Abstract
Objective: To estimate the prevalence off alls and analyze their association with polypharmacy, functional capacity and the use of potentiallyin appropriate medication in elderly people treated in primary health care. Methods: This cross-sectional study included 100 older adults from Northeastern Brazil. Data collection involved the Elderly Person's Health Bookletand assessment of hand grips trength. Explanatory variables for the outcome "Falls" were grouped according to demographic characteristics and elderly health assessment. Descriptive and bivariate analyses were performed, followed by Multiple Poisson Regression analysis.
Results: Participants had a mean age of 71.5 years (SD: 6.08-6.34), predominantly female (68%). The prevalence off alls was 42%, and factors associated with falls included polypharmacy (p = 0.015; PR: 5.04; 95%CI 1.36-18.6), weak hand grips trength (p = 0.414; PR: 1.81; 95%CI 0.43-7.63), and age of 75 years (p = 0.001; PR: 1.05; 95%CI 1.02-1.09). Most participants had one or more chronic diseases. Conclusion: The interaction between falls, polypharmacy, and hand grips trength high lights the importance of PHC in fall prevention and the promotion of active aging.
References
ALLEY DE, et al. Grip strength cut points for the identification of clinically relevant weakness. Journals of Gerontology Series A: Biological Sciencesand Medical Sciences, 2014; 69(5): 559-566.
AGS. AMERICAN GERIATRICS SOCIETY. Updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 2023; 71(7): 2052-2081.
AZEVEDO LM, et al. Identificação do risco de quedas em pessoas idosas residentes em instituições de longa permanência. Revista Ibero-Americana de Saúde e Envelhecimento, 2024; 10: 27-42.
BONANNO EG, et al. Polypharmacy prevalence among older adults based on the Survey of Health, Ageing and Retirement in Europe: an update. Journal of Clinical Medicine, 2025; 14(4): 1-24.
BRASIL. Manual de utilização da Caderneta de Saúde da Pessoa Idosa. 2018. Disponível em: https ://bvsms.saude.gov.br/bvs/publicacoes/manual_utilizacao_caderneta_pessoa_idosa.pdf. Acesso em: 26 de outubro de 2024.
BRASIL. MINISTÉRIO DA SAÚDE. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde. Departamento de Assistência Farmacêutica e Insumos Estratégicos. Contribuições para a promoção do Uso Racional de Medicamentos. Brasília: Ministério da Saúde, 2021; 127.
BRASIL. Plano de Ações Estratégicas para o Enfrentamento das Doenças Crônicas e Agravos não Transmissíveis no Brasil 2021-2030. 2021. Disponível em: https ://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/svsa/doencas-cronicas-nao-transmissiveis-dcnt/09-plano-de-dant-2022_2030. pdf /view. Acesso em: 26 de outubro de 2024.
BRASIL. Relação Nacional de Medicamentos Essenciais: Rename 2024. 2024. Disponível em: http ://bvsms.saude.gov.br/bvs/publicacoes/relacao_nacional_medicamentos_2024.pdf. Acessado em: 26 de junho de 2024.
CHEN B e SHIN S. Bibliometric Analysis on Research Trend of Accidental Falls in Older Adults by Using Cite space-Focused on Web of Science Core Collection (2010–2020). International Journal of Environmental Research and Public Health, 2021; 18(4): 1-17.
CORTÉS OL, et al. Systematic review and meta-analysisofclinicaltrials. Medicine, 2021; 100(41): 1-8.
COSTANZO S, et al. Polypharmacy in older adults: the hazard o fhospitalization and mortality is mediated by potentially inappropriate prescriptions, findings from the MOLI-SANI study. International Journal of Public Health, 2024; 69: 1-11.
DELARA M, et al. Prevalence and factors associated with polypharmacy: a systematic review and meta-analysis. BMC Geriatrics, 2022; 22(1): 1-12.
GAGNON ME, et al. Polypharmacy and risk of fractures in older adults: a systematic review. Journal Of Evidence-Based Medicine, 2024; 17(1): 145-171.
GIACOMINI SBL e FHON JR, et al. Frailty and risk of falling in the older adult living at home. Acta Paulista de Enfermagem, 2020; 33(8): 1-8.
LIMA-COSTA MF, et al. The Brazilian Longitudinal Study of Aging (ELSI-Brazil): objectives and design. American Journal of Epidemiology, 2018; 187(7): 1345-1353.
MATTOS JCO e BALSANELLI AP. A liderança do enfermeiro na atenção primária à saúde: revisão integrativa. Enfermagem em Foco, 2019; 10(4): 164-171.
MIDÃO L et al. Polypharmacy prevalence among older adults based on the survey of health, ageing and retirement in Europe. Archives o f Gerontology and Geriatrics, 2018; 78: 213-220.
MONTERO-ODASSO M, et al. World guidelines for falls prevention and management for older adults: a global initiative. Age and Ageing, 2022; 51(9): 1-36.
MOREIRA FSM, et al. Use of potentially inappropriate medications in institutionalized elderly: prevalence and associated factors. Ciência & Saúde Coletiva, 2020; 25(6): 3-16.
NICHOLSON K, et al. Prevalence of multimorbidity and polypharmacy among adults and older adults: a systematic review. The Lancet Healthy Longevity, 2024; 5(4): 287-296.
OLIVEIRA PC, et al. Prevalence and factors associated with polypharmacy among the elderly treated in Primary Health care in Belo Horizonte, State of Minas Gerais, Brazil. Ciência & Saúde Coletiva, 2021; 26(4): 1553-1574.
PEIXOTO RT, et al. O farmacêutico na Atenção Primária à Saúde no Brasil: análise comparativa 2014-2017. Saúde em Debate, 2022; 46(133): 358-375.
PLACIDELI N, et al. Evaluation of comprehensive care for older adults in primary care services. Revista de Saúde Pública, 2020; 54: 1-14.
SALARI N, et al. Global prevalence of falls in the older adults: a comprehensive systematic review and meta-analysis. Journal of Orthopaedic Surgery and Research, 2022; 17(1): 2-13.
SIQUEIRA BR, et al. Síndrome da fragilidade do idoso: uma revisão narrativa. Revista Eletrônica Acervo Saúde, 2021; 13(12): 9329.
YOSHIDA Y, et al. Effects of multimorbidity and polypharmacy on physical function in community-dwelling older adults: a 3-year prospective cohort study from the SONIC. Archives of Gerontology and Geriatrics, 2024; 126: 105521.
YOU L, et al. Association between multimorbidity and falls and fear of falling amon golder adults in eastern China: a cross-sectionalstudy. Frontiers in Public Health, 2023; 11: 1-8.
