Falls syndrome in the elderly in social hospitals in the Kyrgyz Republic: incidence and causes

BACKGROUND. The most common causes of falls are balance disorders, gait disorders, decreased muscle strength, visual acuity and cognitive functions, chronic diseases and the use of psychotropic drugs. Falls are common among the elderly population: their frequency varies from 15 to 30 %, increases with the age of patients and reaches 50 % in 80-year-olds.

OBJECTIVE. The study of the main parameters of impaired motor activity in elderly patients - wards of social inpatient institutions of the Kyrgyz Republic.

MATERIALS AND METHODS. The object of the study was elderly and senile people (65 years and older), wards of the Nizhne-Serafimovsky social inpatient institution for the elderly and people with disabilities (hereinafter referred to as SII). Criteria for the inclusion of patients in the study: the age of patients aged 65 years and older. Exclusion criteria: age less than 65 years, severe and extremely serious condition. 55 people were examined, 31 men (56.4 %), 24 women (43.6 %). The average age of the subjects was (72.40 ± 6.93) year.

A specialized geriatric examination (SGE) was performed using the computer program «Optimization of geriatric care depending on the degree of senile asthenia». In our study, of all the parameters of the SGE, the main focus is on identifying the degree of mobility and assessing the degree of independence in everyday life.

RESULTS. In our study, impaired general motor activity was observed in 41 ((74.50 ± 5.77) %) patients. However, violations of stability parameters were more pronounced, which were detected in 51 ((92.70 ± 8.13) %) and walking parameters in 48 ((87.30 ± 6.82) %) patients. The degree of moderate impairments prevailed in only one parameter of general sitting stability (69.00 ± 5.43%, in contrast to gross impairments ― 31.00 ± 2.81%; p < 0.05).

In other parameters, gross impairments were more pronounced than moderate impairments: in standing with closed eyes, (63.60 ± 4.16) % vs. (41.1 ± 3.4) %; p < 0.05; in backward bending stability, (56.40 ± 5.26) % vs. (38.20 ± 4.56) %; p < 0.05.

A one-year study of a continuous sample of patients aged 65 and older showed that the main geriatric syndromes among the patients of a social inpatient institution are violations of the general parameters of stability and walking. The disorders identified in the study contributed to the high dependence of patients on outside help: 76.4% of patients were dependent to varying degrees.

CONCLUSION. A comprehensive geriatric assessment to identify the main geriatric syndromes, followed by mandatory correction in wards of a social inpatient institution aged 65 years and older, should become an integral part of the organization of medical care aimed at solving the problems of elderly and senile patients.