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Zhou Y, Berridge C, Hooyman N, Mroz TM, Sadak T, Choi SW, Phelan EA. Care Partners' Engagement in Preventing Falls for Community-Dwelling Older People With Dementia. THE GERONTOLOGIST 2024; 64:gnae064. [PMID: 38832587 PMCID: PMC11247405 DOI: 10.1093/geront/gnae064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Little is known about how to prevent falls in community-dwelling older people with dementia. Although their care partners adopt various behaviors to prevent their falls, it is unclear if these behaviors reduce falls for those with different levels of fall risk. RESEARCH DESIGN AND METHODS Linking the 2015 and 2016 National Health and Aging Trends Study and the 2015 National Study of Caregiving (NSOC), we identified 390 community-dwelling older people with dementia with 607 care partners. We selected 26 NSOC items representing fall risk management (FRM) behaviors. We examined the prevalence and dimensionality of these behaviors and investigated associations between care partners' behaviors in 2015 (T1) and older people's falls in 2016 (T2) stratified by their fall incidence at T1, adjusting for covariates. RESULTS Five domains of FRM were identified: mobility and safety assistance, medical service coordination, health management, social service coordination, and accommodation. For those who did not fall at T1, mobility and safety assistance and social service coordination were each associated with an increased risk of falling at T2 (adjusted incidence rate ratio [aIRR] = 1.39, 95% confidence interval [CI] = 1.06-1.83, p = .019, aIRR = 1.25, 95% CI = 1.01-1.55, p = .043). For those who had fallen at T1, social service coordination was associated with a decreased risk of falling at T2 (aIRR = 0.83, 95% CI = 0.73-0.94, p = .004). DISCUSSION AND IMPLICATIONS The different impacts of dementia care partners' FRM behaviors emphasize the need to address specific behaviors when involving care partners in preventing falls for older people with dementia at varying levels of fall risk.
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Affiliation(s)
- Yuanjin Zhou
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, Texas, USA
| | - Clara Berridge
- School of Social Work, University of Washington, Seattle, Washington, USA
| | - Nancy Hooyman
- School of Social Work, University of Washington, Seattle, Washington, USA
| | - Tracy M Mroz
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Tatiana Sadak
- Yale School of Nursing, Yale University, West Haven, Connecticut, USA
| | - Seung W Choi
- College of Education, University of Texas at Austin, Austin, Texas, USA
| | - Elizabeth A Phelan
- Department of Medicine, Division of Gerontology and Geriatric Medicine, University of Washington, Seattle, Washington, USA
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, Washington, USA
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Chan WLS, Pin TW, Chan JYH, Siu GCH, Tsang SMH. The Ability of Physical Performance Measures to Identify Fall Risk in Older Adults Living With Dementia: A Systematic Review and Meta-Analysis. J Am Med Dir Assoc 2024; 25:105100. [PMID: 38908396 DOI: 10.1016/j.jamda.2024.105100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 06/24/2024]
Abstract
OBJECTIVES To determine whether physical performance measures commonly used in clinical settings can discriminate fallers from nonfallers and predict falls in older adults with dementia. DESIGN Systematic review and meta-analysis. SETTING AND PARTICIPANTS Older adults with dementia residing in the community, hospitals, and residential care facilities. METHODS MEDLINE, Embase, PsycINFO, CINAHL, SPORTDiscus, the Cochrane Library, and the PEDro databases were searched from inception until December 27, 2023 (PROSPERO registration number: CRD42022303670). Retrospective or prospective studies that evaluated the associations between physical performance measures and falls in older adults with dementia were included. A random effects model was used to calculate the standardized mean difference (SMD) and 95% CI for each physical performance measure between fallers and nonfallers. Sensitivity analyses were conducted on the longitudinal studies to determine the ability of physical performance measures to predict future falls. RESULTS Twenty-eight studies were included in this review (n = 3542). The 5-time chair stand test [SMD = 0.23 (0.01, 0.45)], the Berg Balance Scale [SMD = -0.52 (-0.87, -0.17)], postural sway when standing on the floor [SMD = 0.25 (0.07, 0.43)] and on a foam surface [SMD = 0.45 (0.25, 0.66)], and the Short Physical Performance Battery total score [SMD = -0.46 (-0.66, -0.27)] could discriminate fallers from nonfallers. Sensitivity analyses showed that gait speed could predict future falls in longitudinal cohort studies [SMD = -0.29 (-0.49, -0.08)]. Subgroup analyses showed that gait speed [SMD = -0.21 (-0.38, -0.05)] and the Timed Up and Go test [SMD = 0.54 (0.16, 0.92)] could identify fallers staying in residential care facilities or hospitals. CONCLUSIONS AND IMPLICATIONS The 5-time chair stand test, the Berg Balance Scale, postural sway when standing on the floor and a foam surface, and the Short Physical Performance Battery can be used to predict falls in older adults with dementia. Gait speed and the Timed Up and Go test can be used to predict falls in institutionalized older adults with dementia. Clinicians are recommended to use these physical performance measures to assess fall risk in older adults with dementia.
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Affiliation(s)
- Wayne L S Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China.
| | - Tamis W Pin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Jason Y H Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - George C H Siu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Sharon M H Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
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Zhou Y, Thakkar N, Phelan EA, Ishado E, Li CY, Borson S, Sadak T. How do care partners overcome the challenges associated with falls of community-dwelling older people with dementia? A qualitative study. DEMENTIA 2024:14713012241267137. [PMID: 39033360 DOI: 10.1177/14713012241267137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2024]
Abstract
BACKGROUND AND OBJECTIVES Previous studies have found that falls among community-dwelling older people with dementia negatively impact the health and well-being of their relative/friend care partners. Limited studies have explored the challenges care partners experience because of older people's falls (including fall incidents and fall risks). We sought to investigate care partners' experiences of these challenges and how care partners responded. METHODS We conducted an inductive thematic analysis of 48 dementia care partner interviews (age range: 33-86, mean: 61, 70.8% women; 58.3% adult children; 29.2% spouse; 62.5% completed college; 25% people of color), conducted after a health crisis of older people with dementia from three local university-affiliated hospitals in the United States. FINDINGS Care partners reported that falls in older people with dementia can intensify overall care demands and lead to self-sacrificing behaviors, dissatisfaction with healthcare providers, conflicts with care recipients, and intense emotions. Care partners described several adaptations to mitigate these impacts, including practicing acceptance, approaching falls as an opportunity for learning, facilitating collaborations within formal/informal care networks, collaborating with older people with dementia to balance autonomy and safety, and modifying the physical environment. DISCUSSIONS AND IMPLICATIONS Falls among older people with dementia are a significant stressor and an important activation stimulus for their care partners. Our findings suggest that care partners are "second clients" and "competent collaborators." As they provide important insights about fall prevention, care partners should be engaged to co-design new multi-level interventions to facilitate collaborations among care networks, older people with dementia, and service providers.
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Affiliation(s)
- Yuanjin Zhou
- Steve Hicks School of Social Work, University of Texas at Austin, USA
| | - Nirali Thakkar
- Steve Hicks School of Social Work, University of Texas at Austin, USA
| | - Elizabeth A Phelan
- Department of Health Systems and Population Health, University of Washington, USA
| | - Emily Ishado
- School of Nursing, University of Washington, USA
| | - Chih-Ying Li
- Department of Occupational Therapy, and School of Public and Population Health, University of Texas Medical Branch, USA
- Department of Population Health and Health Disparities, University of Texas Medical Branch, USA
| | - Soo Borson
- Department of Family Medicine, University of Southern California Keck School of Medicine, USA
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Wang C, Zhang Y, Wang J, Wan L, Li B, Ding H. A study on the falls factors among the older adult with cognitive impairment based on large-sample data. Front Public Health 2024; 12:1376993. [PMID: 38947354 PMCID: PMC11212509 DOI: 10.3389/fpubh.2024.1376993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 05/30/2024] [Indexed: 07/02/2024] Open
Abstract
Introduction This study explored the correlative factors of falls among the older adult with cognitive impairment, to provide distinct evidence for preventing falls in the older adult with cognitive impairment compared with the general older adult population. Methods This study was based on a cross-sectional survey, with an older adult population of 124,124 was included. The data was sourced from the Elderly Care Unified Needs Assessment for Long-Term Care Insurance in Shanghai. Binary and multivariable logistic regression analyses were conducted sequentially on the correlative factors of falls. Multivariable logistic regression was performed on variables that were significant, stratified by cognitive function levels. Results The incidence of fall in the past 90 days was 17.67% in this study. Specific variables such as gender (male), advanced age (≥80), residence with a elevator (or lift), mild or moderate disability, quality of sleep (acceptable/poor) were negatively correlated with falls, while higher education level, living alone, residence with indoor steps, unclean and untidy living environment, MCI or dementia, chronic diseases, restricted joints, impaired vision, and the use of diaper were positively correlative factors of falls. Comparing with older adult with normal cognitive functions, older adult with dementia faced a higher risk of falling due to accessibility barrier in the residence. For general older adults, less frequency of going outside and poor social interactions were positively correlated with falls, while for older adult with cognitive impairments, going outside moderately (sometimes) was found positively correlated with falls. Older adults with cognitive impairments have increased fall risks associated with chronic diseases, restricted joints, and the use of diaper. The risk of falling escalated with the greater number of chronic diseases. Discussion For older adult with cognitive impairments, it is advisable to live with others. Additionally, creating an accessible living environment and maintaining the cleanness and tidiness can effectively reduce the risk of falls, particularly for those with MCI or dementia. Optimal outdoor activity plans should be developed separately based on the cognitive function of older adults. Older adult with dementia who have comorbidities should be paid special attention in fall prevention compared to the general older adult population.
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Affiliation(s)
- Changying Wang
- Shanghai Health Development Research Center, (Shanghai Medical Information Center), Shanghai, China
| | - Yunwei Zhang
- Shanghai Health Development Research Center, (Shanghai Medical Information Center), Shanghai, China
| | - Jin Wang
- Shanghai Health Development Research Center, (Shanghai Medical Information Center), Shanghai, China
| | - Lingshan Wan
- Shanghai Health Development Research Center, (Shanghai Medical Information Center), Shanghai, China
| | - Bo Li
- Minhang Hospital, Fudan University, Shanghai, China
| | - Hansheng Ding
- Shanghai Health Development Research Center, (Shanghai Medical Information Center), Shanghai, China
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Lin P, Lin G, Wan B, Zhong J, Wang M, Tang F, Wang L, Ye Y, Peng L, Liu X, Deng L. Development and validation of prediction model for fall accidents among chronic kidney disease in the community. Front Public Health 2024; 12:1381754. [PMID: 38873317 PMCID: PMC11171714 DOI: 10.3389/fpubh.2024.1381754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 05/07/2024] [Indexed: 06/15/2024] Open
Abstract
Background The population with chronic kidney disease (CKD) has significantly heightened risk of fall accidents. The aim of this study was to develop a validated risk prediction model for fall accidents among CKD in the community. Methods Participants with CKD from the China Health and Retirement Longitudinal Study (CHARLS) were included. The study cohort underwent a random split into a training set and a validation set at a ratio of 70 to 30%. Logistic regression and LASSO regression analyses were applied to screen variables for optimal predictors in the model. A predictive model was then constructed and visually represented in a nomogram. Subsequently, the predictive performance was assessed through ROC curves, calibration curves, and decision curve analysis. Result A total of 911 participants were included, and the prevalence of fall accidents was 30.0% (242/911). Fall down experience, BMI, mobility, dominant handgrip, and depression were chosen as predictor factors to formulate the predictive model, visually represented in a nomogram. The AUC value of the predictive model was 0.724 (95% CI 0.679-0.769). Calibration curves and DCA indicated that the model exhibited good predictive performance. Conclusion In this study, we constructed a predictive model to assess the risk of falls among individuals with CKD in the community, demonstrating good predictive capability.
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Affiliation(s)
- Pinli Lin
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Guang Lin
- The Fourth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Biyu Wan
- School of Nursing Hunan University of Chinese Medicine, Changsha, China
| | - Jintao Zhong
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Mengya Wang
- School of Nursing Hunan University of Chinese Medicine, Changsha, China
| | - Fang Tang
- Department of Chronic Disease Management, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Traditional Chinese Medicine), Guangzhou, China
| | - Lingzhen Wang
- Department of Nephrology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Traditional Chinese Medicine), Guangzhou, China
| | - Yuling Ye
- Department of Nephrology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Traditional Chinese Medicine), Guangzhou, China
| | - Lu Peng
- Department of Nephrology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Traditional Chinese Medicine), Guangzhou, China
| | - Xusheng Liu
- Department of Nephrology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Traditional Chinese Medicine), Guangzhou, China
| | - Lili Deng
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
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Das Gupta D, Kelekar U, Turner SC. Older Adult Falls in the Community: Does Unsafe Home Environment Have a Risk Role Through the Mediating Effect of Functional Limitations? THE GERONTOLOGIST 2024; 64:gnad139. [PMID: 37870156 DOI: 10.1093/geront/gnad139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Fall incidents from unsafe home environments are frequent in older-adult homes but the literature is ambiguous whether it is the presence/absence, or the interplay of such conditions and physical functioning that is of salience. We therefore estimated whether unsafe home environment is adversely associated with subsequent falls among older adults and what proportion of this association was mediated through limitations in daily and instrumental activities of daily living (ADL/IADL). RESEARCH DESIGN AND METHODS Using a nationally representative sample of community-dwelling Medicare beneficiaries (≥65 years) in the 2018-2019 National Health and Aging Trends Study (n = 2,599), we conducted bivariate and multivariable analyses. We examined baseline conditions of home disorders, unsafe bathroom settings, unsafe house/building features, and house disrepairs in 2018 and their relation with subsequent falls in 2019, after controlling for covariates. To assess whether ADL/IADL limitations mediated this relationship, we employed the Karlson-Holm-Breen methodology. RESULTS In 2019, the self-reported prevalence of falls among older adults was estimated at 34.68%. Although baseline home disorders had both a direct (adjusted odds ratio [aOR]: 1.14, 95% confidence interval [CI]:1.03,1.26) and an indirect effect through limitations in ADL and IADL (aOR: 1.01; 95% CI: 1.00,1.03), the relation between unsafe bathroom settings and subsequent falls was unclear. Unsafe house/building features and house disrepairs were not statistically significantly related either directly or indirectly with subsequent falls. DISCUSSION AND IMPLICATIONS Addressing home disorders through policy and housing assessments to highlight home environmental safety would be essential to address falls among older adults.
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Affiliation(s)
- Debasree Das Gupta
- Department of Kinesiology and Health Science, Emma Eccles Jones College of Education and Human Services, Utah State University, Logan, Utah, USA
| | - Uma Kelekar
- School of Business, College of Business, Innovation, Leadership and Technology, Marymount University, Marymount Center for Optimal Aging, Arlington, Virginia, USA
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Kehrer-Dunlap AL, Keleman AA, Bollinger RM, Stark SL. Falls and Alzheimer Disease. ADVANCES IN GERIATRIC MEDICINE AND RESEARCH 2024; 6:e240001. [PMID: 38549879 PMCID: PMC10977097 DOI: 10.20900/agmr.20240001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/01/2024]
Abstract
Falls are the leading cause of injury, disability, and injury-related mortality in the older adult population. Older adults with Alzheimer disease (AD) are over twice as likely to experience a fall compared to cognitively normal older adults. Intrinsic and extrinsic fall risk factors may influence falls during symptomatic AD; intrinsic factors include changes in cognition and impaired functional mobility, and extrinsic factors include polypharmacy and environmental fall hazards. Despite many known fall risk factors, the high prevalence of falls, and the presence of effective fall prevention interventions for older adults without cognitive impairment, effective fall prevention interventions for older adults with AD to date are limited and inconclusive. Falls may precede AD-related cognitive impairment during the preclinical phase of AD, though a narrow understanding of fall risk factors and fall prevention interventions for older adults with preclinical AD limits clinical treatment of falls among cognitively normal older adults with preclinical AD. This mini review explores fall risk factors in symptomatic AD, evidence for effective fall prevention interventions in symptomatic AD, and preclinical AD as an avenue for future falls research, including recommendations for future research directions to improve our understanding of falls and fall risk during preclinical AD. Early detection and tailored interventions to address these functional changes are needed to reduce the risk of falls for those at risk for developing AD. Concerted efforts should be dedicated to understanding falls to inform precision fall prevention strategies for this population.
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Affiliation(s)
- Abigail L. Kehrer-Dunlap
- Program in Occupational Therapy, Washington University in St. Louis School of Medicine, 4444 Forest Park Ave., Box 8505, St. Louis, MO 63110, USA
| | - Audrey A. Keleman
- Program in Occupational Therapy, Washington University in St. Louis School of Medicine, 4444 Forest Park Ave., Box 8505, St. Louis, MO 63110, USA
| | - Rebecca M. Bollinger
- Program in Occupational Therapy, Washington University in St. Louis School of Medicine, 4444 Forest Park Ave., Box 8505, St. Louis, MO 63110, USA
| | - Susan L. Stark
- Program in Occupational Therapy, Washington University in St. Louis School of Medicine, 4444 Forest Park Ave., Box 8505, St. Louis, MO 63110, USA
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Zhu YH, Hu P, Luo YX, Yao XQ. Knowledge mapping of trends and hotspots in the field of exercise and cognition research over the past decade. Aging Clin Exp Res 2024; 36:19. [PMID: 38308660 PMCID: PMC10838253 DOI: 10.1007/s40520-023-02661-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 11/09/2023] [Indexed: 02/05/2024]
Abstract
Exercise elicits a wide range of physiological responses in mammalian tissues that enhance a broad range of functions, particularly in improving cognitive performance. However, the field lacks a comprehensive bibliometric analysis that clarifies its knowledge structure and research hotspots. This study aims to address this gap and map the research landscape regarding the role of exercise in cognitive function enhancement. Firstly, the frequencies and co-occurrence of keywords were analysed to identify six main clusters: aging, cognitive impairment, rehabilitation, obesity, fatigue, and hippocampus. Secondly, reference timeline co-citation analysis revealed that hippocampus and aging were the major bursts with high intensity and long attention span while children had recently emerged as a topical subject. Finally, the evolution of themes from 2012 to 2022 was analysed, and found that older adults had been the leading research theme for exercise affecting cognition. Childhood obesity was an emerging theme that attracted increasing research attention in recent years while the hippocampus research theme expanded rapidly during the decade but remained a niche topic with less relevance to others. This research identified and summarised research priorities and evolutionary trends in exercise to improve cognition by constructing knowledge networks through visual analysis. It provides researchers with a comprehensive insight into the current state of the field to facilitate further research.
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Affiliation(s)
- Ying-Hai Zhu
- Department of Rehabilitation, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Peng Hu
- Department of Rehabilitation, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ya-Xi Luo
- Department of Rehabilitation, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
| | - Xiu-Qing Yao
- Department of Rehabilitation, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
- Chongqing Municipality Clinical Research Center for Geriatric Medicine, Chongqing, China.
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Zhang H, Xu C, Yuan C, Shi B, Zhu W, Wang H, Fu F, Tang D, Wang Y. Causal associations between genetically determined common psychiatric disorders and the risk of falls: evidence from Mendelian randomization. Eur J Med Res 2023; 28:578. [PMID: 38071363 PMCID: PMC10709873 DOI: 10.1186/s40001-023-01502-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 11/03/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The causal associations between psychiatric disorders and falls risk remains uncertain. Consequently, this study aimed to explore the causal relationship between genetically determined three common psychiatric disorders and the risk of falls based on Mendelian randomization (MR). METHODS The genome-wide association study (GWAS) data for schizophrenia (SCZ) (N = 320,404), major depressive disorder (MDD) (N = 480,359), and Alzheimer's disease (AD) (N = 63,926) were obtained as exposures. The GWAS data for falls risk (N = 451,179) was obtained as outcome. Univariate Mendelian randomization (UVMR) was used to evaluate the direct causal relationship between SCZ, MDD, AD, and risk of falls. Inverse variance weighting (IVW) was used as the primary analysis method. Sensitivity analysis was performed to assess the validity of the casualty. Multivariate Mendelian randomization (MVMR) analysis was conducted after adjusting body mass index and smoking initiation. Mediating MR was conducted to calculate the mediating effects of potential intermediaries. RESULTS UVMR analysis showed that SCZ (OR 1.02, 95% CI 1.01-1.04, p = 8.03E-03) and MDD (OR 1.15, 95% CI 1.08-1.22, p = 1.38E-05) were positively associated with the risk of falls. Sensitivity analysis results were reliable and robust. MVMR results indicated that the relationship between MDD and SCZ and falls risk remained significant. Mediating MR results demonstrated that smoking initiation mediated partial causal effect of SCZ (0.65%, P = 0.03) and MDD (14.82%, P = 2.02E-03) on risk of falls. CONCLUSIONS This study provides genetic evidence for a causal relationship of individuals with SCZ and MDD on an increased risk of falls. Healthcare providers should be aware of the risk of falls in MDD and SCZ patients and develop strategies accordingly.
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Affiliation(s)
- Haitao Zhang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Wan-Ping South Road 725#, Xuhui District, Shanghai, 200032, China
- Spine Institute, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chuanglong Xu
- Ningxia Hospital of Traditional Chinese Medicine and Chinese Medicine Research Institute, Ningxia, China
| | - Chunchun Yuan
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Wan-Ping South Road 725#, Xuhui District, Shanghai, 200032, China
- Spine Institute, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Binhao Shi
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wenhao Zhu
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Wan-Ping South Road 725#, Xuhui District, Shanghai, 200032, China
- Spine Institute, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hongyu Wang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Wan-Ping South Road 725#, Xuhui District, Shanghai, 200032, China
- Spine Institute, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Furui Fu
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Wan-Ping South Road 725#, Xuhui District, Shanghai, 200032, China
- Spine Institute, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Dezhi Tang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Wan-Ping South Road 725#, Xuhui District, Shanghai, 200032, China.
- Spine Institute, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China.
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China.
| | - Yongjun Wang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Wan-Ping South Road 725#, Xuhui District, Shanghai, 200032, China.
- Spine Institute, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China.
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China.
- Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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Wu X, Guo Q. Correspondence to comment on "Comparison of the relationship between cognitive function and future falls in Chinese community-dwelling older adults with and without diabetes mellitus". J Formos Med Assoc 2023; 122:1349-1350. [PMID: 37419752 DOI: 10.1016/j.jfma.2023.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 06/26/2023] [Indexed: 07/09/2023] Open
Affiliation(s)
- Xinze Wu
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Qi Guo
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China.
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Chen TY, Rajan SI, Saito Y. Nutritional Status Predicts Injurious Falls Among Community-Dwelling Older Adults: Does Sex Matter? J Appl Gerontol 2023; 42:2207-2218. [PMID: 37340374 DOI: 10.1177/07334648231184950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023] Open
Abstract
The association of poor nutritional status with falls-related injuries other than fractures is unclear. Although there are sex differences in poor nutritional status and the rate of falls-related injuries, whether the impacts of poor nutritional status on falls-related injuries differ by sex is unclear. We investigated whether baseline poor nutritional status predicted injurious falls, fall-related minor injuries, and fractures at 3-year follow-up and whether these relationships differed by sex among community-dwelling older adults (N = 3257). We found that being at risk of malnutrition at baseline significantly predicted injurious falls but not minor injuries and fractures at follow-up. Compared to older males at risk of malnutrition at baseline, females at risk of malnutrition were significantly more likely to have injurious falls and minor injuries later. Being at risk of malnutrition predicted injurious falls, especially among older females. Regular nutritional screenings among older females should be implemented to provide prompt interventions against falls.
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Affiliation(s)
- Tuo-Yu Chen
- Master Program in Global Health and Development, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - S Irudaya Rajan
- The International Institute of Migration and Development (IIMAD), Kerala, India
| | - Yasuhiko Saito
- College of Economics, Nihon University, Chiyoda, Japan
- Economic Research Institute for ASEAN and East Asia, Jakarta, Indonesia
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