Factores de riesgo de caídas en ancianos: revisión sistemática

OBJETIVO: Sistematizar los hallazgos de los estudios de cohorte prospectivos sobre los multiples factores de riesgo de caidas en ancianos y valorar la calidad metodologica de los mismos. METODOS: Revision sistematica de estudios epidemiologicos en las bases de datos Medline, SciELO y Lilacs. Fueron incluidos estudios con numero de sujetos >100, con edad >64 anos, de ambos sexos, residentes en la comunidad o en instituciones para ancianos. RESULTADOS: De 726 publicaciones encontradas, 15 estudios cumplieron con los criterios de inclusion, habiendo sido publicados entre 1988 y 2005. Los estudios presentaron heterogeneidad metodologica. Los principales factores asociados a un aumento del riesgo de caida son: antecedente de caida, alteracion de la marcha, incapacidad funcional, deterioro cognitivo, consumo de medicacion psicotropica y exceso de actividad fisica. A pesar de hallazgos contradictorios, ser del sexo femenino y tener edad avanzada, tambien pueden ser predictores de caida. CONCLUSIONES: Se identifican algunas carencias metodologicas de los estudios de cohorte prospectivo sobre caidas: carencia de estudios sobre determinantes extrinsecos, necesidad de enmascaramiento del evaluador durante el seguimiento y de un mejor control del seguimiento con menores intervalos entres las recogidas de datos.

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