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Presença de alterações vestibulares em idosos com historial de quedas e impacto no seu medo de cair e qualidade de vida: um estudo caso-controlo
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Introdução: Cerca de um terço das pessoas com mais de 65 anos sofre quedas anualmente. Em Portugal, as quedas representam 89,4% dos acidentes domésticos nos idosos, aumentando o declínio funcional, a dependência de cuidados e a sobrecarga nos sistemas de saúde. O medo de cair associado ao risco de quedas compromete a sua qualidade de vida. A prevalência de vestibulopatias é elevada nos idosos, mas o conhecimento sobre o seu impacto como fator de quedas é limitado. Objetivos: Verificar se a presença de alterações vestibulares nos idosos pode constituir um fator de risco presente na população idosa com historial de quedas, avaliar o seu impacto no medo de cair e qualidade de vida. Metodologia: Estudo transversal de análise caso-controlo, com amostra de conveniência de 144 participantes ≥65 anos, divididos consoante a presença (48 casos; 77,17± 6,74 anos) ou ausência (96 controlos; 75,99±6,19 anos) de quedas no último ano. A avaliação centrou-se na realização dos testes clínicos vestibulares de despiste (oculomotricidade central, pesquisa de nistagmo periférico, avaliação do reflexo vestíbulo-ocular e vertigem posicional paroxística benigna) e foram ainda avaliados o medo de cair (Falls Efficacy Scale–International), qualidade de vida (Short Form Health Survey/SF-36v2) e a limitação auto-reportada das queixas de tontura e desequilíbrio (Dizziness Handicap Inventory-DHI). Para análise de dados foi utilizada estatística descritiva e inferencial. Resultados: Não foram encontradas diferenças significativas (p>0,05) entre os grupos na avaliação vestibular. Verificaram-se diferenças significativas (p=0,017) entre os grupos no medo de cair e na qualidade de vida apenas na dimensão “Saúde Geral” (p=0,028) do SF-36v2. Foram identificadas correlações significativas negativas moderadas (p<0,001) em todas as dimensões do DHI. Conclusões: As alterações vestibulares estão presentes nos participantes com e sem historial de quedas recente, aumentando o seu medo de cair. A perceção do impacto das queixas vestibulares associa-se a menor qualidade de vida.
Introduction: Around one-third of people over sixty-five years old suffer falls each year. In Portugal, falls account for 89.4% of domestic accidents among older adults, leading to functional decline, care dependency, with significant burden on healthcare systems. The fear of falling, associated with the risk of falls, compromises their quality of life. The prevalence of vestibulopathies is high among older people, but the knowledge about their impact as a factor for falls is limited. Objectives: To examine if the presence of vestibular changes among the older people may constitute a risk factor present in the those with a history of falls and to evaluate its impact on the fear of falling and quality of life. Methodology: Cross-sectional study with a case-control analysis and convenience sample of 144 participants (≥65 years), divided according to the presence (48 cases; 77,17±6,74 years) or absence (96 controls; 75,99±6,19 years) of falls in the past year. The assessment focused on performing vestibular clinical screening tests (central oculomotor function, evaluation of peripheral nystagmus, vestibulo-ocular reflex and benign paroxysmal positional vertigo). Additionally, fear of falling (Falls Efficacy Scale–International), quality of life (Short Form Health Survey/SF-36v2), and self-reported limitations related to dizziness and imbalance were also assessed (Dizziness Handicap Inventory-DHI). Descriptive and inferential statistics were used for data analysis. Results: No significant differences (p>0.05) were found between groups in the vestibular assessment. Significant differences (p=0.017) were observed between the groups in fear of falling and quality of life, specifically in the “General Health” dimension (p=0.028) of SF-36v2. Moderate negative correlations (p<0.001) were identified in physical, functional, and emotional dimensions of DHI. Conclusion: Vestibular alterations are present in participants both with and without a recent history of falls, increasing their fear of falling. The perception of the impact of vestibular symptoms is associated with lower quality of life.
Introduction: Around one-third of people over sixty-five years old suffer falls each year. In Portugal, falls account for 89.4% of domestic accidents among older adults, leading to functional decline, care dependency, with significant burden on healthcare systems. The fear of falling, associated with the risk of falls, compromises their quality of life. The prevalence of vestibulopathies is high among older people, but the knowledge about their impact as a factor for falls is limited. Objectives: To examine if the presence of vestibular changes among the older people may constitute a risk factor present in the those with a history of falls and to evaluate its impact on the fear of falling and quality of life. Methodology: Cross-sectional study with a case-control analysis and convenience sample of 144 participants (≥65 years), divided according to the presence (48 cases; 77,17±6,74 years) or absence (96 controls; 75,99±6,19 years) of falls in the past year. The assessment focused on performing vestibular clinical screening tests (central oculomotor function, evaluation of peripheral nystagmus, vestibulo-ocular reflex and benign paroxysmal positional vertigo). Additionally, fear of falling (Falls Efficacy Scale–International), quality of life (Short Form Health Survey/SF-36v2), and self-reported limitations related to dizziness and imbalance were also assessed (Dizziness Handicap Inventory-DHI). Descriptive and inferential statistics were used for data analysis. Results: No significant differences (p>0.05) were found between groups in the vestibular assessment. Significant differences (p=0.017) were observed between the groups in fear of falling and quality of life, specifically in the “General Health” dimension (p=0.028) of SF-36v2. Moderate negative correlations (p<0.001) were identified in physical, functional, and emotional dimensions of DHI. Conclusion: Vestibular alterations are present in participants both with and without a recent history of falls, increasing their fear of falling. The perception of the impact of vestibular symptoms is associated with lower quality of life.
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Quedas Pessoas idosas Alteração vestibular Medo de cair Qualidade de vida Falls Older people Vestibular deficits Fear of falling Quality of life