Stürze im höheren Lebensalter

Zusammenfassung

Stürze im höheren Lebensalter gehen mit verminderter Alltagstauglichkeit sowie mit erhöhter Morbidität und Mortalität einher. Deshalb erfordert jeder Sturz eine sorgfältige Evaluation. Chirurgische Sturzfolgen wie Frakturen, Schädelverletzungen oder Prellungen tre-ten bei etwa 10–20 % der gestürzten Per-sonen auf. Nichtchirurgische Sturzfolgen, so vor allem die Angst vor weiteren Stürzen (Post-Fall-Syndrom), sind noch häufiger, wer-den allerdings oft übersehen. Der Sturzher-gang muss ermittelt werden, und Sturzrisikofaktoren müssen identifiziert werden. Der wichtigste Sturzrisikofaktor ist die verminderte Muskelkraft, die mit einem 4,4-fach erhöh-ten Sturzrisiko einhergeht. Die Prävention weiterer Stürze umfasst neben der Aufklärung des Patienten die Behandlung individueller Sturzrisikofaktoren sowie Physiotherapie (ins-besondere Kraft- und Balancetraining). Weite-re Maßnahmen zur Sturzprävention sind die Modifikation der häuslichen Umgebung, die Überprüfung der Medikation und die Gabe von Vitamin D. Durch diese Maßnahmen können etwa 20 Prozent der Stürze vermieden werden. Interdisziplinäre Sturzzentren können dazu beitragen, Stürze in größerer Zahl zu verhindern.

Summary

Falls in old age are associated with reduced activities of daily living and increased morbidity and mortality. Therefore every fall in old age has to be evaluated carefully. Surgical consequences like fractures, injuries of the skull or bruises are seen in about 10–20 % of persons after a fall. In many cases, non surgical consequences like the post fall anxiety syndrome are overlooked. The exact circumstances of the fall must be elucidated and risk factors for a fall must be identified. In most cases falls in old age are not due to one single cause, but to many contributing factors. The main risk factor for a fall is reduced muscle strength, which is associated with a 4.4 fold increase in risk of fall. The prevention of further falls encompasses the treatment of individual risk factors and physiotherapy (especially strength and balance training). Environmental modification, review of medication and supplementation of vitamin D add to fall prevention. About 20 % of all falls can be avoided by these measures. Interdisciplinary falls clinics may play an important role in the prevention of falls.

Schlüsselwörter

Sturz - Alter - Prävention - Sturzklinik

Keywords

Falls - elderly - prevention - fall clinic

• Literatur

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