Medo de cair em adultos e idosos com tontura crônica com e sem histórico de quedas
Data
2024-08-12
Autores
Barroso, Alexandre Silva 
Orientadores
Branco-Barreiro, Fátima Cristina Alves
Tipo
Trabalho de conclusão de curso
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: Vertigem e tontura, queixas frequentes na população idosa, levam ao medo de cair, que é considerado um forte preditor de quedas. Objetivos: investigar o medo de cair em idosos com tontura crônica, com e sem histórico de quedas, bem como caracterizar as quedas relatadas pelos pacientes quanto a local, período e causa. Metodologia: Estudo observacional prospectivo, de corte transversal e descritivo, realizado no Ambulatório de Avaliação e Reabilitação Vestibular da Disciplina de Otoneurologia do Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço da Escola Paulista de Medicina/Universidade Federal de São Paulo-UNIFESP. Os participantes responderam um questionário para caracterização sociodemográfica e de saúde, um questionário para investigação do histórico e caracterização de quedas nos últimos 6 meses contendo número de quedas, período, local e causa. (Howcroft et al., 2017) e a FES-I Brasil (Falls Efficacy Scale) para avaliar o medo de cair em 16 situações do dia a dia. Nesta escala, cada situação é pontuada de 1 (nada preocupado) a 4 (muito preocupado) dependendo de quão preocupado o paciente está com a possibilidade de cair ao realizar tal atividade. A pontuação total da FES-I varia de 16 (sem preocupação em cair) a 64 pontos (grave preocupação). Resultados: Foram avaliados 29 pacientes encaminhados para o ambulatório de reabilitação vestibular. Destes, 88,89% dos participantes apresentavam histórico de quedas; eram mulheres; 55,55% cursaram até o ensino fundamental; 55,56% tinham diagnóstico de hipofunção vestibular bilateral; 88,88% referiram hipertensão arterial; 44,44% relataram ter diabetes e 88,88% faziam uso de polifarmácia. Dentre os participantes sem histórico de quedas, 65% eram mulheres, 57,14% cursaram até o ensino médio; 50% foram diagnosticados com hipofunção vestibular unilateral, 57,14% relataram hipertensão arterial e 23,8% diabetes e 71,42% faziam uso de polifarmácia. A média de idade dos participantes com histórico de queda foi de 71,22 anos e a dos participantes sem histórico foi de 68,30 anos. A pontuação média dos participantes com histórico de quedas na FES-I foi de 38,89 pontos e daqueles sem histórico foi de 32,10 pontos. As quedas ocorreram mais dentro de casa (55,56%), nos períodos da manhã (44,44%) e da tarde (44,44%) e, a maioria dos participantes (66,67%) acreditava que a causa havia sido a tontura. 100% dos pacientes com histórico de quedas apresenta maior preocupação com cair, ao passo que 75% do grupo sem histórico tinha essa preocupação. Conclusão: O medo de cair esteve presente em adultos e idosos com tontura crônica tanto com histórico de quedas, quanto naquelas que não vivenciaram este evento. Neste estudo também foi possível observar que as quedas relatadas ocorreram mais dentro da residência, ao longo do dia e tendo como agente causador do evento a tontura.
Introduction: Vertigo and dizziness, common complaints in the elderly population, lead to fear of falling, which is considered a strong predictor of falls. Objectives: to investigate the fear of falling in elderly people with chronic dizziness, with and without a history of falls, as well as to characterize the falls reported by patients in terms of location, period and cause. Methodology: Prospective, cross-sectional and descriptive observational study, carried out at the Vestibular Assessment and Rehabilitation Outpatient Clinic of the Otoneurology Discipline of the Department of Otorhinolaryngology and Head and Neck Surgery of the Escola Paulista de Medicina/Federal University of São Paulo-UNIFESP. The participants answered a questionnaire for sociodemographic and health characterization and one to investigate the history and characterization of falls in the last 6 months, encompassing the number of falls, period, place and cause (Howcroft et al., 2017) and, the FES-I Brasil (Falls Efficacy Scale) to assess the patient's fear of falling in everyday situations. On this scale, each situation is scored from 1 (not at all worried) to 4 (very worried) depending on how worried the patient is about the possibility of falling while carrying out such an activity. The FES-I total score ranges from 16 (no concern about falling) to 64 points (severe concern). Results: 29 patients referred to the vestibular rehabilitation were evaluated. Out of these, 88.89% of participants who had a history of falls were women,55.55% completed elementary school; 55.56% had a diagnosis of bilateral vestibular hypofunction; 88.88% reported hypertension and 44.44% reported diabetes and 88.88% used polypharmacy. Regarding the participants without a history of falls, 65% were women, 57, 14% completed high school; 50% were diagnosed with unilateral vestibular hypofunction; 57.14% reported systemic arterial hypertension and 23.8% diabetes; 71.42% used polypharmacy. The average age of participants with a history of falls was 71.22 years and that of participants without a history was 68.30 years. The average score of participants with a history of falls was 38.89 points and of those without a history was 32.10 points. Falls occurred more often at home (55.56%), in the morning (44.44%) and in the afternoon (44.44%) and, the majority of participants (66.67% ) believed that its cause was dizziness. 100% of the participants with a history of falls were more concerned about falling, while 75% of the group without a history had this concern. Conclusion: The fear of falling was present in adults and elderly people with chronic dizziness, both with a history of falls and in those who have not experienced this event. In this study it was also possible to observe that the reported falls occurred more within the residence, throughout the day and with dizziness as the causative agent of the event. Key-words: Accidental Falls; Fear; Aged; Adult; Dizziness
Introduction: Vertigo and dizziness, common complaints in the elderly population, lead to fear of falling, which is considered a strong predictor of falls. Objectives: to investigate the fear of falling in elderly people with chronic dizziness, with and without a history of falls, as well as to characterize the falls reported by patients in terms of location, period and cause. Methodology: Prospective, cross-sectional and descriptive observational study, carried out at the Vestibular Assessment and Rehabilitation Outpatient Clinic of the Otoneurology Discipline of the Department of Otorhinolaryngology and Head and Neck Surgery of the Escola Paulista de Medicina/Federal University of São Paulo-UNIFESP. The participants answered a questionnaire for sociodemographic and health characterization and one to investigate the history and characterization of falls in the last 6 months, encompassing the number of falls, period, place and cause (Howcroft et al., 2017) and, the FES-I Brasil (Falls Efficacy Scale) to assess the patient's fear of falling in everyday situations. On this scale, each situation is scored from 1 (not at all worried) to 4 (very worried) depending on how worried the patient is about the possibility of falling while carrying out such an activity. The FES-I total score ranges from 16 (no concern about falling) to 64 points (severe concern). Results: 29 patients referred to the vestibular rehabilitation were evaluated. Out of these, 88.89% of participants who had a history of falls were women,55.55% completed elementary school; 55.56% had a diagnosis of bilateral vestibular hypofunction; 88.88% reported hypertension and 44.44% reported diabetes and 88.88% used polypharmacy. Regarding the participants without a history of falls, 65% were women, 57, 14% completed high school; 50% were diagnosed with unilateral vestibular hypofunction; 57.14% reported systemic arterial hypertension and 23.8% diabetes; 71.42% used polypharmacy. The average age of participants with a history of falls was 71.22 years and that of participants without a history was 68.30 years. The average score of participants with a history of falls was 38.89 points and of those without a history was 32.10 points. Falls occurred more often at home (55.56%), in the morning (44.44%) and in the afternoon (44.44%) and, the majority of participants (66.67% ) believed that its cause was dizziness. 100% of the participants with a history of falls were more concerned about falling, while 75% of the group without a history had this concern. Conclusion: The fear of falling was present in adults and elderly people with chronic dizziness, both with a history of falls and in those who have not experienced this event. In this study it was also possible to observe that the reported falls occurred more within the residence, throughout the day and with dizziness as the causative agent of the event. Key-words: Accidental Falls; Fear; Aged; Adult; Dizziness
Descrição
Curso de Especialização (Pós-Graduação Lato Sensu) Audiologia
Citação
BARROSO, Alexandre Silva. Medo de cair em adultos e idosos com tontura crônica com e sem histórico de quedas. 2024. 50 f. Trabalho de Conclusão de Curso (Especialização em Audiologia) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP). São Paulo, 2024