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A Smartphone-Based Gait Data Collection System for the Prediction of Falls in Elderly AdultsMartinez, Matthew, De Leon, Phillip L. 10 1900 (has links)
ITC/USA 2015 Conference Proceedings / The Fifty-First Annual International Telemetering Conference and Technical Exhibition / October 26-29, 2015 / Bally's Hotel & Convention Center, Las Vegas, NV / Falls prevention efforts for older adults have become increasingly important and are now a significant research effort. As part of the prevention effort, analysis of gait has become increasingly important. Data is typically collected in a laboratory setting using 3-D motion capture, which can be time consuming, invasive and requires expensive and specialized equipment as well as trained operators. Inertial sensors, which are smaller and more cost effective, have been shown to be useful in falls research. Smartphones now contain Micro Electro-Mechanical (MEM) Inertial Measurement Units (IMUs), which make them a compelling platform for gait data acquisition. This paper reports the development of an iOS app for collecting accelerometer data and an offline machine learning system to classify a subject, based on this data, as faller or non-faller based on their history of falls. The system uses the accelerometer data captured on the smartphone, extracts discriminating features, and then classifies the subject based on the feature vector. Through simulation, our preliminary and limited study suggests this system has an accuracy as high as 85%. Such a system could be used to monitor an at-risk person's gait in order to predict an increased risk of falling.
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Unsupervised Segmentation and Labeling for Smartphone Acquired Gait DataMartinez, Matthew, De Leon, Phillip L. 11 1900 (has links)
As the population ages, prediction of falls risk is becoming an increasingly important
research area. Due to built-in inertial sensors and ubiquity, smartphones provide an at-
tractive data collection and computing platform for falls risk prediction and continuous
gait monitoring. One challenge in continuous gait monitoring is that signi cant signal
variability exists between individuals with a high falls risk and those with low-risk.
This variability increases the di cultly in building a universal system which segments
and labels changes in signal state. This paper presents a method which uses unsu-
pervised learning techniques to automatically segment a gait signal by computing the
dissimilarity between two consecutive windows of data, applying an adaptive threshold
algorithm to detect changes in signal state, and using a rule-based gait recognition al-
gorithm to label the data. Using inertial data,the segmentation algorithm is compared
against manually segmented data and is capable of achieving recognition rates greater
than 71.8%.
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Pagyvenusių žmonių griuvimų rizikos įvertinimas ilgalaikės globos institucijose / Falls risk assessment among elderly in long-term care institutionsSpirgienė, Lina 19 June 2006 (has links)
The aim of this study was to investigate fall risk and predisposing factors for fall among the residents in long-term care institutions.
Methods. Elderly care homes residents 48 men (mean ± SD, 78,6±7,0) and 101 women (mean ± SD, 81,6±6,4), all 149 residents, participated in the study. For investigation a questionnaire was used, which was made according literature and including following instruments: Environmental Falls Audit Tool – Individual, Falls Risk Assessment Tool and Risk Factor Checklist, Mini Mental State Examination.
Results. The most frequently diseases among men and women were heart and vascular (89,6 % and 92,1 %) and eyes diseases (70,8 % and 75,2 %). Ambulatory aid was needed for a half of all residents (54,4 %); ambulatory aid, which respondents didn’t want to used were three times common for women than men (p=0,007). Most residents had low fall risk (72,5 %), but high fall risk was more common in women (14,9 %) than men group (4,2 %); there were no significant difference between groups. High fall risk significantly dominated among the residents older than 85 year in comparison with 65-74 and 75-84 year age groups. Residents who had lower education (p<0,001), were older (p=0,005) and took more medications (p=0,002) had higher fall risk scores evaluated by Fall Risk Assessment Tool. Residents who had such risk factors as unsafe mobility, over-reaches transfer, forgot gait aids, observed behavioural agitation, disorientation had more medium-high fall risk... [to full text]
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Clinimetric evaluation of current and novel methods for the assessment of fall and fracture risk in residential aged care.Miss Anna Barker Unknown Date (has links)
No description available.
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Falls Risk Assessment and ModificationFlores, Emily K. 01 August 2012 (has links)
Home health clinicians are uniquely qualified to fully evaluate patient falls risk and carry out clinical interventions to reduce risk. The objectives of this article are to give home health providers an update on the risk factors for falling, review the current guideline recommendations for prevention of falls, and provide a stepwise approach to evaluate patients and apply the clinical literature to decrease falls in older patients living at home. Many falls may be prevented with patient screening, assessment of risk, and modification of risk factors. Since the risk of falling is an interaction between three groupings of patient-specific factors, namely, environmental factors, diseases/disorders, and medication use, a multifactorial fall risk assessment can help identify the factors to consider modifying in an individual patient.
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Practices of falls risk assessment and prevention in acute hospital settings: a realist investigationRandell, Rebecca, McVey, Lynn, Wright, J., Zaman, Hadar, Cheong, V-Lin, Woodcock, D., Healey, F., Dowding, D., Gardner, Peter, Hardiker, N.R., Lynch, A., Todd, C., Davey, Christopher J., Alvarado, Natasha 11 September 2023 (has links)
No / Background: Falls are the most common safety incident reported by acute hospitals. NICE recommends multifactorial falls risk assessment and tailored interventions, but implementation is variable.
Aim: Determine how and in what contexts multifactorial falls risk assessment and tailored interventions are used in acute NHS hospitals in England.
Design: Realist review and multi-site case study. (1) Systematic searches to identify stakeholders’ theories, tested using empirical data from primary studies. Review of falls prevention policies of acute Trusts. (2) Theory testing and refinement through observation, staff interviews (N=50), patient and carer interviews (N=31), and record review (N=60).
Setting: Three Trusts, one orthopaedic and one older person ward in each.
Results: Seventy-eight studies were used for theory construction and 50 for theory testing. Four theories were explored: (1) Leadership: Wards had falls link practitioners but authority to allocate resources for falls prevention resided with senior nurses. (2) Shared Responsibility: A key falls prevention strategy was patient supervision. This fell to nursing staff, constraining the extent to which responsibility for falls prevention could be shared. (3) Facilitation: Assessments were consistently documented but workload pressures could reduce this to a tick-box exercise. Assessment items varied. While individual patient risk factors were identified, patients were categorised as high or low risk to determine who should receive supervision. (4) Patient Participation: Nursing staff lacked time to explain to patients their falls risks or how to prevent themselves from falling, although other staff could do so. Sensitive communication could prevent patients taking actions that increase their risk of falling.
Limitations: Within the realist review, we completed synthesis for only two theories. We could not access patient records before observations, preventing assessment of whether care plans were enacted.
Conclusions: (1) Leadership: There should be a clear distinction between senior nurses’ roles and falls link practitioners in relation to falls prevention; (2) Shared Responsibility: Trusts should consider how processes and systems, including the electronic health record, can be revised to better support a multidisciplinary approach, and alternatives to patient supervision should be considered; (3) Facilitation: Trusts should consider how to reduce documentation burden and avoid tick-box responses, and ensure items included in the falls risk assessment tools align with guidance. Falls risk assessment tools and falls care plans should be presented as tools to support practice, rather than something to be audited; (4) Patient Participation: Trusts should consider how they can ensure patients receive individualised information about risks and preventing falls and provide staff with guidance on brief but sensitive ways to talk with patients to reduce the likelihood of actions that increase their risk of falling.
Future work: (1) Development and evaluation of interventions to support multidisciplinary teams to undertake, and involve patients in, multifactorial falls risk assessment and selection and delivery of tailored interventions; (2) Mixed method and economic evaluations of patient supervision; (3) Evaluation of engagement support workers, volunteers, and/or carers to support falls prevention. Research should include those with cognitive impairment and patients who do not speak English. / This project was funded by the National Institute for Health Research (NIHR) Health and Social Care Delivery Research programme and will be published in the Health and Social Care Delivery Research Journal.
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Aerobic fitness, physical function and falls among older people : a prospective studyBell, Rebecca A. January 2008 (has links)
Falls in people aged over 65 years account for the largest proportion of all injury-related deaths and hospitalisations within Australia. Falls contributed to 1,000 deaths and 50,000 hospitalisations in older people during 1998 (Commonwealth Department of Health and Aged Care 2001). It has been predicted that by 2016, 16% of the Australian population will be aged over 65 years (Australian Bureau of Statistics 1999) placing considerable pressure on the health care system. Furthermore, prospective studies have shown that 30-50% of people aged 65 years and over, will experience a fall (Tinetti et al. 1988b; Campbell et al. 1989; Lord et al. 1994b; Hill 1999; Brauer et al. 2000; Stalenhoef et al. 2002) and this figure increases exponentially with age (Lord et al. 1994b). Many physiological falls risk factors have been established including reduced leg strength, poor balance, impaired vision, slowed reaction time and proprioception deficits. However, little research has been conducted to determine whether performance on aerobic fitness tasks is also a physiological falls risk factor. Aerobic fitness has previously been related to an individual's ability to perform activities of daily living, which in turn has been linked to falls. It was therefore proposed that aerobic fitness might also be a risk factor for falls among community dwelling older people. This research aimed to provide clinical evidence to inform public health practice. This thesis comprised of four objectives: the first to find suitable measures of aerobic fitness for older people; the second investigated relationships between existing clinical tests and future falls; the third explored relationships between aerobic fitness tests and future falls; the final objective was to examine the independent relationships between falls and clinical and physiological characteristics. The participants were recruited through a random sample from the local electoral roll, with an average age of 73 ±6 years. Of the 87 participants who completed the prospective component of the study, 37% were male and 63% were female. Sixty-three participants (65%) reported no previous falls, 19 (20%) reported a single fall, and 16 (15%) reported two or more falls in the previous 12 months. The first objective required participants recruited from the community to take part in submaximal and maximal fitness tests in order to find suitable measures of aerobic fitness. A further objective was to determine whether older people were able to fulfil the 'standard' criteria for completion of a maximum oxygen consumption test. The measures used in this research included: maximum oxygen consumption, peak oxygen consumption, ventilatory threshold, oxygen uptake kinetics, oxygen deficit, efficiencies, oxygen consumption at zero, 30 and 50 watts, predicted max and Six-Minute Walk Test distance. Only weak relationships were observed between submaximal aerobic measures and peak oxygen consumption. Furthermore, only 54% of participants were able to fulfil the criteria to complete a test of maximum oxygen consumption, indicating it was not a suitable measure for use among a sample of community dwelling older people. Therefore submaximal aerobic variables were used in the following chapters. The second objective investigated the relationship between clinical measures and falls among older people and was carried out to enable comparisons between the population in this study and those described in the literature. This research found that the Timed Up and Go (TUG) test was the most sensitive of all clinical tests (including the Berg Balance Scale, Function Reach, Performance Oriented Mobility Assessment and Physiological Profile Assessment) for the assessment of future falls. The TUG requires participants to stand up, walk 3m, turn, walk back, and sit down. Time taken to complete the test is the recorded value. For this study, a cut-off value of 7-seconds was established, above which individuals were at increased risk of falls. Previous research suggested cut-off times of over 10s were appropriate for older people. However, this is the first study to assess falls prospectively and definitively find that the TUG can discriminate between future fallers and non-fallers. This research also investigated the differences in falls risk factors for functionally different subsamples, as defined by their ability to undertake and complete the cycle test. The participants who could complete the test had significantly better balance ability and strength than those unable to undertake or complete the cycle test. However, this inability to undertake or complete the cycle test was not itself a predictor of future falls. These two groups also differed in the relationships between clinical test results and falls risk. Participants in the no-cycle group had very similar results to that of the entire cohort. Even after adjustment for age, the TUG, foot and hand reaction times and knee flexion strength were all performed better by non-fallers than fallers. However, none of these differed between fallers and non-fallers for participants in the cycle group. This group had better balance ability and strength than the no-cycle group. These results indicated that the cycle group differed from the no-cycle group and the entire sample, further indicating that factors other than the physiological variables measured in this research influence falls risk in strong participants with good balance ability. Similar results were reported when aerobic tests and falls were investigated in the third objective. In the whole sample, the fallers walked significantly less distance than non-fallers for the 6-MWT. Similar results were found for participants in the no-cycle group but not the cycle group. All participants were able to complete the Six-Minute Walk Test (6-MWT) although only 74% were able to undertake and complete the cycle test. The fourth objective was to consider all measures from the previous chapters as potential predictors of falls. The variables most predictive of future falls were the TUG and having experienced one or more falls in the previous 12 months. As a result they could be used as screening tools for the identification of high-risk fallers who require referral for further assessment. This could be completed by a General Practitioner or Practice Nurse, which would ensure that screening is being undertaken in the wider population. If the patient is at high risk they should be referred for falls risk factor assessment to determine an optimal tailored intervention to reduce future falls. Low risk patients should be referred for preventive evidence-based activities. These steps can potentially improve quality of life for individuals, and if effective in preventing future falls, will result in reduced costs to the individual and the Australian public. The results of this work demonstrate that the best screening tests are simple tasks like the TUG and asking an individual if they have experienced a fall in the last 12 months. This research also found that strong, mobile older people who could undertake and complete a submaximal cycle ergometer test, still experienced falls in the following 12 months, although the causes of this are currently unknown. This research showed that physiological falls risk factors are less relevant as these highly functional older people do not have physiological deficits. However, this research found that the 6-MWT showed promise as a predictor of falls in a group who could not complete a submaximal cycle ergometer test, who had lower strength, balance and functional fitness scores than a group who could complete this cycle test. The results showed that physiological falls risk factors are still very important for older people with lower physical abilities, and this is where aerobic fitness may still be related to falls. While the association between aerobic fitness and falls remains unclear, these are novel and provocative findings highlighting the need for future falls risk investigations to consider aerobic fitness as a contributing factor.
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Falls in older people in geriatric care settings : predisposing and precipitating factors /Kallin, Kristina, January 2004 (has links)
Diss. (sammanfattning) Umeå : Univ., 2004. / Härtill 5 uppsatser.
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Desarrollo de procedimientos de valoración funcional mediante sensores portables. Estudios de aplicación en enfermedades neurodegenerativas: Parkinson y Alzheimer.Pedrero Sánchez, José Francisco 23 January 2024 (has links)
[ES] La valoración funcional es fundamental en la evaluación y seguimiento de patologías musculoesqueléticas y neurológicas, ya que permite conocer, entre otras cosas, la forma de caminar de una persona, su equilibrio y su fuerza muscular; esto facilita la prescripción de tratamientos rehabilitadores o intervenciones quirúrgicas. En el caso de las personas mayores, esta evaluación adquiere mayor importancia, ya que la Organización Mundial de la Salud (OMS) considera que la salud en las personas mayores se mide en términos de función; es parte fundamental de una valoración geriátrica integral y permite evaluar la fragilidad de las personas mayores mediante la capacidad para realizar actividades diarias. Mediante una evaluación funcional temprana y continua se puede promover un envejecimiento saludable, prevenir y diagnosticar de forma precoz posibles declives en la función, mejorando así la calidad de vida y manteniendo la independencia de las personas mayores durante el mayor tiempo posible.
En la presente tesis doctoral se presenta el desarrollo de una metodología instrumentada de valoración funcional para las personas mayores. Una herramienta ágil y portable que, lejos de ser una metodología diagnóstica, puede servir de soporte para la toma de decisiones clínicas ante múltiples patologías del sistema locomotor y que permite clasificar y predecir en base a la funcionalidad del sistema musculoesquelético, el grado de alteración.
Se ha llevado a cabo una serie de estudios con diferentes grupos de personas mayores: con enfermedad de Alzheimer, Parkinson y personas mayores frágiles con riesgo de sufrir una caída. El objetivo principal de los diferentes estudios era objetivar y determinar la capacidad de realizar algunas de las actividades funcionales básicas, como el equilibrio, la marcha, el giro para sentarse y levantarse de una silla en comparación con personas sanas de la misma edad; el objetivo secundario era estudiar la fiabilidad del procedimiento en estas poblaciones, así como generar una serie de modelos matemáticos basados tanto en estadística tradicional como en redes neuronales combinando diferentes tipologías de datos.
Los aspectos más destacables de esta metodología son, por una parte, la inclusión de la valoración de actividades de la vida diaria con la duración reducida de la prueba, que es inferior a 2 minutos, lo que la hace más práctica y viable en el ámbito clínico y, en segundo lugar, que se trata de una instrumentación sencilla que consta de un único sensor embebido en un smartphone, que es capaz de gestionar todo el proceso de registro y realizar los cálculos necesarios para analizar las medidas obtenidas. Con todo ello se pone de manifiesto la utilidad del procedimiento y la viabilidad de los modelos desarrollados para la valoración funcional de personas mayores en un entorno clínico. / [CA] La valoració funcional és fonamental en l'avaluació i seguiment de patologies musculoesquelètiques i neurològiques, ja que permet conéixer, entre altres coses, la forma de caminar d'una persona, el seu equilibri i la seua força muscular; això facilita la prescripció de tractaments rehabilitadors o intervencions quirúrgiques. En el cas de les persones majors, aquesta avaluació adquireix major importància, ja que l'Organització Mundial de la Salut (OMS) considera que la salut en les persones majors es mesura en termes de funció; és part fonamental d'una valoració geriàtrica integral i permet avaluar la fragilitat de les persones majors mitjançant la capacitat per realitzar activitats diàries. Mitjançant una avaluació funcional precoç i contínua es pot promoure un envelliment saludable, prevenir i diagnosticar de forma precoç possibles deterioraments en la funció, millorant així la qualitat de vida i mantenint la independència de les persones majors durant el major temps possible.
En la present tesi doctoral es presenta el desenvolupament d'una metodologia instrumentada de valoració funcional per a les persones majors, eina àgil i portàtil que, lluny de ser una metodologia diagnòstica, pot servir de suport per a la presa de decisions clíniques davant múltiples patologies del sistema locomotor i que permet classificar i predir en base a la funcionalitat del sistema musculoesquelètic, el grau d'alteració.
S'han dut a terme una sèrie d'estudis amb diferents grups de persones majors: amb malaltia d'Alzheimer, Parkinson i persones majors fràgils amb risc de patir una caiguda. L'objectiu principal dels diferents estudis era objectivar i determinar la capacitat per a realitzar algunes de les activitats funcionals bàsiques, com l'equilibri, la marxa, el gir per seure i aixecar-se d'una cadira en comparació amb persones sanes de la mateixa edat; l'objectiu secundari era estudiar la fiabilitat del procediment en aquestes poblacions, així com generar una sèrie de models matemàtics basats tant en estadística tradicional com en xarxes neuronals, combinant diferents tipologies de dades.
Els aspectes més destacables d'aquesta metodologia són, d'una banda, la inclusió de la valoració d'activitats de la vida quotidiana amb la duració reduïda de la prova, que és inferior a 2 minuts, la qual cosa la fa més pràctica i viable en l'àmbit clínic i, en segon lloc, que es tracta d'una instrumentació senzilla que consta d'un únic sensor embegut en un \textit{smartphone}, que és capaç de gestionar tot el procés de registre i realitzar els càlculs necessaris per analitzar les mesures obtingudes. Amb tot això es posa de manifest la utilitat del procediment i la viabilitat dels models desenvolupats per a la valoració funcional de persones majors en un entorn clínic. / [EN] Functional assessment is fundamental in the evaluation and monitoring of musculoskeletal and neurological pathologies, as it allows understanding a person's gait, balance, and muscular strength. This facilitates the prescription of rehabilitative treatments or surgical interventions. In the case of older adults, this assessment becomes even more important, as the World Health Organization (WHO) considers that health in older individuals is measured in terms of function, which is a fundamental part of a comprehensive geriatric assessment and allows evaluating frailty in older adults based on their ability to perform daily activities. Through early and continuous functional assessment, healthy aging can be promoted, and possible declines in function can be prevented and diagnosed early, thus improving quality of life and maintaining independence in older adults for as long as possible.
This doctoral thesis presents the development of an instrumented methodology for functional assessment in older adults, which is an agile and portable tool that, far from being a diagnostic methodology, can support clinical decision-making regarding multiple pathologies of the musculoskeletal system. It enables classification and prediction of the degree of impairment based on the functionality of the musculoskeletal system.
A series of studies have been conducted involving different groups of older adults: those with Alzheimer's disease, Parkinson's disease, and frail older adults at risk of falling. The main objective of these studies was to objectively determine the ability to perform functional activities such as balance, gait, turning to sit and stand from a chair, in comparison with healthy individuals of the same age. The secondary objective was to study the reliability of the procedure in these populations and to generate a series of mathematical models based on both traditional statistical methods and neural networks, combining different types of data.
The most notable aspects of this methodology are, firstly, the inclusion of assessment of activities of daily living within a shortened testing duration of less than 2 minutes, making it more practical and feasible in a clinical setting. Secondly, it involves a simple instrumentation consisting of a single sensor embedded in a smartphone, capable of managing the entire registration process and performing the necessary calculations to analyze the obtained measurements. All of this highlights the usefulness of the procedure and the feasibility of the developed models for functional assessment of older adults in a clinical environment. / El proyecto ha sido coordinado por el Instituto de Biomecánica de Valencia y financiado por el IVACE en el marco del programa de ayudas dirigidas a centros tecnológicos para el ejercicio 2016, cofinanciado por el Fondo Europeo de Desarrollo Regional (FEDER) en un porcentaje del 50% a través del Programa Operativo FEDER de la Comunitat Valenciana 2014-2020. Ref: IMDECA/2016/16 / Pedrero Sánchez, JF. (2023). Desarrollo de procedimientos de valoración funcional mediante sensores portables. Estudios de aplicación en enfermedades neurodegenerativas: Parkinson y Alzheimer [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/202450
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Фактори ризика за пад и функционална способност старих особа / Faktori rizika za pad i funkcionalna sposobnost starih osoba / Fall risk factors and functionality in elderly personsIvanović Sunčica 12 October 2017 (has links)
<p>Увод. Годишње најмање 30% особа старијих од 65 година доживи један или више падова. Са повећањем година повећава се и озбиљност компликација услед пада, степен функционалног оштећења и ниво инвалидитета. Одговорност за пад приписује се многим факторима ризика. Због сложености њихове природе, од кључног је значаја да се ревидирају концептуални и методолошки оквири за разумевање и предвиђање пада у популацији старих особа. Циљеви истраживања. Утврдити учесталост падова код особа старијих од 65 година; утврдити најзначајније факторе ризика од пада и проценити њихову интеракцију са функционалним способностима и забринутост због пада. Материјал и методологија. Истраживање је спроведено у од фебруара до јуна 2014. године у виду студије пресека и обухватило је 400 испитаника старијих од 65 година. Испитаници су тестирани у кућним условима приликом посете патронажне службе. Коришћени су следећи инструменти: општи упитник, Elderly Fall Screening Test – ЕFST, Multi-factor Falls Questionnaire – MFQ, Tinetti Balance Assessment, Lawton Instrumental Activities of Daily Living Scale − IADL, Falls Efficacy Scale International FES-I. Стaтистички прорaчуни су вршени прогрaмом SPSS верзијa 20. Резултати истраживања. Резултати студије показују да је пад доживело 55% испитаника. Регресиони модел EFST са варијаблама био је статистички значајан, а као независни предиктори показали су се женски пол (OR = 2,751; < 0,001), године старости (OR = 1,138; p < 0,001), и степен образовања (OR = 0,554; p = 0,027). Слични резултати су добијении и за регресиони модел са Тинетијевим скором где су се као независни предиктори показали пол (Beta = -0,107; p = 0,029) старост (Beta = -0,260; p < 0,001) и степен образовања (Beta = 0,191; p < 0,001). Све корелације између ЕFST, FESI, IADL и скором Тинетијевог теста биле су статистички значајне (p < 0,05). Вредности скора FESI биле су у јакој позитивној корелацији са скором ЕFST и изузетно негативној корелацији са IADL и скором Тинетијевог теста. Скор ЕFST показао је умерену негативну корелацију са скором IADL и јаку негативну са скором Тинетијевог теста, док су скор IADL и скор Тинетијевог теста показали умерену позитивну корелацију. Модел EFST био је статистички значајан и у целини тачно класификује 83,3% случајева. Варијабле које су се показале као независни предиктори били су: Тинети скор (OR = 0,783; p < 0,001), скор (OR = 1,041; p = 0,019) и ортостатска хипотензија (OR = 2,291; p = 0,035). Закључак. У испитиваној популацији падови су веома учестала појава и више од половине особа доживела је пад у последњих годину дана. У повећаном ризику од пада су жене. Такође ризик од пада повећава се са годинама старости. Нижи степен образовања показао се као независни предиктор пада. Предикција ризика од пада утврђеног на основу скрининг тест за пад код старих особа у општој популацији могућа је уз висок степен детерминације на основу скора Тинетијевог теста и, скора FESI и ортостатске хипотензије.</p> / <p>Uvod. Godišnje najmanje 30% osoba starijih od 65 godina doživi jedan ili više padova. Sa povećanjem godina povećava se i ozbiljnost komplikacija usled pada, stepen funkcionalnog oštećenja i nivo invaliditeta. Odgovornost za pad pripisuje se mnogim faktorima rizika. Zbog složenosti njihove prirode, od ključnog je značaja da se revidiraju konceptualni i metodološki okviri za razumevanje i predviđanje pada u populaciji starih osoba. Ciljevi istraživanja. Utvrditi učestalost padova kod osoba starijih od 65 godina; utvrditi najznačajnije faktore rizika od pada i proceniti njihovu interakciju sa funkcionalnim sposobnostima i zabrinutost zbog pada. Materijal i metodologija. Istraživanje je sprovedeno u od februara do juna 2014. godine u vidu studije preseka i obuhvatilo je 400 ispitanika starijih od 65 godina. Ispitanici su testirani u kućnim uslovima prilikom posete patronažne službe. Korišćeni su sledeći instrumenti: opšti upitnik, Elderly Fall Screening Test – EFST, Multi-factor Falls Questionnaire – MFQ, Tinetti Balance Assessment, Lawton Instrumental Activities of Daily Living Scale − IADL, Falls Efficacy Scale International FES-I. Statistički proračuni su vršeni programom SPSS verzija 20. Rezultati istraživanja. Rezultati studije pokazuju da je pad doživelo 55% ispitanika. Regresioni model EFST sa varijablama bio je statistički značajan, a kao nezavisni prediktori pokazali su se ženski pol (OR = 2,751; < 0,001), godine starosti (OR = 1,138; p < 0,001), i stepen obrazovanja (OR = 0,554; p = 0,027). Slični rezultati su dobijenii i za regresioni model sa Tinetijevim skorom gde su se kao nezavisni prediktori pokazali pol (Beta = -0,107; p = 0,029) starost (Beta = -0,260; p < 0,001) i stepen obrazovanja (Beta = 0,191; p < 0,001). Sve korelacije između EFST, FESI, IADL i skorom Tinetijevog testa bile su statistički značajne (p < 0,05). Vrednosti skora FESI bile su u jakoj pozitivnoj korelaciji sa skorom EFST i izuzetno negativnoj korelaciji sa IADL i skorom Tinetijevog testa. Skor EFST pokazao je umerenu negativnu korelaciju sa skorom IADL i jaku negativnu sa skorom Tinetijevog testa, dok su skor IADL i skor Tinetijevog testa pokazali umerenu pozitivnu korelaciju. Model EFST bio je statistički značajan i u celini tačno klasifikuje 83,3% slučajeva. Varijable koje su se pokazale kao nezavisni prediktori bili su: Tineti skor (OR = 0,783; p < 0,001), skor (OR = 1,041; p = 0,019) i ortostatska hipotenzija (OR = 2,291; p = 0,035). Zaključak. U ispitivanoj populaciji padovi su veoma učestala pojava i više od polovine osoba doživela je pad u poslednjih godinu dana. U povećanom riziku od pada su žene. Takođe rizik od pada povećava se sa godinama starosti. Niži stepen obrazovanja pokazao se kao nezavisni prediktor pada. Predikcija rizika od pada utvrđenog na osnovu skrining test za pad kod starih osoba u opštoj populaciji moguća je uz visok stepen determinacije na osnovu skora Tinetijevog testa i, skora FESI i ortostatske hipotenzije.</p> / <p>Introduction. Annually at least 30% of people over 65 experience one or more falls. With the increase in years, the severity of complications due to falls, degree of functional impairment and level of disability also increase. The responsibility for the fall is attributed to many risk factors. Due to the complexity of their nature, it is crucial that the conceptual and methodological frameworks for understanding and predicting the decline in the elderly population are revised. Research goals. Determine the incidence of falls in people over 65 years of age; identify the most important risk factors of the fall and evaluate their interaction with functional abilities and fear for falling. Material and methodology. The survey was conducted from February to June 2014 in the form of a cross sectional study and included 400 respondents over 65 years of age. Respondents were tested at home during a visit of the patronage service. The following instruments were used: general questionnaire, Elderly Fall Screening Test - EFST, Multi-factor Falls Questionnaire - MFQ, Tinetti Balance Assessment, Lawton Instrumental Activities of Daily Living Scale - IADL, Falls Efficacy Scale International FES-I. Statistical calculations were performed by the SPSS version 20 program. Research results. The results of the study show that the fall was experienced by 55% of respondents. The regression model EFST with variables was statistically significant, and as independent predictors the female sex (OR = 2,751; <0,001), age (OR = 1,138; p <0,001), and the level of education (OR = 0,554; p = 0.027) were shown. Similar results were obtained for the regression model with the Tinetti's score, where the gender (Beta = -0.107; p = 0.029) age (Beta = -0.260; p <0.001) and education (Beta = 0.191; p < 0.001) were shown as independent predictors. All correlations between EFST, FESI, IADL and the Tinetti's test score were statistically significant (p <0.05). The FESI score values were in a strong positive correlation with the EFST score and extremely negative correlation with IADL and the Tinetti’s test score. The EFST score showed a moderate negative correlation with the IADL score and a strong negative with the Tinetti’s test score, while the IADL score and the Tinetti test score showed moderate positive correlation. The EFST model was statistically significant and in its entirety accurately classified 83.3% of cases. Variables that proved to be independent predictors were: Tinetti score (OR = 0.783; p <0.001), score (OR = 1.041; p = 0.019) and orthostatic hypotension (OR = 2.291; p = 0.035). Conclusion. In the studied population, falls are a very common occurrence and more than half of the people experienced a fall in the past year. Women are at increased risk of falling. Also, the risk of falling increases with age. A lower level of education has proven to be an independent fall predictor. Prediction of the risk of a fall that has been established on the basis of a screening test for elderly people in the general population is possible with a high degree of determination based on the Tinetti test score and, recent FESI and orthostatic hypotension.</p>
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