Levencron Shalom, Kimyagarov Simha
Geriatric Center Gil-Ad, Sheba Medical Center, Tel Hashomer.
Harefuah. 2007 Aug;146(8):589-93, 647.
One of the serious problems in geriatrics is falling among the elderly population. It is noted that, as age progresses, the frequency of falling increases, reaching 1.4-4.5 falls per person annually among nursing home residents. Furthermore, recurrent falls are one of the main reasons for their residence in the geriatric nursing home.
The purpose of the study was to determine the frequency and main causes of recurrent falls among mobile nursing home residents, to examine the influence of medications on the frequency of falls and to observe the influence of falls on changes in their health condition and mortality.
During the past 5 years, researchers tracked falls among 242 mobile residents at the "Gil-Ad" Geriatric Center, (mean age 85.2+/-1.2 years). Among observed patients 170 (70.2%) had fallen 959 times, (1.13 falls per person annually). This created a statistical image of the mobile resident, predisposed to recurrent falls: she is the elderly woman aged 83 years and older, suffering from pain, cardiovascular diseases (55.8%), touch infringements due to decreased visual acuity and hearing (76.4%), atrophic musculoskeletal diseases or after orthopedic operations (68.6%) and acute infections (51.2%). A direct link was found between the frequency of falls and the amount of medications provided to the elderly patients: for residents, predisposed to recurrent falls, treatment by 5 and more kinds of drugs, including diuretics, was characteristic. The study proves a mutual dependency between frequency of falls and the functional status of the elderly residents of the geriatric center.
For prevention of falls and bone fractures among elderly nursing home residents, the clinicians should carefully assess their functional status, in view of diseases and drug treatment.
老年医学中一个严重的问题是老年人跌倒。据指出，随着年龄的增长，跌倒的频率会增加，养老院居民中每人每年跌倒的频率达到1.4 - 4.5次。此外，反复跌倒也是他们入住老年护理院的主要原因之一。
本研究的目的是确定流动养老院居民反复跌倒的频率和主要原因，研究药物对跌倒频率的影响，并观察跌倒对他们健康状况变化和死亡率的影响。
在过去5年中，研究人员追踪了“吉尔 - 阿德”老年中心242名流动居民（平均年龄85.2±1.2岁）的跌倒情况。在观察的患者中，170人（70.2%）跌倒了959次（每人每年1.13次跌倒）。这形成了一个易反复跌倒的流动居民的统计画像：她是83岁及以上的老年女性，患有疼痛、心血管疾病（55.8%）、因视力和听力下降导致的触觉障碍（76.4%）、萎缩性肌肉骨骼疾病或骨科手术后（68.6%）以及急性感染（51.2%）。跌倒频率与给老年患者提供的药物数量之间发现了直接联系：对于易反复跌倒的居民，使用5种及更多种类药物（包括利尿剂）进行治疗是其特征。该研究证明了老年中心老年居民的跌倒频率与功能状态之间存在相互依存关系。
为预防老年护理院居民跌倒和骨折，临床医生应根据疾病和药物治疗情况仔细评估他们的功能状态。
