Epidemiology of falls in St. Petersburg (based on research by the Department of Family Medicine)

Abstract

Introduction: prevention of falls and fractures in older adults is a strategic task of the geriatric service.Aim: to estimate the prevalence of falls and its risk factors, as well as their association with geriatric syndromes in St. Petersburg.Materials and methods: analysis of the results of four studies conducted in St. Petersburg between 2009 and 2019. The total number of participants was 1398 persons aged 60 years and older. Main parameters: comprehensive geriatric assessment, measurement of cardio-ankle vascular index (CAVI) using Vasera VS-1500 volumetric sphygmography computer complex, detection of silent atrial fibrillation using «MyDiagnostick 1001R» device.Results: every third person falls at the age of 65 to 74 years old, and every second person falls at the age of 85 and older. In 50% of cases, falls are accompanied by injuries. The main factors associated with a higher risk of falls were arterial hypertension, atrial fibrillation, stroke/transient ischemic attack, cognitive impairment, sensory deficits, urinary incontinence, decreased physical functioning and CAVI above predicted value. Vision correction reduced the risk of falls by 46.7%, improved/good nutrition status according to self-assessment data by 55.3%, correction of urinary incontinence by 55.8%, improved cognitive functioning by 73.3%, and eating two or more fruits and vegetables a day by 66.0%. Individualized analysis of fall risk factors and development of fall prevention programs can reduce the risk of falls by a factor of nine within the first year.Conclusion: Screening to assess the risk of falls and compiling individual fall prevention programs can significantly reduce the risk of falls in older and senile age. The effectiveness of individual fall risk reduction programs decreases after the first year of implementation. Consequently, it is necessary to conduct annual screening of older patients to assess the risk of falls and subsequent adjustment of personalized fall prevention plan.