Risk factors for falls in different age groups of patients with chronic cerebral ischaemia

Abstract

Introduction. Cognitive impairment, gait and balance disorders are the most important risk factors for falls in older persons. These neurological impairments are the main clinical manifestations of chronic cerebral ischaemia (CCI), and can develop at a younger age. Aim: to evaluate the risk factors for falls in patients with CCI in different age groups and to identify the most significant predictors of falls. Materials and methods. We examined 104 patients with CCI. Patients were divided into three age groups: middle age (4059 years old; n = 13), older age (6074 years old; n = 62), and the elderly (75 years and older; n = 29). We assessed the frequency of falls and the presence of risk factors. Results. Thirty-seven (36%) patients had a history of falls, with its incidence increasing from 8% in the middle-aged group to 37% in the older persons and 45% in the elderly. Some patients had multiple risk factors for falls, while the presence of 5 risk factors increased the risk of falling fourfold. The most common factors in middle age were pain due to degenerative spine conditions (85%), anxiety (54%), and visual impairment (31%); in older age back pain (77%), cognitive impairment (45%), visual impairment (39%), and decreased walking speed (23%); in the elderly visual impairment (76%), cognitive impairment (69%), back pain (69%), decreased walking speed (38%), and orthostatic hypotension (28%). Discriminant analysis revealed that the best predictors of falls in CCI were female sex, age over 69 years, depression, cognitive impairment, and a walking speed below 1 m/sec. Conclusion. Falls were observed in all age groups of people with CCI. Not only the presence of a specific risk factor for falls, but the presence of multiple risk factors, has predictive value. The presence of five or more risk factors, as well as a walking speed below 1 m/sec, can indicate a high risk of falls.