis, 2015.
  40. Y. M. Lim. Effects of Movement/Exercise on Physical and emotional Functioning in Elders with Cognitive Impairments, Journal of the Korea Gerontological Society, vol. 21, no. 3, pp. 197- 211. 2002.
  41. Y. J. Kim. Effects of a resistant balance exercise on ADL and fall related fitness of older adults with dementia, Korea National Sport University master thesis, 2015.
  42. M. Prince, R. Bryce, E. Albanese, A. Wimo, W. Ribeiro, CP. Ferri. The global prevalence of dementia: A systematic review and meta analysis, Alzheimer's & Dementia, vol. 9, no. 1, pp. 63-75. 2013. DOI: http://dx.doi.org/10.1016/j.jalz.2012.11.007
  43. F. Li, P. Harmer, K. John Fisher, E. McAuley, N. Chaumeton, E. Eckstrom, N. L. Wilson. Tai Chi and Fall Reductions in Older Adults: A Randomized Controlled Trial, The Journals of Gerontology: Series A, vol. 60, no. 2, pp. 187-194. 2005. DOI: https://doi.org/10.1093/gerona/60.2.187
  44. R. Tideiksaar. Falling in Old Age: its Prevention and Treatment. New York: Springer Publishing Company, 1989.
  45. J. Kim, H. Suh. Risk Factors for Falls in the Elderly by Life-cycle, Korean Journal of Health Education and Promotion, vol. 27, no. 1, pp. 21-34, 2010.