Efectividad del uso combinado de varias escalas para medir el riesgo de caídas en ancianos

Objective

To attempt to establish a relationship among combined actions of several assessment scales of risk of falls related to previous reports of involuntary falls by elderly institutionalized subjects in a day care service during the last year.

Patients and methods

Evaluations of day care center users were carried out with the Tinetti test, Timed up and Go, Functional Reach test and JH Dowton fall risk scale. In addition to age, the Barthel index of functional capacity and existence or not of falls during the last year was recorded.

Results

38 people (25 women and 13 men) were studied. Mean age was 81.5 (SD: 5.4) and the Barthel index 84.1(17.2). Individual tests showed a similar proportion of falls among users at risk (approx. 55 %) and a greater difference among users without risks. In an isolated way, the greatest predictive effectiveness on falls followed the next sequence: Tinetti, JH Dowton, Timed Up and Go and Functional Reach. Nevertheless, when the four trials are combined, it can be observed that 63.6% of the elderly have had 3 or 4 positive trials have suffered at least one fall during the last year, while this percentage is reduced to 25 % among those with 2 or less positives on the risk assessment scales.

Conclusions

The combined use of the four assessment scales used in this study shows better sensitivity to the risk of fall than evaluation with individual use of the above-mentioned tests.