Cic edizioni internazionali
Clinical Cases in mineral and bone metabolism

Fall prevention in the elderly

Mini-reviews, 91 - 95
doi: 10.11138/ccmbm/2013.10.2.091
Tag this article
Abstract
Enhanced HTML Full text PDF
Falls are frequent in the elderly and affect mortality, morbidity, loss of functional capacity and institutionalization.
In the older patient the incidence of falls can sometimes be underestimated, even in the absence of a clear cognitive impairment, because it is often difficult to reconstruct the dynamics. It is quite common that forms due to syncope are associated with retrograde amnesia and in 40 to 60% of the cases falls happen in the absence of witnesses.
The pathogenesis of falls is often multifactorial, due to physiological age-related changes or more properly pathological factors, or due to the environment. The identification of risk factors is essential in the planning of preventive measures. Syncope is one of major causes of falls. About 20% of cardiovascular syncope in patients older than 70 appears as a fall and more than 20% of older people with Carotid Sinus Syndrome complain of falls as well as syncope. These data clearly state that older
patients with history of falls should undergo a cardiovascular and neuroautonomic assessment besides the survey of other risk factors. Multifactorial assessment requires a synergy of various specialists. The geriatrician coordinates the multidisciplinary intervention in order to make the most effective evaluation of the risk of falling, searching for all predisposing factors, aiming towards a program of prevention. In clear pathological conditions it is possible to enact a specific treatment. Particular attention must indeed be paid to the re-evaluation of drug therapy, with dose adjustments or withdrawal especially for antihypertensive, diuretics and benzodiazepines. The Guidelines of the American Geriatrics Society recommend modification of environmental hazards, training paths, hip protectors and appropriate use of support tools (sticks, walkers), which can be effective elements of a multifactorial intervention program. Balance exercises are also recommended. In conclusion, an initial assessment, supported by a comprehensive cardiovascular and neuroautonomic evaluation, allows for reaching a final diagnosis in most cases, demonstrating a key role in the real identification of the etiology of the fall and implementing the treatment measures.

Vol. XV (No. 1) 2018 January - April

  1. From the Editor-in-Chief
    Brandi M.L.
    doi: 10.11138/ccmbm/2017.15.1.007
  2. The use of null-hypothesis significance testing: issues and solutions
    Gronchi G., Brandi M.L.
    doi: 10.11138/ccmbm/2017.15.1.009
  3. Role of Mediterranean diet in bone health
    Migliaccio S., Marrocco C., Mocini E., Lenzi A., Greco E.A.
    doi: 10.11138/ccmbm/2017.15.1.016
  4. The Mediterranean diet for bone health in osteoporosis. Children and adolescents
    Pampaloni B., Quattrini S., Brandi M.L.
    doi: 10.11138/ccmbm/2017.15.1.019
  5. Parmigiano Reggiano cheese: a super-food for bone health
    Pampaloni B., Cianferotti L., Ciampi V., Nocetti M., Brandi M.L.
    doi: 10.11138/ccmbm/2017.15.1.029
  6. Pain from osteoporotic fractures: rationale of therapeutic options
    Hans G. Kress
    doi: 10.11138/ccmbm/2017.15.1.036
  7. New therapeutic strategies in the management of chronic pain related to osteoporosis
    Arghetti S., Magenta P., Racagni M.
    doi: 10.11138/ccmbm/2017.15.1.041
  8. Atypical femur fractures
    Cozzi Lepri A., Capone A., Del Prete A., Soderi S., Muncibì F., Civinini R.
    doi: 10.11138/ccmbm/2017.15.1.043
  9. Surgical strategies for high-energy fractures in patients with osteoporosis
    Cozzi Lepri A., Capone A., Del Prete A., Soderi S., Soderi S., Muncibì F., Innocenti M.
    doi: 10.11138/ccmbm/2017.15.1.060
  10. Sequential therapy: the way to go to prevent fragility fractures
    Gonnelli S., Alessandri M., Caffarelli C.
    doi: 10.11138/ccmbm/2017.15.1.066
  11. Atypical fractures following prolonged bisphosphonate use: a report of two cases
    Daniel-Lavee G., Nudelman P., Deltoff M., Shtarker H.
    doi: 10.11138/ccmbm/2017.15.1.070
  12. Osteoporosis treatment following a low trauma wrist fracture presenting to the Accident and Emergency Department from 2011 to 2015
    Sim Yeap S., Mat Akhir N.S., Thirunavukkarasu V., Thambiah S.C., Samsudin I.N., Zahari Sham S.Y., Balan P., Hew1 F.L., Chan S.P.
    doi: 10.11138/ccmbm/2017.15.1.074
  13. Low intestinal tract adenomatous polyps regression in FAP patients by dietary-induced erbeta upregulation
    Tonelli F., Fabbri S., Ficari F., Batignani G., Femia A.P., Caderni G., Brandi M.L.
    doi: 10.11138/ccmbm/2017.15.1.079
  14. Calcific arteriolopathy beyond chronic kidney disease. The role of hemochromatosis and vitamin K antagonists
    Rodelo-Haad R.-H., De La Puebla Gimenez R.F., Ortega R., Rodriguez M., Aljama P.
    doi: 10.11138/ccmbm/2017.15.1.085
  15. Successful treatment of gonadotropin releasing hormone induced severe pregnancy and lactation-associated osteoporosis with teriparatide
    Tahsini Tekantapeh S., Khabbazi A.
    doi: 10.11138/ccmbm/2017.15.1.089
  16. Serious osteoporomalacia with vertebral fracturing progression in bariatric surgery: case report
    Bruno R., Seriolo C., Palermo A., Nardi A., Molfetta L.
    doi: 10.11138/ccmbm/2017.15.1.094
  17. Late diagnosis of angioleiomyoma of the knee: a case report
    Galanakos S.P., Mavrogenis A.F., Ignatiadis I., Macheras G.A.
    doi: 10.11138/ccmbm/2017.15.1.097
  18. A rare case of Melnick Needles syndrome. Case report and brief review of literature
    Mangaraj S., Choudhury A.K., Mishra I., Patro D., Baliarsinha A.K.
    doi: 10.11138/ccmbm/2017.15.1.100
  19. Coexistence of torus palatinus and acromegaly, an association with a common origin
    Morales J., Folleco M.
    doi: 10.11138/ccmbm/2017.15.1.103
  20. Thoracic and lumbar spinal stenosis in a patient with Klippel-Feil syndrome
    Igoumenou V.G., Karantzoulis V.G., Vazifehdan F.
    doi: 10.11138/ccmbm/2017.15.1.107
  21. Acute deafness as the first symptom of paraneoplastic syndrome: experience of two cases
    Wang X., Yu X.
    doi: 10.11138/ccmbm/2017.15.1.111
  22. Severe secondary osteoporosis in a premenopausal woman: should a specific treatment for osteoporosis be started?
    Baleanu F., Iconaru L., Karmali R., Body J.-J.
    doi: 10.11138/ccmbm/2017.15.1.115
  23. Osteogenesis imperfecta type V: clinico-radiological diagnosis of two cases in a limited resource setting
    Chawla M., Bhardwaj G.
    doi: 10.11138/ccmbm/2017.15.1.119
  24. Multi-organ extraosseous 99mTc-HMDP uptake in a case of metastatic melanoma
    Calandri E., Aretano I., Pultrone M., Liberatore M.
    doi: 10.11138/ccmbm/2017.15.1.123
  25. Bilateral transient osteoporosis of the hip. A case report and review of the literature
    Pallis D., Florin Georgiou D., Rizou S., Symeonidou Z., Sarzi-Puttini P., Troupis T., Casale R.
    doi: 10.11138/ccmbm/2017.15.1.128
  26. Effects of endocrine disrupting compounds on Vitamin D circulating levels
    Fossi C., Pampaloni B., Brandi M.L.
    doi: 10.11138/ccmbm/2017.15.1.132
Last Viewed articles: la lista degli ultimi x visitati.
  1. Fall prevention in the elderly
    Ungar A., Rafanelli M., Iacomelli I., Brunetti M.A., Ceccofiglio A., Tesi F., Marchionni N.
    doi: 10.11138/ccmbm/2013.10.2.091
credits