Falls ( Collapse )

Prof. Kareem AL-Tameemi

Objectives of learning :
To know the incidence and risk of falls .
To know the risk factors of falls .
To know the screening investigations foe acute illness .
To know what are the abnormal gait and their problem causes .
To learn the intervention to prevent falls .
To know important causes of falls ( acute illness , blackout , mechanical , drugs, and multifactorial ) .

Incidence
30 % over 65 years
40 % over 80 years
10 – 15 % of falls lead to serious injury .
Falls is the cause of 90 % in the hip II in the this age .
Lead to loss of confidence , fear and may let the older people to move to institution
care .

Risk factors for falls :

Muscle weakness
History of falls
Gait and balance abnormality
Use of a walking aid
Visual impairment
Arthritis
Impaired activity
Depression
Cognitive impairment
Age over 80 years
Psychological medication

Screening investigations for acute illness ***

Full blood count
Urea & electrolytes , LFT , Ca+2 , glucose
Chest X ray
ECG
CRP : useful for occult infection or inflammation disease .
Blood culture if pyrexial

Abnormal gait and probable cause

Antalgic : arthropathy
Waddling : proximal myopathy
Stamping ??
Foot droop ??
Ataxic ??
Shuffling / festination ??
March a petit pas ??
Hemiplegic ??
Apraxial ??

Intervention to prevent falls

1.Strength and balance training
2.Rationalization of medication
3.Correction of vision
4.Home environment assessment
5.Calcium & Vit. D supplement