ALTERACIONES

DE LA MARCHA,
INESTABILIDAD
Y CAÍDAS
Alejandro Garcia Escamilla
Kevin Alexis Muños Salas
Brayan Arturo segira beltran
Perla Nayeli Rojas Hernández.
Maximo Saul Ramirez Corpus
Caídas, trastornos de la marcha e inestabilidad
La Organización Mundial de la Salud (OMS) define caída como la
consecuencia de cualquier acontecimiento que precipita al paciente al suelo,
contra su voluntad. Junto con la inestabilidad, constituye uno de los grandes
síndromes geriátricos
Factores intrínsecos
Son los cambios y trastornos relacionados con el envejecimiento
que afectan a las funciones necesarias para mantener el equilibrio.
Estas funciones son: la propioceptiva, la vestibular y la visual que se
integran a nivel del cerebelo. También son importantes en este
sentido la función musculoesquelética y la cognitiva.
Factores intrínsecos
01.
Alteraciones oculares
La deprivación visual
contribuye en un 50% a la
inestabilidad. Los problemas
visuales se relacionan con el
25- 50% de las caídas
03.
Alteraciones de la propiocepción
La sensibilidad propioceptiva
es la que permite al cuerpo
orientarse en bipedestación y
en movimiento con respecto al
suelo y a las partes del cuerpo
02.
Alteraciones vestibulares
Con la edad se produce una
pérdida de cilios en el oído
interno, angioesclerosis y
alteraciones bioeléctricas que
se traducen en una respuesta
deficiente del reflejo vestíbulo-
ocular
04.
Alteraciones
musculoesqueléticas
Con la edad, disminuye progresiva la
masa magra muscular (sarcopenia). Ésta
a su vez se traduce en una disminución
progresiva de la fuerza
muscular
Factores intrínsecos
05.
Cambios cardiovasculares
Los trastornos del ritmo, la
patología valvular o la
cardiopatía isquémica pueden
provocar un bajo gasto
cardiaco y favorecer así la caída
06.
Patología degenerativa
articular
Facilitan la aparición de caídas
el dolor, la inestabilidad
articular y la aparición de
posiciones articulares viciosas.

07.
Deterioro cognitivo
La demencia puede acrecentar
el número de caídas por tener
alterada la capacidad de
percepción visuoespacial,
comprensión y orientación
geográfica
Factores extrínsecos
Nos referimos en este apartado a los factores ambientales que
acompañan a la caída. En general, actúan como factor coadyuvante
o agravante de los factores intrínsecos anteriormente descritos.
Factores extrínsecos
02.
01.
En la calle.
En el domicilio
Suelos irregulares, deslizantes, muy Aceras estrechas, con
pulidos, con desniveles, presencia desniveles y obstáculos;
de alfombras, cables u otros pavimento defectuoso, mal
elementos no fijos. Calzado conservado o deslizante;
inadecuado no cerrado y sin
semáforos de breve duración,
sujeción firme al pie
bancos a una altura
03. excesivamente alta o baja

En los medios de transporte.

Escaleras de acceso
excesivamente altas,
movimientos bruscos
del vehículo, tiempos cortos
para entrar o salir
Factores iatrogenos
Existen además factores iatrógenos es cualquier condición física o mental adversa o
desfavorable inducida en un paciente por efectos indeseables o lesivos del
tratamiento que aumentan el riesgo de sufrir una caída. Entre éstos, el más
importante es el producido por fármacos. Se trata, sin embargo, de uno de los
factores de riesgo más modificables. Existe una relación directa entre el número de
medicamentos y el mayor riesgo de sufrir una caída.
Consecuencias de las caídas
● Físicas
pueden ocasionar contusiones, heridas, desgarros, fracturas, traumatismos
craneoencefálicos, torácicos y abdominales.
● Contusiones
Sangre o sangrado debajo de la piel debido a un traumatismo de cualquier tipo.
● Heridas
Es una lesión física en el cuerpo que causa daño a la estructura del área lesionada.
● DESGARROS
se produce cuando un músculo o un tendón se estira demasiado o se rompe.
● Fracturas
es una ruptura, generalmente en un hueso.
● Traumatismos
es una lesión producida porque nos golpeamos con algo duro, por ej. al caer al
suelo, o por las escaleras.
Consecuencias de las caídas
● Psicológicas
La más importante es el síndrome postcaída, que se caracteriza por miedo a volver a
caer. Esto supone una serie de cambios de comportamiento que se traducen en una
disminución de las actividades físicas habituales y sociales.
● Sindrome post caida
podemos definirlo como el miedo a padecer una nueva caída, la pérdida de confianza
para desarrollar una determinada actividad sin caerse y una disminución de la
movilidad y de la capacidad funcional.
¿Como valorar el riesgo de caídas?
Para valorar el riesgo de caídas se utilizan varias tablas de valoración que analizan
desde la forma de caminar la estabilidad y el riesgo de caídas que tiene el adulto
mayor de sufrir alguna lesión.
Son las siguientes:
● Tinetti para la marcha y el equilibrio
● Dowton para riesgo de caídas
● Katz índice de actividad de la vida diaria
● Lawtton y Brody actividades instrumentales de la vida diaria
Tablas de valoración para el síndrome
Tinetti para la marcha y el equilibrio
Tablas de valoración para el síndrome
Downton escala de riesgo de caídas
Este es el caso de la escala de Downton, que se utiliza para evaluar el
riesgo que presenta una persona de sufrir una caída con el fin de, en caso
necesario, poder implementar medidas preventivas encaminadas a evitar
nuevas caídas.
Tablas de valoración para el síndrome
Katz índice de actividad de la vida diaria
Se trata de un instrumento para evaluar la independencia de un
enfermo en cuanto a la realización de las actividades básicas de la vida
diaria.
Tablas de valoración para el síndrome
Escala de Lawton y Brody
La escala de Lawton y Brody fue desarrollada en el Centro Geriátrico de Filadelfia
y publicada en 1969. Es uno de los instrumentos de medición de AIVD (actividades
instrumentales de la vida diaria).
 INTRODUCTION OF
ALZHEIMER'S
DISEASE
You can give a brief description of the topic you
want to talk about here. For example, if you want
to talk about Mercury, you could say that it’s the
smallest planet in the entire Solar System
01.
About Alzheimer’s
You can enter a subtitle here if you need it
WHOA!
This can be the part of the presentation where you introduce
yourself, write your email…
ABOUT WORLD ALZHEIMER'S DAY

Do you know what helps you make your point clear?

Lists like this one:
● They’re simple
● You can organize your ideas
● You’ll never forget to buy some milk and cookies!

And the most important thing: the audience won’t miss

the point of your presentation
 CAUSES OF THE DISEASE

Advanced age Family history

Mercury is the closest planet Venus has a beautiful name
to the Sun and the smallest and is the second planet from
one in the Solar System—it’s the Sun. It’s hot and has a
only larger than the Moon poisonous atmosphere
A PICTURE IS
WORTH A
THOUSAND WORDS
 IDENTIFYING THE DISEASE

Memory Concentration Attention

It’s the closest planet to the Venus has a beautiful name Despite being red, Mars is
Sun and the smallest in the and is the second planet actually a cold place. It’s full
Solar System from the Sun of iron oxide dust
PHASES OF THE DISEASE
Initial phase
1 ● First failures of memory, concentration and attention
Symptoms ● Mood swings, sadness or anxiety

Intermediate phase
2 ● Failure to execute simple movements
Symptoms ● Inappropriate behavior, insomnia and restlessness

Final phase
3 ● Complete loss of memory and judgment
Symptoms ● Loss of sphincter control and immobility
HOW TO CHALLENGE THE STIGMA
AROUND IT?

Disorder Apathy
It’s the third planet Mars is a cold place.
from the Sun and the The planet is full of
only that harbors life iron oxide dust

Insomnia Clumsiness
Neptune is the fourth- It has a beautiful name
largest planet in the and is the second
Solar System planet from the Sun
 MOST COMMON SYMPTOMS

54% 39% 68%

Communication Energy Orientation

It’s the closest planet It’s the farthest planet Jupiter is the biggest
to the Sun from the Sun planet of them all
DISEASE DAMAGES

Reasoning Organs
It’s the closest planet to Saturn is a gas giant and
the Sun and the smallest has several rings

Circulation Mobility
Its name has nothing to It was named after the
do with the liquid metal Roman god of the skies

Stability Joints
Earth is the third planet It has a pretty name and
from the Sun is the second planet
 OTHER SYMPTOMS

Dialogue Disorientation
Despite being red, Mars is It’s terribly hot, even
actually a cold place hotter than Mercury

Coordination Recognize
Earth is the planet where Mercury was named after
we all live on the Roman messenger god
EVOLUTION OF ALZHEIMER'S DISEASE

Risk factors
Mercury is the closest planet to
the Sun and the smallest one in
the Solar System—it’s only a bit
larger than the Moon

Follow the link in the graph to modify its data and then
paste the new one here. For more info, click here.
DIAGNOSIS OF THE DISEASE
Mercury Saturn
It’s the closest planet to It’s composed of
the Sun hydrogen and helium

Jupiter Mars
Venus is the second Mars is actually a very
planet from the Sun cold place

Venus Neptune
Jupiter is the biggest It’s the farthest planet
planet of them all from the Sun
AWESOME
WORDS
03.
Treatments
You can enter a subtitle here if you need it
 PATIENT MEDICAL HISTORY

Venus is the second It’s composed of

planet from the Sun hydrogen and helium
2019 2021

2018 2020
Mars is actually a very It’s the farthest planet
cold place from the Sun
 MEDICAL TREATMENT

Mercury
Mercury is the closest
planet to the Sun, also
is the smallest one in
the Solar System

Earth
Earth is the third planet
from the Sun and the
only one that harbors
life in the Solar System
CONTRAINDICATIONS & INDICATIONS

Contraindications Indications
● You can describe a reason to stop ● You can describe a reason to start
the treatment here the treatment here
● You can describe a reason to stop ● You can describe a reason to start
the treatment here the treatment here
● You can describe a reason to stop ● You can describe a reason to start
the treatment here the treatment here
● You can describe a reason to stop ● You can describe a reason to start
the treatment here the treatment here
 WORLDWIDE NUMBERS

200,000
Americans under 65 suffering from disease

50 M
People living with dementia worldwide
6%
People aged 65 years and older are affected
“This is a quote. Words full of
wisdom that someone important
said and can make the reader
get inspired”
—Someone Famous
 Preventive measures

01. 03.
Routines Search for help
Venus is the second It’s the biggest planet in
planet from the Sun the Solar System

02. 04.
Avoiding risks Brain exercises
Despite being red, Mars is Saturn is a gas giant and
a cold place has several rings
 SPECIALIZED HOSPITALS

Mercury Ceres
It’s the closest It’s located in the
planet to the Sun main asteroid belt

Pluto Saturn
It’s considered a It’s a gas giant and
dwarf planet has several rings
3,584,154
Big numbers catch your audience’s attention
BEHAVIORAL CHANGES

Personality changes
It’s the closest planet to the Sun and the
smallest in the Solar System

Social isolation
Jupiter is a gas giant and the biggest planet in
the Solar System

Irritability and aggressiveness

Earth is the third planet from the Sun and the
one where we live on
STUDIES IN PROGRESS

Study 1
Neptune is the fourth-largest object by diameter in
the Solar System
20%

Study 2
It's composed of hydrogen and helium. It was
named after the Roman god of wealth and 33%
agriculture
CONCLUSIONS

Adapt the routine

01. It’s the closest planet to the Sun and
the smallest in the Solar System

Reduce stress
02. It’s the third planet from the Sun and
the only one that harbors life

Organize the home

03. It’s the second-brightest natural object
in the night sky after the Moon
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