Caídas como forma de presentación de una espondilosis cervical
ABSTRACT Falls in the elderly are a very significant problem that is frequently underassessed. This is significant due both to the morbi-mortality generated as well as to the costs produced, so that they should be prevented and the causes provoking them investigated.
Herein, the case of a 79 year old woman sent to the hospital of Cantoblanco for functional recovery after a femoral fracture is presented in the context of loss of strength in the upper limbs, impairment and repeated falls in the last 6 months. A study and differential diagnosis were performed, taking her symptoms as a reference and it was discovered that the cause of the falls was a compressive cervical myelopathy.
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ABSTRACT: To describe the circumstances of falls resulting in hip fractures among older people and to determine whether the circumstances differ by gender, age, and residential status. Cross-sectional study. Two hospitals in Auckland, New Zealand, in which all individuals aged 60 years or older with a fracture of the proximal femur are hospitalized. A total of 911 individuals (97% response rate) were hospitalized with fractures of the proximal femur; 77% were women, 66% were aged 80 years or older, and 58% were living in private homes at the time of fracture. Data were collected face-to-face by a trained interviewer using a standardized questionnaire. Ninety-six percent of the fractures were associated with a fall, with fewer that 2% of subjects reporting that their fractures occurred spontaneously before a fall. Sixteen percent of fractures were associated with an acute medical or physical condition. Although 85% of the fractures involving a fall occurred at home, only about 25% of these were associated with an environmental hazard, and only a proportion of these were likely to have been amenable to modification. The circumstances of falls differed significantly by age and residential status. Strategies aimed at preventing fall-related hip fractures among the old old and among institutionalized individuals should focus primarily on the modification of intrinsic factors. Modification of environmental hazards has the greatest potential for prevention among the young old and those living in private homes.Journal of the American Geriatrics Society 10/1997; 45(9):1108-12. DOI:10.1111/j.1532-5415.1997.tb05975.x · 4.22 Impact Factor
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ABSTRACT: To assess the prevalence, type, location of and injuries from home accidents, including falls and other accidents, and to explore whether variables including socio-demographic characteristics, medication use and home hazards were associated with all home accidents and falls. 657 older people were interviewed about accidents in the previous four weeks. For a subsample (n = 425), a home hazard check was completed. Of the 101 accidents reported, 51% (n = 51) were falls and 50% (n = 50) were other accidents. The most common location for all accidents was outside (30%). Most resulted in minor injury to the legs (43%) or arms (39%). Medical treatment was sought for 14% of accidents. Having more than five hazards and infrequent home visits by healthcare providers were associated with having at least one accident and at least one fall. Use of a walking aid was also associated with falling. Rates of falls and other accidents are considerable. Work is required to confirm the importance of the relationships suggested and to provide data on the burden of injury associated with non-fall accidents.Australian and New Zealand Journal of Public Health 01/2001; 24(6):633-6. DOI:10.1111/j.1467-842X.2000.tb00532.x · 1.90 Impact Factor
Article: Osteoarthritis in Older Adults[Show abstract] [Hide abstract]
ABSTRACT: This review highlights the clinical and pathophysiologic features of osteoarthritis (OA) of the peripheral joints and discusses the current and future management options for this common but potentially disabling disease. This article also addresses the contribution of osteoarthritis to falls and functional impairment in older people. A critical assessment of current data regarding the pathogenesis of osteoarthritis, current and future therapies, and the potential role of OA in falls and functional impairment in older people. Osteoarthritis is the most prevalent articular disease in older adults. Disease markers that will detect early disease and allow early intervention with pharmacologic agents that modify, if not halt, disease progression are much needed, but they are presently unavailable. Current management should include safe and adequate pain relief using systemic and local therapies and should also include medical and rehabilitative interventions to prevent, or at least compensate for, functional deficits. Although OA can result in impaired mobility and lower extremity function, its contribution as a cause of recurrent falls or impaired self-care, relative to other comorbid conditions, remains ill-defined. Further analysis of the determinants of disability, loss of mobility and falls in older patients with OA is needed.Journal of the American Geriatrics Society 03/1998; 46(2):216-25. DOI:10.1111/j.1532-5415.1998.tb02543.x · 4.22 Impact Factor