Audiology Department, Mater Misericordiae University Hospital, Dublin, Ireland.
Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK.
BMC Geriatr. 2024 Oct 12;24(1):824. doi: 10.1186/s12877-024-05405-3.
The 2022 world guidelines for falls prevention and management suggest measuring sensory function including dizziness, vision, and hearing. These variables are not included in the falls risk stratification algorithm. This study sought to investigate the utility of the guidelines and potential avenues for improvement. This study applied the falls risk stratification recommendations and reviewed the individual sensory impairment risk factor variables predictive of falls and falls risk grouping in those assessed by a frailty intervention team (FIT) based in an emergency department (ED).
Patients over 65 years old who attended the ED and had a comprehensive geriatric assessment carried out by FIT over a period of four months were included in this retrospective cross-sectional study. Patient characteristics, medication, physical and sensory function status data was retrieved and analysed with respect to falls and falls risk grouping.
Data was gathered retrospectively from 392 patients. Excluding those with missing data, almost all attendees were in the high-risk of falls category (n = 170, 43.4%), or the low-risk category (n = 149, 38.0%). Few people were in the intermediate-risk category (n = 19, 4.8%). Hearing loss and dizziness were significantly associated with falls incidence, whereas vision and balance were not. Hearing loss, balance and dizziness were significantly associated with risk grouping, whereas vision was not.
Most older adults included in the analysis fell into the low- or high-risk categories, with a minority in the intermediate-risk category. This suggests that the inclusion criteria for the intermediate category could be altered for greater sensitivity. While impaired balance and vision were the most common impairments, hearing status, balance and dizziness were associated with risk group. These results, through a practical application of the world guidelines for falls to an acute clinical sample, raise the possibility of refining the falls risk stratification criteria, and highlight the capacity for additional sensory intervention to mitigate falls risk.
2022 年世界跌倒预防和管理指南建议测量包括头晕、视力和听力在内的感觉功能。这些变量不包含在跌倒风险分层算法中。本研究旨在探讨指南的实用性和改进的潜在途径。本研究应用跌倒风险分层建议，并回顾了在急诊科（ED）设立的虚弱干预团队（FIT）评估中，个体感觉障碍危险因素与跌倒和跌倒风险分组相关的预测因素。
本回顾性横断面研究纳入了在 ED 就诊且在四个月内接受 FIT 全面老年评估的 65 岁以上患者。检索了患者特征、药物、身体和感觉功能状态数据，并根据跌倒和跌倒风险分组进行分析。
从 392 名患者中回顾性收集数据。排除缺失数据的患者后，几乎所有患者均处于高跌倒风险类别（n=170，43.4%）或低跌倒风险类别（n=149，38.0%）。处于中跌倒风险类别的人数较少（n=19，4.8%）。听力损失和头晕与跌倒发生率显著相关，而视力和平衡则没有。听力损失、平衡和头晕与风险分组显著相关，而视力则没有。
分析中大多数老年患者落入低风险或高风险类别，少数落入中风险类别。这表明中间类别的纳入标准可以通过提高敏感性进行修改。虽然平衡和视力受损最常见，但听力状况、平衡和头晕与风险组相关。这些结果通过将世界跌倒指南应用于急性临床样本进行实际应用，提出了细化跌倒风险分层标准的可能性，并强调了通过额外的感觉干预来降低跌倒风险的能力。
