Falls in older patients: characteristics depending on functional status

Abstract

Background: Falls and frailty are associated geriatric syndromes. Knowing the features of falls in patients with different functional status will make it possible to personalize the fall prevention and reduce the progression of frailty.Aim: To characterise falls in older depending on geriatric status (robust, prefrailty and frailty).Materials and methods: Included 1002 patients (77,5±8,2) hospitalized in the geriatric department. The frailty was screened on the scale «Age Not Interference». With the score 1–2, frailty was not diagnosed. With the score 3 or more, comprehensive geriatric assessment was carried out and 2 more groups were allocated: with prefrailty (n=199, 19.9%) and with frailty (n=482,48.1%). All patients found out the fact of falls during the year, if there was, they were characterized by falls. To analyze the effect of falls on functional status, it was evaluated in patients with frailty and falls and frailty without falls.Results: With increasing severity of geriatric status, the prevalence of falls increased, reaching 57% in patients with frailty. 63.7% previously noted falls, 44.7% formed a fear of falls. One in 10 falls resulted in a serious consequence, which caused hospitalization. The risk of falls increased depending on geriatric deficiency: patients with frailty at high risk were 2 times greater compared to robust patients. The findings demonstrate that patients with frailty undergoing falls compared to patients without falls.In patients with frailty and falls, compared to patients without falls, despite younger age and lower comorbidity, functional status was worse. They had a significantly lower score on the MNA, higher score on the PHQ-9 and anxiety score, and performed the chair stand longer. Multivariate analysis showed that a reduction in the sum of the SPPB by 0.35 and the PHQ-9 scale by 0.77, an increase in SARC-F by 0.68 and a time of performance of the chair stand by 3.39 seconds is associated with a fall in older people with frailty adjusted for age and comorbidity.Conclusion: Frailty is a conditionally reversible syndrome, and falls is often prevented. Considering the identified features of falls in patients with reduced functioning will allow individualizing the fall prevention plan.