Medical findings in an interdisciplinary geriatric outpatient clinic specialising in falls.
BACKGROUND
Falls are common among elderly people, leading to increased morbidity and reduced quality of life. A broad-based interdisciplinary study, for example in an outpatient clinic specialising in falls, has been recommended in light of the multiple and complex causes that tend to be involved. At present there are few outpatient clinics in Norway specialising in falls, and no data from such studies have yet been published.


METHODS
The information stems from 111 patients at the Fallpoliklinikken, Oslo University Hospital, from its establishment in 2008 until 2011. An interdisciplinary study was undertaken by a nurse, a doctor and a physiotherapist. Further investigations and measures were proposed on the basis of individual risk factors.


RESULTS
The patient group had a number of known risk factors for falls. The most frequently identified risk factors included orthostatism (26 of 110 patients, 24%), vitamin D deficiency (14 of 79 patients, 18%) and carotid sinus hypersensitivity (6 of 55 patients examined, 11%). Rare, but significant findings included colon cancer, subdural haematoma (one case of each) and normal pressure hydrocephalus (two cases). The most frequent measures for preventing new falls included exercise/physiotherapy (close to all patients), adjustment of medications (25 patients, 23%) and implantation of a pacemaker (six patients, 5%).


CONCLUSIONS
Falls among elderly people have varying and complex causes and a serious underlying pathology may manifest itself as a tendency to fall. This testifies to the importance of a thorough interdisciplinary study of falls.
Institutt for klinisk medisin Universitetet i Oslo.
Kristofer Lislerud
KL
Smebye
Institutt for helse og samfunn Universitetet i Oslo og Avdeling for medisinsk klinisk service Oslo universitetssykehus.
Solveig
S
Granum
Institutt for klinisk medisin Universitetet i Oslo og Geriatrisk avdeling Oslo universitetssykehus.
Torgeir Bruun
TB
Wyller
Institutt for klinisk medisin Universitetet i Oslo og Geriatrisk avdeling Oslo universitetssykehus.
Marte
M
Mellingsæter
D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D000369:Aged, 80 and over; D002304:Cardiac Pacing, Artificial; D015444:Exercise; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D007024:Hypotension, Orthostatic / Q000150:complications; D033183:Interdisciplinary Communication; D008297:Male; D059065:Medication Reconciliation; D009664:Norway; D009726:Nurses; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration*; D010348:Patient Care Team; D059825:Physical Therapists; D010820:Physicians; D012307:Risk Factors; D013575:Syncope / Q000150:complications; D014808:Vitamin D Deficiency / Q000150:complications