Immobility syndrome in older people

| In older people, due to the presence of diseases such as musculoskeletal, cardiovascular or respiratory diseases, or due to the lesser social stimulus, it is easy for there to be a gradual decrease in mobility and physical exercise.

Immobility in older people usually occurs after 65 years, 18% of individuals have problems moving without help, 50% of those over 75 have problems leaving home and of them 20% remain confined at home.

The origins of immobility in older people may be due to:

• Decreased ability to breathe, which is compensated unconsciously (what causes suffocation is not done).
• Joint pain and stiffness.
• Decreased balance and fear of falls.
• Alterations in sight or hearing.
• Lack of social encouragement (not going for a walk alone).
• Depressive symptoms and many other causes serve to initiate and perpetuate lack of movement.
• Architectural barriers (stairs inside and outside the home, lack of elevators).
• Iatrogenesis, such as the effect of sedatives and hypnotics.

This decrease in mobility or "syndrome of immobility in older people" causes decreased muscle and bone mass, upsets the balance, alters the integrity of the skin facilitating the appearance of pressure ulcers and can even favor the loss of cognitive status due to lack of stimuli.

It is one of the main factors that helps the development of fragility or decay of the elderly and is considered a major geriatric syndrome.

Immobility syndrome and acute pathology

Immobility syndrome is especially important in times of acute disease, especially if hospitalization is required. For example, an 85-year-old has an episode of bedridden fever and dyspnea for a week. It is complicated at the beginning with confusional syndrome, so it does not collaborate in the usual care.

A few days after admission, painful pressure ulcers appear on the heels, which limit walking and standing. By the time the confusional syndrome has subsided and the heel ulcers have improved, the patient's muscles have diminished so much that they cannot walk without help and there are significant balance problems, with great risk of falling and impairing the ability to perform basic activities of daily life, both instrumental and basal.

This is what is called a “cascade of events” and in extreme cases it can even lead to death, due to complications such as falls, aspiration of food into the respiratory tree due to generalized weakness, superinfected decubitus ulcers, dehydration, etc. In any case, it can extraordinarily complicate the prognosis of any acute pathological episode in the elderly; Suffice it to say that 50% of elderly patients who are immobility due to an acute process die within 6 months.

Not all cases of immobility syndrome they originate from acute situations, cut out in time. In other cases, immobility is installed insidiously, little by little. These are elderly people who limit the amount of movement they perform due to decreased respiratory capacity or the appearance of pain when walking. Many times this situation is not sought, but the older person gradually adjusts to a more tolerable situation for their functional reserve, without realizing that this situation encourages the loss of function of the elderly.

Family members can contribute to perpetuate this situation with overprotective attitudes.