Factors that influence the postural balance on institutionalized elderly: a cross-sectional study
Natalia Moya Rodrigues Pereira, Marcel Jean Pierre Massè Araya, Eduardo Federigui Baisi Chagas, Marcos Eduardo Scheicher
Abstract
Introduction: Older adults living in Nursing Homes are a complex population, with a high prevalence of dependency in activities of daily living, multimorbidity, polypharmacy, and reduced mobility and poor balance when compared with community-dwelling elderly. Objectives: The aim of this study was to investigate if the postural balance of institutionalized elderly is influenced by the length of institutionalization, age, number of medications, number of falls, body mass index (BMI) and cognitive status. Methods: 98 elderly people living in the three Nursing Homes were evaluated and 45 were included. Were considered the following variables: ages over 60 years old; length of institutionalization, falls in the previous year, anthropometric measurements (height and weight) and cognitive status. The balance was evaluated by Berg Balance Scale (BBS) and by the Short Physical Performance Battery (SPPB). Results: Of all the variables evaluated, only number of medication and BMI had a negative correlation with scores of BBS and SPPB. In the regression analysis, the significant effect of the number of medications on the SPPB and BERG scores was confirmed. Conclusion: Elderly people living in nursing homes have a poor postural balance and the number of medications and BMI contribute significantly to this.
Keywords
References
1. United Nations. World Population Ageing 2013 [Internet]. 2013 [cited 2018 Jun 7]. Available from: http://www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeing2013.pdf
2. Pickard L, Comas-Herrera A, Costa-Font J, Gori C, di Maio A, Patxot C, et al. Modelling an entitlement to long-term care services for older people in Europe: projections for long-term care expenditure to 2050. J Eur Soc Policy. 2007 Feb 24;17(1):33–48.
3. de Meijer CAM, Majer IM, Koopmanschap MA, van Baal PH. Forecasting lifetime and aggregate long-term care spending: accounting for changing disability patterns. Med Care. 2012 Aug;50(8):722–9.
4. Camarano A. Brazilian Population Ageing: Differences in well-being by rural and urban areas. 2015. Available from: http://repositorio.ipea.gov.br/bitstream/11058/4962/1/DiscussionPaper_113.pdf
5. de Souto Barreto P, Lapeyre-Mestre M, Mathieu C, Piau C, Bouget C, Cayla F, et al. A multicentric individually-tailored controlled trial of education and professional support to nursing home staff: research protocol and baseline data of the IQUARE study. J Nutr Health Aging. 2013 Feb 15;17(2):173–8.
6. Faber LM. Comparação do equilíbrio estático e mobilidade entre idosos institucionalizados e idosos moradores da comunidade. Universidade Estadual Paulista - UNESP; 2017. Available from: https://repositorio.unesp.br/bitstream/handle/11449/150340/faber_lm_me_rcla. pdf?sequence=8&isAllowed=y
7. Nitz JC, Josephson DL. Enhancing Functional Balance and Mobility Among Older People Living in Long-Term Care Facilities. Geriatr Nurs (Minneap). Mosby, Inc.; 2011 Mar;32(2):106–13.
8. Álvarez Barbosa F, del Pozo-Cruz B, del Pozo-Cruz J, Alfonso-Rosa RM, Sañudo Corrales B, Rogers ME. Factors Associated with the Risk of Falls of Nursing Home Residents Aged 80 or Older. Rehabil Nurs. 2016 Jan;41(1):16–25.
9. Brucki SMD, Nitrini R, Caramelli P, Bertolucci PHF, Okamoto IH. Sugestões para o uso do mini-exame do estado mental no Brasil. Arq Neuropsiquiatr. 2003 Sep;61(3B):777–81.
10. Miyamoto ST, Lombardi Junior I, Berg KO, Ramos LR, Natour J. Brazilian version of the Berg balance scale. Brazilian J Med Biol Res. 2004 Sep;37(9):1411–21.
11. Nakano MM. Versão Brasileira da Short Physical Performance Battery – SPPB: Adaptação Cultural e Estudo da Confiabilidade. Vol. 53. 2013. Available from: http://repositorio.unicamp.br/bitstream/REPOSIP/252485/1/Nakano_MarciaMariko_M.pdf
12. Nnodim JO, Yung RL. Balance and its Clinical Assessment in Older Adults - A Review. J Geriatr Med Gerontol. 2015;1(1):1–19.
13. Greve J, Alonso A, Bordini ACPG, Camanho GL. Correlation between body mass index and postural balance. Clinics. 2007;62(6):717–20.
14. Teasdale N, Hue O, Marcotte J, Berrigan F, Simoneau M, Doré J, et al. Reducing weight increases postural stability in obese and morbid obese men. Int J Obes. 2007;31(1):153–60.
15. Corbeil P, Simoneau M, Rancourt D, Tremblay A, Teasdale N. Increased risk for falling associated with obesity: mathematical modeling of postural control. IEEE Trans Neural Syst Rehabil Eng. 2001 Jun;9(2):126–36.
16. Hue O, Simoneau M, Marcotte J, Berrigan F, Doré J, Marceau P, et al. Body weight is a strong predictor of postural stability. Gait Posture. 2007 Jun;26(1):32–8.
17. Zanandrea V, Barreto de Souto P, Cesari M, Vellas B, Rolland Y. Obesity and nursing home: A review and an update. Clin Nutr. Elsevier Ltd; 2013;32(5):679–85.
18. Campbell AJ, Borrie MJ, Spears GF. Risk Factors for Falls in a CommunityBased Prospective Study of People 70 Years and Older. J Gerontol. 1989 Jul 1;44(4):M112–7.
19. Nakagawa HB, Ferraresi JR, Prata MG, Scheicher ME. Postural balance and functional independence of elderly people according to gender and age: cross-sectional study. Sao Paulo Med J. 2017;135(3):260–5.
20. Leipzig RM, Cumming RG, Tinetti ME. Drugs and Falls in Older People: A Systematic Review and Meta-analysis: I. Psychotropic Drugs. J Am Geriatr Soc. 1999 Jan;47(1):30–9.
21. Leipzig RM, Cumming RG, Tinetti ME. Drugs and falls in older people: a systematic review and meta-analysis: II. Cardiac and analgesic drugs. J Am Geriatr Soc. 1999;47(1):40–50.
22. French DD, Campbell R, Spehar A, Cunningham F, Foulis P. Outpatient Medications and Hip Fractures in the US. Drugs Aging. 2005;22(10):877–85.
23. Beers MH, Baran RW, Frenia K. Drugs and the elderly, Part 2: Strategies for improving prescribing in a managed care environment. Am J Manag Care. 2001 Jan;7(1):69–72.
24. Woolcott JC. Meta-analysis of the Impact of 9 Medication Classes on Falls in Elderly Persons. Arch Intern Med. 2009;169(21):1952–60.
25. Johnell K, Klarin I. The relationship between number of drugs and potential drug-drug interactions in the elderly: a study of over 600,000 elderly patients from the Swedish Prescribed Drug Register. Drug Saf. 2007;30(10):911–8.
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email