[Epidemiology of falls in the elderly in Spain: a systematic review, 2007]. / Epidemiología de caídas de ancianos en España: una revisión sistemática, 2007.

Falls in the elderly are a serious problem that results in large health care expenditures. To prevent them, it has been shown that the key is an epidemiologic knowledge of the target population. The purpose of this systematic review was to identify the incidence, risk factors and consequences of falls in the Spanish population, by analyzing the methodological quality of studies that provide these data. Two independent authors identified 54 studies through manual and electronic means (MEDLINE, Dialnet, Tesis en Red, TESEO y CSIC [ICYT, IME, ISOC]). A total of 13 studies performed in Spain with non-hospitalized elderly individuals older than 64 years of age were selected and assessed for their methodological quality. We found heterogeneity in the characteristics and quality of the studies, and a general inadequacy of data analyses. The risk factors and consequences must be viewed with caution, since in most of the studies a causal inference cannot be made. We showed that the current fall rates are at the same level as those of the first epidemiologic study published 15 years ago. We conclude that Spain has a high incidence of falls and needs studies on risk factors directed toward cause and effect in the community and comparisons among nursing homes. Finally, the physical, psychosocial and economic consequences must be investigated more thoroughly.

Epidemiología de caídas de ancianos en España. Una revisión sistemática, 2007 / Epidemiology of falls in the elderly in spain. A systematic review, 2007

Las caídas representan un importante problema de salud para las personas mayores y repercuten en costes elevados. Para prevenirlas se ha demostrado que es clave el conocimiento epidemiológico de la población diana. Esta revisión sistemática tiene como objetivo identificar la incidencia, los factores de riesgo y las consecuencias de las caídas en la población española, analizando la calidad metodológica de los estudios que aportan estos datos. Dos personas identificaron 54 estudios mediante búsqueda manual y electrónica (MEDLINE, Dialnet, Tesis en Red, TESEO y CSIC [ICYT, IME, ISOC]). Se seleccionaron 13 estudios realizados en España con personas no hospitalizadas mayores de 64 años, y se valoró su calidad metodológica. Se aprecia heterogeneidad en las características y calidad de los estudios, siendo en general los análisis de los datos insuficientes. Los factores de riesgo y las consecuencias deben ser vistos con precaución, pues en la mayoría de los estudios no es posible hacer inferencia causal. Se identifica que los índices de caídas actuales se encuentran en el mismo nivel del primer estudio epidemiológico publicado hace 15 años. Se concluye que en España la incidencia de caídas es elevada, precisándose estudios sobre factores de riesgo con dirección causa efecto en la comunidad y comparaciones entre residencias de ancianos. Finalmente, las consecuencias físicas, psicosociales y económicas, deben ser investigadas con más profundidad (AU)

Falls in the elderly are a serious problem that results in large health care expenditures. To prevent them, it has been shown that the key is an epidemiologic knowledge of the target population. The purpose of this systematic review was to identify the incidence, risk factors and consequences of falls in the Spanish population, by analyzing the methodological quality of studies that provide these data. Two independent authors identified 54 studies through manual and electronic means (MEDLINE, Dialnet, Tesis en Red, TESEO y CSIC [ICYT, IME, ISOC]). A total of 13 studies performed in Spain with non-hospitalized elderly individuals older than 64 years of age were selected and assessed for their methodological quality. We found heterogeneity in the characteristics and quality of the studies, and a general inadequacy of data analyses. The risk factors and consequences must be viewed with caution, since in most of the studies a causal inference cannot be made. We showed that the current fall rates are at the same level as those of the first epidemiologic study published 15 years ago. We conclude that Spain has a high incidence of falls and needs studies on risk factors directed toward cause and effect in the community and comparisons among nursing homes. Finally, the physical, psychosocial and economic consequences must be investigated more thoroughly (AU)