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2020, Number 1

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Aten Fam 2020; 27 (1)

Elderly Falling over Syndrome Risk Factors and Polypharmacy

Cabrera VO, Roy GI, Toriz SA

Language: Spanish
References: 19
Page: 27-31
PDF size: 162.34 Kb.


ABSTRACT

Objective: To determine the risk factors associated with the elderly falling over syndrome with polypharmacy. Methods: cross-sectional study conducted from March to April 2019. Adults over the age of 60 were included who attended an external consultation in the Family Medicine Unit No. 28, with prescription and minimum consumption of four drugs simultaneously (polypharmacy). The World Health Organization (WHO) study questionnaire was used to assess falls. The assessed variables as risk factors for falls were: age, gender, marital status, education, weight, size, body mass index, medications, comorbidities and the use of external supports when moving. To understand the differences according to the presence of falls, the χ2 test in the qualitative variables was used; to determine the risk factors for falls, OR were calculated and an adjusted logistic regression model was made for the use of antidepressants, diuretics and benzodiazepines. Results: A total of 264 patients were included, the average medicines consumed were six (RIC 4-7), the most frequently prescribed drugs were antihypertensive, nonsteroidal anti-inflammatory drugs and diuretics. Of the total participants, 79 had falls in the last six months (29.9%). When analyzing risk factors associated with falls in the multivariate model, the use of antidepressants showed an OR 3.14 (IC95% 1.46-6-71) and diuretics an OR 1.84 (IC95% 1.1-3.37). Conclusion: the risk factors associated with falls in patients with polypharmacy were the use of antidepressants and diuretics.


REFERENCES

  1. INEGI. Encuesta Intercensal 2015 del Instituto Nacional de Estadística y Geografía. [Internet]. [Citado 2019 Mayo 27] Disponible en: https://www. inegi.org.mx/programas/intercensal/2015/

  2. Guía de Práctica Clínica para la Prescripción Farmacológica Razonada en Adulto Mayor. México: Secretaría de Salud, 2010.

  3. Zia A, Kamaruzzaman SB, Tan MP. Polypharmacy and falls in older people: Balancing evidence- based medicine against falls risk. Postgraduate Medicine. 2015;127(3):330-337. 10.1080/00325481.2014.996112

  4. Aguirre, N. Gómez, et al. Pluripatología, polifarmacia, complejidad terapéutica y uso adecuado de la medicación. Revista Clínica Española 2017;217(5):289-295. 10.1016/j.rce.2016.12.013

  5. Wedmann, F., Himmel, W. &Nau, R. Eur J ClinPharmacol (2019). 10.1007/s00228-019- 02668-3

  6. de Vries, Max, et al. Fall-risk-Increasing drugs: a systematic review and meta-analysis: I. cardiovascular drugs. Journal of the American Medical Directors Association 2018;19(4):371-e1. 10.1016/j. jamda.2017.12.013

  7. Seppala, Lotta J., et al. Fall-risk-increasing drugs: a systematic review and meta-analysis: II. Psychotropics. Journal of the American Medical Directors Association. 2018;19(4):371-e11. 10.1016/j. jamda.2017.12.098

  8. Organización Mundial de la Salud. Caídas. [Internet]. [Citado 2019 May 27] Disponible en: https://www.who.int/es/news-room/fact-sheets/ detail/falls.

  9. Boletín informativo: volumen 1, numero 12. Enero 2019. [Internet]. [Citado Ene 2019]. Disponible en: http://geriatria.salud.gob.mx/contenidos/ensenanza/ archivo-boletin.html

  10. Richardson, K., Bennett, K., & Kenny, R. A. Polypharmacy including falls risk-increasing medications and subsequent falls in community-welling middle-aged and older adults. Age And Ageing. 2015;44(1):90-96. 10.1093/ageing/afu141

  11. Reis, K. M. C. D., & Jesus, C. A. C. D. Relationship of polypharmacy and polypathology with falls among institutionalized elderly. Texto Contexto Enferm, 2017;26(2). 10.1590/0104- 07072017003040015.

  12. Fernández, M., Valbuena, C., & Natal, C. Riesgo de caídas asociado al consumo de medicamentos en la población anciana. J. Healthc. Qual. Res. 2018;33(2):105-108. 10.1016/j.cali.2017.12.007

  13. Rodrigues Molinero A et al. Caídas en la población anciana española: incidencia, consecuencias y factores de riesgo. Revista Española de Geriatría y Gerontología. 2015;50:274-280. 10.1016/j. regg.2015.05.005

  14. Martinez-Cengotitabengo, Monica, et al. Prescripción de benzodiacepinas y caídas en mujeres y hombres ancianos. 2018;11(1):12-18. 10.1016/j. rpsm.2017.01.004

  15. Alvarez, Idalmis de la Caridad Tejeda, et al. Factores de riesgo de caídas en el adulto mayor hospitalizado. Correo científico médico de Holguín. 2015; 9(2).

  16. Prizer LP, Smith ML, Housman J, Ory MG. Depressive symptomology management and falls among middle aged and older adults. AgingMent Health. 2016;20(1):13-21. 10.1080/13607863.2015.1021748.

  17. De Picker L, Van Den Eede F, Dumont G, Moorkens G, Sabbe BG. Antidepressants and the risk of hyponatremia: a class-by-classreview of literature. Psychosomatics. 2014;55:536–54. 10.1016/j.psym.2014.01.010

  18. Lobo Rodríguez, Carmen, et al. Prevalencia de hiponatremia en pacientes mayores de 65 años que sufren una caída intrahospitalaria. Nefrología. 2016;36(3):292-298. 10.1016/j. nefro.2016.03.014

  19. Tinneth Monge Acuña, Yislen Solis Jiménez. El síndrome de caídas en personas adultas mayores y su relación con la velocidad en la marcha. Revista Médica de Costa Rica y Centro América LXXIII. (618);91-95,2916.




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