Falls Prevention: A Multidimensional and Intersectoral Approach—The AGE-IT Approach
摘要
Fall prevention in elderly is important because they can lead to fractures with consequent increased risk of mortality, limitation or loss of autonomy and increased risk of institutionalization. For this reason, it is important to identify patients at risk of falling, to underline possible causes, to plan rehabilitation treatments and to promote physical activity. As part of the AGE-IT project, the aim of our task is to determine a model for the prevention of falls in the elderly, through: characterization and determination of the elderly population at risk of falling and mapping of needs; identification of innovative solutions and their applications in the elderly population at risk of falls; development and implementation of fall risk prevention interventions in elderly patients; clinical-functional evaluation of the effectiveness of fall risk prevention protocols; processing of data and economic-health intervention models for the prevention of the risk of falling in elderly patients. Prevention of falls is important because they can lead to fractures and, specifically, fracture of the proximal neck of the femur can lead to an increased risk of mortality in the elderly; limitation or loss of autonomy; increased risk of institutionalization. For this reason it is important to identify patients at risk of falling, ascertain the pathologies that cause it, plan rehabilitation treatments and promote physical activity. Our prevention model has the following objectives: awareness of the importance of prevention: multidomain approach; the identification and evaluation of risk factors and determinant indices of frailty (e.g., nutrition, physical functionality, etc.); the identification and implementation of realistic and effective interventions (multidomain); integration of rehabilitation programs with AFA (adapted physical activity) and correct nutrition. In this context it is important to focus on physical exercise. Adequate exercise with regular weight-bearing and muscle-strengthening exercises can improve physical performance, bone mass, muscle strength and balance and can also reduce the risk of falls. Furthermore, we focused on the sarcopenic elderly patient. We set up the review by asking ourselves this question: Which rehabilitation interventions are effective for preventing the risk of falling in elderly sarcopenic patients? Preliminary data shows more evidence on aerobic training, muscle strengthening, balance exercises, flexibility, and resistance. The objective of this review is to design personalized training for the sarcopenic elderly patient at risk of falling. We also defined the needs of the elderly sarcopenic patient using the person blueprint tool. The tools are represented by: Our clinical studies are represented by: Falls occur a lot due to an obstacle during the patient’s walking (a carpet, a step). The aim of a next study will be to define the type of obstacle that causes the fall to create compensation strategies.