Falls in the elderly of the Family Health Program
Arlete Maria Valente Coimbra
, Natalia Aquaroni Ricci
Ibsen Bellini Coimbra
lian Tereza Lavras Costallat
Faculty of Medical Sciences, Family Health Program, State University of Campinas (UNICAMP), Rua Vital Brasil, 50, Bara
o Geraldo, Campinas-SP 13083-888, Brazil
Faculty of Medical Sciences, Gerontology Post-Graduation Program, State University of Campinas (UNICAMP), Rua Tessa
lia Vieira de Camargo,
o Geraldo, Campinas-SP 13083-887, Brazil
Faculty of Medical Sciences, Departmentof Medical Clinics, State University of Campinas (UNICAMP), Rua Tessa
lia Vieira de Camargo, 126, Bara
o Geraldo, Campinas-SP 13083-887,Brazil
The elderly are currently considered the fastest growing age
group worldwide. According to the US Census Bureau (2004), the
population aged 65 years-old and over comprises almost 440
million people, i.e., 7.0% of the planet’s inhabitants. It is well known
that this age group is more susceptible to chronic diseases and
disabilities that require long-term care. This picture indicates the
importance of community care provided by the FHP, which is
responsible for the execution of effective low-cost actions, focused
on prevention, recovery and rehabilitation in this population
(Silvestre and Costa Neto, 2003).
Among all negative outcomes derived from elderly health
conditions, falling is considered one of the main causes of
functional impairment. Falling frequency increases signiﬁcantly
with age and statistics reveals that one in three elderly individuals
falls annually (Tinetti et al., 1988). Among those who fall, around
20% present injuries which predispose them to mobility restriction,
dependence and premature death risk (Alexander et al., 1992).
Therefore, prevention should be considered one of the key points in
elderly primary health care.
The literature (Lopes et al., 2002) suggests that health-care
teams that include members belonging to the community, as the
FHP does, are more likely to succeed during treatment. This
accomplishment could also be considered as a consequence of the
global approach adopted by this model, which considers the
interaction of biological, social, and environmental factors. Such a
comprehensive approach may improve the understanding of the
Most studies that report data concerning falls are performed in
hospitals, nursing homes and community environments (Perracini
and Ramos, 2002; Silvestre and Costa Neto, 2003; Este
cio et al., 2004). Therefore, they do not permit the proper
identiﬁcation of risk factors for elderly individuals who are assisted
by the FHP. A better description of this group may allow for
appropriate planning of public health policies in relation to the
factors associated with falling.
The present study was designed in order to determine isolated
and combined factors that may be related to the occurrence of falls
in the elderly assisted by the FHP.
2. Subjects and methods
This is a cross-sectional epidemiological study, which
analyzes factors related to falls in the elderly assisted by the
FHP in the city of Amparo, state of Sa
o Paulo, Brazil. Amparo is
Archives of Gerontology and Geriatrics 51 (2010) 317–322
Received 11 August 2009
Received in revised form 18 January 2010
Accepted 20 January 2010
Available online 12 February 2010
Falls of elderly
Family Health Program in Brazil
This study aims to determine the factors that may be related to falls in the elderly assisted by the Family
Health Program (FHP). Elderly individuals aged 60 years or over, who were assisted by the FHP primary
care system (n = 2209), responded to a sociodemographic and health questionnaire. Mental health was
evaluated using the Geriatric Depression Scale (GDS) and quality of life was assessed by the Medical
Outcome Study Short-Form Health Survey (SF-36). In order to verify which independent variables
affected the occurrence of falls, logistic regression analysis was performed. 27.1% of the sample reported
one fall during the previous year, and 8.7% were recurrent fallers over the same period. The factors
considered in the ﬁnal model for falls were: age over 80 years-old, female gender, the presence of more
than eight associated diseases, need for hospitalization during the previous year and appointments
outside the FHP routine, hearing complaints, GDS score over 11 points, and emotional problems SF-36
score between 25 and 74 points. The factors included in the ﬁnal model for falls can be easily identiﬁed
and properly overcome by FHP strategy. Patient falling history investigation should thus form part of the
FHP team routine. This concern should be reinforced when it comes to women aged 80 years and over.
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