According to the National Institute of Statistics, the number of older people (people over 65) has increased in Portugal, so that in 1993 there were 81 older people per 100 young people under the age of 15, and in 2013 it increased to 139 older people per the same 100 young people.
Falls, defined as “unintentional displacement of the body to a level below the original position with the inability to correct it in time and due to multifactorial circumstances that threaten stability”, are the most frequent domestic accidents among the elderly and are the main cause of accidents in this population and the seventh cause of death in the world.
The health consequences of falls place a heavy burden on individuals, families and communities. About half of falls cause injuries ranging from 5 to 6% severity. large and another 5% of fractures. In Portugal, between 2000 and 2013, out of every 100 hospitalizations of people over 65, three had a drop that lasted an average of 13 days.
It should be noted that many older adults do not report falling to others because they associate it with shame with the aging process and / or fear further restriction of their activities or even hospitalization, but someone who suffers from a fall has a risk of 60 up to 70%. return to fall next year.
A fall is facilitated by internal factors (decreased motor skills, vision changes, drug side effects, etc.), external factors (loose carpets, inappropriate shoes, architectural obstacles, etc.) and situational factors (running to the toilet, bus, etc.). Etc.), etc.). However, about 20% of falls in older adults do not have an obvious cause and are classified as unexplained or non-accidental, and often the treatment of the traumatic consequences of a fall is the main focus of immediate medical attention, and its cause. can be forgotten or left in the background.
In older people, cardiovascular disease is an important cause of the etiology of unexplained falls due to syncope. Fainting, more commonly known as syncope, is short-term loss of consciousness and spontaneous and complete recovery. About 40% of falls in older adults may have knowledge-related amnesia, and about 60% of these events go unnoticed, which can lead to many episodes of fainting being misinterpreted as an accidental fall. Here, the most common diagnoses are orthostatic hypotension, vasovagal syncope, carotid sinus hypersensitivity syndrome, and cardiac arrhythmia.
In this context, implanted event recorders are very reliable tools for diagnosing or excluding arrhythmias as a cause of syncope, so the current European Society of Cardiology guidelines recommend their use in patients with syncope or recurrent unexplained falls.
These small implanted devices can account for up to 71% of new diagnoses in people with unexplained falls and a possible heart cause.
Remember, it is very important to see your doctor to determine the cause so that you can recommend the most effective treatment. Don’t “stumble” in your heart.
Article by physician Luis Ferreira dos Santos, coordinator of cardiology at the CUF Viseu hospital.
