Risco de queda e fatores associados em idosos residentes na comunidade

Abstract

Ageing falls are a complex geriatric syndrome, common in the elderly, preventable and associated with morbidity and mortality, characterized significant issues of public health. The purpose was to verify the fall risk prevalence and analyze the associated factors. Were analyzed the correlation between functional mobility, functional capacity, fear of falling, number of falls and handgrip strength (HGS) and the identification of HGS as a discriminator for the fall risk in community-dwelling elderly. This was a cross - sectional study from the second wave of the Inquérito de Saúde da População Idosa de Juiz de Fora conducted between October 2014 and March 2015. Were entered in this study 339 elderly (60 years old and over), both sex, not institutionalized. It was considered demographic and socioeconomic characteristics, health profile, fall risk (Timed Up and Go test), history of falls, fear of falling (Falls Efficacy Scale–International–Brazil), functional capability (Lawton and Brody Scale) and HGS (dynamometer JAMAR). The data was processed in a database on the software Statistical Package for Social Sciences, complex analyze module, 15.0 version. Several methods of statistical analysis were adopted to achieve the goals. The significance level was 5% and confidence interval of 95%. For fall risk associated factors, a theoretical model of determination with two hierarchical blocks, adjusted by mutinomial regression, was built. The low, moderate and high fall risk prevalence was 36%, 43.7% and 20.3%, respectively. Sex and age were associated to moderate fall risk. Age, general health perception, need for walking aid and fear of falling were associated to high fall risk. Functional mobility had a moderate correlation with HGS and functional capacity in both sexes and with fear of falling in the female sex. Weak correlation with fear of falling in males and with number of falls in both sexes. The area under the ROC curve showed HGS as a good discriminator for the fall risk in community-dwelling elderly. The cut-off point of 18.2 kgF had the best sensitivity (78.9%) and specificity (50.0%) combined in females and the cut-off point of 27.0 kgF had the best sensitivity (81.3%) and specificity (57.7%) combined in males. The results presented revealed a high prevalence of the fall risk increased in community dwelling elderly. The understanding of the associated factors may help in the implementation of preventive and health promotion actions focused on active and healthy aging.