Comprehensive personalized protocol for the prevention of repeated falls in elderly and senile patients

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OBJECTIVE

To study evaluation of the effectiveness of a comprehensive personalized protocol for the prevention of repeated falls in elderly and senile patients.

MATERIAL AND METHODS

Over the course of one year, 300 patients aged 60 and older who suffered two or more falls during the year were observed. Patients of group 1 (n=100) were recommended a comprehensive personalized protocol for the prevention of repeated falls, the observance of which was regularly monitored; patients of group 2 (n=100) received standard recommendations for the prevention of falls upon discharge from the hospital, the observance of which was not actively monitored; patients of group 3 (n=100) were observed by a therapist on an outpatient basis. Primary endpoints: frequency of falls, death from any cause; secondary endpoints: the frequency of fractures, the frequency of hospitalizations for any reason.

RESULTS

In group 1, after a year, the frequency of falls decreased by 5 times (100% vs. 21%, p<0.0001), in groups 2 and 3 — by 38% (p=0.013) and 81% (p<0.001). There was no significant decrease in the number of all fractures in any group, but in group 3, the frequency of vertebral fractures increased during the year (p=0.029). Statistically significant positive dynamics of indicators characterizing the geriatric status has been established: walking speed, values on the basic activity scale, a short nutrition assessment scale, the results of the drawing hours test have increased, the intensity of pain has decreased. No one died in group 1, unlike 5 patients in group 2 and 8 in group 3 (p=0.011).

CONCLUSION

The use of a comprehensive personalized protocol for the prevention of repeated falls can reduce the number of complications in elderly and senile patients.

Keywords:

falls

fractures

fall prevention

comprehensive geriatric assessment

polypragmasia

osteoporosis

osteoarthritis

chronic pain

Authors:

Khovasova N.O.

Pirogov Russian National Research Medical University

Naumov A.V.

Pirogov Russian National Research Medical University

Tkacheva O.N.

Pirogov Russian National Research Medical University

ORCID: 0000-0002-4193-688X

Moroz V.I.

Pirogov Russian National Research Medical University

Received:

18.02.2021

Accepted:

15.03.2021

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