Tontura e vertigem posicional paroxística benigna em idosos na atenção primária e associação com quedas
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2017-06-05
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Universidade Federal de Goiás
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Thesis held in the papers format. The first article is a systematic review that aimed to investigate the relationship between BPPV and falls (with and without fracture). The review was carried out independently by two researchers, using the combined descriptors in English, Portuguese and Spanish, "vertigo" and "elderly" and "accidental falls"; "benign paroxysmal positional vertigo" and "accidental falls"; in the Virtual Health Library and United States National Library of Medicine (PubMED) databases, being the last search in August 2016. Six scientific papers were selected. The results showed that there were double falls in the elderly with the diagnosis of BPPV and this the relationship increased with advancing age. There was evidence of a decrease in episodes of falls above 60% of the elderly who were treated for BPPV. In elderly people with more than one cause for dizziness, BPPV can not be considered as an independent risk factor for falls. However, in the hospital environment, the relationship between BPPV and falls was not observed when the investigation was performed from the hip fracture. However, when the study included elderly patients hospitalized for various consequences of falls, BPPV could be identified in more than 50% of the patients. It can be concluded that BPPV is associated with falls. The second article, whose primary objective was to evaluate dizziness in the elderly in the primary care for the recognition of BPPV and the secondary one, to analyze the association between dizziness and BPPV with falls. It was a cross-sectional study of 298 diabetic and / or hypertensive elderly individuals enrolled in the Hypertensive and Diabetic Monitoring System of the Basic Family Health Unit of the Madre Germana II neighborhood of Goiânia, Goiás. The evaluation was carried out at the residence of the elderly, including the Mini Mental State Examination, sociodemographic profile, record of self-reported health conditions with emphasis on reporting dizziness and / or vertigo and record of falls in the last 12 months. The elderly who reported dizziness and/or vertigo were revisited for functional otoneurological evaluation for BPPV, using the Dix Hallpike test for the posterior and anterior semicircular canals and the Supine Roll test for the horizontal semicircular canal. The study included 150 elderly individuals with a mean age of 69.7 (+/- 7.36), the majority of them were female. Dizziness was reported by 50 elderly (33.3%). Among the 50 patients who reported dizziness, 19 had objective and subjective BPPV (38.8%). There was association between the complaint of dizziness and falls (p = 0.05), which did not occur with BPPV. The assessment of dizziness and BPPV can be performed in the home of the elderly in primary care. This proactive approach can help prevent falls because dizziness has increased the chances of the elderly falling. Although elderly people who presented objective or subjective BPPV did not increase their chances of falls, the identification of this disease, which has a known, effective and financially inexpensive treatment, may lead to the resolution of this clinical condition.
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SCHIMCHAK, Gabriella Assumpção Alvarenga. Tontura e vertigem posicional paroxística benigna em idosos na atenção primária e associação com quedas. 2017. 115 f. Tese (Doutorado em Ciências da Saúde) - Universidade Federal de Goiás, Goiânia, 2017.