Perception of elderly related to the risk of falls and their associated factors

Blaz, Bruna Soares Vasques; Azevedo, Rosemeiry Capriata de Souza; Agulhó, Daniela Luzia Zagoto; Reiners, Annelita Almeida Oliveira; Segri, Neuber José; Pinheiro, Tiago Antônio Borges

doi:10.1590/2177-9465-EAN-2019-0079

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RESEARCH • Esc. Anna Nery 24 (1) • 2020 • https://doi.org/10.1590/2177-9465-EAN-2019-0079 copy

Perception of elderly related to the risk of falls and their associated factors

Percepción de adultos mayores relacionada con el riesgo de caídas y sus factores associados

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To analyze the association of the perception of the elderly on the risk factors for falls.

Methods:

An Analytical cross-sectional study with 190 elderly from the Healthy Longevity Program of a public university in Mato Grosso, from May to August 2016. The collection wasdone through a structured interview and vignettes. Performed descriptive and bivariate analyzes - Pearson chi-square test (x²) significance level of 5%. The crude and adjusted prevalence ratios (PR), with confidence intervals (95%), were also estimated, followed by Poisson multiple regression.

Results:

Of the participants, 64.2% had a satisfactory perception about the risk factors for falls. The prevalence of unsatisfactory risk perception was 105% higher in those with income from 1 to 3 minimum wages, 75% higher in those with low risk of falls and 46% higher in those who did not attend another social group.

Conclusion and implications for the practice:

A significant proportion of the elderly have an unsatisfactory risk perception for the risk factors for falls associated with low income, not attending another social group and the low risk of falls. Knowledge about the risk perception of falls in the elderly helps nurses to plan and implement fall prevention programs for this population.

Keywords:
Risk factors; Falls; Aged

Vignettes	Risk factors for falls	Number of RF per vignette	Minimum number of perceived risk factors
01	Sofa foot, rug, slick floor.	03	02
02	Steps, not using handrail, carrying weight when climbing a stair	03	02
03	Uneven sidewalk	01	01
04	Inappropriate slippers, slick floor	02	01
05	Objects scattered on the floor, rug	02	01
06	Climbing a stair without a safety device	02	01
07	Slick floor, climbing on a bench, using inappropriate slippers	03	02
08	Toys scattered on the floor, children around, rug	03	02
09	Wet and uneven floor, a hose, washing the sidewalk wearing inappropriate slippers.	05	03
10	Vases on stairs, inappropriate lighting, misuse of cane, rug on stairs, steps	05	03
11	Climbing the steps of a bus, uneven sidewalk, carrying weight when climbing steps	03	02
12	Drinking alcohol	01	01
Total		33	21

Variables	Frequency (n)	Percentage (%)
Health self-assessment ^* * Classification according to VIGITEL (2014).
Poor	5	2.6
Regular	60	31.6
Good	93	49.0
Very good	32	16.8
Smoker
Yes	3	1.6
No	150	78.9
Former smoker	37	19.5
Consumes alcohol
Yes	6	3.2
Sometimes	59	31.1
No	125	65.8
Health Problems
Yes	187	98.4
No	3	1.6
Number of health problems ^ n=187 (refers to individuals with health problems).
One health problem	20	10.7
Two health problems	46	24.6
More than two health problems	121	64.7
Self-reported health problems ^* ***** Multiple choice questions 1 Sensorial: eyesight, hearing, tactile or smell; 2 Osteoarticular conditions: arthritis, arthrosis, osteoporosis or rheumatism; 3 Degenerative diseases: Alzheimer or Parkinson.
Sensorial¹	166	88.8
Hypertension	118	63.1
Osteoarticular²	68	36.4
Back problems	41	21.9
Degenerative diseases³	2	1.1
Dyslipidemia	51	27.3
Diabetes	25	27.3
CHF	2	1.1
Urinary incontinence	41	21.6
Others	84	44.2
Uses medication
Yes	171	90.0
No	19	10.0
Self-reported balance status
Yes	45	23.7
No	145	76.3
Self-reported difficult mobility
Yes	22	11.6
No	168	88.4
Exercises
Yes	182	95.8
No	8	4.2
Level of dependence for DLA and IDLA ^** ****** Among all the elderly individuals, n= 41 (presented urinary incontinence) and, in regard to DLA, were considered independent for all activities but one (had occasional "accidents" - urine or feces loss) but were considered totally independent regardless.
Independent	190	100.0
Dependent	0	0.0

Variables	Frequency (n)	Percentage (%)
Self-reported falls in the last 12 months
Yes	41	21.6
No	149	78.4
Numbers of self-reported falls
One fall	21	51.3
Two falls	14	34.1
More than two falls	6	14.6
Self-reported consequences from fall ^ n=35 (refer to individuals who experienced consequences after falls. Multiple choice question).
	16	38.9
Bruise	14	34.1
Fracture	5	12.2
Sprains	4	9.8
Risk for falls (Fall Risk Score)
Low risk for falls	99	52.1
High risk for falls	91	47.9
Fear of falling (FES-I-BRAZIL)
Little worried about falling	113	59.5
Very worried about falling	54	28.4
Extremely worried about falling	23	12.1

Variables	n*	Prevalence (%)	p-value^* ** Chi-square test.*

Female	63	36.6	0.456
Male	5	27.8	0.456
Age group
60 - 69 years old	47	36.7	0.196
70 - 79 years old	17	30.4	0.196
80 years old or older	4	66.7
Marital status
Single	5	23.8	0.060
Married or stable union	21	30.4
Separated or divorced	14	31.8
Widowed	28	50.0
Years of schooling
1 to 4 years	22	64.7	<0.001
5 to 8 years	14	41.2
9 to 10 years	7	70.0
>11 years	25	22.3
Occupational situation
Retired	31	31.6	0.048
Working	6	42.9
Retired but still working	1	6.7
Pensioner	14	56.0
Retired and pensioner	8	50.0
Pensioner and working	2	28.6
Unemployed	6	40.0
Monthly income
One to 3 times the minimum wage	55	42.4	0.004
More than 3 times the minimum wage	13	21.3	0.004
Family arrangement
Living alone	16	32.7	0.489
Spouse or partner	9	29.0
Family (Spouse + family member)	12	32.4
Family (Only family members, no spouse/partner)	31	42.5
Visits friends/relatives
Yes	33	30.3	0.066
No	35	43.2	0.066
Visits friends/relatives
Yes	61	35.3	0.627
No	7	41.2	0.627
Receives visits from friends/relatives
Yes	63	35.4	0.661
No	5	41.7	0.661

Variables	Prevalence (%)	Raw PR (IC95%)	Adjusted PR^* * Adjusted for sex, age and sensorial problems; PR: prevalence ratio; CI 95%: confidence interval of 95%. (IC95%)	p-value
Income
One to 3 times the minimum wage	42.4	2.00 (1.19-3.38)	2.05 (1.23-3.41)	0.006
More than three times the minimum wage	21.3	1.00	1.00	0.006
Risk for falls
Low risk for falls	43.4	1.58 (1.06-2.37)	1.75 (1.16-2.66)	0.008
High risk for falls	27.5	1.00	1.00	0.008
Participates in other social group(s)
Yes	30.3	1.00	1.00	0.042
No	43.2	1.43 (0.98-2.09)	1.46 (1.01-2.11)	0.042

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[1] Corresponding author Bruna Soares Vasques Blaz. E-mail: brunablaz@hotmail.com