Mobilität und Sturzprävention bei selbstständig  lebenden älteren Menschen

Ellen Freiberger; Cornel C. Sieber; Katrin Singler

doi:10.1055/a-0922-7535

DMW - Deutsche Medizinische Wochenschrift, Table of Contents

Dtsch Med Wochenschr 2020; 145(13): 932-943
DOI: 10.1055/a-0922-7535

CME-Fortbildung

Mobilität und Sturzprävention bei selbstständig lebenden älteren Menschen

Mobility and Fall Prevention in older Community-dwelling Persons

Authors

Ellen Freiberger
Cornel C. Sieber
Katrin Singler

Abstract

An increasing proportion of oldest old persons (over 80 years) accompanies the demographic change. Furthermore, the gender ration will also change and the percentage of older men will increase. Mobility is an important factor for maintaining independence and for “healthy aging”. Mobility has to be regarded in the context of individual and environmental factors. With increasing age, the risk of mobility limitation increases. Next to mobility, falls are also a drastic experience for older persons and cannot only have physical consequences like injuries but also psychological consequences as fall-related psychological concerns. These psychological consequences can produce negative behavior e. g. reducing physical activity.

Mobilität ist ein wesentlicher Faktor im Selbstständigkeitserhalt und im „gesunden“ Altern. Mit zunehmendem Alter steigt das Risiko einer Mobilitätseinschränkung. Auch Stürze stellen für den älteren Menschen ein einschneidendes Erlebnis dar und können nicht nur physische Konsequenzen wie Verletzungen haben, sondern auch psychische Konsequenzen wie Sturzangst mit negativen Verhaltensanpassungen bewirken, z. B. sich weniger zu bewegen.

Schlüsselwörter

Mobilität - Sturzprävention - ältere Menschen - CME

Key words

mobility - fall prevention - older persons - CME

Full Text

References

Literatur
1 Adcock M, Sonder F, Schattin A. et al. A usability study of a multicomponent video game-based training for older adults. Eur Rev Aging Phys Act 2020; 17: 3
2 Aranda-Gallardo M, Morales-Asencio JM, Canca-Sanchez JC. et al. Instruments for assessing the risk of falls in acute hospitalized patients: a systematic review and meta-analysis. BMC Health Serv Res 2013; 13: 122
3 Ayoubi F, Launay C, Annweiler C. et al. Fear of falling, falls, and gait variability in older community-dwelling individuals: Is there an association?. Journal of the American Geriatrics Society 2013; 61: 1236-1238
4 Ayoung-Chee P, McIntyre L, Ebel BE. et al Long-term outcomes of ground-level falls in the elderly. The journal of trauma and acute care surgery 2014; 76: 498-503 ; discussion 503
5 Becker C, Cameron ID, Klenk J. et al. Reduction of Femoral Fractures in Long-Term Care Facilities: The Bavarian Fracture Prevention Study. PloS one 2011; 6: e24311
6 Becker C, Blessing-Kapelke U, Borhof A. et al. Empfehlungspapier für das körperliche Training zur Sturzprävention bei älteren, zu Hause lebenden Menschen. Z Gerontol Geriat 2011; 44: 121-128
7 Cesari M, Araujo de Carvalho I, Amuthavalli Thiyagarajan J. et al. Evidence for the domains supporting the construct of intrinsic capacity. J Gerontol A Biol Sci Med Sci 2018; 73: 1653-1660
8 Chung J, Demiris G, Thompson HJ. Instruments to assess mobility limitation in community-dwelling older adults: a systematic review. J Aging Phys Act 2015; 23: 298-313
9 Close J, Swift C. Prevention of falls in the elderly trial (PROFET): a randomised ctolled trial. Journal Article workform 1999; 353: 93-97
10 Cruz-Jentoft AJ, Bahat G, Bauer J. et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 2018;
11 Davis JC, Best JR, Bryan S. et al. Mobility is a key predictor of change in well-being among older adults who experience falls: evidence from the Vancouver Falls Prevention Clinic Cohort. Arch Phys Med Rehabil 2015; 96: 1634-1640
12 Demnitz N, Zsoldos E, Mahmood A. et al. Associations between mobility, cognition, and brain structure in healthy older adults. Frontiers in aging neuroscience 2017; 9: 155
13 Denkinger MD, Lukas A, Nikolaus T. et al. Factors associated with fear of falling and associated activity restriction in community-dwelling older adults: a systematic review. Am J Geriat Psychiat 2015; 23: 72-86
14 Destatis. Demografischer Wandel. In: DESTATIS https://www.destatis.de/DE/Themen/Querschnitt/Demografischer-Wandel/Aeltere-Menschen/bevoelkerung-ab-65-j.html
15 Donath L, Faude O, Bridenbaugh SA. et al. Transfer effects of fall training on balance performance and spatiotemporal gait parameters in healthy community-dwelling older adults: a pilot study. J Aging Phys Act 2014; 22: 324-333
16 Freiberger E, Sieber C. Mobilität im Alter: Trainingsaspekte bei selbständig lebenden Menschen. Dtsch Med Wochenschr 2013; 138: 2007-2010
17 Gray LC, Peel NM, Costa AP. et al. Profiles of older patients in the emergency department: findings from the interRAI Multinational Emergency Department Study. Ann Emerg Med 2013; 62: 467-474
18 Guralnik J, Ferrucci L, Pieper CF. et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci 2000; 55: M221-M231
19 Haines TP, Lee DCA, O’Connell B. et al. Why do hospitalized older adults take risks that may lead to falls?. Health Expectations 2015; 18: 233-249
20 Harada CN, Natelson Love MC, Triebel KL. Normal cognitive aging. Clin Geriatr Med 2013; 29: 737-752
21 Healey F, Scobie S, Oliver D. et al. Falls in English and Welsh hospitals: a national observational study based on retrospective analysis of 12 months of patient safety incident reports. Qual Saf Health Care 2008; 17: 424-430
22 Hill AM, Hoffmann T, Haines TP. Circumstances of falls and falls-related injuries in a cohort of older patients following hospital discharge. Clin Intervent Aging 2013; 8: 765-774
23 Hill KD, Day L, Haines TP. What factors influence community-dwelling older people’s intent to undertake multifactorial fall prevention programs?. Clin Intervent Aging 2014; 9: 2045-2053
24 Hopewell S, Adedire O, Copsey BJ. et al. Multifactorial and multiple component interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev 2018; 7: Cd012221
25 Hughes CC, Kneebone II, Jones F. et al. A theoretical and empirical review of psychological factors associated with falls-related psychological concerns in community-dwelling older people. International psychogeriatrics/IPA 2015; 27: 1071-1087
26 Icks A, Arend W, Becker C. et al. Incidence of hip fractures in Germany, 1995–2010. Arch Osteoporos 2013; 8: 140
27 Kwon S, Perera S, Pahor M. et al. What is a meaningful change in physical performance? Findings from a clinical trial in older adults (the LIFE-P study). J Nutr Health Aging 2009; 13: 538-544
28 Kyrdalen IL, Moen K, Roysland AS. et al. The Otago exercise program performed as group training versus home training in fall-prone older people: a randomized controlled trial. Physiother Res Int 2013;
29 Lamb SE, Jorstad-Stein EC, Hauer K. et al. Development of a Common outcome data set for fall injury prevention trials: the Prevention of Falls Network Europe Consensus. J Am Geriatr Soc 2005; 53: 1618-1622
30 Lindemann U, Schwenk M, Klenk J. et al. Problems of older persons using a wheeled walker. Aging Clin Exp Res 2016; 28: 215-220
31 Mackenzie L, McIntyre A. How Do General practitioners (GPs) Engage in falls prevention with older people? A pilot survey of GPs in NHS England suggests a gap in routine practice to address falls prevention. Frontiers in public health 2019; 7: 32
32 Masud T, Morris RO. Epidemiology of falls. Age Ageing 2001; 30 (Suppl. 04) 3-7
33 Middleton A, Fritz SL. Assessment of gait, balance, and mobility in older adults: considerations for clinicians. Curr Translat Geriat Exp Gerontol Rep 2013; 2: 205-214
34 Middleton A, Fritz SL, Lusardi M. Walking speed: the functional vital sign. J Aging Phys Activity 2015; 23: 314-322
35 Miller ME, Magaziner J, Marsh AP. et al. Gait Speed and mobility disability: revisiting meaningful levels in diverse clinical populations. J Am Geriatr Soc 2018; 66: 954-961
36 Montero-Odasso M, Almeida QJ, Bherer L. et al. Consensus on shared measures of mobility and cognition: from the Canadian Consortium on Neurodegeneration in Aging (CCNA). J Gerontol A Biol Sci Med Sci 2019; 74: 897-909
37 Morris R, Lord S, Bunce J. et al. Gait and cognition: Mapping the global and discrete relationships in ageing and neurodegenerative disease. Neurosci Biobehav Rev 2016; 64: 326-345
38 Musich S, Wang SS, Ruiz J. et al. The impact of mobility limitations on health outcomes among older adults. Geriatric Nursing 2017;
39 Nyman SR, Victor CR. Older people’s participation in and engagement with falls prevention interventions in community settings: an augment to the cochrane systematic review. Age Ageing 2012; 41: 16-23
40 Oliver D, Daly F, Martin FC. et al. Risk factors and risk assessment tools for falls in hospital in-patients: a systematic review. Age Ageing 2004; 33: 122-130
41 Payette MC, Belanger C, Leveille V. et al. Fall-related psychological concerns and anxiety among community-dwelling older adults: systematic review and meta-analysis. PloS one 2016; 11: e0152848
42 Pflaum M, Lang FR, Freiberger E. Fit mit Rollator. Z Gerontol Geriatr 2016;
43 Rantakokko M, Portegijs E, Viljanen A. et al. Life-space mobility and quality of life in community-dwelling older people. J Am Geriatr Soc 2013; 61: 1830-1832
44 Robertson MC, Devlin N, Scuffham P. et al. Economic evaluation of a community based exercise programme to prevent falls. J Epidemiol Community Health 2001; 55: 600-606
45 Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing 2006; 35 (Suppl. 02) ii37-ii41
46 Sandlund M, Pohl P, Ahlgren C. et al. Gender perspective on older people’s exercise preferences and motivators in the context of falls prevention: a qualitative study. BioMed research international 2018; 2018: 6865156
47 Schoene D, Heller C, Aung YN. et al. A systematic review on the influence of fear of falling on quality of life in older people: is there a role for falls?. Clin Intervent Aging 2019; 14: 701-719
48 Schwendimann R, Buhler H, De Geest S. et al. Characteristics of hospital inpatient falls across clinical departments. Gerontology 2008; 54: 342-348
49 Schwenk M, Lauenroth A, Stock C. et al. Definitions and methods of measuring and reporting on injurious falls in randomised controlled fall prevention trials: a systematic review. BMC Medical Research Methodology 2012; 12: 50
50 Sherrington C, Fairhall NJ, Wallbank GK. et al. Exercise for preventing falls in older people living in the community. Cochrane Database Syst Rev 2019; 1: Cd012424
51 Shumway-Cook A, Ciol MA, Yorkston KM. et al. Mobility Limitations in the Medicare Population: Prevalence and Sociodemographic and Clinical Correlates. J Am Geriatr Soc 2005; 53: 1217-1221
52 Siegrist M, Freiberger E, Geilhof B. et al. Fall prevention in a primary care setting. Dtsch Arztebl Int 2016; 113: 365-372
53 Todd C, Skelton D. What are the main risk factors for falls among older people and what are the most effecxtive interventions to prevent these falls?. Copenhagen: WHO Regional Office for Europe; 2004
54 Verghese J, Wang C, Holtzer R. Relationship of clinic-based gait speed measurement to limitations in community-based activities in older adults. Arch Phys Med Rehabil 2011; 92: 844-846
55 Verghese J, Wang C, Lipton RB. et al. Motoric cognitive risk syndrome and the risk of dementia. J Gerontol A Biol Sci Med Sci 2013; 68: 412-418
56 Visser M, Goodpaster BH, Kritchevsky SB. et al. Muscle mass, muscle strength, and muscle fat infiltration as predictors of incident mobility limitations in well-functioning older persons. J Gerontol A Biol Sci Med Sci 2005; 60: 324-333
57 Webber SC, Porter MM, Menec VH. Mobility in older adults: a comprehensive framework. Gerontologist 2010; 50: 443-450
58 Zijlstra G, van Haastregt JCM, van Eijk JTM. et al. Prevalence and correlates of fear of falling, and associated avoidance of activity in the general population of community-living older people. Age Ageing 2007; 36: 304-309