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      Assessment of risk of falls in elderly living at home 1

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          ABSTRACT

          Objective:

          to assess the risk of falls in elderly, by comparing the sociodemographic and cognitive factors, history of falls and self-reported comorbidities.

          Method:

          cross-sectional and quantitative study with 240 elderly. Data were collected based on the social profile, through the instrument of risk of falls and assessment of falls, by univariate analysis, bivariate and multiple logistic regression. The Statistical Package for the Social Sciences (SPSS) version 19 was used for statistical analysis.

          Results:

          there was a significant association of the risk of falls, as measured by the Fall Risk Score, with sex (<0.001), age (0.054), cognitive status (<0.001) and history of falls (<0.001). All variables were statistically significant and contributed to the occurrence of falls. In logistic regression, the variables that showed association with risk of falls were: fall, with whom they live, hypertension and visual impairment.

          Conclusion:

          female gender, older elderly (over 80 years old), with low cognitive status and occurrence of previous falls in the last six months are factors that increase the prevalence of falls. In logistic regression, the variables that were associated with risk of falls were: fall, with whom they live, visual impairment and rheumatologic diseases.

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          Most cited references32

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          [The Mini-Mental State Examination in a general population: impact of educational status].

          To assess the influence of age and education on cognitive performance in our population, 530 adults were interviewed using the MMSE (Mini-Mental Status Examination). Education level, classified as illiterate, elementary and middle ( 8 years), was a significant predictor of performance (p or = 65 years). The reference cut-off values were taken from the fifth percent lowest score for each group: illiterate, 13; elementary and middle, 18; and high, 26. When compared to 94 patients with cognitive impairment, our cut-off values achieved high sensitivity (82.4% for illiterates; 75.6% for elementary and middle; 80% for high) and specificity (97.5% for illiterate; 96.6% for elementary and middle; 95.6% for high educational level). Education-specific reference values for the MMSE are necessary in interpreting individual test results in populations of low educational level, in order to reduce the false positive results.
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            Prevalence and correlates of fear of falling, and associated avoidance of activity in the general population of community-living older people.

            Little is known about the prevalence rates and correlates of fear of falling and avoidance of activity due to fear of falling in the general population of community-living older people. To assess prevalence rates and study correlates of fear of falling and avoidance of activity due to fear of falling in this population. cross-sectional study in 4,031 community-living people aged > or =70 years. Fear of falling was reported by 54.3% and associated avoidance of activity by 379% of our population. Variables independently associated with fear of falling were: higher age (> or =80 years: odds ratio (OR) =1.79; 95% confidence interval (CI) =1.49-2.16), female gender (OR = 3.23; 95% CI = 2.76-3.79), poor perceived general health (OR = 6.93; 95% CI = 4.70-10.21) and multiple falls (OR = 5.72; 95% CI = 4.40-7.43). Higher age (> or =80 years: OR = 1.92; 95% CI = 1.59-2.32), poor perceived general health (OR = 11.91; 95% CI = 8.38-16.95) and multiple falls (OR = 4.64; 95% CI = 3.73-5.76) were also independently associated with avoidance of activity. Fear of falling and avoidance of activities due to fear of falling, were highly prevalent in our sample of community-living older people. Particularly, poor perceived general health showed a strong, independent association with both, fear of falling, and related avoidance of activity. Findings of our study may help health care professionals to identify people eligible for interventions aimed at reducing fear of falling and activity restriction.
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              Falls and fear of falling: burden, beliefs and behaviours.

              this study estimated the frequency of recent falls and prevalence of fear of falling among adults aged 65 and older. a cross-sectional, list-assisted random digit dialling telephone survey of US adults from 2001 to 2003. 1,709 adults aged 65 or older who spoke either English or Spanish. prevalence estimates were calculated for recent falls, fall injuries, fear of falling and fall prevention beliefs and behaviours. an estimated 3.5 million, or 9.6%, of older adults reported falling at least once in the past 3 months. About 36.2% of all older adults said that they were moderately or very afraid of falling. Few older adults who fell in the past 3 months reported making any changes to prevent future falls. the high prevalence of falls and fear of falling among US older adults is of concern. Both can result in adverse health outcomes including decreased quality of life, functional limitations, restricted activity and depression. Older adults' fear of falling and their reluctance to adopt behaviours that could prevent future falls should be considered when designing fall prevention programmes.
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                Author and article information

                Journal
                Rev Lat Am Enfermagem
                Rev Lat Am Enfermagem
                rlae
                Revista Latino-Americana de Enfermagem
                Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo
                0104-1169
                1518-8345
                06 April 2017
                2017
                : 25
                : e2754
                Affiliations
                [2 ]MSc.
                [3 ]PhD, Associate Professor, Universidade Federal da Paraíba, João Pessoa, PB, Brazil.
                [4 ]PhD, Full Professor, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.
                [5 ]PhD, Researcher, Universidade Federal da Paraíba, João Pessoa, PB, Brazil.
                [6 ]PhD, Adjunct Professor, Universidade Federal da Paraíba, João Pessoa, PB, Brazil.
                [7 ]PhD, Professor, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
                Author notes
                Corresponding Author: Adriana de Azevedo Smith Universidade Federal da Paraíba Cidade Universitária CEP: 58.051-900, João Pessoa, PB, Brasil E-mail: drikasmith@ 123456hotmail.com
                Article
                00318
                10.1590/1518-8345.0671.2754
                5396481
                28403333
                78d9c852-70c3-455d-a09f-8b4af4eafba2

                This is an open-access article distributed under the terms of the Creative Commons Attribution License

                History
                : 16 April 2015
                : 19 January 2016
                Page count
                Figures: 0, Tables: 9, Equations: 0, References: 24, Pages: 1
                Categories
                Original Article

                elderly,accidental falls,risk
                elderly, accidental falls, risk

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