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Fall og fallskader hos eldre: Årsaker

Fall skyldes vanligvis ikke en enkeltfaktor, men det er oftest en kombinasjon av årsaker hos pasienten og i omgivelsene. Ytre forhold er grovt sett utløsende årsak i halvparten av tilfellene.

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Noen faktorer er kjent for å disponere for fall og fallskader:

  • Økende alder
  • Tidligere fall er en indikator på økt risiko for nye fall
  • Demens eller annen form for forvirring
  • Nedsatt mobilitet, lavt aktivitetsnivå
  • Svimmelhetstilstand
  • Bruk av flere medikamenter sammen
  • Bruk av beroligende medisiner eller sovemedisiner

Viktige faktorer i omgivelsene

  • Dårlig lys
  • Dørterskler, løse tepper, glatte underlag
  • Uegnet fottøy
  • Plutselige forstyrrelser

I de fleste tilfeller vil årsaken til at eldre faller, kunne finnes ved beskrivelse av hvordan fallet skjedde, eventuelt supplert med enkle undersøkelser.

Dette dokumentet er basert på det profesjonelle dokumentet Fall og falltendens hos eldre . Referanselisten for dette dokumentet vises nedenfor

  1. Montero-Odasso M, van der Velde N, Martin FC, et al. World guidelines for falls prevention and management for older adults: a global initiative Age Ageing. 2022;51(9):afac205.PMID: 36178003 PubMed
  2. Helsedirektoratet (2024). Nasjonale faglige råd for forebygging av fall hos eldre [nettdokument]. Oslo: Helsedirektoratet (siste faglige endring 16. mai 2024, lest 06. september 2024). www.helsedirektoratet.no
  3. Kinge JM, Dieleman JL, Karlstad Ø, et al. Disease-specific health spending by age, sex, and type of care in Norway: a national health registry study. BMC Med. 2023;21(1):201. Published 2023 Jun 6. PMID: 37277874 PubMed
  4. Delbaere K, Close JC, Brodaty H, et al. Determinants of disparities between perceived and physiological risk of falling among elderly people: cohort study. BMJ 2010; 341: c4165. BMJ (DOI)
  5. Menant JC, Wong AK, Trollor JN, et al. Depressive symptoms and orthostatic hypotension are risk factors for unexplained falls in community-living older people. J Am Geriatr Soc 2016; 64:1073. PMID: 27225359 PubMed
  6. Leavy B, Michaëlsson K, Åberg AC, Melhus H, Byberg L. The Impact of Disease and Drugs on Hip Fracture Risk. Calcif Tissue Int. 2017;100(1):1-12. PubMed
  7. Midttun M. Elektrokardiografi med R-test er effektiv i diagnostikken ved fald. Ugeskr Læger 2010, Oktober 11 Epub ahead of print.
  8. Gillespie LD, Robertson MC, Gillespie WJ, et al. Interventions for preventing falls in older people living in the community. Cochrane Database of Syst. Rev. 2012, Issue 9. Art. No.: CD007146. DOI: 10.1002/14651858.CD007146.pub3. The Cochrane Library
  9. Sherrington C, Whitney JC, Lord SR, Herbert RD, Cumming RG, Close JC. Effective exercise for the prevention of falls: a systematic review and meta-analysis. J Am Geriatr Soc 2008; 56: 2234-43. PubMed
  10. Uusi-Rasi K, Patil R, Karinkanta S, et al. Exercise and Vitamin D in Fall Prevention Among Older Women: A Randomized Clinical Trial. JAMA Intern Med. 2015 Mar 23.
  11. Sousa N, Mendes R, Silva A, et al. Combined exercise is more effective than aerobic exercise in the improvement of fall risk factors: A randomized controlled trial in community-dwelling older men. Clin Rehabil. 2016. PMID: 27353246 PubMed
  12. Bolland MJ, Grey A, Gambe GD, Reid IR. Vitamin D supplementation and falls: a trial sequential meta-analysis. Lancet Diabetes & Endocrinology 2014. doi: 10.1016/S2213-8587(14)70068-3 DOI
  13. U.S. Preventive Services Task Force. Falls prevention in community-dwelling older adults: Inteventions www.uspreventiveservicestaskforce.org
  14. Saag KG, Petersen J, Brandi ML, et al. Romosozumab or Alendronate for Fracture Prevention in Women with Osteoporosis. N Engl J Med. 2017;377(15):1417-1427. PubMed
  15. Da Q, Xiao Y, Wu F, Chen Y, Li L. Does hip protector prevent falls and hip fractures? An umbrella review of meta-analyses. BMC Geriatr. 2024;24(1):514. Published 2024 Jun 12. PMID: 38867191 PubMed
  16. Daoust R, Paquet J, Moore L et al. Recent opioid use and fall-related injury among older patients with trauma. CMAJ 2018; 190: 500-6. pmid:29685910 PubMed
  17. Ang GC, Low SL, How CH. Approach to falls among the elderly in the community. Singapore Med J. 2020;61(3):116-121. PubMed
  18. Karlsson MK, Vonschewelov T, Karlsson C, Cöster M, Rosengen BE. Prevention of falls in the elderly: a review. Scand J Public Health. 2013;41(5):442-454. PubMed
  19. Sarmiento K, Lee R. STEADI: CDC’s approach to make older adult fall prevention part of every primary care practice. J Safety Res. 2017 Dec; 63: 105–109. www.ncbi.nlm.nih.gov
  20. Bischoff-Ferrari HA, Dawson-Hughes B, Staehelin HB, et al. Fall prevention with supplemental and active forms of vitamin D: a meta-analysis of randomised controlled trials. BMJ 2009; 339: b3692. BMJ (DOI)
  21. Nordic Council of Ministers. Nordic Nutrition Recommendations 2012. Copenhagen: Nordisk Ministerråd, 2014, sist revidert sept 2016. DOI: 10.6027/Nord2014-002 DOI
  22. Meyer G, Warnke A, Bender R, Mühlhauser I. Effect on hip fractures of increased use of hip protectors in nursing homes: cluster randomised controlled trial. BMJ 2003; 326: 76-.
  23. Santesso N1, Carrasco-Labra A, Brignardello-Petersen R. Hip protectors for preventing hip fractures in older people. Cochrane Database Syst Rev. 2014;3:CD001255. doi: 10.1002/14651858.CD001255.pub5. DOI
  24. Folkehelseinstituttet. Myke hoftebeskyttere best i bruk. Publisert 03.09.2007.
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