Multifactorial assessment of the risk of falls in low bone density older women

• Published in: Fisioterapia em movimento 2016-09, Vol.29 (3), p.439-448
• Main Authors: Garcia, Patrícia Azevedo, Dias, João Marcos Domingues, Reis, Rosane Liliane dos, Dias, Rosângela Corrêa
• Format: Article
• Language: English
• Subjects: Acidentes por Quedas; Densidade Óssea; Idoso; ORTHOPEDICS; Osteoporose; Programas de Rastreamento; REHABILITATION
• ISSN: 0103-5150; 1980-5918; 0103-5150
• DOI: 10.1590/1980-5918.029.003.AO01

Abstract Introduction: Identifying effective assessment instruments for predicting falls, specifically in older women with low bone mineral density (BMD) that are more susceptible to fractures remains a challenge. Objective: To evaluate risk factors for falls at baseline, to identify the falls occurrence over six months of follow-up and to investigate the predictive validity of the Quickscreen Clinical Falls Risk Assessment for predicting multiple falls among low BMD older women. Methods: A methodological study with 110 older women with diagnosis of osteoporosis or osteopenia (70.26 ± 6.24 years). The presence of two or more of the eight risk factors assessed by the QuickScreen characterized the risk of falling (baseline) and monthly phone calls identified the occurrence of falls during the six months of follow-up. Results: The most prevalent falls risk factors were self-reported previous falls, polypharmacy and impairment in shifting weight and lateral instability. Most of the older women (67.3%) had two or more risk factors, 24.5% reported a single fall and 13.6% reported multiple falls over the six months. The QuickScreen (cutoff ≥ 2 risk factors) showed good sensitivity (73.3%) and high negative predictive value (88.89%) for predicting multiple falls among low BMD older women. Conclusions: The results indicated a high frequency of falls among low BMD older women. Additionally, the results highlighted that the QuickScreen instrument was able to predict multiple falls in the six months of follow-up among these older women. Resumo Introdução: A identificação de instrumentos de avaliação eficazes na predição de quedas, especificamente em idosas com baixa densidade mineral óssea (DMO) e mais susceptíveis a fraturas, permanece um desafio. Objetivo: Avaliar os fatores de risco para quedas na linha de base, identificar a ocorrência de quedas em seis meses de acompanhamento e investigar a validade preditiva do teste Quickscreen Clinical Falls Risk Assessment para predizer quedas múltiplas em idosas com baixa DMO. Métodos: Estudo metodológico com 110 idosas com diagnóstico de osteoporose ou osteopenia (70,26 ± 6,24 anos). O risco de queda (linha de base) foi caracterizado pela presença de dois ou mais dos oito fatores de risco avaliados no QuickScreen e a ocorrência de quedas nos seis meses posteriores identificada por meio de telefonemas mensais. Resultados: Os fatores de risco para quedas mais frequentes foram o autorrelato de quedas prévias, a polifarmácia e