RESUMO
BACKGROUND: Falls and fall-related injuries are a major public health problem in industrialized countries. Faced with this challenge, a French national plan was launched in 2022 aiming to reduce by 20% the incidence of falls-related hospitalizations or deaths. OBJECTIVES: To describe the main pillars of the 2022-2024 French national plan against falls in older persons. Methods and assessment: The six pillars of the plan are: 1) screening and monitoring risks of falls and alert health and care workers; 2) home safety assessment and getting out safely; 3) developing technical aids for mobility and the use of assistive technologies at home; 4) appropriate physical activity, best weapon against falls; 5) tele-assistance devices for all older persons; 6) a cross-cutting pillar: Informing, raising awareness, training, and involving local actors. The plan, deployed in the 18 French regions, will provide a unique opportunity to determine the best strategies to achieve the objectives and the barriers encountered. CONCLUSIONS: The deployment of the French national plan will bring useful data for considering a long-term strategy in France and helping countries or regions wishing to implement a fall prevention plan on their territory.
Assuntos
Acidentes por Quedas , Hospitalização , Humanos , Idoso , Idoso de 80 Anos ou mais , Acidentes por Quedas/prevenção & controle , Exercício Físico , FrançaRESUMO
BACKGROUND: Falls and fall-related injuries are common in older adults, have negative effects on functional independence and quality of life and are associated with increased morbidity, mortality and health related costs. OBJECTIVE: To synthesize evidence-based and expert consensus-based 2022 world guidelines for the management and prevention of falls in older adults. These recommendations consider a person-centred approach that includes the preferences of the patient, caregivers and other stakeholders, gaps in previous guidelines, recent developments in e-health and both local context and resources. RECOMMENDATIONS: All older adults should be advised on falls prevention and physical activity. Opportunistic case finding for falls risk is recommended for communitydwelling older adults. An algorithm is proposed to stratify falls risk and interventions for persons at low, moderate or high risk. Those considered at high risk should be offered a comprehensive multifactorial falls risk assessment with a view to co-design and implement personalised multidomain interventions. Other recommendations cover details of assessment and intervention components and combinations, and recommendations for specific settings and populations. CONCLUSIONS: The core set of recommendations provided will require flexible implementation strategies that consider both local context and resources.
RESUMO
"Falls prévention in older persons Falls in persons aged 65 or older are a major public health problem. Some simple questions (have you experienced any fall in the previous year ? Do you have a fear of falling when walking ?) And a few simple examinations (one-leg stance, timed up and go, chair-rising, stop walking when talking test) allow to differentiate between patients at low risk of falling, for whom education and risk reassessment at 12 months are offered, patients at moderate risk of falling, for whom a physical examination and a prescription review to modify the cause of instability, and referral to a adapted physical exercise program are offered, the effect of which will be evaluated at 3-6months, and patients at high risk of falls, for whom a standardized geriatric assessment shoud be offered, at best carried out by a geriatric team, allowing the establishment of an individualized program targeting all risk factors for falls, the effectiveness of which will be reassessed at 1-3 months."
"Prévention des chutes chez le sujet âgé Les chutes après 65ans constituent un important problème de santé publique. L'entretien médical (à la recherche d'antécédents de chute, d'une peur de tomber) et quelques examens simples (temps d'appui unipodal, timed up and go test, test de relever de chaise, stop walking when talking test) permettent au médecin de distinguer trois types de profils de risque. Pour les patients à risque faible, une éducation thérapeutique et une réévaluation du risque à 12mois sont proposées. Les patients à risque modéré sont examinés (et leur ordonnance révisée) à la recherche de causes d'instabilité, puis orientés vers un programme d'activités physiques adaptées dont l'effet sera évalué à 3-6mois. Les patients à haut risque de chute doivent bénéficier d'une évaluation gérontologique standardisée, dans l'idéal effectuée par une équipe gériatrique, pour mettre en place un programme individualisé ciblant tous les facteurs de risque de chute, dont l'efficacité doit être réévaluée à 1-3mois."
