Dados do Trabalho

Título

REM SLEEP BEHAVIOR DISORDER IS ASSOCIATED TO FALLS IN THE ELDERLY: A SYSTEMATIC REVIEW

Introdução

Unintentional injuries are leading causes of death in the elderly, with falls ranking second. Evidence shows that about 40% of seniors residing at home will fall at least once a year. The increasing prevalence of falls in elderly populations per year has been reported globally, as 31% in the United States, 20-30% in Canada, 25.6% in Australia, and 27.6% in Brazil. REM sleep behavior disorder (RBD) is characterized by dream enactment and loss of muscle atonia during REM sleep. RBD is a common cause of falls potentially leading to severe injuries. Therefore, the relationship between both should be clarified and discussed.

Objetivo

To evaluate the association between RBD and the occurrence of falls in the elderly.

Métodos

This systematic review that adopted the following descriptors: probable RBD; falls; elderly. Inclusion criteria: articles comprising elderly people ≥ 65 years, both sexes, with an investigation of the number of falls in the previous 12 months, polysomnography performed to identify RBD, studies published in the last five years. Exclusion criteria: studies performed on animals, abstracts and congress letters, review articles.

Resultados

A total of 509 studies were found in the virtual databases, after which 5 articles were selected according to the inclusion criteria for complete analysis, n=12,211. The following results were observed: 1. RBD was associated with a higher occurrence of falls; 2. The occurrence of falls did not vary significantly concerning the level of education, occupation, average income, smoking, alcohol consumption, physical activity; 3. The percentage of women who reported falls was higher than men; the average number of women was 68.3%, while that of men was 31.7%. 4. Among those reporting falls, the average number of falls during the previous year was 1.66 ranging from 1 to 14 falls. 5. The following factors were associated with the occurrence of falls in the previous year: difficulty falling asleep, poor sleep quality, difficulty maintaining sleep, and daytime sleepiness. Furthermore, indices of sleep fragmentation were also associated with an increased risk of falls.

Conclusões

A systematic review of the literature showed a positive relationship between RBD falls, particularly in older women. Those RBD patients who live alone, live alone, have never been married, and are single, seems to be more prone to fall. Therefore, directed preventive measures should be developed in order to avoid potentially severe sequelae.

Palavras -chave

REM sleep behavior disorder; falls; elderly.