• Title/Summary/Keyword: Intrinsic Fall Risk Factors

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Prevention of Falls in the Elderly: A review of exercise interventions (노인 낙상예방을 위한 운동중재에 관한 고찰)

  • Cho Mi-sook;Park Rae-joon
    • The Journal of Korean Physical Therapy
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    • v.15 no.2
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    • pp.157-167
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    • 2003
  • Falls are a leading cause of injury, disability and death among people older than 65. Even without injury, falls cause a loss of confidence that results in reduced physical activity, increased dependency and social withdrawal. Fall prevention in the eldery people is a multifaced task that includes both the identification of risk factors and their modification strategies. Fall risk factors have been identified as both intrinsic and extrinsic. Intrinsic factors are those related to the physical and cognitive function of the person. Extrinsic factors are those which are included in the environmental hazards of everyday life. Combinations of interventions aimed at modifying both intrinsic and extrinsic risk factors can result in significant fall prevention in the geriatric population. This article selectively reviews the literature reporting exercise intervention to improve strength, balance and mobility.

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Comparisons of the Falls and Intrinsic Fall Risk Factors according to Gender in the elderly at Ttransitional Periods of Life (생애전환 초기 노인의 성별에 따른 낙상경험 및 내재적 요인 비교)

  • Yim, Eunshil;Kim, Dosuk;Kim, Bohwan
    • The Journal of the Korea Contents Association
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    • v.13 no.12
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    • pp.276-290
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    • 2013
  • PURPOSE: This study compared the elderly falls and the intrinsic fall risk factors according to gender. METHODS: This descriptive cross-sectional study was a secondary analysis of the data collected for medical checkups for the Transitional Periods of Life supported from the National Health Insurance. The subjects examined were 255,505 people aged 66 years in Korea between January and December, 2008. RESULTS: The elderly people aged 66 when in the transitional periods of life experienced 10.6% of their first falls. The first falls of women (12.4%) was greater than that of men (8.5%) in the elderly. The risk factors for falls included dysuria with an odds ratio of 6.2 to 6.6, depression with an odds ratio of 1.5 to 1.8, gait disturbance with an odds ratio of 1.3 to 1.5, and blindness with an odds ratio of 1.3 to 1.4 in both elderly women and men. CONCLUSIONS: Effective fall prevention should focus on dysuria because it is a more important predictor of falls, even though many intrinsic fall risk factors can affect falls in elderly people.

Fall Risk Assessment of the Elderly living in Nursing Home (노인요양시설 거주 노인의 낙상 위험요인 조사 연구)

  • Yang, Sun-Hee;Park, Young-Hae;Cho, Hae-Sook;Baek, Hee-Chong
    • Journal of Home Health Care Nursing
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    • v.12 no.2
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    • pp.1-15
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    • 2005
  • Purpose: This study was conducted to assess the fall risk factors. Method: The subjects were 87 persons who were older than 65 years living at 28 nursing home in Seoul and Gyunggi province. Subjects were interviewed using RAFS II for intrinsic factor and the environmental factor were assessed using a structured questionnaire from Oct. to Dec. in 2004. The data were analyzed by SPSS(ver. 12.0) programs, using descriptive statistics, $x^2$-test, and t-test. Result: The 37.9% of the subjects experienced the fall, and its average number is $1.94\pm1.75$. The Women's experience of the fall was higher than that of the men, but it was no significant difference with gender. There was no significant difference with the age and duration of living. The mean of the intrinsic risk factor was 13.38 in total score 39 points marks on the RAFS II scales. The intrinsic risk factor score of the fallen group 15.71 was significantly higher than the non-fallen group 12.10. The variables of recent fall experience(t=4.72, p=0.000) and urinary dysfunction(t=2.64, p=0.010) was significantly higher than the non-fallen group. The highest variable of the intrinsic factor was the age and the variables of drug intake, balance, chronic disease, recent fall experience, urinary dysfunction were followed in order. The mean of the environmental risk factor was 0.24 points. No significant differences were shown in environmental risk factor between the fallen and the non-fallen groups. To the fallen group, the place of entrance was the highest risky environmental factor. To see in area dimension, the floor surfaces was the highest risky environmental factor and equipment and illumination factor was the following risky elements in order. In the total score of environmental risk factors based on the ares, the fallen group was 0.26 and the non-fallen group was 0.24, but there were no significant differences between the groups. Conclusion: This results suggested that visual protection strategy, set up the safety device in the place of entrance and inner stairway, bathroom and nonskid mat in the nursing home would be contribute to the prevention of the fall for the elderly.

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Fall Risk in Low-Income Elderly People in One Urban Area (도시 빈곤 노인의 낙상발생 위험요인에 관한 연구)

  • Choi, Kyung-Won;Lee, In-Sook
    • Journal of Korean Academy of Nursing
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    • v.40 no.4
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    • pp.589-598
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    • 2010
  • Purpose: The purpose of this study was to investigate the factors that increase of the risk for falls in low-income elders in urban areas. Methods: The participants were elderly people registered in one of public health centers in one city. Data were collected by interviewing the elders, assessing their environmental risk factors, and surveying relevant secondary data from the public health center records. For data analysis, descriptive statistics and multiple logistic regression were performed using SPSS version 14. Results: Stroke, diabetes, visual deficits, frequency of dizziness, use of assistive devices and moderate depression were statistically significant risk factors. The comorbidity of chronic diseases with other factors including depression, visual deficit, dizziness, and use of assistive devices significantly increased the risk of falls. From multiple logistic regression analysis, statistically significant predictors of falls were found to be stroke, total environmental risk scores, comorbiditiy of diabetes with visual deficits, and with depression. Conclusion: Fall prevention interventions should be multifactorial, especially for the elders with stroke or diabetes, who were identified in this study as the high risk group for falls. A fall risk assessment tool for low-income elders should include both the intrinsic factors like depression, dizziness, and use of assistive devices, and the extrinsic factors.

Factors Related to Fall in Elderly Patients with Osteoporosis (골다공증 노인 환자의 낙상 관련요인에 관한 연구)

  • Kim, Ju-Yeun;Lee, Young-Whee;Ham, Ok-Kyung
    • Korean Journal of Adult Nursing
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    • v.21 no.2
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    • pp.257-267
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    • 2009
  • Purpose: The purpose of this study was to identify risk factors of fall and to examine its results among patients aged 60 and over diagnosed with osteoporosis. Methods: A retrospective descriptive survey was conducted with 91 patients admitted in a university hospital in a city. Data were collected using an interview method with a structured questionnaire, and were analyzed using descriptive statistics and multiple logistic regression. Results: In patients with osteoporosis, the intrinsic risk factors of falls were aging (OR = 3.742), gait disturbance (OR = 12.565), taking one or fewer medicine (OR = 7.873), and having two or more diseases (OR = 5.173). The extrinsic risk factors included the use of a bed (OR = 3.093), slippery floors (OR = 12.130), bathroom mat without anti-slip rubber backing (OR = 3.564), and presence of a night light on the passage from the bedroom to the bathroom (OR = 2.980). Conclusion: For the elderly aged over 70 who are most vulnerable to falls, screening tests such as bone mineral density (BMD) should be conducted in health examinations and the risk of fracture caused by osteoporosis should be communicated to the vulnerable elderly. Besides, development of new exercise programs combining weightbearing exercise is needed to prevent bone loss and increase functional activities.

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Fall-Related Injury and Balance of the Elderly (노인의 낙상과 균형)

  • Kim On-Ju;Kim Tae-Sook;Bae Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.10 no.2
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    • pp.161-171
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    • 1998
  • Balance can be defined as the ability to maintain the body's center of gravity within the base of support with minimal sway. Falls occur frequently in the elderly persons by the physiological change and dysfunction with age. Injuries resulting from falls include soft tissue damage and fractures of the radius, humerus, and femoral neck other consequences of falls include decreased mobility, reduced confidence, long lies (which can give rise to hypothermia, dehydration and pneumonia), and death Risk factors for falls have beau classified as intrinsic (those related to the individual) and extrinsic(those associated with environmental features), Intrinsic factors include decreased strength, visual deficits, vestibular dysfunction, and decreased vibratory sensation in the feet. Improvement of the balance related to the increased probability for fells in the elderly persons and is important for fall preventions and improvement of the living quality ef the elderly persons

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Environmental Factors Influencing the Prevalence of Falls in South Korea

  • Kim, Beomryong;Do, Kwangsun;Yim, Jongeun
    • Physical Therapy Rehabilitation Science
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    • v.11 no.1
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    • pp.66-77
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    • 2022
  • Objective: This study is a systematic review conducted to analyze the environmental factors that cause falls in the older adult. Design: Systematic review Methods: The study was conducted by searching the Research Information Sharing Service (RISS), Korean studies Information Service System (KISS), and Data Base Periodical Information Academic (DBpia) databases for literature published in South Korea up to July 2020. A total of 12 studies were selected for analysis based on the inclusion and exclusion criteria. Results: The results of the analysis revealed that all the selected literature were surveys and the study subjects were 65 years of age and above. The sample size ranged from a minimum of 95 subjects to a maximum of 3,278. A total of eight tools were used to measure the environmental factors associated with falls. The prevalence and recurrence of falls increase with age and deterioration of health. Older adult individuals who experience falls encounter difficulties in recovering from impaired physical function and disability; moreover, in severe cases, falls may lead to death. Falls are largely associated with a combination of intrinsic and extrinsic (i.e., environmental) factors. The purpose of this study was to assess potential extrinsic risk factors for falls. Falls occur in indoor environments, such as washrooms, bathrooms and living rooms, and outdoor environments, including roads and stairways, depending on the season, time of day, and use of ambulatory aids. In such environments, falls are mainly caused by slipping and stuttering. Conclusions: Therefore, as the rate of fall is influenced by several factors, extrinsic factors should be improved by developing comprehensive accident prevention programs that address the improvement of environmental risk factors around places of residence to reduce risk factors among the older adult, who, especially, are at a high risk for falls.

A Study on Fall Accident (1개 종합병원 환자의 낙상에 관한 조사)

  • Lee, Hyeon-Suk;Kim, Mae-Ja
    • The Korean Nurse
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    • v.36 no.5
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    • pp.45-62
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    • 1998
  • The study was conducted from November 1995 to May 1996 at the one general hospital in Seoul. The total subjects of this study were 412 patients who have the experience of fall accident, among them 31 was who have fallen during hospitalization and 381 was who visited emergency room and out patient clinic. The purposes of this study were to determine the characteristics, risk factors and results of fall accident and to suggest the nursing strategies for prevention of fall. Data were collected by reviewing the medical records and interviewing with the fallers and their family members. For data analysis, spss/pc+ program was utilized for descriptive statistics, adjusted standardized $X^2$-test. The results of this study were as follows: 1) Total subjects were 412 fallers, of which 245(59.5%) were men and 167(40.5%) were women. Age were 0-14 years 79(19.2%), 15-44 years 125(30.4%), 45-64 years 104(25.2%), over 65 years 104(25.2%). 2) There was significant association between age and the sexes ($X^2$=39.17, P=0.00). 3) There was significant association between age and history of falls ($X^2$=44.41. P= .00). And history of falls in the elderly was significantly associated with falls. 4) There was significant association with age and medical diagnosis ($X^2$=140.66, P= .00), chief medical diagnosis were hypertension(34), diabetis mellitus(22), arthritis(11), stroke(8), fracture(7), pulmonary tuberculosis(6), dementia(5) and cataract(5), 5) There was significant association between age and intrinsic factors: cognitive impairment, mobility impairment, insomnia, emotional problems, urinary difficulty, visual impairments, hearing impairments, use of drugs (sedatives , antihypertensive drugs, diuretics, antidepressants) (P < 0.05). But there was no significant association between age and dizziness ($X^2$=2.87, P=.41). 6) 15.3% of total fallers were drunken state when they were fallen. 7) Environmental factors of fall accident were unusual posture (50.9%), slips(35.2%), trips (9.5%) and collision(4.4%). 8) Most of falls occurred during the day time, peak frequencies of falls occurred from 1pm to 6pm and 7am to 12am. 9) The places of fall accident were roads(22.6%), house-stairs 06.7%), rooms, floors, kitchen (11.2%), the roof-top, veranda, windows(10.9%), hospital(7.5%), ice or snowy ways(5.8%), bathroom(4.9%), playground, park(4.9%), subway-stairs(4.4%) and public-bathrooms (2.2%). 10) Activities at the time of fall accident were walking(37.6%), turning around or reaching for something(20.9%), going up or down stairs09.2%), exereise, working07.4%), up or down from a bed(2.7%), using wheelchair or walking aids, standing up or down from a chair(2.2%) and standing still(2.2%). 11) Anatomical locations of injuries by falls were head, face, neck(31.3%), lower extremities (29.9%). upper extremities(20.6%), spine, thorax, abdomen or pelvic contents(l1.4%) and unspecified(2.9%). 12) Types of injures were fracture(47.6%), bruises03.8%), laceration (13.3%), sprains(9.0%), headache(6.6%), abrasions(2.9%), intracranial hemorrage(2.4%) and burns(0.5%). 13) 41.5% of the fallers were hospitalized and average of hospitalization was 22.3 days. 14) The six fallers(1.46%) died from fall injuries. The two fallers died from intracranial hemorrage and the four fallers died of secondary infection; pneumonia(2), sepsis(1) and cell lulitis(1). It is suggested that 1) Further study is needed with larger sample size to identify the fall risk factors. 2) After the fall accident, comprehensive nursing care and regular physical exercise should be emphasized for the elderly person. 3) Safety education and safety facilities of the public place and home is necessary for fall prevention.

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