الفهرس 
Falls among Elderly OutpatientsOnly 14 pages are availabe for public view
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Abstract
A report by the WHO shows that the rate of falls among older people in recent studies worldwide ranges from 4% to 35% and increases steadily with age.
Currently, there is a demographic transition in many parts of the world including the Middle East, where there is an increase in the proportion of the elderly population.
Indeed, studies have reported that age is a critical risk factor for falling. This strong association between age and falls can be attributed to an age-induced decline in physical, sensory and cognitive function, as well as an increase in the number of comorbid conditions.
Consequently, this study was conducted and aimed to assess the prevalence of falls and detect the risk factors among elderly patients attending outpatient clinic of the Geriatrics and Gerontology department, Ain Shams University.
This cross-sectional quantitative research design was conducted at Geriatric Department, Faculty of Medicine, Ain Shams University Hospitals 15 November 2022 and 15 May 2023.
During this study, 250 elderly patients attended geriatric outpatient clinic were enrolled, after consenting each of them and subjected to comprehensive geriatric assessment, fall risk assessment scale which included the intrinsic risk factors such as, musculoskeletal reason, neuromotor disease, cognitive impairment, and poor vision, home fall prevention checklist for older adults, Timed Up and GO Test, 30-Second Chair stand Test and 4 Stage Balance Test.
The prevalence of falls in this study was found to be 34.8 % with number of falls ranging from1-15 fall and Mean ± SD is 3.21±1.14.
As regard age, this study showed a higher mean age among faller (70-90 years) compared to non fallers (60-70) and the difference is highly significant statistically (p value <0.004).
As regard marital status and education, divorced women were higher among fallers and there was highly statistically significant higher frequency of illiterate and primary education in fallers was 18.4% and 62.1%, respectively comparing to non-fallers 9.2% and 42.9%, respectively.
Also, there was no significant difference between fallers and non fallers as regard gender and smoking as numbers of demographic variables.
Individuals included in this study who have functional impairment in ADL, IADL, TUGT (30 Second chair stand Test and 4 Stage Balance test) showed a significant higher falls risk and most of them gave a history of falls in the last 12 months when compared to those without functional impairment
(p < 0.009 and0.006 respectively).
Regarding central processing, depression, neuromotor disorders, Parkinsons disease, stroke and neuropathy were considered a significant risk factor for falls (P value < 0.04).
According to current study, 52.6 % of the patient gave a history of falls in last year with significant difference (p.value=0.001) and a positive correlation between degree of depression (measured by GDS-15) and number of falls.
As regard comorbidities the prevalence of comorbidities in the studied group and their relation to falls was assessed and it was found that the only significant comorbidities that associated with risk of falls are balance and gait disorders, arrhythmias, Cerebrovascular disease, Peripheral neuropath, and visual impairment . Also, neurologic and musculoskeletal disorders, IHD, hypertention, DM, cerebrovascular diseases, anemia, poor vision and polypharmacy were significant risk factors of fall.
Extrinsic factors contributing to fall as environmental obstacles, poor lighting, inappropriate clothing were statistically significant higher among faller cases 85 (97.7%) vs. 69 (42.3%). On the other hand, using of assistive device was statistically significant lower among faller cases.
In conclusion, due to the higher frequency of co morbidities, age-related physiological changes, and delayed functional recovery, older adults are more vulnerable to fall-related injuries. This ultimately results in further deconditioning and an increased risk of falls.
Falls are a major health issue for the aged, contributing to significant morbidity and death as well as lowering many seniors’ quality of life.
Falls are associated with a variety of multifactorial risk factors. Those with cognitive impairment, depression, functional impairment in ADL and IADL, balance disorders, gait disorders, arrhythmias, CV illness, peripheral neuropathy, and visual impairment were found to have the greatest connections.
Among the study group, age, the number of prescribed medications, the number of chronic illnesses and gait or balance abnormalities are independent risk factors for falls.
The risk of falls increases with the amount of prescription medicines filled specifically employing hypnotics, diuretics, and antidepressants.
Conclusion
Due to the higher frequency of co morbidities, age-related physiological changes, and delayed functional recovery, older adults are more vulnerable to fall-related injuries. This ultimately results in further deconditioning and an increased risk of falls.
Falls are a major health issue for the aged, contributing to significant morbidity and death as well as lowering many seniors’ quality of life.
Among our study cases, there have been between 1 and 15 falls among senior Egyptian females, with an incidence of falls among them of 34.8%.
Falls are associated with a variety of multifactorial risk factors. Those with cognitive impairment, depression, functional impairment in ADL and IADL, balance disorders, gait disorders, arrhythmias, peripheral neuropathy, and visual impairment were found to have the greatest connections.
Among the study group, age, the number of prescribed medications, the number of chronic illnesses and gait or balance abnormalities are independent risk factors for falls.
The risk of falls increases with the amount of prescription medicines filled. specifically employing hypnotics, diuretics, and antidepressants.
Recommendations
All older patients should have access to falls risk assessment instruments in primary health care clinics so that those who require early prevention can be identified and prevented from falling.
Every elderly patient seeing a healthcare professional should have a fall screening performed. If the results are positive, they should be routinely reassessed for fall risk and any detected concerns should be reduced or eliminated.
It is imperative to heighten the consciousness of medical professionals and the elderly regarding the consequences of falls and the significance of routine screening and evaluation.
Programs for preventing falls should be implemented in order to manage the reversible risk factors of falls, paying particular emphasis to the most common and important risk variables.