1
|
Hark LA, Wang Y, Gorroochurn P, Simon PR, Maruri SC, Henriquez DR, Diamond DF, Horowitz JD, Park L, Wang Q, Auran JD, Carrion J, Friedman DS, Liebmann JL, Cioffi GA, Harizman N. Manhattan Vision Screening and Follow-up Study (NYC-SIGHT): a nested cross-sectional assessment of falls risk within a cluster randomised trial. Br J Ophthalmol 2024:bjo-2022-323052. [PMID: 38609163 DOI: 10.1136/bjo-2022-323052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/19/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND To investigate the feasibility of using the Stopping Elderly Accidents, Deaths and Injuries (STEADI) Falls Risk Tool Kit during community-based eye health screenings to assess falls risk of participants enrolled in the Manhattan Vision Screening and Follow-Up Study (NYC-SIGHT). METHODS Cross-sectional analysis of data from a 5-year prospective, cluster-randomised clinical trial conducted in affordable housing developments in New York City in adults age 40 years and older. Prescreening questions determined whether participants were at risk of falling. STEADI tests classified participants at low, moderate or high risk of falling. Multivariate logistic regression determined odds of falls risk of all enrolled participants. RESULTS 708 participants completed the eye health screening; 351 (49.6%) performed STEADI tests; mean age: 71.0 years (SD±11.3); 72.1% female; 53.6% Black, non-Hispanic, 37.6% Hispanic/Latino. Level of falls risk: 32 (9.1%) low, 188 (53.6%) moderate and 131 (37.3%) high. Individuals age >80 (OR 5.921, 95% CI (2.383 to 14.708), p=0.000), had blurry vision (OR 1.978, 95% CI (1.186 to 3.300), p=0.009), high blood pressure (OR 2.131, 95% CI (1.252 to 3.628), p=0.005), arthritis (OR 2.29876, 95% CI (1.362 to 3.875), p=0.002) or foot problems (OR 5.239, 95% CI (2.947 to 9.314), p=0.000) had significantly higher odds of falling, emergency department visits or hospitalisation due to falling. CONCLUSION This study detected a significant amount of falls risk in an underserved population. The STEADI Falls Risk screening questions were easy for eye care providers to ask, were highly predictive of falls risk and may be adequate for referral to occupational health and/or physical therapy.
Collapse
Affiliation(s)
- Lisa A Hark
- Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Edward S Harkness Eye Institute, New York, NY, USA
| | - Yujia Wang
- Edward S Harkness Eye Institute, New York, NY, USA
| | - Prakash Gorroochurn
- Biostatistics, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Phyllis R Simon
- Occupational Therapy, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | | | | | - Daniel F Diamond
- Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Edward S Harkness Eye Institute, New York, NY, USA
| | - Jason D Horowitz
- Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Edward S Harkness Eye Institute, New York, NY, USA
| | - Lisa Park
- Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Edward S Harkness Eye Institute, New York, NY, USA
| | - Qing Wang
- Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Edward S Harkness Eye Institute, New York, NY, USA
| | - James D Auran
- Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Edward S Harkness Eye Institute, New York, NY, USA
| | | | - David S Friedman
- Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA
| | - Jeffrey L Liebmann
- Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Edward S Harkness Eye Institute, New York, NY, USA
| | - George A Cioffi
- Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Edward S Harkness Eye Institute, New York, NY, USA
| | - Noga Harizman
- Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Edward S Harkness Eye Institute, New York, NY, USA
| |
Collapse
|
2
|
Chen Q, Liang L, Shi Y, Lu F. Epidemiological and clinical characteristics of open globe injuries in Southwest China. Front Med (Lausanne) 2024; 11:1303683. [PMID: 38384411 PMCID: PMC10879276 DOI: 10.3389/fmed.2024.1303683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/23/2024] [Indexed: 02/23/2024] Open
Abstract
Background Open globe injuries (OGIs) are one of the leading causes of monocular vision loss, and the clinical characteristics of OGIs are region specific. The features and patterns of OGIs in Southwest China are poorly known and not well studied. Our study aimed to review the epidemiological and clinical characteristics of patients hospitalized for OGIs in Southwest China. Methods A retrospective study of OGI patients admitted to the West China Hospital from January 1st, 2015, to December 31st, 2019, was performed. Demographic characteristics and injury details were recorded. The Birmingham Eye Trauma Terminology system and the ocular trauma score (OTS) were used. Results A total of 3,014 patients were included. The male-to-female ratio was 5.2:1, and the mean age was 35.6 ± 19.1 years. 15.2% of patients were from the ethnic groups. The highest-risk occupation was the farmer (30.3%), followed by the worker (28.5%). OGIs occurred more frequently in people with middle (37.0%) and primary school (33.1%) education levels. Types of injuries included 46.8% penetration, 21.2% rupture, 2.9% perforation, and 29.1% intraocular foreign body (IOFB). The injuries types differed between age and occupation groups (p < 0.001). IOFBs had a higher risk of causing endophthalmitis, retinal detachment, and traumatic cataracts (p < 0.001). The most common injuries resulted from sharp objects (72.7%). The causes of the injuries were significantly associated with age, ethnicity, and occupation (p < 0.001). Explosion injuries and attacks by animals were more common among people of Tibetan and Yi ethnicities. Blunt trauma, vehicle crashes, falls and age older than 60 years were risk factors for a lack of light perception and lower OTS scores prognosis. Conclusion OGIs in Southwest China mainly affected working-aged males, especially workers or farmers. Severe vision loss and IOFBs are more common findings. OGIs in older patients and ethnic minorities requires additional attention.
Collapse
Affiliation(s)
| | | | | | - Fang Lu
- The Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
3
|
Stalin A, Narayan A, Labreche T, Khan S, Stanberry A, Christian LWT, Leat SJ. Status of Vision and Eye Care Among Patients in Rehabilitation Hospital Units: A Cross-Sectional Study. J Am Med Dir Assoc 2024; 25:361-367.e1. [PMID: 38052415 DOI: 10.1016/j.jamda.2023.10.030] [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: 06/14/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 12/07/2023]
Abstract
OBJECTIVES The prevalence of vision disorders is high among geriatric and hospital inpatient populations, yet they often go undetected, resulting in consequences such as falls or prolonged recovery time. A needs assessment study was conducted to investigate levels of vision and the potential prevalence of unmanaged/undiagnosed ocular disorders among adult inpatients in a hospital-based rehabilitation unit. DESIGN Cross-sectional study. SETTING & PARTICIPANTS Inpatient rehabilitation units of an acute care hospital system in Ontario, Canada. Adults (n = 112) in a hospital inpatient rehabilitation unit participated from October 2018 to February 2019. METHODS Participants were surveyed regarding their demographic, ocular, and medical data and spectacle wear. Visual acuity, contrast sensitivity, visual fields, and stereoacuity plus the spectacle condition were directly assessed. RESULTS The majority (75%) were found to have reduced habitual vision while in hospital. Nearly 60% of participants reported at least some difficulty reading a newspaper or distinguishing a face or were "not happy with their vision." This was despite 80% of participants reporting that they had an eye care practitioner and 70% that they had an eye examination within the last 2 years. More than half (51.8%) of the participants received the recommendation to follow up with their eye care practitioner on discharge from the hospital. CONCLUSIONS AND IMPLICATIONS Reduced vision and vision disorders has a high prevalence among hospital patients in rehabilitation units and should be evaluated at or soon after hospital intake. By incorporating vision screening tools, necessary precautions may be taken to avoid possible falls and promote recovery.
Collapse
Affiliation(s)
- Amritha Stalin
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada.
| | | | - Tammy Labreche
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Shamrozé Khan
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Andre Stanberry
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Lisa W T Christian
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Susan J Leat
- School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| |
Collapse
|
4
|
El Marhraoui Y, Bouilland S, Boukallel M, Anastassova M, Ammi M. CNN-Based Self-Attention Weight Extraction for Fall Event Prediction Using Balance Test Score. SENSORS (BASEL, SWITZERLAND) 2023; 23:9194. [PMID: 38005580 PMCID: PMC10675741 DOI: 10.3390/s23229194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/16/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023]
Abstract
Injury, hospitalization, and even death are common consequences of falling for elderly people. Therefore, early and robust identification of people at risk of recurrent falling is crucial from a preventive point of view. This study aims to evaluate the effectiveness of an interpretable semi-supervised approach in identifying individuals at risk of falls by using the data provided by ankle-mounted IMU sensors. Our method benefits from the cause-effect link between a fall event and balance ability to pinpoint the moments with the highest fall probability. This framework also has the advantage of training on unlabeled data, and one can exploit its interpretation capacities to detect the target while only using patient metadata, especially those in relation to balance characteristics. This study shows that a visual-based self-attention model is able to infer the relationship between a fall event and loss of balance by attributing high values of weight to moments where the vertical acceleration component of the IMU sensors exceeds 5 m/s² during an especially short period. This semi-supervised approach uses interpretable features to highlight the moments of the recording that may explain the score of balance, thus revealing the moments with the highest risk of falling. Our model allows for the detection of 71% of the possible falling risk events in a window of 1 s (500 ms before and after the target) when compared with threshold-based approaches. This type of framework plays a paramount role in reducing the costs of annotation in the case of fall prevention when using wearable devices. Overall, this adaptive tool can provide valuable data to healthcare professionals, and it can assist them in enhancing fall prevention efforts on a larger scale with lower costs.
Collapse
Affiliation(s)
- Youness El Marhraoui
- CLI Department, University of Paris 8, 93200 Saint-Denis, France;
- Laboratoire Analyse, Géométrie et Applications, University of Sorbonne Paris Nord, 93430 Villetaneuse, France
| | | | - Mehdi Boukallel
- Laboratory for Integration of Systems and Technology, CEA, 91120 Palaiseau, France; (M.B.); (M.A.)
| | - Margarita Anastassova
- Laboratory for Integration of Systems and Technology, CEA, 91120 Palaiseau, France; (M.B.); (M.A.)
| | - Mehdi Ammi
- CLI Department, University of Paris 8, 93200 Saint-Denis, France;
| |
Collapse
|
5
|
Jeon W, Borrelli J, Hsiao HY. Effects of Visual Input Absence on Balance Recovery Responses to Lateral Standing Surface Perturbations in Older and Younger Adults. J Appl Biomech 2023; 39:184-192. [PMID: 37142405 DOI: 10.1123/jab.2022-0029] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 02/08/2023] [Accepted: 03/21/2023] [Indexed: 05/06/2023]
Abstract
Although the ability to recover balance in the lateral direction has important implications with regard to fall risk in older adults, the effect of visual input on balance recovery in response to lateral perturbation and the effect of age are not well studied. We investigated the effect of visual input on balance recovery response to unpredictable lateral surface perturbations and its age-related changes. Ten younger and 10 older healthy adults were compared during balance recovery trials performed with the eyes open and eyes closed (EC). Compared with younger adults, older adults showed increased electromyography (EMG) peak amplitude of the soleus and gluteus medius, reduced EMG burst duration of the gluteus maximus and medius, and increased body sway (SD of the body's center of mass acceleration) in EC. In addition, older adults exhibited a smaller % increase (EC-eyes open) of the ankle eversion angle, hip abduction torque, EMG burst duration of the fibularis longus, and a greater % increase of body sway. All kinematics, kinetics, and EMG variables were greater in EC compared with eyes open in both groups. In conclusion, the absence of visual input negatively affects the balance recovery mechanism more in older adults compared with younger adults.
Collapse
Affiliation(s)
- Woohyoung Jeon
- Department of Health and Kinesiology, The University of Texas at Tyler, Tyler, TX,USA
| | - James Borrelli
- Department of Biomedical Engineering, Stevenson University, Owings Mills, MD,USA
| | - Hao-Yuan Hsiao
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX,USA
| |
Collapse
|
6
|
Kehrer AL, Barkocy B, Downs B, Rice S, Chen SW, Stark S. Interventions to promote independent participation among community-dwelling middle-aged adults with long-term physical disabilities: a systematic review. Disabil Rehabil 2022; 44:7739-7750. [PMID: 34757870 DOI: 10.1080/09638288.2021.1998668] [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: 01/18/2023]
Abstract
PURPOSE People aging with long-term physical disabilities (PAwLTPD) are aging at an accelerated rate beginning in middle-age. They face age-related challenges in conjunction with their existing disabilities; thus, maintaining independence as they age is often difficult. The aim of this systematic review was to examine the effectiveness of rehabilitation interventions for middle-aged PAwLTPD to participate independently in the home and community. MATERIALS AND METHODS We searched four databases - MEDLINE, CINAHL, Web of Science, and EMBASE - for studies published from January 2005 to December 2020. Information from included studies was extracted using a critical appraisal form. Studies were categorized based on common themes, assigned level of evidence, and assessed for risk of bias. RESULTS Fourteen articles were included. Common themes derived were fall risk reduction, functional capacity, community mobility, and function within the home. The strongest evidence supports wheelchair skills training programs (WSTPs) among manual wheelchair users and targeted paretic limb exercise post-stroke. Moderate evidence supports exercise and multicomponent interventions for those with multiple sclerosis, adaptive strategy training and WSTPs to improve satisfaction with mobility for power wheelchair users, and home modifications/assistive technology for mobility-impaired individuals. CONCLUSION Interventions with strong and moderate evidence should be routinely offered for middle-aged PAwLTPD. Future research should focus on developing evidence-based interventions for middle-aged PAwLTPD.IMPLICATIONS FOR REHABILITATIONMiddle-aged PAwLTPD face the same aging-related challenges as people without disabilities but will experience additional difficulties due to compounding effects of long-term health conditions and aging.Current effective interventions to promote participation for middle-aged PAwLTPD have been measured over a wide range of outcomes, and many interventions should be used by clinicians on a case-by-case basis.Wheelchair skills training was found to have the strongest evidence and is recommended for use with middle-aged PAwLTPD who use manual and power wheelchairs.
Collapse
Affiliation(s)
- Abigail L Kehrer
- Program in Occupational Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Brianna Barkocy
- Program in Occupational Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Britney Downs
- Program in Occupational Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Susan Rice
- Program in Occupational Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Szu-Wei Chen
- Program in Occupational Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Susan Stark
- Program in Occupational Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| |
Collapse
|
7
|
Sala A, Vitali A, Remelli F, Zurlo A, Volpato S. Delirium in hip fractured patients. JOURNAL OF GERONTOLOGY AND GERIATRICS 2022. [DOI: 10.36150/2499-6564-n544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
8
|
Providing Accessible Fall Prevention Education for Older Adults With Low Vision. TOPICS IN GERIATRIC REHABILITATION 2022. [DOI: 10.1097/tgr.0000000000000364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
9
|
Mathur A, Bhardwaj P, Joshi NK, Jain YK, Singh K. Intrinsic capacity of rural elderly in thar desert using world health organization integrated care for older persons screening tool: A pilot study. Indian J Public Health 2022; 66:337-340. [PMID: 36149117 DOI: 10.4103/ijph.ijph_731_22] [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: 11/04/2022] Open
Abstract
Integrated Care for Older Persons (ICOPE) screening tool helps to address declines in physical and mental capacities in older people. In India, majority of the older population resides in rural areas and there is a paucity of studies that demonstrates the utility of the ICOPE screening tool in India. Thus, a cross-sectional study was conducted to demonstrate the feasibility of using the World Health Organization ICOPE screening tool in a rural population. Comprehensive geriatric assessment of intrinsic capacity revealed cognitive decline in 31.5% (n = 142) participants, diminished mobility 52.1% (n = 235) participants, eye problems in 49.4% (n = 223) participants, and hearing loss in 68.3% (n = 308) participants. Gender difference was statistically significant with mobility limitation (P = 0.005; χ2 = 7.95) and feeling of pain (P = 0.001; χ2 = 15.64), being more in females than males. This tool seems suitable in identifying the intrinsic capacity of the rural elderly.
Collapse
Affiliation(s)
- Arvind Mathur
- Director, Asian Centre for Medical Education, Research and Innovation, Jodhpur, Rajasthan, India
| | - Pankaj Bhardwaj
- Additional Professor, Community Medicine and Family Medicine, Coordinator, School of Public Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Nitin Kumar Joshi
- Demonstrator, School of Public Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Yogesh Kumar Jain
- Demonstrator, School of Public Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Kuldeep Singh
- Academic Head School of Public Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| |
Collapse
|
10
|
Mathur A, Bhardwaj P, Joshi NK, Jain YK, Singh K. Intrinsic capacity of rural elderly in thar desert using world health organization integrated care for older persons screening tool: A pilot study. Indian J Public Health 2022. [PMID: 36149117 DOI: 10.1101/2022.02.04.22270231] [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: 05/16/2023] Open
Abstract
Integrated Care for Older Persons (ICOPE) screening tool helps to address declines in physical and mental capacities in older people. In India, majority of the older population resides in rural areas and there is a paucity of studies that demonstrates the utility of the ICOPE screening tool in India. Thus, a cross-sectional study was conducted to demonstrate the feasibility of using the World Health Organization ICOPE screening tool in a rural population. Comprehensive geriatric assessment of intrinsic capacity revealed cognitive decline in 31.5% (n = 142) participants, diminished mobility 52.1% (n = 235) participants, eye problems in 49.4% (n = 223) participants, and hearing loss in 68.3% (n = 308) participants. Gender difference was statistically significant with mobility limitation (P = 0.005; χ2 = 7.95) and feeling of pain (P = 0.001; χ2 = 15.64), being more in females than males. This tool seems suitable in identifying the intrinsic capacity of the rural elderly.
Collapse
Affiliation(s)
- Arvind Mathur
- Director, Asian Centre for Medical Education, Research and Innovation, Jodhpur, Rajasthan, India
| | - Pankaj Bhardwaj
- Additional Professor, Community Medicine and Family Medicine, Coordinator, School of Public Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Nitin Kumar Joshi
- Demonstrator, School of Public Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Yogesh Kumar Jain
- Demonstrator, School of Public Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Kuldeep Singh
- Academic Head School of Public Health, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| |
Collapse
|
11
|
Moreira NB, Bento PCB, Vieira ER, da Silva JLP, Rodacki ALF. Association between Domains of the Clinical-Functional Vulnerability Index and Falls History in Older Adults: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137949. [PMID: 35805607 PMCID: PMC9265731 DOI: 10.3390/ijerph19137949] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/13/2022] [Accepted: 06/27/2022] [Indexed: 02/01/2023]
Abstract
Objectives: The study aimed to determine which domains, sets, and isolated or combined questions of the Clinical-Functional Vulnerability Index (CFVI-20) are associated with falls history in older adults. Methods: Instruments used were the CFVI-20 assessment and reported falls during the last year. The receiver operating characteristics (ROC) curves identified the performance of the CFVI-20 domains and questions in identifying older adults with and without falls history, while logistic regression identified relevant questions to identify fall history. Results: This study included 1725 individuals (71.9 ± 7.3 years). The area under the curve (AUC) between the CFVI-20 and fall history was 0.69. The mobility domain presented the largest AUC (0.71; p < 0.01), and most isolated domains showed low AUCs (0.51 to 0.58). Isolated questions were limited to identifying fallers. The regression analysis identified 7 questions of the CFVI-20 with falls. Conclusions: The CFVI-20 general score identified older adults with a fall history. When considered in isolation, most domains were limited to identifying falls, except for the mobility domain. Combining the CFVI-20 questions enabled identification of fallers.
Collapse
Affiliation(s)
- Natália B. Moreira
- Departamento de Prevenção e Reabilitação em Fisioterapia, Rua Coronel H dos Santos, Jardim das Américas, 100-Centro Politécnico, Universidade Federal do Paraná, Curitiba 81530-000, Paraná, Brazil;
| | - Paulo C. B. Bento
- Departamento de Educação Física, Rua Coronel H dos Santos, Jardim das Américas, 100-Centro Politécnico, Universidade Federal do Paraná, Curitiba 81530-000, Paraná, Brazil;
| | - Edgar Ramos Vieira
- Department of Physical Therapy, Nicole Wertheim College of Nursing and Health Sciences, International University, Miami, FL 33199, USA;
| | - José L. P. da Silva
- Departamento de Estatística, Rua Coronel H dos Santos, Jardim das Américas, 100-Centro Politécnico, Universidade Federal do Paraná, Curitiba 81530-000, Paraná, Brazil;
| | - André L. F. Rodacki
- Departamento de Educação Física, Rua Coronel H dos Santos, Jardim das Américas, 100-Centro Politécnico, Universidade Federal do Paraná, Curitiba 81530-000, Paraná, Brazil;
- Correspondence: ; Tel.: +55-41-3361-3072
| |
Collapse
|
12
|
Sohail A, Du J, Nawaz Abbasi B, Taiwo AK. Prevalence, causes, and impact of self-reported vision impairment among older people in China: Findings from the China health and retirement longitudinal study. BRITISH JOURNAL OF VISUAL IMPAIRMENT 2022. [DOI: 10.1177/02646196221099160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article investigated the prevalence, causes, and impact of self-reported vision impairment among older people in China. A total of 12,910 participants aged ⩾50 years were included in this study from China Health and Retirement Longitudinal Study (CHARLS) over the periods of 2011, 2013, and 2015. All data were reported by participants via a self-reported questionnaire. Distance vision was assessed by asking if they could see the face of a person on the other side of the street. Near vision was assessed by asking if they could read ordinary newspaper. Depressive symptoms were evaluated by 10-item Center for Epidemiological Studies Depression Scale. The analysis method included the χ2 – square distribution test and multiple regression analysis. This article first found that prevalence of self-reported vision impairment was much higher in rural than in urban areas; in urban areas, females had a greater chance of being affected than males, and for both sexes, it increases with increasing age. Second, some factors found are significantly associated with increased vision impairment rates, include increasing age, female gender, rural residents, elementary-level education, unmarried individuals, and non-agricultural occupations. Third, the leading cause of vision impairment was a refractive error and the most common causes of vision impairment include cataracts and glaucoma. Fourth, vision impairment was significantly associated with falls and depressive symptoms and has a negative effect on the quality of life of older Chinese. The article concluded that older people with self-reported vision impairment were relatively low and it is majorly caused by refractive error. Older people with distance vision impairment and near vision impairment were more likely to report falls and depressive symptoms in the future. In line with these findings, a couple of policy recommendations for further research were made.
Collapse
Affiliation(s)
- Ali Sohail
- Xian Jiaotong University, China; Shaanxi Normal University, China
| | | | | | | |
Collapse
|
13
|
Srivastava S, Muhammad T. Prevalence and risk factors of fall-related injury among older adults in India: evidence from a cross-sectional observational study. BMC Public Health 2022; 22:550. [PMID: 35305595 PMCID: PMC8934483 DOI: 10.1186/s12889-022-12975-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 03/14/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Falls and related injuries in older ages have become a major public health problem. This study aims to identify the prevalence of self-reported fall-related injury and to describe risk factors associated with fall-related injury among older adults in India.
Method
The study used data from the "Building Knowledge Base on Population Ageing in India" (BKPAI), which was carried out in seven major states in India (2011). Bivariate and multivariable logistic regression analyses were conducted to examine the prevalence and risk factors of fall-related injury among older people.
Results
The study found that 3.6% of older adults had a fall-related injury. Older adults with walk difficulty had a significantly higher likelihood of reporting fall-related injuries in comparison to their counterparts [adjusted odds ratio (AOR):1.80; confidence interval (CI): 1.38–2.36]. Older adults who consumed alcohol had significantly higher odds of reporting fall-related injuries than those who did not consume alcohol [AOR: 1.97; CI: 1.31–2.97]. Poor self-rated health was another risk factor for fall-related injury [AOR: 1.24; CI: 1.05–1.61]. Further, older adults with dementia were 2.15 times significantly more likely to report fall-related injuries than older adults with no dementia [AOR: 2.15; CI: 1.03–5.05]. Also, older women compared to men were 98% significantly more likely to report fall-related injury [AOR: 1.98; CI: 1.43–2.75]. The odds of reporting fall-related injury was significantly higher among those who had a secondary level education compared to those with no education [AOR: 1.44; CI: 1.01–2.06].
Conclusions
Walking disabilities, alcohol consumption, poor self-rated health, dementia, and female gender were found to be the risk factors for fall-related injury among older adults. The results highlight the importance of improving physical as well as mental health of older individuals including dementia in terms of reducing the risk of experiencing fall-related injury.
Collapse
|
14
|
Recording of Falls in Elderly Fallers in Northern Greece and Evaluation of Aging Health-Related Factors and Environmental Safety Associated with Falls: A Cross-Sectional Study. Occup Ther Int 2022; 2022:9292673. [PMID: 35082561 PMCID: PMC8759840 DOI: 10.1155/2022/9292673] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/05/2021] [Accepted: 12/23/2021] [Indexed: 11/18/2022] Open
Abstract
Background Elderly falls constitute a global problem with huge social and economic aspects. Fall risk factors are both intrinsic (physical and psychological) and extrinsic (related with environmental safety). Aim To record both intrinsic and extrinsic risk factors and their correlation in elderly fallers in order to suggest specific guidelines for their medical care and environmental modification inside and outside the home. Method The study involved 150 elderly fallers (median age 70 (67-74)), who completed a record containing information on known risk factors related to their health status, as well as information on the conditions and causes that led to the fall. Each fall was considered an independent event, while measurements were performed regarding balance, strength, their functional ability, and the fear of a possible fall. Descriptive analysis and frequency analysis were used to record the health and activity status of the participants as well as the fall-related environmental factors. Severity of each fall event across a variety of locations was examined using the Kruskal-Wallis one-way analysis of variance. Multiple linear regression was applied to examine the effect of the mean values of functional tests and medical records on the number of fall events. Results In the span of 12 months, a total of 304 fall events were recorded. Regarding location, 77.6% occurred indoors; more frequent were the bedroom (28.6%) and the bathroom (28%). The interior stairs (10.5%), the kitchen (4.9%), and the living room (3.3%) were the less frequent locations. Concerning danger, falling on the interior stairs caused the longest hospitalization, followed by the kitchen and the bathroom. Extrinsic factors that led to both indoor and outdoor falls were the administration of psychotropic medication, poor space ergonomics, lack of basic safety standards, and poor lighting conditions. Vision problems and dizziness resulted in more falls than other intrinsic factors. Furthermore, reduced performance in the FICSIT-4 test and the 30-Second Chair Stand Test, as well as high scores in the CONFbal–GREEK questionnaire and the Short FES-I, shows a linear relationship with an increased number of falls. Conclusions Ergonomic interventions can help prevent indoor elderly falls. Poor construction and lack of adequate lighting mainly cause outdoor falls. Regular eye examinations, management of vertigo, improvement of the balance and strength of the lower limbs, and reduction of fear of impending falls are the intrinsic factors that help prevent falls the most.
Collapse
|
15
|
Saccadic eye movement performance reduces visual manipulation influence and center of pressure displacements in older fallers. Exp Brain Res 2021; 240:395-406. [PMID: 34741190 DOI: 10.1007/s00221-021-06256-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 10/24/2021] [Indexed: 10/19/2022]
Abstract
This study examined changes in postural control and gaze performance of faller and non-faller older adults under conditions of visual tasks and optical flow manipulations. Fifteen older non-fallers (69.8 years, ± 3.2) and fifteen older fallers (71.1 years, ± 6.4) stood on a force platform inside a moving room wearing an eye tracker. Four tasks were performed: gaze fixation; predictable saccades; unpredictable saccades; and free-viewing. The stimuli appeared at a frequency of 1.1 Hz during conditions of predictable and unpredictable saccades. Sixteen trials were divided into two blocks. In the first block, the room remained stationary. In the second block, the room oscillated, without the participant's awareness, with a 0.6 cm amplitude and 0.2 Hz frequency. Results showed postural sway attenuation in older fallers during the saccadic tasks compared to gaze fixation and free-viewing tasks, in both stationary and moving room conditions. Both groups showed increased center of pressure (CoP) magnitude during the moving room condition and CoP displacements strongly coupled to the room's movement. The influence of the moving room on the postural sway was reduced during the saccadic tasks for both older groups. Older fallers exhibited higher variability compared to older non-fallers. Gaze behavior differences between groups were dependent on the goals of the visual tasks. Therefore, CoP displacements of older adults are reduced during saccadic tasks regardless of their falling history. However, postural and gaze performance of older fallers suggests increased deterioration of postural and oculomotor control which may be used as a predictor of fall risk.
Collapse
|
16
|
Özkan E, Akı E. The effect of occupation-based postural stability training on postural stability and occupational performance in visually impaired individuals: A randomised controlled trial. Br J Occup Ther 2021. [DOI: 10.1177/0308022620988468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Introduction The purpose of this research was to examine the effect of occupation-based postural stability training on occupational performance and postural stability in visually impaired individuals. Method The research was designed as pre-test/post-test, with two groups (study group and control group). A total of 34 individuals with visual impairment were randomly assigned to the two groups. Participants were evaluated using a sociodemographic information form, the Biodex Balance System for postural stability, the Canadian Occupational Performance Measurement for assessing performance and satisfaction of occupations and the semi-structured interview form. The control group received only postural stability training with the Biodex Balance System and the study group received individualised occupation-based postural stability training with the Biodex Balance System BBS during a 12-week intervention (24 sessions). Results A statistically significant difference was found between the postural stability values of the study group and the control group when looking at pre and post-training measurements ( p < 0.05). It was observed that there was an improvement in the postural stability of the participants in both groups. There was a statistically significant increase in the occupational performance and satisfaction of participants in the study group ( p < 0.01). Conclusion Adding person-centred, meaningful and purposeful occupations into rehabilitation programmes that use technological devices increases functionality in activities of daily living.
Collapse
Affiliation(s)
- Esma Özkan
- Department of Occupational Therapy, Gulhane Faculty of Health Sciences, University of Health Sciences Turkey, Ankara, Turkey
| | - Esra Akı
- Department of Occupational Therapy, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| |
Collapse
|
17
|
Alghamdi M, Vallis LA, Leat SJ. The association between visual attention and body movement-controlled video games, balance and mobility in older adults. BMC Geriatr 2021; 21:405. [PMID: 34193074 PMCID: PMC8247204 DOI: 10.1186/s12877-021-02358-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 06/23/2021] [Indexed: 11/25/2022] Open
Abstract
Background Body movement-controlled video games involving physical motion and visual attention may have the potential to train both abilities simultaneously. Our purpose was to determine the associations between performance in these games and visual attention, balance and mobility in a group of older adults. The long-term goal is to identify the optimal type of interactive games with regards to training potential. Methods Fifty healthy adults aged 65+ years participated in this cross-sectional study. Visual attention was measured with static and dynamic versions of a useful field of view (UFV) and a multiple object tracking (MOT) test. Balance was measured with a force plate in bi-pedal quiet stance test (QST) and one-legged stance (OLST). Gait variability and walking speed were assessed with the Five Meter Walk Test (5MWT). Four Microsoft™ Xbox® 360 Kinect™ interactive video games were chosen based on the apparent levels of visual attention demand. Results Visual attention (UFV and MOT) was significantly associated with performance in Xbox® Kinect™ games that appeared to have a high visual attention demand (p < 0.05), while there was minimal or no significant association with games with apparent low visual attention demand. Balance and mobility show correlations with visual attention, and with Xbox games. Conclusion The results suggest that there are relationships between visual attention, balance, mobility and Xbox® Kinect™ game performance. Since different Xbox® games were associated with different balance, mobility and visual attention scores, a variety of such games, rather than a single game, may be most effective for training for falls prevention.
Collapse
Affiliation(s)
- Mansour Alghamdi
- Department of Optometry, College of Applied Medical Sciences, King Saud University, PO BOX 68953, Riyadh, Riyadh, 11537, Saudi Arabia. .,School of Optometry and Vision Science, University of Waterloo, 200, University Ave. West, Waterloo, ON, N2L 3G1, Canada.
| | - Lori Ann Vallis
- Department of Human Health & Nutritional Sciences, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Susan Jennifer Leat
- School of Optometry and Vision Science, University of Waterloo, 200, University Ave. West, Waterloo, ON, N2L 3G1, Canada
| |
Collapse
|
18
|
Armstead AB, Wilkerson JM, Gemeinhardt G, Nyitray A, Collins DM. Antiretroviral Therapy Adherence, Functional Independence, and Falls among People with HIV. Occup Ther Health Care 2021; 35:318-335. [PMID: 34137654 DOI: 10.1080/07380577.2021.1938337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Chronic disease management coupled with education may improve outcomes for those with chronic disease. As Human Immunodeficiency Virus (HIV) is now a chronic disease, addressing the needs of as people living with HIV (PLWH) is essential as they experience an accelerated aging process due to the mechanisms of the disease and medications taken. Although studies exist on the management of chronic HIV, few discuss the implications of medication adherence and activities of daily living related to falls among PLWH. To inform occupational therapy services for PLWH, this case-control study used extracted data from the electronic medical records of PLWH who had received occupational therapy (OT) at a large academic hospital. Two-hundred-and-four subjects were included in the final dataset; sixty-eight were cases that reported a fall within the last 12 months, while 136 were controls which were PLWH who had not sustained a fall. The association between falls and antiretroviral therapy adherence indicated males who were ART non-adherent and had balance deficits were more likely to fall. The association between ADL dysfunction and falls among PLWH showed those more likely to fall had moderate ADL dysfunction and balance deficits. The findings suggest further examination of the person factors of PLWH who are categorized clinically as non-adherent with antiretroviral therapy and have ADL dysfunction may improve health outcomes and reduce falls when paired with occupation-based interventions.
Collapse
Affiliation(s)
- Amber B Armstead
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA.,Department of Occupational Therapy, School of Health Professions, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA
| | - J Michael Wilkerson
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA
| | - Gretchen Gemeinhardt
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA
| | - Alan Nyitray
- School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA
| | - Diane M Collins
- Department of Occupational Therapy, School of Health Professions, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA
| |
Collapse
|
19
|
Venkataraman AP, Rosén R, Heredia AA, Piers P, Vidal CC, Lundström L. Peripheral vision and hazard detection with average phakic and pseudophakic optical errors. BIOMEDICAL OPTICS EXPRESS 2021; 12:3082-3090. [PMID: 34221646 PMCID: PMC8221950 DOI: 10.1364/boe.419120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 05/06/2023]
Abstract
The impact of peripheral optical errors induced by intraocular lenses was evaluated by simulating the average phakic and pseudophakic image qualities. An adaptive optics system was used to simulate the optical errors in 20° nasal and inferior visual field in phakic subjects. Peripheral resolution acuity, contrast sensitivity and hazard detection were evaluated. Pseudophakic errors typical for monofocal designs had a negative effect on resolution acuity and contrast sensitivity and the hazard detection task also showed increased false positive and misses and a longer reaction time compared to phakic optical errors. The induced peripheral pseudophakic optical errors affect the peripheral visual performance and thereby impact functional vision.
Collapse
Affiliation(s)
- Abinaya Priya Venkataraman
- Department of Applied Physics, Biomedical and X-ray Physics, KTH Royal Institute of Technology, Stockholm, Sweden
- Division of Eye and Vision, Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
| | - Robert Rosén
- Johnson & Johnson Surgical Vision, R&D, Groningen, Netherlands
| | | | - Patricia Piers
- Johnson & Johnson Surgical Vision, R&D, Groningen, Netherlands
| | | | - Linda Lundström
- Department of Applied Physics, Biomedical and X-ray Physics, KTH Royal Institute of Technology, Stockholm, Sweden
| |
Collapse
|
20
|
Bruce J, Hossain A, Lall R, Withers EJ, Finnegan S, Underwood M, Ji C, Bojke C, Longo R, Hulme C, Hennings S, Sheridan R, Westacott K, Ralhan S, Martin F, Davison J, Shaw F, Skelton DA, Treml J, Willett K, Lamb SE. Fall prevention interventions in primary care to reduce fractures and falls in people aged 70 years and over: the PreFIT three-arm cluster RCT. Health Technol Assess 2021; 25:1-114. [PMID: 34075875 DOI: 10.3310/hta25340] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Falls and fractures are a major problem. OBJECTIVES To investigate the clinical effectiveness and cost-effectiveness of alternative falls prevention interventions. DESIGN Three-arm, pragmatic, cluster randomised controlled trial with parallel economic analysis. The unit of randomisation was the general practice. SETTING Primary care. PARTICIPANTS People aged ≥ 70 years. INTERVENTIONS All practices posted an advice leaflet to each participant. Practices randomised to active intervention arms (exercise and multifactorial falls prevention) screened participants for falls risk using a postal questionnaire. Active treatments were delivered to participants at higher risk of falling. MAIN OUTCOME MEASURES The primary outcome was fracture rate over 18 months, captured from Hospital Episode Statistics, general practice records and self-report. Secondary outcomes were falls rate, health-related quality of life, mortality, frailty and health service resource use. Economic evaluation was expressed in terms of incremental cost per quality-adjusted life-year and incremental net monetary benefit. RESULTS Between 2011 and 2014, we randomised 63 general practices (9803 participants): 21 practices (3223 participants) to advice only, 21 practices (3279 participants) to exercise and 21 practices (3301 participants) to multifactorial falls prevention. In the active intervention arms, 5779 out of 6580 (87.8%) participants responded to the postal fall risk screener, of whom 2153 (37.3%) were classed as being at higher risk of falling and invited for treatment. The rate of intervention uptake was 65% (697 out of 1079) in the exercise arm and 71% (762 out of 1074) in the multifactorial falls prevention arm. Overall, 379 out of 9803 (3.9%) participants sustained a fracture. There was no difference in the fracture rate between the advice and exercise arms (rate ratio 1.20, 95% confidence interval 0.91 to 1.59) or between the advice and multifactorial falls prevention arms (rate ratio 1.30, 95% confidence interval 0.99 to 1.71). There was no difference in falls rate over 18 months (exercise arm: rate ratio 0.99, 95% confidence interval 0.86 to 1.14; multifactorial falls prevention arm: rate ratio 1.13, 95% confidence interval 0.98 to 1.30). A lower rate of falls was observed in the exercise arm at 8 months (rate ratio 0.78, 95% confidence interval 0.64 to 0.96), but not at other time points. There were 289 (2.9%) deaths, with no differences by treatment arm. There was no evidence of effects in prespecified subgroup comparisons, nor in nested intention-to-treat analyses that considered only those at higher risk of falling. Exercise provided the highest expected quality-adjusted life-years (1.120), followed by advice and multifactorial falls prevention, with 1.106 and 1.114 quality-adjusted life-years, respectively. NHS costs associated with exercise (£3720) were lower than the costs of advice (£3737) or of multifactorial falls prevention (£3941). Although incremental differences between treatment arms were small, exercise dominated advice, which in turn dominated multifactorial falls prevention. The incremental net monetary benefit of exercise relative to treatment valued at £30,000 per quality-adjusted life-year is modest, at £191, and for multifactorial falls prevention is £613. Exercise is the most cost-effective treatment. No serious adverse events were reported. LIMITATIONS The rate of fractures was lower than anticipated. CONCLUSIONS Screen-and-treat falls prevention strategies in primary care did not reduce fractures. Exercise resulted in a short-term reduction in falls and was cost-effective. FUTURE WORK Exercise is the most promising intervention for primary care. Work is needed to ensure adequate uptake and sustained effects. TRIAL REGISTRATION Current Controlled Trials ISRCTN71002650. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 34. See the NIHR Journals Library website for further project information.
Collapse
Affiliation(s)
- Julie Bruce
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Anower Hossain
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK.,Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
| | - Ranjit Lall
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Emma J Withers
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Susanne Finnegan
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Martin Underwood
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Chen Ji
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Chris Bojke
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Roberta Longo
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Claire Hulme
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Susie Hennings
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Ray Sheridan
- General Medicine/Care of the Elderly, Royal Devon and Exeter Hospital, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Katharine Westacott
- Elderly Care Department, Warwick Hospital, South Warwickshire NHS Foundation Trust, Warwick, UK
| | - Shvaita Ralhan
- Gerontology Department, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Finbarr Martin
- St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - John Davison
- Falls and Syncope Service, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Fiona Shaw
- Falls and Syncope Service, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Dawn A Skelton
- Centre for Living, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Jonathan Treml
- Geriatric Medicine, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Keith Willett
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Sarah E Lamb
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK.,College of Medicine and Health, University of Exeter, Exeter, UK.,Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| |
Collapse
|
21
|
Cai Y, Schrack JA, Wang H, E JY, Wanigatunga AA, Agrawal Y, Urbanek JK, Simonsick EM, Ferrucci L, Swenor BK. Visual Impairment and Objectively Measured Physical Activity in Middle-Aged and Older Adults. J Gerontol A Biol Sci Med Sci 2021; 76:2194-2203. [PMID: 33837407 DOI: 10.1093/gerona/glab103] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Vision loss is associated with increased falls risk and restricted physical activity, yet the relationship between multiple vision measures and objectively measured physical activity, especially activity patterns, in mid-to-late life is not well understood. METHODS This study included 603 participants aged ≥ 50 years (mean age=73.5) in the Baltimore Longitudinal Study of Aging who had the following assessments: presenting and best-corrected visual acuity, contrast sensitivity, visual fields, stereo acuity, and free-living physical activity using a wrist-worn ActiGraph accelerometer for 7 days. Linear regression models were used to examine the association between vision measures and daily activity counts, active minutes, and activity fragmentation (defined as an active-to-sedentary transition probability), adjusting for potential confounders. Mixed-effects models estimated differences in activity by time of day comparing those with and without each visual impairment. RESULTS In the fully adjusted model, worse presenting visual acuity, contrast sensitivity, and visual fields were associated with fewer activity counts, less active time, and more fragmented activity patterns (p<0.05 for all). Participants with presenting or best-corrected visual acuity impairment had 19.2 and 29.3 fewer active minutes (p=0.05, p=0.03, respectively) per day. Visual field impairment was associated with 268,636 fewer activity counts (p=0.02), 46.2 fewer active minutes (p=0.02) per day, and 3% greater activity fragmentation (p=0.009). Differences in activity levels tended to be greatest from 6am-6pm (p<0.05). CONCLUSIONS Older adults with visual impairment have restricted and more fragmented patterns of daily activity. Longitudinal studies to quantify the long-term impacts of visual impairments on activity decline are warranted.
Collapse
Affiliation(s)
- Yurun Cai
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Jennifer A Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Center on Aging and Health, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Hang Wang
- Center on Aging and Health, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Jian-Yu E
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Wilmer Eye Institute, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Amal A Wanigatunga
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Center on Aging and Health, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Yuri Agrawal
- Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Jacek K Urbanek
- Center on Aging and Health, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD.,Division of Geriatric Medicine, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD
| | | | - Luigi Ferrucci
- Intramural Research Program, National Institute on Aging, Baltimore, MD
| | - Bonnielin K Swenor
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Center on Aging and Health, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD.,Wilmer Eye Institute, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD.,The Johns Hopkins Disability Health Research Center, Johns Hopkins University, Baltimore, MD
| |
Collapse
|
22
|
Sultana A, Deb K, Dhar PK, Koshiba T. Classification of Indoor Human Fall Events Using Deep Learning. ENTROPY 2021; 23:e23030328. [PMID: 33802164 PMCID: PMC8000947 DOI: 10.3390/e23030328] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 12/02/2022]
Abstract
Human fall identification can play a significant role in generating sensor based alarm systems, assisting physical therapists not only to reduce after fall effects but also to save human lives. Usually, elderly people suffer from various kinds of diseases and fall action is a very frequently occurring circumstance at this time for them. In this regard, this paper represents an architecture to classify fall events from others indoor natural activities of human beings. Video frame generator is applied to extract frame from video clips. Initially, a two dimensional convolutional neural network (2DCNN) model is proposed to extract features from video frames. Afterward, gated recurrent unit (GRU) network finds the temporal dependency of human movement. Binary cross-entropy loss function is calculated to update the attributes of the network like weights, learning rate to minimize the losses. Finally, sigmoid classifier is used for binary classification to detect human fall events. Experimental result shows that the proposed model obtains an accuracy of 99%, which outperforms other state-of-the-art models.
Collapse
Affiliation(s)
- Arifa Sultana
- Department of Computer Science and Engineering, Chittagong University of Engineering & Technology (CUET), Chattogram 4349, Bangladesh; (A.S.); (P.K.D.)
| | - Kaushik Deb
- Department of Computer Science and Engineering, Chittagong University of Engineering & Technology (CUET), Chattogram 4349, Bangladesh; (A.S.); (P.K.D.)
- Correspondence:
| | - Pranab Kumar Dhar
- Department of Computer Science and Engineering, Chittagong University of Engineering & Technology (CUET), Chattogram 4349, Bangladesh; (A.S.); (P.K.D.)
| | - Takeshi Koshiba
- Faculty of Education and Integrated Arts and Sciences, Waseda University, 1-6-1 Nishiwaseda, Shinjuku-ku, Tokyo 169-8050, Japan;
| |
Collapse
|
23
|
Bist J, Kaphle D, Marasini S, Kandel H. Spectacle non-tolerance in clinical practice - a systematic review with meta-analysis. Ophthalmic Physiol Opt 2021; 41:610-622. [PMID: 33751648 DOI: 10.1111/opo.12796] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 12/09/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE Spectacle non-tolerance or adverse events to spectacle wear are serious concerns for both patients and practitioners. Non-tolerance may contribute to a negative impact on the practitioner's ability and practice. Therefore, a detailed understanding of frequency and causes of spectacle non-tolerance in clinical ophthalmic practice is essential. This review aimed to determine the prevalence and causes of non-tolerance to spectacles prescribed and dispensed in clinical practice. METHOD The current systematic review included quantitative studies published in the English language that reported spectacle non-tolerance in clinical practice. A comprehensive search was conducted in PubMed, Scopus and the Web of Science database for studies published until 13 July 2020. An adapted version of the Newcastle-Ottawa Scale (NOS) modified for cross-sectional studies was used to assess the quality of each included study. Five investigations with 205,478 study participants were included in the review. The prevalence of spectacle non-tolerance from individual studies was pooled using MetaXL software. The pooled prevalence of spectacle non-tolerance was 2.1% (95% CI: 1.6-2.7) ranging from 1.6% to 3.0%. The papers were also reviewed to identify the potential causes of non-tolerances. Nearly half reported that non-tolerance (47.4%) was due to an error in refraction. Other causes identified were errors related to communication (16.3%), dispensing (13.5%), non-adaptation (9.7%), data entry (8.7%), binocular vision (7.4%) and ocular pathology (6.4%). SUMMARY This review improves our understanding of spectacle non-tolerance in clinical practice. This is important because non-tolerance may lead to spectacle wear discontinuation, which may deprive patients of optimal vision. Increased non-tolerance in clinical practice may affect a clinician's reputation and incur additional costs associated with reassessments and replacements. Spectacle non-tolerance occurred due to a multitude of factors related to optical dispensing and wearer adaptation. Therefore, there is a need for vigilance while prescribing spectacles. The limited evidence highlights the need for more studies, especially in limited-resource settings, to improve the quality of refractive error services.
Collapse
Affiliation(s)
| | - Dinesh Kaphle
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Sanjay Marasini
- New Zealand National Eye Centre, Department of Ophthalmology, The University of Auckland, Auckland, New Zealand
| | - Himal Kandel
- Save Sight Institute, Discipline of Clinical Ophthalmology and Eye Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
24
|
Incidence, Incident Causes, and Risk Factors of Visual Impairment and Blindness in a Rural Population in India: 15-Year Follow-up of the Andhra Pradesh Eye Disease Study. Am J Ophthalmol 2021; 223:322-332. [PMID: 33007274 DOI: 10.1016/j.ajo.2020.09.035] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 09/20/2020] [Accepted: 09/21/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE To report 15-year incidence rate of visual loss (blindness and visual impairment [VI]), causes, and risk factors for participants in Andhra Pradesh Eye Disease Study III (APEDS III). DESIGN Population-based cohort study. METHODS From 2012 to 2016, all rural participants were interviewed and underwent a comprehensive eye examination, including dilated fundus examination and imaging. Presenting visual acuity (PVA) and best-corrected visual acuity (BCVA) were measured using a standard logarithm of Minimum Angle of Resolution chart at 3 meters. World Health Organization (WHO) and United States of America (USA) categories of VI and blindness were used. Incident visual loss was defined as the development of or worsening of visual loss of one or more categories. RESULTS In APEDS I, 7,771 rural participants were examined using stratified, random-cluster systematic sampling; in APEDS III, 5,395 participants (69.4% of rural or 52.4% of total participants) were re-examined. Using WHO categories, the crude incidence rate of any visual loss based on PVA and BCVA were 14.6 (95% confidence interval [CI]:13.6-15.7) and 6.3 (95% CI: 6.1-6.4) per 100 person-years, respectively. Using USA criteria, the values were 22.6 (95% CI: 22.3-23.0) and 10.6 (95% CI: 10.3-10.8) per 100 person-years, respectively. More than 90% of visual loss was attributable to cataract and uncorrected refractive error. Using WHO categories, significant independent risk factors for the incident visual loss were increasing age, female gender, illiteracy, past or current smoker, and current use of alcohol. Using the USA definition, an additional risk factor was lower level of education. CONCLUSIONS The high incidence likely reflects poor access to eye care in this population, which needs to be taken into account when planning eye care programs.
Collapse
|
25
|
Abstract
Individuals with balance and gait problems encounter additional challenges navigating this post-coronavirus disease-2019 (COVID-19) world. All but the best fitting facemasks partially obscure the lower visual field. Facemask use by individuals with balance and gait problems has the potential to further compromise walking safety. More broadly, as the world reopens for business, balance and gait testing in clinics and research laboratories will also be impacted by facemask use. Here, we highlight some of the challenges faced by patients, clinicians, and researchers as they return to "normal" after COVID-19.Video Abstract is available for insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A328).
Collapse
Affiliation(s)
- Brooke N. Klatt
- Physical Therapy Department, University of Pittsburgh, Pittsburgh, Pennsylvania (B.N.K.); and Department of Otolaryngology, University of Rochester, Rochester, New York (E.R.A.)
| | - Eric R. Anson
- Physical Therapy Department, University of Pittsburgh, Pittsburgh, Pennsylvania (B.N.K.); and Department of Otolaryngology, University of Rochester, Rochester, New York (E.R.A.)
| |
Collapse
|
26
|
Karaduman A, Karoglu-Eravsar ET, Kaya U, Aydin A, Adams MM, Kafaligonul H. The optomotor response of aging zebrafish reveals a complex relationship between visual motion characteristics and cholinergic system. Neurobiol Aging 2020; 98:21-32. [PMID: 33227566 DOI: 10.1016/j.neurobiolaging.2020.10.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 10/10/2020] [Accepted: 10/17/2020] [Indexed: 12/12/2022]
Abstract
Understanding the principles underlying age-related changes in motion perception is paramount for improving the quality of life and health of older adults. However, the mechanisms underlying age-related alterations in this aspect of vision, which is essential for survival in a dynamic world, still remain unclear. Using optomotor responses to drifting gratings, we investigated age-related changes in motion detection of adult zebrafish (wild-type/AB-strain and achesb55/+ mutants with decreased levels of acetylcholinesterase). Our results pointed out negative optomotor responses that significantly depend on the spatial frequency and contrast level of stimulation, providing supporting evidence for the visual motion-driven aspect of this behavior mainly exhibited by adult zebrafish. Although there were no significant main effects of age and genotype, we found a significant three-way interaction between contrast level, age, and genotype. In the contrast domain, the changes in optomotor responses and thus in the detection of motion direction were age- and genotype-specific. Accordingly, these behavioral findings suggest a strong but complicated relationship between visual motion characteristics and the cholinergic system during neural aging.
Collapse
Affiliation(s)
- Aysenur Karaduman
- National Magnetic Resonance Research Center (UMRAM), Bilkent University, Ankara, Turkey; Interdisciplinary Neuroscience Program, Aysel Sabuncu Brain Research Center, Bilkent University, Ankara, Turkey; Department of Molecular Biology and Genetics Zebrafish Facility, Bilkent University, Ankara, Turkey
| | - Elif Tugce Karoglu-Eravsar
- Interdisciplinary Neuroscience Program, Aysel Sabuncu Brain Research Center, Bilkent University, Ankara, Turkey; Department of Molecular Biology and Genetics Zebrafish Facility, Bilkent University, Ankara, Turkey; National Nanotechnology Research Center (UNAM), Bilkent University, Ankara, Turkey
| | - Utku Kaya
- National Magnetic Resonance Research Center (UMRAM), Bilkent University, Ankara, Turkey
| | - Alaz Aydin
- National Magnetic Resonance Research Center (UMRAM), Bilkent University, Ankara, Turkey
| | - Michelle M Adams
- National Magnetic Resonance Research Center (UMRAM), Bilkent University, Ankara, Turkey; Interdisciplinary Neuroscience Program, Aysel Sabuncu Brain Research Center, Bilkent University, Ankara, Turkey; Department of Molecular Biology and Genetics Zebrafish Facility, Bilkent University, Ankara, Turkey; National Nanotechnology Research Center (UNAM), Bilkent University, Ankara, Turkey; Department of Psychology, Bilkent University, Ankara, Turkey
| | - Hulusi Kafaligonul
- National Magnetic Resonance Research Center (UMRAM), Bilkent University, Ankara, Turkey; Interdisciplinary Neuroscience Program, Aysel Sabuncu Brain Research Center, Bilkent University, Ankara, Turkey; Department of Molecular Biology and Genetics Zebrafish Facility, Bilkent University, Ankara, Turkey; National Nanotechnology Research Center (UNAM), Bilkent University, Ankara, Turkey.
| |
Collapse
|
27
|
Kiziltan Eliacik B, Eliacik M. Clarifying the effect of refractive errors and stereopsis on traumatic dental injuries in childhood. Dent Traumatol 2020; 37:108-113. [PMID: 32937007 DOI: 10.1111/edt.12610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 09/04/2020] [Accepted: 09/05/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND/AIM Visual acuity and stereopsis both play an important role in developing posture and balance in children. The aim of this study was to investigate whether children with traumatic dental injuries (TDI) have abnormal stereopsis, due to a reduction in visual acuity, compared to children with good dental health. MATERIAL AND METHODS A total of 140 participants (75 with traumatic dental injuries resulting from falls and crashes, and 65 age-matched controls without dental trauma) were enrolled in this prospective, cross-sectional study. The participants underwent complete dental and ophthalmologic examinations. After the ophthalmologic examination, the stereo acuities were assessed by a Titmus stereo test at 40 cm. RESULTS Titmus test scores were significantly worse in the TDI group (mean score 252.46 ± 629.12 seconds of arc) compared to the control group (mean score 56 ± 27.39 seconds of arc) (P < .05). The percentage of subjects with abnormal Titmus test scores was higher in the TDI group (28%) than in the control group (3.1%). The mean anisometropia value was 3.03 ± 2.37 D and 0.55 ± 0.41 D in the TDI group and the control group, respectively (P < .001). The severity of anisometropia correlated with the degree of stereopsis (r = .83, P < .01). CONCLUSIONS The presence of abnormal stereopsis may lead to postural instability which can lead to traumatic dental injuries. The prevalence of abnormal stereopsis in children with TDI was higher than in children with good binocular vision and stereopsis.
Collapse
Affiliation(s)
- Basak Kiziltan Eliacik
- Department of Pedodontics, Faculty of Dentistry, Health Sciences University, Istanbul, Turkey
| | - Mustafa Eliacik
- Department of Ophthalmology, Istanbul Medipol University, Istanbul, Turkey
| |
Collapse
|
28
|
Wallace S, Alao R, Kuper H, Jackson ML. Multidisciplinary visual rehabilitation in low- and middle-income countries: a systematic review. Disabil Rehabil 2020; 44:1164-1175. [PMID: 32726142 DOI: 10.1080/09638288.2020.1794063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To systematically review the evidence for effectiveness of rehabilitation interventions in people who are visually impaired, living in low- and middle-income countries. METHODS Fifteen databases and the grey literature were searched up until February 2020; papers were identified according to eligibility criteria, and assessed for risk of bias. Eligible studies were controlled trials (randomised or non-randomised) of rehabilitation interventions for blind or visually impaired adults or children from low- and middle-income countries. Possible outcomes included visual acuity, activities of daily living, safety, quality of life and psychological status. RESULTS Fifteen eligible studies were identified from India, Turkey, Nigeria, Croatia and Iran. Six studies were randomised, seven were non-randomised trials, and in two the method of allocation was not clear. Participants were adults, children and both adults and children. Seven studies were small (n ≤ 65) and examined the effect of training programmes. Remaining studies compared the effect of low vision aids, economic rehabilitation, goalball, rehabilitation compliance and service delivery methods, including one large four-arm randomised trial (n = 436). Studies measured a variety of outcomes, and mostly showed a positive effect of interventions for pre- and post-intervention assessment, although between intervention group comparisons were often inconclusive. Overall, only four studies had a low risk of bias. CONCLUSIONS A lack of high-quality evidence for rehabilitation interventions is a barrier to provision of low vision services in low- and middle-income countries. Future research should focus on establishing effectiveness and cost-effectiveness of devices and models of vision rehabilitation appropriate for low-resource settings.IMPLICATIONS FOR REHABILITATIONThe systematic review found a lack of high-quality evidence for rehabilitation interventions is a barrier to provision of low vision services in low- and middle-income countries.Consider how visual rehabilitation interventions which have been shown to be effective can be delivered by non-specialists.Ensure that service providers for people who are visually impaired are trained in recognising depression and anxiety and have pathways for referral to mental health services, as appropriate.
Collapse
Affiliation(s)
| | - Rotimi Alao
- MSc Programme, London School of Hygiene and Tropical Medicine, London, UK
| | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, UK
| | - Mary Lou Jackson
- Department of Ophthalmology, University of British Columbia, Vancouver, Canada
| |
Collapse
|
29
|
Valipoor S, Pati D, Kazem-Zadeh M, Mihandoust S, Mohammadigorji S. Falls in Older Adults: A Systematic Review of Literature on Interior-Scale Elements of the Built Environment. JOURNAL OF AGING AND ENVIRONMENT 2020. [DOI: 10.1080/02763893.2019.1683672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Shabboo Valipoor
- Department of Interior Design, College of Design, Construction and Planning, University of Florida, Gainesville, FL, USA
| | - Debajyoti Pati
- Department of Design, College of Human Sciences, Texas Tech University, Lubbock, TX, USA
| | - Mahshad Kazem-Zadeh
- Rinker School of Construction Management, College of Design, Construction and Planning, University of Florida, Gainesville, FL, USA
| | - Sahar Mihandoust
- Department of Design, College of Human Sciences, Texas Tech University, Lubbock, TX, USA
| | - Soheyla Mohammadigorji
- Department of Interior Design, College of Design, Construction and Planning, University of Florida, Gainesville, FL, USA
| |
Collapse
|
30
|
Lee K, Ko DH, Lee JY. Prevalence of Metabolic Syndrome According to Causes of Physical Activity Limitation. Diabetes Metab Syndr Obes 2020; 13:2455-2463. [PMID: 32765024 PMCID: PMC7360403 DOI: 10.2147/dmso.s257063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 06/18/2020] [Indexed: 12/13/2022] Open
Abstract
PURPOSE One cause of metabolic syndrome (MetS) is inactivity. This study analyzed the prevalence of MetS due to causes of activity limitation (AL) in adults over 40 years old. PATICIPANTS AND METHODS Participants included 2885 people aged 40-79 (1198 men and 1687 women) who completed the Korean National Health and Nutrition Survey (KNHANES) conducted between 2013 and 2017. They were divided into two groups based on age: the middle age group (MA) included 1148 total participants, 515 men and 633 women from 40-59 years old; the older age group (OA) included 1737 total participants, 683 men and 1054 women from 60-79 years old. MetS was diagnosed according to the Third Report of the National Cholesterol Education Program and the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (NCEP-ATP III). Logistic regression was conducted to calculate the odds ratio for MetS prevalence. RESULTS The prevalence of MetS in people with AL increased 1.432-fold in the MA men group, 1.511-fold in the OA men group, 1.546-fold in the MA women group, and 1.565-fold in the OA women group. There were several causes of AL; people with physical activity for diabetes mellitus and hypertension increased MetS prevalence in both sexes and all age groups: MA men group (OR=3.216, 95% CI=1.852-7.354, P=0.034), MA women group (OR=2.159, 95% CI=1.854-5.346, P=0.032), OA men group (OR=3.200, 95% CI=1.235-7.841, P=0.009), and OA women group (OR=3.444, 95% CI=1.310-6.627, P=0.008). Also, mental problems in the MA men group (OR=2.284, 95% CI=1.591-4.986, P=0.012) and OA men group (OR=1.149, 95% CI=1.017-2.941, P=0.012), and musculoskeletal problems in the MA women group (OR=1.784, 95% CI=1.102-2.902, P=0.021) and OA women group (OR=1.459, 95% CI=1.054-1.993, P=0.004) increased the prevalence. CONCLUSION The prevalence of MetS due to activity limitation was increased in MA and OA groups. Activity limitation increased the MetS prevalence from 1.4- to 1.5-times, Therefore, to prevent metabolic syndrome, physical activity should be increased, and guidelines should be presented according to the activity limitation causes, age, and sex.
Collapse
Affiliation(s)
- Kyujin Lee
- Institution of Sports Science, Seoul National University, Seoul, Republic of Korea
| | - Duk Han Ko
- Department of Sports Science Convergence, Dongguk University, Seoul, Republic of Korea
- Correspondence: Duk Han Ko Tel +82 10-2763-0101Fax +82-2-2260-3741 Email
| | - Ji Young Lee
- Department of Physical Education, Gangneung-Wonju National University, Gangneung, Republic of Korea
- Ji Young Lee Tel +82 33-640-2556Fax +82-33-641-3659 Email
| |
Collapse
|
31
|
Peeters G, Cooper R, Tooth L, van Schoor NM, Kenny RA. A comprehensive assessment of risk factors for falls in middle-aged adults: co-ordinated analyses of cohort studies in four countries. Osteoporos Int 2019; 30:2099-2117. [PMID: 31201482 DOI: 10.1007/s00198-019-05034-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 05/27/2019] [Indexed: 01/19/2023]
Abstract
UNLABELLED We identified demographic, health and lifestyle factors associated with falls in adults aged 50-64 years from Australia, The Netherlands, Great Britain and Ireland. Nearly all factors were associated with falls, but there were differences between countries and between men and women. Existing falls prevention programs may also benefit middle-aged adults. INTRODUCTION Between ages 40-44 and 60-64 years, the annual prevalence of falls triples suggesting that middle age may be a critical life stage for preventive interventions. We aimed to identify demographic, health and lifestyle factors associated with falls in adults aged 50-64 years. METHODS Harmonised data were used from four population-based cohort studies based in Australia (Australian Longitudinal Study on Women's Health, n = 10,641, 51-58 years in 2004), Ireland (The Irish Longitudinal Study on Ageing, n = 4663, 40-64 years in 2010), the Netherlands (Longitudinal Ageing Study Amsterdam, n = 862, 55-64 years in 2012-13) and Great Britain (MRC National Survey of Health and Development, n = 2987, 53 years in 1999). Cross-sectional and prospective associations of 42 potential risk factors with self-reported falls in the past year were examined separately by cohort and gender using logistic regression. In the absence of differences between cohorts, estimates were pooled using meta-analysis. RESULTS In cross-sectional models, nearly all risk factors were associated with fall risk in at least one cohort. Poor mobility (pooled OR = 1.71, CI = 1.34-2.07) and urinary incontinence (OR range = 1.53-2.09) were consistently associated with falls in all cohorts. Findings from prospective models were consistent. Statistically significant interactions with cohort and sex were found for some of the risk factors. CONCLUSION Risk factors known to be associated with falls in older adults were also associated with falls in middle age. Compared with findings from previous studies of older adults, there is a suggestion that specific risk factors, for example musculoskeletal conditions, may be more important in middle age. These findings suggest that available preventive interventions for falls in older adults may also benefit middle-aged adults, but tailoring by age, sex and country is required.
Collapse
Affiliation(s)
- G Peeters
- Global Brain Health Institute, Trinity College Institute of Neuroscience, Trinity College Dublin, Lloyd Building, Dublin 2, Ireland.
- Department of Sport and Exercise Sciences, Faculty of Science and Engineering, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, UK.
| | - R Cooper
- Department of Sport and Exercise Sciences, Faculty of Science and Engineering, Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, UK
| | - L Tooth
- Faculty of Medicine, School of Public Health, The University of Queensland, Brisbane, Australia
| | - N M van Schoor
- Department of Epidemiology and Biostatistics Amsterdam UMC, Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - R A Kenny
- Global Brain Health Institute, Trinity College Institute of Neuroscience, Trinity College Dublin, Lloyd Building, Dublin 2, Ireland
- Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
- The Irish Longitudinal Study on Ageing, Trinity College, Dublin, Ireland
| |
Collapse
|
32
|
Rafsten L, Meirelles C, Danielsson A, Sunnerhagen KS. Impaired Motor Function in the Affected Arm Predicts Impaired Postural Balance After Stroke: A Cross Sectional Study. Front Neurol 2019; 10:912. [PMID: 31496989 PMCID: PMC6713045 DOI: 10.3389/fneur.2019.00912] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 08/06/2019] [Indexed: 11/23/2022] Open
Abstract
Background: Impaired postural balance is a common symptom after stroke and a common cause of falling. Most common daily tasks use arm and hand movements. Impairment in an upper extremity is a common stroke symptom, affecting 50–80% in the acute phase after stroke, and 40–50% in the sub-acute phase. The impact of leg function on postural balance has been investigated in several studies, but few have stressed the importance of arm function on postural balance. Objective: To explore whether there is any association between arm function and postural balance after stroke. Method: A cross sectional study where 121 adults (mean age: 70 ± 12.3 years, 72 men) from two different data sources, Gothenburg Very Early Supported Discharge (GOTVED), and a study by Carvalho et al. were merged. Time for assessments ranged from 1 to 13 years when the patients were in the chronic phase. The dependent variables were Berg Balance scale (BBS) and Time Up and Go (TUG) both dichotomized to “impaired postural balance” and “not impaired postural balance.” As independent variables, the Fugl-Meyer Assessment-Upper Extremity (FMA-UE) scale was used. The FMA-UE was presented with the total score. Results: The motor function in the arm affected after stroke onset correlated with postural balance both measured with the BBS (0.321, p < 0.001) and the TUG (−0.315, p = 0.001). Having impaired motor function in the arm was significantly associated with impaired postural balance assessed with the BBS with OR = 0.879 (CI 0.826–0.934, p < 0.001). Regression analysis with the TUG showed the same result, OR = 0.868 (CI 0.813–0.927, p < 0.001) for FM-UE. Conclusion: The motor function of the affected arm was significantly associated with impaired postural balance post stroke, as assessed by BBS or TUG. It could be of clinical importance to be aware of the fact that not only lower extremity impairment, but also arm function can have an impact on postural balance in a late stage after stroke. Trial Registration: VGFOUGSB-669501.
Collapse
Affiliation(s)
- Lena Rafsten
- Department of Clinical Neuroscience and Rehabilitation Medicine, Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Christiane Meirelles
- Department of Therapy Service, University of Chicago Medical Center, Chicago, IL, United States
| | - Anna Danielsson
- Department of Clinical Neuroscience and Rehabilitation Medicine, Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden.,Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden
| | - Katharina S Sunnerhagen
- Department of Clinical Neuroscience and Rehabilitation Medicine, Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
33
|
Zhu J, Rizzo JR, Fang Y. Learning domain-invariant feature for robust depth-image-based 3D shape retrieval. Pattern Recognit Lett 2019. [DOI: 10.1016/j.patrec.2017.09.041] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
34
|
Adams N, Skelton D, Bailey C, Howel D, Coe D, Lampitt R, Wilkinson J, Fouweather T, de Jong LD, Gawler S, Deary V, Gray J, Waterman H, Parry SW. Visually Impaired OLder people’s Exercise programme for falls prevenTion (VIOLET): a feasibility study. PUBLIC HEALTH RESEARCH 2019. [DOI: 10.3310/phr07040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
The visually impaired have a higher risk of falling and are likely to avoid activity.
Objectives
To adapt the existing Falls Management Exercise (FaME) programme, which is delivered in the community, for visually impaired older people (VIOP) and to investigate the feasibility of conducting a definitive randomised controlled trial of this adapted intervention.
Design
Phase I – consultation with stakeholders to adapt the existing programme. Two focus groups were conducted, each with 10 VIOP across the study sites. Phase II – two-centre randomised pilot trial and economic evaluation of the adapted programme for VIOP versus usual care. Phases III and IV – qualitative interviews with VIOP and Postural Stability Instructors regarding their views and experiences of the research process, undertaking the intervention and its acceptability.
Intervention
This was adapted from the group-based FaME programme. A 1-hour exercise programme ran weekly over 12 weeks at the study sites (Newcastle upon Tyne and Glasgow) and was delivered by third-sector organisations. Participants were advised to also exercise at home for 2 hours per week. Those randomised to the usual activities group received no intervention.
Outcome measures
These were completed at baseline, week 12 and week 24. The primary potential outcome measure used was the Short Form Falls Efficacy Scale – International. Secondary outcome assessment measures were activity avoidance, current activity, balance/falls risk, physical activity, loneliness, anxiety and depression, work and social adjustment, quality of life and economic costs. Participants’ compliance was assessed by reviewing attendance records and self-reported compliance with the home exercises. Instructors’ compliance with the course content (fidelity) was assessed by a researcher attending a sample of exercise sessions. Adverse events were collected in a weekly telephone call for all participants in both the intervention and control arm.
Findings
An adapted exercise programme was devised with stakeholders. In the pilot trial, 82 participants drawn from community-living VIOP were screened, 68 met the inclusion criteria and 64 were randomised, with 33 allocated to the intervention and 31 to the usual activities arm. A total of 94% of participants provided data at week 12 and 92% at week 24. Adherence to the study was high. The intervention was found to be both safe and acceptable to participants, with 76% attending nine or more classes. Median time for home exercise was 50 minutes per week. There was little or no evidence that fear of falling, exercise, attitudinal or quality-of-life outcomes differed between trial arms at follow-up. Thematic analysis of the interviews with VIOP participants identified facilitators of and barriers to exercise, including perceived relevance to health, well-being and lifestyle, social interaction, self-perception and practical assistance. Instructors identified issues regarding level of challenge and assistance from a second person.
Limitations
The small sample size and low falls risk of the study sample are study limitations.
Conclusion
Although adaptation, recruitment and delivery were successful, the findings (particularly from qualitative research with instructors and participants) indicated that VIOP with low to moderate falls risk could be integrated into mainstream programmes with some adaptations. A future definitive trial should consider graduated exercises appropriate to ability and falls risk within mainstream provision. Other outcome measures may additionally be considered.
Trial registration
Current Controlled Trials ISRCTN16949845.
Funding
This project was funded by the NIHR Public Health Research programme and will be published in full in Public Health Research; Vol. 7, No. 4. See the NIHR Journals Library website for further project information.
Collapse
Affiliation(s)
- Nicola Adams
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Dawn Skelton
- Institute of Applied Health Research, School of Health and Life Sciences, Centre for Living, Glasgow Caledonian University, Glasgow, UK
| | - Cathy Bailey
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Denise Howel
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Dorothy Coe
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Rosy Lampitt
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK
| | - Jennifer Wilkinson
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK
| | - Tony Fouweather
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Lex D de Jong
- Institute of Applied Health Research, School of Health and Life Sciences, Centre for Living, Glasgow Caledonian University, Glasgow, UK
| | - Sheena Gawler
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Vincent Deary
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Joanne Gray
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | | | - Steve W Parry
- Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK
| |
Collapse
|
35
|
Namazizadeh M, Mirmoezzi M, Sadeghi H, Mohammadi F. Stability while walking is affected by walking speed and cognitive load. INTERNATIONAL ARCHIVES OF HEALTH SCIENCES 2019. [DOI: 10.4103/iahs.iahs_20_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
36
|
Paz LPDS, Borges LDL, Marães VRFDS, Gomes MMF, Bachion MM, Menezes RLD. Factors associated with falls in older adults with cataracts. CIENCIA & SAUDE COLETIVA 2018; 23:2503-2514. [PMID: 30137120 DOI: 10.1590/1413-81232018238.14622016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 09/02/2016] [Indexed: 12/16/2022] Open
Abstract
The aim of the present study was to evaluate factors associated with falls in community-dwelling older adults diagnosed with cataracts. An analytical, cross-sectional study was conducted with a sample of community-dwelling older adults residing in the Federal District of Brazil. Interviews and assessment tools were administered, such as the Timed Up and Go test, Short Physical Performance Battery (SPPB), Biodex Balance System, Katz Index, Lawton Scale, Minnesota Leisure Time Physical Activity Questionnaire and Mini Mental State Examination. Statistical analysis involved binary logistic regression. One hundred forty-two older adults (85 with cataracts) participated in the study (mean age: 69.39 ± 5.67 years). Falls were associated with the female sex (OR: 4.45) and sub-maximum score on the SPPB (OR: 3.53) among patients with cataracts, whereas multimorbidity (OR: 5.10) was the risk factor risk for older adults without cataracts. The data suggest different risk factors for falls among older adults diagnosed with cataracts.
Collapse
Affiliation(s)
- Leonardo Petrus da Silva Paz
- Faculdade de Ceilândia, Universidade de Brasília (UnB). Universidade de Brasília,. QNN14 AE CEI-Sul, Guariroba. 72220-140 Brasília DF Brasil.
| | | | | | | | | | | |
Collapse
|
37
|
Adams N, Skelton DA, Howel D, Bailey C, Lampitt R, Fouweather T, Gray J, Coe D, Wilkinson J, Gawler S, de Jong LD, Waterman H, Deary V, Clarke M, Parry SW. Feasibility of trial procedures for a randomised controlled trial of a community based group exercise intervention for falls prevention for visually impaired older people: the VIOLET study. BMC Geriatr 2018; 18:307. [PMID: 30541483 PMCID: PMC6292024 DOI: 10.1186/s12877-018-0998-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 11/27/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Visually impaired older people (VIOP) have a higher risk of falling than their sighted peers, and are likely to avoid physical activity. The aim was to adapt the existing Falls Management Exercise (FaME) programme for VIOP, delivered in the community, and to investigate the feasibility of conducting a definitive randomised controlled trial (RCT) of this adapted intervention. METHODS Two-centre randomised mixed methods pilot trial and economic evaluation of the adapted group-based FaME programme for VIOP versus usual care. A one hour exercise programme ran weekly over 12 weeks at the study sites (Newcastle and Glasgow), delivered by third sector (voluntary and community) organisations. Participants were advised to exercise at home for an additional two hours over the week. Those randomised to the usual activities group received no intervention. Outcome measures were completed at baseline, 12 and 24 weeks. The potential primary outcome was the Short Form Falls Efficacy Scale - International (SFES-I). Participants' adherence was assessed by reviewing attendance records and self-reported compliance to the home exercises. Adherence with the course content (fidelity) by instructors was assessed by a researcher. Adverse events were collected in a weekly phone call. RESULTS Eighteen participants, drawn from community-living VIOP were screened; 68 met the inclusion criteria; 64 participants were randomised with 33 allocated to the intervention and 31 to the usual activities arm. 94% of participants provided data at the 12 week visit and 92% at 24 weeks. Adherence was high. The intervention was found to be safe with 76% attending nine or more classes. Median time for home exercise was 50 min per week. There was little or no evidence that fear of falling, balance and falls risk, physical activity, emotional, attitudinal or quality of life outcomes differed between trial arms at follow-up. CONCLUSIONS The intervention, FaME, was implemented successfully for VIOP and all progression criteria for a main trial were met. The lack of difference between groups on fear of falling was unsurprising given it was a pilot study but there may have been other contributory factors including suboptimal exercise dose and apparent low risk of falls in participants. These issues need addressing for a future trial. TRIAL REGISTRATION Current Controlled Trials ISRCTN ID: 16949845 Registered: 21 May 2015.
Collapse
Affiliation(s)
- Nicola Adams
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, NE7 7XA UK
| | - Dawn A. Skelton
- Institute of Applied Health Research, School of Health & Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Denise Howel
- Institute of Health and Society, Baddiley-Clark Building, Newcastle University, Newcastle upon Tyne, UK
| | - Cathy Bailey
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, NE7 7XA UK
| | - Rosy Lampitt
- Newcastle Clinical Trials Unit, Newcastle University, 1-4 Claremont Terrace, Newcastle upon Tyne, UK
| | - Tony Fouweather
- Institute of Health and Society, Baddiley-Clark Building, Newcastle University, Newcastle upon Tyne, UK
| | - Joanne Gray
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, NE7 7XA UK
| | - Dorothy Coe
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, NE7 7XA UK
| | - Jennifer Wilkinson
- Newcastle Clinical Trials Unit, Newcastle University, 1-4 Claremont Terrace, Newcastle upon Tyne, UK
| | - Sheena Gawler
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, NE7 7XA UK
| | - Lex D. de Jong
- School of Physiotherapy and Exercise Science, Curtin University, Bentley, Western Australia
| | | | - Vincent Deary
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, NE7 7XA UK
| | - Michael Clarke
- Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Steve W Parry
- Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK
| |
Collapse
|
38
|
Campagna G, Chamberlain P, Orengo-Nania S, Biggerstaff K, Khandelwal S. Ophthalmic Conditions Associated with Inpatient Falls among Veterans. Optom Vis Sci 2018; 95:1114-1119. [DOI: 10.1097/opx.0000000000001312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
39
|
Imbalanced: The Confusing Circular Nature of Falls Research…and a Possible Antidote. Am J Phys Med Rehabil 2018; 96:55-59. [PMID: 27984251 DOI: 10.1097/phm.0000000000000591] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
40
|
Kyrdalen IL, Thingstad P, Sandvik L, Ormstad H. Associations between gait speed and well-known fall risk factors among community-dwelling older adults. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2018; 24:e1743. [DOI: 10.1002/pri.1743] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 06/16/2018] [Accepted: 07/27/2018] [Indexed: 11/12/2022]
Affiliation(s)
| | - Pernille Thingstad
- Department of Neuromedicine and Movement Science; Norwegian University of Science and Technology; Trondheim Norway
| | - Leiv Sandvik
- Faculty of Health and Social Sciences; University College of Southeast; Drammen Norway
| | - Heidi Ormstad
- Faculty of Health and Social Sciences; University College of Southeast; Drammen Norway
| |
Collapse
|
41
|
Bareis N, Sando TA, Mezuk B, Cohen SA. Association Between Psychotropic Medication Polypharmacy and an Objective Measure of Balance Impairment Among Middle-Aged Adults: Results from the US National Health and Nutrition Examination Survey. CNS Drugs 2018; 32:863-871. [PMID: 30014315 PMCID: PMC6146074 DOI: 10.1007/s40263-018-0542-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Psychotropic medications (e.g., antidepressants, anxiolytics, and neuroleptics) are increasingly prescribed with two or more taken concurrently (polypharmacy), and have been associated with an increased risk of falling. The aim of this study was to examine the association between psychotropic medication use and balance impairment using an objective balance measure. METHODS We derived data from participants aged 40 years and older in the US National Health and Nutrition Examination Survey (1999/00-2003/04) who completed the Modified Clinical Trial of Sensory Interaction and Balance and indicated current medications (n = 3090). Balance impairment was defined as failing the Modified Clinical Trial of Sensory Interaction and Balance condition 4 (standing on foam surface, eyes closed). Medication use included specific psychotropic classes, a count of psychotropic medications, and a count of non-psychotropic medications taken concurrently. Nested multiple logistic regression assessed relationships between medication use and balance impairment, adjusting for covariates and complex sampling. RESULTS One third of participants had balance impairment. After accounting for medical comorbidities, there was no relationship between individual classes of psychotropic medications and balance impairment. After adjusting for all covariates, there was a dose-response relationship between the number of psychotropic medications taken and balance impairment, with every additional medication associated with a 35% higher odds (odds ratio = 1.35; 95% confidence interval 1.07-1.70). In comparison, there was no increase in the odds of balance impairment associated with each additional medication taken for participants only taking non-psychotropic medications. CONCLUSIONS Psychotropic medication polypharmacy is associated with an increased odds of balance impairment. Clinicians should exercise caution when prescribing combinations of psychotropic medications, and refer to physical therapy for assessment and treatment if balance impairment is detected.
Collapse
Affiliation(s)
- Natalie Bareis
- Department of Psychiatry, Columbia University Medical Center and the New York State Psychiatric Institute, 1051 Riverside Drive, Room 6402A, New York, NY, USA.
| | - Trisha A Sando
- Division of Epidemiology, Department of Internal Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, USA
| | - Briana Mezuk
- Division of Epidemiology, Department of Internal Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, USA
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Steven A Cohen
- Department of Kinesiology, University of Rhode Island, Kingston, RI, USA
| |
Collapse
|
42
|
Pengpid S, Peltzer K. Prevalence and Risk Factors Associated with Injurious Falls among Community-Dwelling Older Adults in Indonesia. Curr Gerontol Geriatr Res 2018; 2018:5964305. [PMID: 29971097 PMCID: PMC6008814 DOI: 10.1155/2018/5964305] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 02/19/2018] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To assess the prevalence and health correlates of fall-related injury in a national population-based community-dwelling sample of older Indonesians. METHODS Participants were 6698 older adults, 50 years and older (median age 58.0 years, IQR=11.0, and age range of 50-101 years), who took part in in the Indonesia Family Life Survey (IFLS-5) in 2014-15. They provided information about sociodemographic, various health variables, including a falling down and received treatment history in the last two years. RESULTS Overall, 12.8% had one or more fall-related injuries in the past two years, 14.0% among women and 11.5% among men, 7.6% had a single fall, and 5.2% multiple fall-related injuries in the past two years. In multivariable logistic regression models, having two or more chronic conditions, urinary problems, and functional disability was independently associated with multiple fall-related injuries in the past two years in both sexes. Sex-specific risk factors were former tobacco use, having or having had a cataract, sleep disturbance, and sleep impairment in men and poorer economic background, depression symptoms, and low cognitive functioning in women. CONCLUSION A significant proportion of older adults in Indonesia have fall-related injury. Several homogenous between the sexes and sex-specific risk factors for fall-related injury were identified that can help in designing fall-prevention strategies.
Collapse
Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Thailand
- Department of Research & Innovation, University of Limpopo, Turfloop, South Africa
| | - Karl Peltzer
- Department for Management of Science and Technology Development, Ton Duc Thang University, Ho Chi Minh City, Vietnam
- Faculty of Pharmacy, Ton Duc Thang University, Ho Chi Minh City, Vietnam
| |
Collapse
|
43
|
Labreche T, Nandakumar K, Althomali M, Leat SJ. Development and validation of Visual Impairment as a Risk for Falls Questionnaire. Age Ageing 2018; 47:444-450. [PMID: 29385405 DOI: 10.1093/ageing/afx202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Indexed: 11/14/2022] Open
Abstract
Purpose visual impairment is associated with an increased risk of falls, yet eye care professionals are infrequently members of falls prevention clinics. The aim of this preliminary study was to validate a newly created Visual Impairment as a Risk for Falls Questionnaire intended to be used by those professionals not involved in eye care. Methods about 53 participants with various visual impairments known to be associated with falls and 33 participants with normal sight were contacted within 4 months of a full oculo-visual assessment and were asked the questions from the current questionnaire pertaining to their visual function. A retrospective file review was undertaken and the sensitivity and specificity of participants' responses were calculated compared to the actual vision impairment based on the findings from their visual assessment. Results the question regarding ability to read was included to identify people with central vision loss, a risk factor for falling. It was found to have sensitivity of 74% and specificity of 87%. Both sensitivity and specificity improved when participants with cognitive impairment were excluded. The question on recognising facial features gave sensitivity of 73% and specificity of 97% for this subgroup. However, questions related to impairments in stereopsis and peripheral fields were not useful. Conclusion the study demonstrates that several questions of the new questionnaire are useful; however, further testing with a larger population is needed to fully validate the questionnaire for use by health care professionals.
Collapse
Affiliation(s)
- Tammy Labreche
- Waterloo Optometry and Vision Science, University of Waterloo
| | | | | | - Susan J Leat
- Waterloo Optometry and Vision Science, University of Waterloo
| |
Collapse
|
44
|
Lu N, Wu Y, Feng L, Song J. Deep Learning for Fall Detection: Three-Dimensional CNN Combined With LSTM on Video Kinematic Data. IEEE J Biomed Health Inform 2018; 23:314-323. [PMID: 29994460 DOI: 10.1109/jbhi.2018.2808281] [Citation(s) in RCA: 142] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Fall detection is an important public healthcare problem. Timely detection could enable instant delivery of medical service to the injured. A popular nonintrusive solution for fall detection is based on videos obtained through ambient camera, and the corresponding methods usually require a large dataset to train a classifier and are inclined to be influenced by the image quality. However, it is hard to collect fall data and instead simulated falls are recorded to construct the training dataset, which is restricted to limited quantity. To address these problems, a three-dimensional convolutional neural network (3-D CNN) based method for fall detection is developed, which only uses video kinematic data to train an automatic feature extractor and could circumvent the requirement for large fall dataset of deep learning solution. 2-D CNN could only encode spatial information, and the employed 3-D convolution could extract motion feature from temporal sequence, which is important for fall detection. To further locate the region of interest in each frame, a long short-term memory (LSTM) based spatial visual attention scheme is incorporated. Sports dataset Sports-1 M with no fall examples is employed to train the 3-D CNN, which is then combined with LSTM to train a classifier with fall dataset. Experiments have verified the proposed scheme on fall detection benchmark with high accuracy as 100%. Superior performance has also been obtained on other activity databases.
Collapse
|
45
|
Abstract
Globally, 32.4 million individuals are blind and 191 million have moderate or severe visual impairment (MSVI); 80% of cases of blindness and MSVI are avoidable. However, great efforts are needed to tackle blindness and MSVI, as eye care in most places is delivered in isolation from and without significant integration with general health sectors. Success stories, including control of vitamin A deficiency, onchocerciasis, and trachoma, showed that global partnerships, multisectoral collaboration, public-private partnerships, corporate philanthropy, support from nongovernmental organizations-both local and international-and governments are responsible for the success of these programs. Hence, the World Health Organization's universal eye health global action plan for 2014-2019 has a goal of reducing the public health problem of blindness and ensuring access to comprehensive eye care; the plan aims to integrate eye health into health systems, thus providing universal eye health coverage (UEHC). This article discusses the challenges faced by low- and middle-income countries in strengthening the six building blocks of the health system. It discusses how the health systems in these countries need to be geared toward tackling the issues of emerging noncommunicable eye diseases, existing infectious diseases, and the common causes of blindness and visual impairment, such as cataract and refractive error. It also discusses how some of the comprehensive eye care models in the developing world have addressed these challenges. Moving ahead, if we are to achieve UEHC, we need to develop robust, sustainable, good-quality, comprehensive eye care programs throughout the world, focusing on the areas of greatest need. We also need to develop public health approaches for more complex problems such as diabetic retinopathy, glaucoma, childhood blindness, corneal blindness, and low vision. There is also a great need to train high-level human resources of all cadres in adequate numbers and quality. In addition to this, we need to exploit the benefits of modern technological innovations in information, communications, biomedical technology, and other domains to enhance quality of, access to, and equity in eye care.
Collapse
Affiliation(s)
- Rohit C Khanna
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad 500086, India.,Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad 500034, India
| | - Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad 500086, India.,Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad 500034, India.,Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad 500034, India.,Wellcome Trust/Department of Biotechnology India Alliance, L V Prasad Eye Institute, Hyderabad 500034, India
| | - Gullapalli N Rao
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad 500086, India.,Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad 500034, India.,Brien Holden Institute of Optometry and Vision Science, L V Prasad Eye Institute, Hyderabad 500034, India
| |
Collapse
|
46
|
Leat SJ, Zecevic AA, Keeling A, Hileeto D, Labreche T, Brymer C. Prevalence of vision loss among hospital in-patients; a risk factor for falls? Ophthalmic Physiol Opt 2018; 38:106-114. [PMID: 29265472 DOI: 10.1111/opo.12428] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 10/29/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE Despite poor vision being a risk factor for falls, current hospital policies and practices often do not include a vision assessment at patient admission or in the hospital's incident reporting system when a fall occurs. Our purpose was to document the prevalence of vision loss in hospital general medicine units to increase awareness of poor vision as a potential risk factor for falls that occur within the hospital, and inform future preventative practice. METHODS This cross-sectional study took place in medicine units of an acute care hospital. Participants were adult in-patients. Visual acuity (VA), contrast sensitivity and stereoacuity were measured, and patients were screened for field loss, extinction and neglect. RESULTS 115 participants took part (average age 67 ± 17, 48% female). Overall, 89% had a visual impairment defined as being outside the age-norms for one or more vision measure, 62% had low vision, and 36% had vision loss equivalent to legal blindness [VA equal to or poorer than 1.0 logMAR (6/60, 20/200) or ≥10x below age-norms]. There was a considerable discrepancy between the prevalence of low vision and the percentage of patients who reported an ocular diagnosis that would result in visual loss (30%). Ten patients fell during the study period, and of these 100% had visual impairment, 90% had low vision and 60% had vision loss equivalent to legal blindness, which compares to 58%, 22% and 9% for non-fallers. Similar high prevalences were found in those whose reason for admission to the hospital was a fall (92%, 63% and 33% respectively). CONCLUSIONS Vision loss has a high prevalence among patients in hospital medicine units, and is higher still among those who fall. Since vision loss may be a contributing factor to falls that occur in hospitals, implementing an assessment of vision at hospital admission would be useful to alert staff to those patients who are at risk for falls due to poor vision, so that preventative measures can be applied.
Collapse
Affiliation(s)
- Susan J Leat
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Canada
| | | | - Alexis Keeling
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Canada
| | - Denise Hileeto
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Canada
| | - Tammy Labreche
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Canada
| | | |
Collapse
|
47
|
Almegbel FY, Alotaibi IM, Alhusain FA, Masuadi EM, Al Sulami SL, Aloushan AF, Almuqbil BI. Period prevalence, risk factors and consequent injuries of falling among the Saudi elderly living in Riyadh, Saudi Arabia: a cross-sectional study. BMJ Open 2018; 8:e019063. [PMID: 29326189 PMCID: PMC5781015 DOI: 10.1136/bmjopen-2017-019063] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Approximately 28% to 35% of people aged 65 and over fall each year. The consequent injuries of falls are considered a major public health problem. Falls account for more than half of injury-related hospitalisations among old people. The aim of this study was to measure a 1-year period prevalence of falling among old people in Riyadh, Saudi Arabia. In addition, this study described the most common risk factors and consequent injuries of falls. SETTING AND PARTICIPANTS A cross-sectional survey was carried out in Riyadh, using a convenient sampling. The targeted population were Saudi citizens who were 60 years or above. Over a 6-month period, 1182 individuals were sampled (545 men and 637 women). RESULTS The 1-year prevalence of falling among old Saudis (>=60 years) was 49.9%. Our results show that 74% of the participants who experienced falls had postfall injuries. Old participants who were uneducated and those with middle school certification were associated with falls (adjusted OR (aOR) 1.72; 95% CI 1.15 to 2.56, aOR 1.81; 95% CI 1.15 to 2.85, respectively). Those who live in rented houses had a higher risk of falls. Interestingly, having a caregiver was significantly associated with more falls (aOR 1.39; 95% CI 1.08 to 1.79). However, not using any medications was significantly related to fewer falls. In addition, old individuals using walking aids were more likely to fall than those who did not. Participants who mentioned 'not having stressors were associated with less frequent falls (aOR 0.62; 95% CI 0.39 to 0.97). Cerebrovascular accidents were strongly associated with falls with an estimated OR of 2.75 (95% CI 1.18 to 6.43). Moreover, osteoporosis, poor vision and back pain were found to be predictors for falls among the elderly. CONCLUSION 49.9% of elderly Saudis had experienced one or more falls during a 12-month period. Several preventable risk factors could be addressed by routine geriatric assessment. Research on the impact of these risk factors is needed.
Collapse
Affiliation(s)
- Faisal Yousef Almegbel
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Ibrahim Muthyib Alotaibi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Faisal Ahmed Alhusain
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Emad M Masuadi
- Research Unit, Medical Education Department, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Salma Lafyan Al Sulami
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Amairah Fahad Aloushan
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | | |
Collapse
|
48
|
Palagyi A, Morlet N, McCluskey P, White A, Meuleners L, Ng JQ, Lamoureux E, Pesudovs K, Stapleton F, Ivers RQ, Rogers K, Keay L. Visual and refractive associations with falls after first-eye cataract surgery. J Cataract Refract Surg 2017; 43:1313-1321. [DOI: 10.1016/j.jcrs.2017.07.029] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 07/04/2017] [Accepted: 07/11/2017] [Indexed: 10/18/2022]
|
49
|
Varadaraj V, Mihailovic A, Ehrenkranz R, Lesche S, Ramulu PY, Swenor BK. Gait Characteristics of Age-Related Macular Degeneration Patients. Transl Vis Sci Technol 2017; 6:14. [PMID: 28781927 PMCID: PMC5539799 DOI: 10.1167/tvst.6.4.14] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 06/11/2017] [Indexed: 11/30/2022] Open
Abstract
Purpose To identify potential differences between age-related macular degeneration (AMD) patients and controls in fall-relevant gait characteristics. Methods Spatiotemporal gait characteristics using the GAITRite walkway were collected from 29 AMD patients and 20 controls, aged 60 to 90 years, at the Wilmer Eye Institute. Multiple linear regressions, controlling for age, sex, body mass index (BMI), and comorbidities were used to assess associations between gait characteristics and AMD. Results Study participants were predominantly white (86%) and female (55%). Mean age of the full study population was 73.51 (SD: 8.14) years, and mean BMI was 27.80 (SD: 5.44) kg/m2. Median better-eye acuity (logMAR) was 0.23 (interquartile range [IQR] = 0.18, 0.36) and −0.02 (IQR = −0.08, 0.02), while median binocular log contrast sensitivity was 1.44 (IQR = 1.32, 1.56) and 1.76 (IQR = 1.76, 1.80) for the AMD and control groups, respectively. In multivariable regression models, AMD patients had significantly slower walking speeds (β = −0.118 m/sec [95% confidence interval (CI): −0.229, −0.007], P = 0.038) and stride velocities (β = −0.119 m/sec [95% CI: −0.232, −0.007], P = 0.038), and greater double support time (β = 3.381% of the walk cycle, 95% CI = 1.006, 5.757, P = 0.006) than controls. There were no group differences in base of support, step length, stride length, or gait variability measures. Conclusion AMD patients exhibited many fall-relevant gait characteristics. Translational Relevance The finding of fall-relevant gait characteristics suggests that AMD patients may be at a greater risk of falls during ambulation than those without AMD.
Collapse
Affiliation(s)
- Varshini Varadaraj
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Aleksandra Mihailovic
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rebecca Ehrenkranz
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Stephen Lesche
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Pradeep Y Ramulu
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Bonnielin K Swenor
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| |
Collapse
|
50
|
Ruwitch MM, Row Lazzarini B. Development of a rapid stepping test to challenge rapid weight-shifting function in older adults. Aging Clin Exp Res 2017; 29:701-709. [PMID: 27460065 DOI: 10.1007/s40520-016-0609-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 07/09/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND The ability to step rapidly, shift weight from side-to-side, and maintain temporal rhythmicity are important functional elements for walking independently and preventing falls in seniors. AIMS The purpose of this study was to develop a clinically feasible test of rapid stepping performance that challenges the ability to step rapidly, shift weight from side-to-side, and maintain temporal rhythmicity. METHODS Participants were a volunteer sample of healthy, self-ambulating older adults aged 70-98 years. A Repeated Alternating Stair Touch Test was developed, which involved rapidly shifting weight in the medial-lateral direction by tapping each foot alternately onto a step. Performance on the test was assessed using trunk acceleration signals. Associations between the number of steps completed on the Repeated Alternating Stair Touch Test in 20 s and acceleration magnitude, variability, and stepping rhythmicity were assessed using Pearson correlations and linear regression. Repeatability was assessed during a 2-week follow-up period. RESULTS The acceleration magnitude, variability, and stepping rhythmicity variables related moderately with the number of steps on the Repeated Alternating Stair Touch Test (r = 0.534-0.572, p < 0.05) and were independent predictors of the number of steps taken (R 2 adj. = 0.624, p < 0.001). Repeatability was mixed, though most acceleration variables and number of steps had moderate to high correlations between sessions (intraclass correlations: 0.486-0.828), but a learning effect was evident; performance improved between sessions. CONCLUSION The Repeated Alternating Stair Touch Test has potential as a simple test of rapid, rhythmic weight-shifting function, but requires modification to improve repeatability.
Collapse
Affiliation(s)
- Margaret M Ruwitch
- Department of Exercise Science, Willamette University, 900 State St., Salem, OR, 97301, USA
| | - Brandi Row Lazzarini
- Department of Exercise Science, Willamette University, 900 State St., Salem, OR, 97301, USA.
| |
Collapse
|