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Abstract
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BACKGROUND: Care giving produces great amounts of caregiver burden and stress. Falls are a common and complex geriatric syndrome that cause considerable mortality, morbidity, reduced functioning, and premature nursing home admissions.
AIM: To evaluate the risk factors of recurrent falls and effect on care giving family members.
MATERIALS AND METHODS: Case control study, performed with structured questionnaire conducted in an outpatient geriatric unit on 150 elder patients, divided into 2 groups; first: cases (100 subjects), second: controls (50 subjects). Comprehensive geriatric assessment and Timed Up and Go test (TUG) were applied. Caregiver burden and potential determinants were measured in all participant partners using Caregiver Burden Questionnaire.
RESULTS: The mean age of the cases was 69.6 ± 6.8, while for controls was 67.2 ± 4.7, [P: 0.02]. Sex did not show a significant difference between cases and controls [P: 0.123]. The mean BMI of the cases was 26.03 ± 6.4, and of controls: 29.1 ± 6.8, [P: 0.007]. The functional state assessed by ADL showed significant difference between cases and controls, [P: <0.001]. Also the use of assistive device was more among cases than controls, [P: 0.01]. Depression and polypharmacy were significantly found in cases more than controls, [P: 0.006, 0.01 respectively]. The mean value of TUG test in cases was 23.9 sec ± 11.1 while for controls was 19.6 ± 11.3, [P: 0.02], and the number of subjects with impaired TUG test was significantly higher in cases than controls [P: 0.002]. Table 3 showed that caregiver stress was significantly prevalent and more severe in cases (84%) than controls (54%), [P: <0.001, 0.002 respectively], also the mean value of ZBI test in cases was 31.9 sec ± 22.8 while for controls was 18.5 ± 21.4, [P: 0.001]. Table 4 displayed possible determinants of severity of caregiver stress in cases. It was found that presence of depression and functional impairment in the cases group were significant determinants of caregiver stress [P: 0.006, 0.003] respectively, also the number of falls significantly determined the severity of caregiver stress; the more the number of falls, the more severe caregiver stress score [P: <0.001].
CONCLUSION: Age, lower BMI, functional impairment, polypharmacy, depression and use of assistive device are risk factors for recurrent falls in older adults, and the caregiver stress is more prevalent in those with recurrent falls especially with increase in the number of falls, the presence of depression and functional impairment. So we recommend assessment of these risk factors for falls in all older patients and also assessment of caregiver stress especially in the elders with recurrent falls. Key words: recurrent falls, elderly patients, care giving family members
Language: en |