The patient who falls: "It's always a trade-off"

JAMA

Volumn 303, Issue 3, 2010, Pages 258-266

  Tinetti, Mary E ^a   Kumar, Chandrika ^a  

^a YALE UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ACETYLSALICYLIC ACID; ALLOPURINOL; CORTICOSTEROID; DIPHENHYDRAMINE; DOCUSATE SODIUM; GLYCERYL TRINITRATE; HYDROCHLOROTHIAZIDE; HYDROCODONE BITARTRATE PLUS PARACETAMOL; LISINOPRIL; METOPROLOL; OMEPRAZOLE; OXYCODONE; SIMVASTATIN; VITAMIN D;

AGED; ANAMNESIS; BALANCE IMPAIRMENT; BLOOD CELL COUNT; BLOOD CHEMISTRY; BLOOD PRESSURE MEASUREMENT; BONE PLATE; BRAIN INFARCTION; CASE REPORT; CATARACT EXTRACTION; CLINICAL ASSESSMENT; CLINICAL EXAMINATION; CLINICAL PRACTICE; COMMUNITY LIVING; COMPUTER ASSISTED TOMOGRAPHY; DAILY LIFE ACTIVITY; DELIRIUM; DEMENTIA; DEVICE REMOVAL; DISABILITY; DISEASE EXACERBATION; DISEASE PREDISPOSITION; DIZZINESS; DRUG DOSE INCREASE; ECHOCARDIOGRAPHY; EVIDENCE BASED MEDICINE; EXERCISE; FALLING; GAIT; GERIATRIC PATIENT; HEADACHE; HEART RHYTHM; HIP FRACTURE; HIP PAIN; HUMAN; HUMERUS FRACTURE; LIMB WEAKNESS; MALE; MINI MENTAL STATE EXAMINATION; MUSCLE STRENGTH; NEUROLOGIC EXAMINATION; NUCLEAR MAGNETIC RESONANCE; OSTEOPOROSIS; PATIENT CARE; PATIENT SAFETY; PHYSIOTHERAPY; PREVALENCE; PREVENTION AND CONTROL; PRIORITY JOURNAL; PROPRIOCEPTION; PRURITUS; PSEUDARTHROSIS; PULSE RATE; RANGE OF MOTION; REVIEW; RHINORRHEA; RISK ASSESSMENT; RISK BENEFIT ANALYSIS; RISK FACTOR; RISK REDUCTION; STRENGTH; SYSTOLIC HEART MURMUR; THORAX PAIN; URINALYSIS; WEIGHT; WEIGHT REDUCTION; X RAY FILM;

EID: 74549140992     PISSN: 00987484     EISSN: 15383598     Source Type: Journal    
DOI: 10.1001/jama.2009.2024     Document Type: Review

References (62)

1. Folstein MF, Folstein SE, McHugh PR. Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12(3):189-198.
2. Wolf-Klein GP, Silverstone FA, Levy AP, Brod MS. Screening for Alzheimer's disease by clock drawing. J Am Geriatr Soc. 1989;37(8):730-734.
3. Scanlan J, Borson S. The Mini-Cog: receiver operating characteristics with expert and naïve raters. Int J Geriatr Psychiatry. 2001;16(2):216-222.
4. Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Care. 2003;41(11):1284-1292.
5. Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged: the index of ADL. JAMA. 1963;185:914-919.
6. Lawton MP, Brody EM. Assessment of older people-self maintaining and instrumental activities of daily living. Gerontologist. 1969;9(3):179-186.
7. Mathias S, Nayak US, Isaacs B. Balance in elderly patients: the "get-up and go" test. Arch Phys Med Rehabil. 1986;67(6):387-389.
8. Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc. 1986;34(2):119-126.
9. Tinetti ME, Speechley M, Ginter S. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988;319(26):1701-1707.
10. Centers for Disease Control and Prevention (CDC). Self-reported falls and fallrelated injuries among persons aged >65 years-United States, 2006.MMWRMorb Mortal Wkly Rep. 2008;57(9):225-229.
11. Nevitt MC, Cummings SR, Kidd S, Black D. Risk factors for recurrent nonsyncopal falls: a prospective study. JAMA. 1989;261(18):2663-2668.
12. Bishop CE, Gilden D, Blom J, et al. Medicare spending for injured elders: are there opportunities for savings? Health Aff (Millwood). 2002;21(6):215-223.
13. Tinetti ME, Doucette J, Claus E, Marottoli R. Risk factors for serious injury during falls by older persons in the community. J Am Geriatr Soc. 1995;43(11):1214-1221.
14. Falls among older adults: an overview. Centers for Disease Control and Prevention Web site. http://www.cdc.gov/HomeandRecreationalSafety/Falls/ adultfalls .html. Accessed April 27, 2009.
15. Tinetti ME, Liu WL, Claus E. Predictors and prognosis of inability to get up after falls among elderly persons. JAMA. 1993;269(1):65-70.
16. Tinetti ME, Williams CS. Falls, injuries due to falls, and the risk of admission to a nursing home. N Engl J Med. 1997;337(18):1279-1284.
17. Gill TM, Desai MM, Gahbauer EA, Holford TR, Williams CS. Restricted activities among community-living older persons: incidence, precipitants and health care utilization. Ann Intern Med. 2001;135(5):313-321.
18. Tinetti ME,Williams CS. The effect of falls and fall injuries on functioning in community-dwelling older persons. J Gerontol. 1998;53(2):M112-M119.
19. Tinetti ME, Inouye SK, Gill TM, Doucette JT. Shared risk factors for falls, incontinence, and functional dependence: unifying the approach to geriatric syndromes. JAMA. 1995;273(17):1348-1353.
20. Ensrud KE, Ewing SK, Taylor BC, et al; for the Study of Osteoporotic Fractures Research Group. Frailty and risk of falls, fracture, and mortality in older women: the study of osteoporotic fractures. J Gerontol A Biol Sci Med Sci. 2007;62(7):744-751.
21. Gandhi TK, Weingart SN, Borus J, et al. Adverse drug events in ambulatory care. N Engl J Med. 2003;348(16):1556-1564.
22. Gurwitz JH, Field TS, Harrold LR, et al. Incidence and preventability of adverse drug events among older persons in the ambulatory setting. JAMA. 2003;289 (9):1107-1116.
23. Ziere G, Dieleman JP, van der Cammen TJ, Hofman A, Pols HA, Stricker BH. Selective serotonin reuptake inhibiting antidepressants are associated with an increased risk of nonvertebral fractures. J Clin Psychopharmacol. 2008;28(4):411-417.
24. Ensrud KE, Blackwell TL, Mangione CM, et al; Study of Osteoporotic Fractures Research Group. Central nervous system-active medications and risk for falls in older women. J Am Geriatr Soc. 2002;50(10):1629-1637.
25. Woolcott JC, Richardson KJ,Wiens MO, et al. Meta-analysis of the impact of 9 medication classes on falls in elderly persons. Arch Intern Med. 2009;169(21): 1952-1960.
26. American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention. Guideline for the prevention of falls in older persons. J Am Geriatr Soc. 2001;49(5):664-672.
27. Gillespie LD, Robertson MC, Gillespie WJ, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2009;(2): CD007146.
28. Kenny RA, Seifer CM. SAFE PACE 2 syncope and falls in the elderly pacing and carotid sinus evaluation: a randomized controlled trial of cardiac pacing in older adults with falls and carotid sinus hypersensitivity. Am J Geriatr Cardiol. 1999;8(2):87.
29. Harwood RH, Foss AJE, Osborn F, Gregson RM, Zaman A, Masud T. Falls and health status in elderly woman following first eye cataract surgery: a randomised controlled trial. Br J Ophthalmol. 2005;89(1):53-59.
30. Foss AJ, Harwood RH, Osborn F, Gregson RM, Zaman A, Masud T. Falls and health status in elderly women following second cataract surgery: a randomized controlled trial. Age Ageing. 2006;35(1):66-71.
31. Cumming RG, Ivers R, Clemson L, et al. Improving vision to prevent falls in frail older people: a randomized trial. J Am Geriatr Soc. 2007;55(2):175-181.
32. Tinetti ME, McAvay G, Claus E. Does multiple risk factor reduction explain the reduction in fall rate in the Yale FICSIT Trial? Frailty and Injuries Cooperative Studies of Intervention Techniques. Am J Epidemiol. 1996;144(4):389-399.
33. Campbell AJ, Robertson MC, Gardner MM, Norton RN, Buchner DM. Psychotropic medication withdrawal and a home-based exercise program to prevent falls: a randomized, controlled trial. J Am Geriatr Soc. 1999;47(7):850-853.
34. Pit SW, Byles JE, Henry DA, Holt L, Hansen V, Bowman DA. A Quality Use of Medicines program for general practitioners and older people: a cluster randomised controlled trial. Med J Aust. 2007;187(1):23-30.
35. Campbell AJ, Robertson MC. Rethinking individual and community fall prevention strategies: a meta-regression comparing single and multifactorial interventions. Age Ageing. 2007;36(6):656-662.
36. Chang JT, Morton SC, Rubenstein LZ, et al. Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials. BMJ. 2004;328(7441):680.
37. Gates S, Fisher JD, Cooke MW, Carter YH, Lamb SE. Multifactorial assessment and targeted intervention for preventing falls and injuries among older people in community and emergency care settings: systematic review and meta-analysis. BMJ. 2008; 336(7636):130-133.
38. Shaw FE, Bond J, Richardson DA, et al. Multifactorial intervention after a fall in older people with cognitive impairment and dementia presenting to the accident and emergency department: randomised controlled trial. BMJ. 2003;326(7380):73.
39. Mahoney JE, Shea TA, Przybelski R, et al. Kenosha County falls prevention study: a randomized, controlled trial of an intermediate-intensity, community-based multifactorial falls intervention. J Am Geriatr Soc. 2007;55(4):489-498.
40. Qaseem A, Snow V, Shekelle P, Hopkins R Jr, Forciea MA, Owens DK; Clinical Efficacy Assessment Subcommittee of the American College of Physicians. Screening for osteoporosis in men: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2008;148(9):680-684.
41. Liu H, Paige NM, Goldzweig CL, et al. Screening for osteoporosis in men: a systematic review for an American College of Physicians guideline. Ann InternMed. 2008; 148(9):685-701.
42. National Osteoporosis Foundation. Clinicians' guide to prevention and treatment of osteoporosis. National Osteoporosis Foundation Web site. http://www.nof .org/professionals/NOF-Clinicians-Guide.pdf. 2008. Accessibility verified December 22, 2009.
43. MacLean C, Newberry S, Maglione M, et al. Systematic review: comparative effectiveness of treatments to prevent fractures in men and women with low bone density or osteoporosis. Ann Intern Med. 2008;148(3):197-213.
44. Parker MJ, Gillespie WJ, Gillespie LD. Effectiveness of hip protectors for preventing hip fractures in elderly people: systematic review. BMJ. 2006;332(7541):571-574.
45. Bischoff-Ferrari HA, Willett WC,Wong JB, et al. Prevention of nonvertebral fractureswith oral vitamin D and dose dependency: a meta-analysis of randomized controlled trials. Arch Intern Med. 2009;169(6):551-561.
46. Ganz DA, Bao Y, Shekelle PG, Rubenstein LZ. Will my patient fall? JAMA. 2007; 297(1):77-86.
47. Mayfield D, McLeod G, Hall P. The CAGE questionnaire: validation of a new alcoholism screening instrument. Am J Psychiatry. 1974;131(10):1121- 1123.
48. Piccinelli M, Tessari E, Bortolomasi M, et al. Efficacy of the Alcohol Use Disorders Identification Test as a screening tool for hazardous alcohol intake and related disorders in primary care: a validity study. BMJ. 1997;314(7078):420-424.
49. Royall DR, Lauterbach EC, Kaufer DM, Malloy P, Coburn KL, Black KJ; Committee on Research of the American Neuropsychiatric Association. The cognitive correlates of functional status: a review from the Committee on Research of the American Neuropsychiatric Association. J Neuropsychiatry Clin Neurosci. 2007;19(3): 249-265.
50. Sheridan PL, Hausdorff JM. The role of higher-level cognitive function in gait: executive dysfunction contributes to fall risk in Alzheimer's disease. Dement Geriatr Cogn Disord. 2007;24(2):125-137.
51. Bonelli RM, Cummings JL. Frontal-subcortical dementias. Neurologist. 2008; 14(2):100-107.
52. Cauley JA, Ensrud K. Considering competing risks . . . not all black and white. Arch Intern Med. 2008;168(8):793-795.
53. Tinetti ME, McAvay GJ, Fried TR, et al. Health outcome priorities among competing cardiovascular, fall injury, and medication-related symptom outcomes. J Am Geriatr Soc. 2008;56(8):1409-1416.
54. Leveille SG, Bean J, Bandeen-Roche K, Jones R, Hochberg M, Guralnik JM.Musculoskeletal pain and risk for falls in older disabled women living in the community. J Am Geriatr Soc. 2002;50(4):671-678.
55. Blyth FM, Cumming R, Mitchell P, Wang JJ. Pain and falls in older people. Eur J Pain. 2007;11(5):564-571.
56. Forbes D, Forbes S, Morgan DG, Markle-ReidM, Wood J, Culum I. Physical activity programs for persons with dementia. Cochrane Database Syst Rev. 2008; (3):CD006489.
57. Steultjens EM, Dekker J, Bouter LM, Jellema S, Bakker EB, van den Ende CH. Occupational therapy for community dwelling elderly people. Age Ageing. 2004; 33(5):453-460.
58. Kuzuya M, Masuda Y, Hirakawa Y, et al. Falls in the elderly are associated with burden of caregivers in the community. Int J Geriatr Psychiatry. 2006;21(8):740-745.
59. Bédard M, Molloy DW, Squire L, Dubois S, Lever JA, O'Donnell M. The Zarit Burden Interview: a new short version and screening version. Gerontologist. 2001; 41(5):652-657.
60. Baker DI, King MB, Fortinsky FH, et al. Dissemination of an evidence-based multicomponent fall risk assessment and management strategy throughout a geographic area. J Am Geriatr Soc. 2005;53(4):675-680.
61. Reuben DB, Roth C, Kamberg C, Wenger NS. Restructuring primary care practices to manage geriatric syndromes: the ACOVE-2 intervention. J Am Geriatr Soc. 2003;51(12):1787-1793.
62. Tinetti ME, Gordon C, Sogolow E, Lapin P, Bradley EH. Fall-risk evaluation and management: challenges in adopting geriatric care practices. Gerontologist. 2006; 46(6):717-725.