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Ma W, Liang X, Wang H, Wen Z, Liu L, Fan L, Zhang X. Association between fear of falling and mortality in middle-aged and older adults: A systematic review and meta-analysis. Geriatr Nurs 2024; 59:113-120. [PMID: 38996768 DOI: 10.1016/j.gerinurse.2024.06.032] [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: 03/15/2024] [Revised: 06/17/2024] [Accepted: 06/27/2024] [Indexed: 07/14/2024]
Abstract
BACKGROUND Fear of falling (FOF) has emerged as a significant public health issue, contributing to excess disability among middle-aged and older adults. The association between FOF and mortality remains unclear. METHODS Prominent electronic databases (PubMed, Web of Science, the Cochrane Library, Embase, CINHAL, PsycINFO, Scopus, China National Knowledge Infrastructure, China Biology Medicine disc, and Wanfang Database) were searched from inception until October 21, 2023 (data updated on June 9, 2024), for cohort or longitudinal studies investigating the association between FOF and mortality. The heterogeneity between studies was quantitatively assessed using I2. A fixed-effect model calculated the pooled effect size. RESULTS A total of seven cohort studies, including 27,714 participants, were analyzed in this systematic review and meta-analysis. The meta-analysis results demonstrated a positive association between FOF and mortality, with a significant increase in the risk of mortality for those with FOF (hazard ratio [HR]:1.29, 95 % confidence interval [CI]: 1.19-1.41, p < 0.05). Subgroup analysis indicated that age, male sex, clinical diagnosis of depression, number of chronic diseases, activity restriction due to FOF, and FOF levels were associated with mortality. CONCLUSIONS FOF and mortality have a positive association, which needs to be confirmed by further prospective studies with large samples and long-term follow-up to provide evidence for clinicians to intervene in FOF to reduce mortality in middle-aged and older adults.
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Affiliation(s)
- Wenlian Ma
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaoli Liang
- Dean Office, Sichuan Nursing Vocational College, Chengdu, China
| | - Hongyan Wang
- Dean Office, Sichuan Nursing Vocational College, Chengdu, China
| | - Zhifei Wen
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Linfeng Liu
- Dean Office, Sichuan Nursing Vocational College, Chengdu, China
| | - Liangliang Fan
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiangeng Zhang
- Dean Office, Sichuan Nursing Vocational College, Chengdu, China.
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Khalagi K, Hoveidaei AH, AziziKia H, Karimi A, Sattarpour R, Fahimfar N, Sanjari M, Mansourzadeh MJ, Nabipour I, Larijani B, Ostovar A. Identifying determinants for falls among Iranian older adults: insights from the Bushehr Elderly Health Program. BMC Geriatr 2024; 24:588. [PMID: 38982344 PMCID: PMC11232168 DOI: 10.1186/s12877-024-05180-1] [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: 08/16/2023] [Accepted: 06/26/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Falls are a common cause of fractures in older adults. This study aimed to investigate the factors associated with spontaneous falls among people aged ≥ 60 years in southern Iran. METHODS The baseline data of 2,426 samples from the second stage of the first phase of a prospective cohort, the Bushehr Elderly Health (BEH) program, were included in the analysis. A history of spontaneous falls in the year before recruitment was measured by self-report using a standardized questionnaire. Demographic characteristics, as well as a history of osteoarthritis, rheumatoid arthritis, low back pain, Alzheimer's disease, epilepsy, depression, and cancer, were measured using standardized questionnaires. A tandem gait (heel-to-toe) exam, as well as laboratory tests, were performed under standard conditions. A multiple logistic regression model was used in the analysis and fitted backwardly using the Hosmer and Lemeshow approach. RESULTS The mean (standard deviation) age of the participants was 69.34 (6.4) years, and 51.9% of the participants were women. A total of 260 (10.7%, 95% CI (9.5-12.0)%) participants reported a spontaneous fall in the year before recruitment. Adjusted for potential confounders, epilepsy (OR = 4.31), cancer (OR = 2.73), depression (OR = 1.81), low back pain (OR = 1.79), and osteoarthritis (OR = 1.49) increased the risk of falls in older adults, while the ability to stand ≥ 10 s in the tandem gait exam (OR = 0.49), being male (OR = 0.60), engaging in physical activity (OR = 0.69), and having high serum triglyceride levels (OR = 0.72) reduced the risk of falls. CONCLUSION The presence of underlying diseases, combined with other risk factors, is significantly associated with an increased risk of falls among older adults. Given the relatively high prevalence of falls in this population, it is crucial to pay special attention to identifying and addressing these risk factors.
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Affiliation(s)
- Kazem Khalagi
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute , Tehran University of Medical Sciences, No.10- Jalal-e-ale-ahmad st, Chamran hwy, 14117-13137, Tehran, Iran
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Human Hoveidaei
- Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hani AziziKia
- Student Research Committee, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Amirali Karimi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Sattarpour
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Noushin Fahimfar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute , Tehran University of Medical Sciences, No.10- Jalal-e-ale-ahmad st, Chamran hwy, 14117-13137, Tehran, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Sanjari
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute , Tehran University of Medical Sciences, No.10- Jalal-e-ale-ahmad st, Chamran hwy, 14117-13137, Tehran, Iran
| | - Mohammad Javad Mansourzadeh
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute , Tehran University of Medical Sciences, No.10- Jalal-e-ale-ahmad st, Chamran hwy, 14117-13137, Tehran, Iran
| | - Iraj Nabipour
- The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Bagher Larijani
- Endocrinology Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute , Tehran University of Medical Sciences, No.10- Jalal-e-ale-ahmad st, Chamran hwy, 14117-13137, Tehran, Iran.
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
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Bégin D, Janecek M, Macedo LG, Richardson J, Wojkowski S. The relationship between fear of falling and functional ability following a multi-component fall prevention program: an analysis of clinical data. Physiother Theory Pract 2024; 40:1121-1132. [PMID: 36305706 DOI: 10.1080/09593985.2022.2137384] [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: 03/27/2022] [Revised: 09/26/2022] [Accepted: 09/26/2022] [Indexed: 10/31/2022]
Abstract
OBJECTIVES The first objective was to evaluate clinical data from a multi-component fall prevention program. The second objective was to explore the relationship between physical function and fear of falling (FoF). METHODS Adults (N = 287, mean age = 76 years) who participated in the Building Balance Program between 2011-2020 were assessed with five physical function measures and two FoF measures. Repeated measures ANOVA controlling for age and sex were performed to assess change from baseline. Linear regressions were conducted to evaluate how physical function explained variations in FoF. RESULTS There were significant improvements between pre and post-program Berg Balance Scale (BBS) scores (p < .001), Timed-Up and Go (TUG) times (p < .001), 30 second Chair-Stand (30 CST repetitions) (p < .001), Functional Reach (FR) distance (p < .001), gait speed (p < .001), single item-FoF score (p < .001), and short Falls Efficacy Scale-International (FES-I score) (p < .001). After controlling for sex on all regression analyses, age, and pre-program gait speed explained variations in pre-program short FES-I scores (Adjusted R2 = 0.19). Age, pre-program BBS and 30 CST repetitions explained variations in pre-program level of FoF (Adjusted R2 = 0.25). Variations in post-program short FES-I scores (Adjusted R2 = 0.17) were explained by age, post-program TUG times and FR distance after controlling for age and sex. Robust regressions indicated variations in post-program level of FoF explained by age, post-program TUG and FR distance with a two-way interaction between age and FR. CONCLUSION A multi-component fall prevention program improved physical function and decreased FoF. A small association between physical function and FoF similar between pre- and post-program conditions was identified.
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Affiliation(s)
- Diane Bégin
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Hamilton, ON, Canada
| | - Marci Janecek
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Hamilton, ON, Canada
| | - Luciana G Macedo
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Hamilton, ON, Canada
| | - Julie Richardson
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Hamilton, ON, Canada
| | - Sarah Wojkowski
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Hamilton, ON, Canada
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Baltes M, Stephan A, Andrich S, Meyer G. Development of Fear of Falling after proximal femoral fracture. Pflege 2024. [PMID: 38809228 DOI: 10.1024/1012-5302/a000999] [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: 05/30/2024]
Abstract
Background: Proximal femoral fracture is common in older people. Beyond a long recovery process and significant permanent functional limitations, older people often experience subsequent Fear of Falling. The phenomenon of Fear of Falling is not fully understood; qualitative research is underrepresented but can provide insights into the experience of those affected. Objectives: We aimed to explore the experiences of Fear of Falling development and to what extent it affects peoples' life after proximal femoral fracture. Methods: We conducted semi-structured, in-depth interviews with nine older people, aged between 61 and 88, who participated in a prospective observational study. Interview data were analysed through inductive content analysis. Results: Six major themes emerged: The development of Fear of Falling; the effect of FoF and hope for recovery; alternating between moments of fear and security; fear of helplessness and of losing independence; strategies for dealing with Fear of Falling and maintaining independence; need of support by health care professionals. Conclusion: To identify and support older people in coping with Fear of Falling (after proximal femoral fracture), strategies for dealing with Fear of Falling across occupational groups and all healthcare settings should be implemented. Nurses have a key role in this process.
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Affiliation(s)
- Marion Baltes
- Institute for Health and Nursing Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
- Uniklinik RWTH Aachen, Germany
| | - Astrid Stephan
- Institute for Health and Nursing Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
- Uniklinik RWTH Aachen, Germany
| | - Silke Andrich
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Germany
| | - Gabriele Meyer
- Institute for Health and Nursing Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
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Belvederi Murri M, Triolo F, Coni A, Nerozzi E, Maietta Latessa P, Fantozzi S, Padula N, Escelsior A, Assirelli B, Ermini G, Bagnoli L, Zocchi D, Cabassi A, Tedeschi S, Toni G, Chattat R, Tripi F, Neviani F, Bertolotti M, Cremonini A, Bertakis KD, Amore M, Chiari L, Zanetidou S. The body of evidence of late-life depression: the complex relationship between depressive symptoms, movement, dyspnea and cognition. Exp Aging Res 2024; 50:296-311. [PMID: 37035934 DOI: 10.1080/0361073x.2023.2196504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 03/24/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND Physical symptoms play an important role in late-life depression and may contribute to residual symptomatology after antidepressant treatment. In this exploratory study, we examined the role of specific bodily dimensions including movement, respiratory functions, fear of falling, cognition, and physical weakness in older people with depression. METHODS Clinically stable older patients with major depression within a Psychiatric Consultation-Liaison program for Primary Care underwent comprehensive assessment of depressive symptoms, instrumental movement analysis, dyspnea, weakness, activity limitations, cognitive function, and fear of falling. Network analysis was performed to explore the unique adjusted associations between clinical dimensions. RESULTS Sadness was associated with worse turning and walking ability and movement transitions from walking to sitting, as well as with worse general cognitive abilities. Sadness was also connected with dyspnea, while neurovegetative depressive burden was connected with activity limitations. DISCUSSION Limitations of motor and cognitive function, dyspnea, and weakness may contribute to the persistence of residual symptoms of late-life depression.
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Affiliation(s)
| | - Federico Triolo
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Alice Coni
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi", University of Bologna, Bologna, Italy
| | - Erika Nerozzi
- Department for Life Quality Studies, University of Bologna, Bologna, Italy
| | | | - Silvia Fantozzi
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi", University of Bologna, Bologna, Italy
| | - Nicola Padula
- Association for Research on Mental and Physical Health of the Elderly (ARISMA), Bologna, Italy
| | - Andrea Escelsior
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genova, Italy
| | - Barbara Assirelli
- Department of Primary Care, Azienda Unita' Locale Sanita', Bologna, Italy
| | - Giuliano Ermini
- Department of Primary Care, Azienda Unita' Locale Sanita', Bologna, Italy
| | - Luigi Bagnoli
- Department of Primary Care, Azienda Unita' Locale Sanita', Bologna, Italy
| | - Donato Zocchi
- Department of Primary Care, Azienda Unita' Locale Sanita', Bologna, Italy
| | - Aderville Cabassi
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Stefano Tedeschi
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Giulio Toni
- Association for Research on Mental and Physical Health of the Elderly (ARISMA), Bologna, Italy
| | - Rabih Chattat
- Department of Psychology "Renzo Canestrari", University of Bologna, Bologna, Italy
| | - Ferdinando Tripi
- Association for Research on Mental and Physical Health of the Elderly (ARISMA), Bologna, Italy
| | - Francesca Neviani
- Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena, Italy
| | - Marco Bertolotti
- Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena and Reggio Emilia University, Modena, Italy
| | - Alessandro Cremonini
- Association for Research on Mental and Physical Health of the Elderly (ARISMA), Bologna, Italy
| | - Klea D Bertakis
- Department of Family and Community Medicine, University of California, Davis, California, United States
| | - Mario Amore
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genova, Italy
| | - Lorenzo Chiari
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi", University of Bologna, Bologna, Italy
| | - Stamatula Zanetidou
- Association for Research on Mental and Physical Health of the Elderly (ARISMA), Bologna, Italy
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Lim ML, Perram A, Radford K, Close J, Draper B, Lord SR, Anstey KJ, O'Dea B, Ambrens M, Hill TY, Brown A, Miles L, Ngo M, Letton M, van Schooten KS, Delbaere K. Protocol of a 12-week eHealth programme designed to reduce concerns about falling in community-living older people: Own Your Balance randomised controlled trial. BMJ Open 2024; 14:e078486. [PMID: 38309754 PMCID: PMC10840028 DOI: 10.1136/bmjopen-2023-078486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 01/03/2024] [Indexed: 02/05/2024] Open
Abstract
INTRODUCTION Concerns about falling (CaF) are common in older people and have been associated with avoidance of activities of daily life. Exercise designed to prevent falls can reduce CaF, but the effects are usually short-lived. Cognitive behavioural therapy (CBT) can reduce CaF for longer but is not readily available in the community and unlikely to prevent falls. A multidomain intervention that combines CBT, motivational interviewing and exercise could be the long-term solution to treat CaF and reduce falls in older people with CaF. This paper describes the design of a randomised controlled trial to test the effectiveness of two different 12 week self-managed eHealth programmes to reduce CaF compared with an active control. METHODS A total of 246 participants (82 per group) aged 65 and over, with substantial concerns about falls or balance will be recruited from the community. They will be randomised into: (1) myCompass-Own Your Balance (OYB) (online CBT programme) intervention or (2) myCompass-OYB plus StandingTall intervention (an eHealth balance exercise programme), both including motivational interviewing and online health education or (3) an active control group (online health education alone). The primary outcome is change in CaF over 12 months from baseline of both intervention groups compared with control. The secondary outcomes at 2, 6 and 12 months include balance confidence, physical activity, habitual daily activity, enjoyment of physical activity, social activity, exercise self-efficacy, rate of falls, falls health literacy, mood, psychological well-being, quality of life, exercise self-efficacy, programme adherence, healthcare use, user experience and attitudes towards the programme. An intention-to-treat analysis will be applied. The healthcare funder's perspective will be adopted for the economic evaluation if appropriate. ETHICS AND DISSEMINATION Ethical approval was obtained from the South Eastern Sydney Local Health District Human Research Ethics Committee (2019/ETH12840). Results will be disseminated via peer-reviewed journals, local and international conferences, community events and media releases. TRIAL REGISTRATION NUMBER ACTRN12621000440820.
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Affiliation(s)
- Mei Ling Lim
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
- Ageing Futures Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Amy Perram
- Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Kylie Radford
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- Ageing Futures Institute, University of New South Wales, Sydney, New South Wales, Australia
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Jacqueline Close
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Brian Draper
- Discipline of Psychiatry and Mental Health, University of New South Wales, Randwick, New South Wales, Australia
- Eastern Suburbs Older Persons' Mental Health Service, Randwick, New South Wales, Australia
| | - Stephen R Lord
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- Ageing Futures Institute, University of New South Wales, Sydney, New South Wales, Australia
- School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Kaarin J Anstey
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- Ageing Futures Institute, University of New South Wales, Sydney, New South Wales, Australia
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Bridianne O'Dea
- Black Dog Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Meghan Ambrens
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
- Ageing Futures Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Thi-Yen Hill
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- Prince of Wales Hospital, Randwick, New South Wales, Australia
- Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Alicia Brown
- Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Lillian Miles
- Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Michelle Ngo
- Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Meg Letton
- Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Kimberley S van Schooten
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
- Ageing Futures Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Kim Delbaere
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
- Ageing Futures Institute, University of New South Wales, Sydney, New South Wales, Australia
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Zhang Y, Xue R, Zhou Y, Liu Y, Li Y, Zhang X, Zhang K. Construction and validation of a nomogram for predicting fear of falling related activity restrictions in community-dwelling older adults. Geriatr Nurs 2024; 55:286-296. [PMID: 38113708 DOI: 10.1016/j.gerinurse.2023.12.002] [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: 10/30/2023] [Revised: 12/02/2023] [Accepted: 12/05/2023] [Indexed: 12/21/2023]
Abstract
Fear of falling related activity restrictions are widespread among older adults, leading to several adverse effects. Given these consequences, there is an urgent need for a comprehensive assessment tool that integrates various risk factors to predict the likelihood of older adults experiencing such activity restrictions. This cross-sectional study investigated fear of falling related activity restrictions and its influencing factors, simultaneously constructed and validated a nomogram among older adults residing in the communities in China. The model includes variables like age, gender, self-rated health, past year injurious falls, gait stability, anxiety, and cognitive impairment. It showed an AUC of 0.892. Internal validation had an AUC of 0.893, and external validation had an AUC of 0.939. Calibration curve showed good fit, and decision curve showed high clinical benefits. It's an intuitive tool for medical professionals to identify older adults at high risk of activity restrictions due to fear of falling.
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Affiliation(s)
- Yuxin Zhang
- School of Nursing, Xuzhou Medical University, No.209 Tongshan Road, Yunlong District, Xuzhou City, Jiangsu Province, China
| | - Rong Xue
- School of Nursing, Xuzhou Medical University, No.209 Tongshan Road, Yunlong District, Xuzhou City, Jiangsu Province, China
| | - Yuxiu Zhou
- School of Nursing, Xuzhou Medical University, No.209 Tongshan Road, Yunlong District, Xuzhou City, Jiangsu Province, China
| | - Yu Liu
- School of Nursing, Xuzhou Medical University, No.209 Tongshan Road, Yunlong District, Xuzhou City, Jiangsu Province, China
| | - Yumeng Li
- School of Nursing, Xuzhou Medical University, No.209 Tongshan Road, Yunlong District, Xuzhou City, Jiangsu Province, China
| | - Xiaoyue Zhang
- Department of Nursing, Qingdao Municipal Hospital, Qingdao, China
| | - Kaili Zhang
- School of Nursing, Xuzhou Medical University, No.209 Tongshan Road, Yunlong District, Xuzhou City, Jiangsu Province, China.
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González Montaos A, Castaño Carou A, López Fernández MD, Barreiro Casal L, Villanueva Otero C, Gayoso Diz P. [Validation of the short FES-I scale in Spanish population over 70 years]. Rev Esp Geriatr Gerontol 2024; 59:101436. [PMID: 37992483 DOI: 10.1016/j.regg.2023.101436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 07/15/2023] [Accepted: 10/25/2023] [Indexed: 11/24/2023]
Abstract
INTRODUCTION Falls deteriorate the quality of life of the elderly and the fear of falling has been shown to be an independent risk factor for frailty, so having tools for its evaluation is a priority. The short FES-I scale, short version (7 items) of the FES-I scale (16 items), assesses fear of falling. The objective of this study is to validate the short FES-I scale in the Spanish population over 70 years and to analyze the relationship between fear of falling, risk of falls and frailty. MATERIAL AND METHODS Cross-sectional observational study. SAMPLE 227 subjects (50.7% male; mean age 75.8 years). SETTING northern Spain. VARIABLES sociodemographic, clinical, short physical performance battery (SPPB) and timed up and go test (TUG) execution tests, FES-I and short FES-I. Analysis of psychometric properties: validity and reliability. RESULTS The short FES-I scale shows excellent internal consistency (Cronbach's alpha = 0.90, intraclass correlation coefficient = 0.89) and test-retest reliability (rho Spearman = 0.76). It has a high concomitant criterion validity analyzed by its correlation with FES-I (rho Spearman = 0.90). The discriminant construct validity has been confirmed for both SPPB and TUG. Short FES-I presents good capacity for frailty classification (defined by SPPB) with AUC = 0.715. As a cut-off point, a short FES-I value > 8 is proposed for moderate/high fear of falling. CONCLUSIONS The short FES-I scale is a good instrument to study fear of falling in the Spanish population over 70 years and is valid for clinical and research use.
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Affiliation(s)
| | - Ana Castaño Carou
- Centro de Saúde de Bertamiráns-Ames, Xerencia de Xestión Integrada de Santiago de Compostela, A Coruña, España
| | - M Dolores López Fernández
- Centro de Saúde de Santa Comba, Xerencia de Xestión Integrada de Santiago de Compostela, A Coruña, España
| | - Lucía Barreiro Casal
- Centro de Saúde de Vite-Santiago de Compostela, Xerencia de Xestión Integrada de Santiago de Compostela, A Coruña, España
| | | | - Pilar Gayoso Diz
- Subdirección General, Instituto de Salud Carlos III, Madrid, España
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Kim T, Yu X, Xiong S. A multifactorial fall risk assessment system for older people utilizing a low-cost, markerless Microsoft Kinect. ERGONOMICS 2024; 67:50-68. [PMID: 37079340 DOI: 10.1080/00140139.2023.2202845] [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: 11/10/2022] [Accepted: 03/29/2023] [Indexed: 05/03/2023]
Abstract
Falls among older people are a major health concern. This study aims to develop a multifactorial fall risk assessment system for older people using a low-cost, markerless Microsoft Kinect. A Kinect-based test battery was designed to comprehensively assess major fall risk factors. A follow-up experiment was conducted with 102 older participants to assess their fall risks. Participants were divided into high and low fall risk groups based on their prospective falls over a 6-month period. Results showed that the high fall risk group performed significantly worse on the Kinect-based test battery. The developed random forest classification model achieved an average classification accuracy of 84.7%. In addition, the individual's performance was computed as the percentile value of a normative database to visualise deficiencies and targets for intervention. These findings indicate that the developed system can not only screen out 'at risk' older individuals with good accuracy, but also identify potential fall risk factors for effective fall intervention.Practitioner summary: Falls are the leading cause of injuries in older people. We newly developed a multifactorial fall risk assessment system for older people utilising a low-cost, markerless Kinect. Results showed that the developed system can screen out 'at risk' individuals and identify potential risk factors for effective fall intervention.
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Affiliation(s)
- Taekyoung Kim
- Human Factors and Ergonomics Laboratory, Department of Industrial and Systems Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejoen, Republic of Korea
- KT R&D Center, Seoul, Republic of Korea
| | - Xiaoqun Yu
- Human Factors and Ergonomics Laboratory, Department of Industrial and Systems Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejoen, Republic of Korea
| | - Shuping Xiong
- Human Factors and Ergonomics Laboratory, Department of Industrial and Systems Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejoen, Republic of Korea
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Iriarte E, Araya AX. Walking to Prevent Fear of Falling Among Community-Dwelling Older Adults: A Scoping Review. J Gerontol Nurs 2024; 50:15-21. [PMID: 38170459 DOI: 10.3928/00989134-20231211-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
The current review sought to identify and synthesize the evidence on available interventions that include walking and their impact on fear of falling (FOF) among community-dwelling older adults without cognitive impairment. A 10-year search was conducted (January 2012 to January 2022) in two peer-reviewed databases. A total of 116 articles were identified, and 22 articles were reviewed. Most studies included multicomponent walking interventions, such as walking and another type of intervention or exercise. Among the different questionnaires to assess FOF, the Falls Efficacy Scale-International was the most used in 77.3% (n = 17) of studies. In addition to walking, interventions to reduce FOF mainly included balance training, lower extremity strengthening, cardio or aerobic exercises, or a combination of these exercises. Further research is needed to evaluate the impact of unidimensional walking interventions, as well as those that incorporate psychological and technological elements targeted to FOF prevention and management. [Journal of Gerontological Nursing, 50(1), 15-21.].
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11
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Fernandes VDO, Moreira BDS, de Melo GASC, de Avelar NCP, Costa HS, Bastone ADC. Factors associated with fear of falling in older women with knee osteoarthritis: A cross-sectional study. Geriatr Nurs 2024; 55:333-338. [PMID: 38154414 DOI: 10.1016/j.gerinurse.2023.12.018] [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: 08/24/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 12/30/2023]
Abstract
Knee instability in patients with knee osteoarthritis (KOA) is associated with fear of falling (FoF). This study aimed to investigate the prevalence and the factors associated with FoF in older women with KOA. A cross-sectional study was conducted with 93 older women with KOA. Sociodemographic variables, medical conditions, handgrip strength, and anthropometric and body composition measurements were assessed. The Short Physical Performance Battery was used to measure functional performance. The Western Ontario and McMaster Universities Osteoarthritis Index was applied to assess pain, stiffness, and disability. FoF was assessed by the Falls Efficacy Scale-International. The prevalence of FoF was high (88.2 %). Disability, history of falls, handgrip strength, obesity, number of medications, and pain were independently associated with FoF. Our findings suggest that health professionals should investigate FoF when evaluating older women with KOA and address these risk factors when developing strategies to prevent or minimize FoF in this population.
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Affiliation(s)
- Vanessa de Oliveira Fernandes
- Department of Physical Therapy, Postgraduate Program in Rehabilitation and Functional Performance - Universidade Federal dos Vales do Jequitinhonha e Mucuri/UFVJM, Campus JK, Rodovia MGT 367, Km 583, Nº 5000, Bairro Alto da Jacuba, Diamantina, MG CEP 39100-000, Brazil
| | - Bruno de Souza Moreira
- Center for Studies in Public Health and Aging, Federal University of Minas Gerais, Av. Prof. Alfredo Balena, Nº 190 - Santa Efigênia, Belo Horizonte, MG 30130-100, Brazil
| | - Gisele Aparecida Santos Correia de Melo
- Department of Physical Therapy, Postgraduate Program in Rehabilitation and Functional Performance - Universidade Federal dos Vales do Jequitinhonha e Mucuri/UFVJM, Campus JK, Rodovia MGT 367, Km 583, Nº 5000, Bairro Alto da Jacuba, Diamantina, MG CEP 39100-000, Brazil
| | - Núbia Carelli Pereira de Avelar
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina, Campus Araranguá, Rod. Governador Jorge Lacerda, Araranguá, SC 88040-900, Brazil
| | - Henrique Silveira Costa
- Department of Physical Therapy, Postgraduate Program in Rehabilitation and Functional Performance - Universidade Federal dos Vales do Jequitinhonha e Mucuri/UFVJM, Campus JK, Rodovia MGT 367, Km 583, Nº 5000, Bairro Alto da Jacuba, Diamantina, MG CEP 39100-000, Brazil
| | - Alessandra de Carvalho Bastone
- Department of Physical Therapy, Postgraduate Program in Rehabilitation and Functional Performance - Universidade Federal dos Vales do Jequitinhonha e Mucuri/UFVJM, Campus JK, Rodovia MGT 367, Km 583, Nº 5000, Bairro Alto da Jacuba, Diamantina, MG CEP 39100-000, Brazil.
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Lenouvel E, Ullrich P, Siemens W, Dallmeier D, Denkinger M, Kienle G, Zijlstra GAR, Hauer K, Klöppel S. Cognitive behavioural therapy (CBT) with and without exercise to reduce fear of falling in older people living in the community. Cochrane Database Syst Rev 2023; 11:CD014666. [PMID: 37965937 PMCID: PMC10646947 DOI: 10.1002/14651858.cd014666.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
BACKGROUND Fear of falling (FoF) is a lasting concern about falling that leads to an individual avoiding activities that he/she remains capable of performing. It is a common condition amongst older adults and may occur independently of previous falls. Cognitive behavioural therapy (CBT), a talking therapy that helps change dysfunctional thoughts and behaviour, with and without exercise, may reduce FoF, for example, by reducing catastrophic thoughts related to falls, and modifying dysfunctional behaviour. OBJECTIVES To assess the benefits and harms of CBT for reducing FoF in older people living in the community, and to assess the effects of interventions where CBT is used in combination with exercise. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 1, 2023), MEDLINE Ovid (from 1946 to 11 January 2023), Embase Ovid (from 1980 to 11 January 2023), CINAHL Plus (Cumulative Index to Nursing and Allied Health Literature) (from 1982 to 11 January 2023), PsycINFO (from 1967 to 11 January 2023), and AMED (Allied and Complementary Medicine from 1985 to 11 January 2023). We handsearched reference lists and consulted experts for identifying additional studies. SELECTION CRITERIA This review included randomised controlled trials (RCTs), quasi-RCTs, and cluster-RCTs assessing CBT with and without exercise interventions compared to control groups with sham-treatment, or treatment as usual. We defined CBT as a collaborative, time-limited, goal-oriented, and structured form of speaking therapy. Included studies recruited community-dwelling older adults, with a mean population age of at least 60 years minus one standard deviation, and not defined by a specific medical condition. DATA COLLECTION AND ANALYSIS Two review authors used standard methodological procedures expected by Cochrane. For continuous data, as assessed by single- or multiple-item questionnaires, we report the mean difference (MD) with 95% confidence interval (CI) when studies used the same outcome measures, and standardised mean difference (SMD) when studies used different measures for the same clinical outcome. For dichotomous outcomes, we reported the treatment effects as risk ratios (RR) with 95% CIs. We measured the primary outcome, FoF, immediately, up to, and more than six months after the intervention. We analysed secondary outcomes of activity avoidance, occurrence of falls, depression, and quality of life when measured immediately after the intervention. We assessed risk of bias for each included study, using the GRADE approach to assess the certainty of evidence. MAIN RESULTS We selected 12 studies for this review, with 11 studies included for quantitative synthesis. One study could not be included due to missing information. Of the 11 individual studies, two studies provided two comparisons, which resulted in 13 comparisons. Eight studies were RCTs, and four studies were cluster-RCTs. Two studies had multiple arms (CBT only and CBT with exercise) that fulfilled the inclusion criteria. The primary aim of 10 studies was to reduce FoF. The 11 included studies for quantitative synthesis involved 2357 participants, with mean ages between 73 and 83 years. Study total sample sizes varied from 42 to 540 participants. Of the 13 comparisons, three investigated CBT-only interventions while 10 investigated CBT with exercise. Intervention duration varied between six and 156 hours, at a frequency between three times a week and monthly over an eight- to 48-week period. Most interventions were delivered in groups of between five and 10 participants, and, in one study, up to 25 participants. Included studies had considerable heterogeneity, used different questionnaires, and had high risks of bias. CBT interventions with and without exercise probably improve FoF immediately after the intervention (SMD -0.23, 95% CI -0.36 to -0.11; 11 studies, 2357 participants; moderate-certainty evidence). The sensitivity analyses did not change the intervention effect significantly. Effects of CBT with or without exercise on FoF may be sustained up to six months after the intervention (SMD -0.24, 95% CI -0.41 to -0.07; 8 studies, 1784 participants; very low-certainty evidence). CBT with or without exercise interventions for FoF probably sustains improvements beyond six months (SMD -0.28, 95% CI -0.40 to -0.15; 5 studies, 1185 participants; moderate-certainty of evidence). CBT interventions for reducing FoF may reduce activity avoidance (MD -2.57, 95% CI -4.67 to -0.47; 1 study, 312 participants; low-certainty evidence), and level of depression (SMD -0.41, 95% CI -0.60 to -0.21; 2 studies, 404 participants; low-certainty evidence). We are uncertain whether CBT interventions reduce the occurrence of falls (RR 0.96, 95% CI 0.66 to 1.39; 5 studies, 1119 participants; very low-certainty evidence). All studies had a serious risk of bias, due to performance bias, and at least an unclear risk of detection bias, as participants and assessors could not be blinded due to the nature of the intervention. Downgrading of certainty of evidence also occurred due to heterogeneity between studies, and imprecision, owing to limited sample size of some studies. There was no reporting bias suspected for any article. No studies reported adverse effects due to their interventions. AUTHORS' CONCLUSIONS CBT with and without exercise interventions probably reduces FoF in older people living in the community immediately after the intervention (moderate-certainty evidence). The improvements may be sustained during the period up to six months after intervention (low-certainty evidence), and probably are sustained beyond six months (moderate-certainty evidence). Further studies are needed to improve the certainty of evidence for sustainability of FoF effects up to six months. Of the secondary outcomes, we are uncertain whether CBT interventions for FoF reduce the occurrence of falls (very low-certainty evidence). However, CBT interventions for reducing FoF may reduce the level of activity avoidance, and may reduce depression (low-certainty evidence). No studies reported adverse effects. Future studies could investigate different populations (e.g. nursing home residents or people with comorbidities), intervention characteristics (e.g. duration), or comparisons (e.g. CBT versus exercise), investigate adverse effects of the interventions, and add outcomes (e.g. gait analysis). Future systematic reviews could search specifically for secondary outcomes.
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Affiliation(s)
- Eric Lenouvel
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern (UPD), Bern, Switzerland
- Graduate School for Health Science, University of Bern, Bern, Switzerland
| | - Phoebe Ullrich
- Geriatrisches Zentrum am Universitätsklinikum Heidelberg, AGAPLESION Bethanien Krankenhaus, Heidelberg, Germany
- Department of Thoracic Oncology, Thoraxklinik Heidelberg, Heidelberg University Hospital, Translational Lung Research Center Heidelberg (TLRC-H), German Center for Lung Research (DZL), Röntgenstraße 1, D-69126, Heidelberg, Germany
| | - Waldemar Siemens
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Cochrane Germany, Cochrane Germany Foundation, Freiburg, Germany
| | - Dhayana Dallmeier
- AGAPLESION Bethesda Clinic Ulm, Research Unit on Ageing, Ulm, Germany
- Department of Epidemiology, Boston University School of Public Health, Boston, USA
| | - Michael Denkinger
- Institute for Geriatric Research, University of Ulm Medical Center, Ulm, Germany
- AGAPLESION Bethesda Clinic Ulm, Geriatric Centre Ulm/Alb-Donau, Ulm, Germany
| | - Gunver Kienle
- Department of Medicine II, Medical Center, University of Freiburg, Freiburg, Germany, Freiburg, Germany
| | - G A Rixt Zijlstra
- Care and Public Health Research Institute, Department of Health Services Research, Maastricht University, Maastricht, Netherlands
- Public Health Service Flevoland (GGD Flevoland), Department of Health Policy & Research, Lelystad, Netherlands, Netherlands
- Health Care and Social Work Division, Windesheim University of Applied Sciences, Almere The Netherlands, Netherlands
| | - Klaus Hauer
- Geriatrisches Zentrum am Universitätsklinikum Heidelberg, AGAPLESION Bethanien Krankenhaus, Heidelberg, Germany
- Robert Bosch Gesellschaft für Medizinische Forschung mbH, Stuttgart, Germany
| | - Stefan Klöppel
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern (UPD), Bern, Switzerland
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Kwak Y, Jang I. Exploring factors influencing health-related quality of life in adult females with injuries: a cross-sectional nationwide study. Front Public Health 2023; 11:1248583. [PMID: 37860800 PMCID: PMC10584303 DOI: 10.3389/fpubh.2023.1248583] [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: 06/27/2023] [Accepted: 09/20/2023] [Indexed: 10/21/2023] Open
Abstract
Objectives This study aimed to identify the types of injury experiences affecting adult females and the associations between injury experiences and health-related quality of life. Methods This study used a secondary analysis of cross-sectional data from the Korea National Health and Nutrition Examination Survey, which employed a stratified multistage probability sampling design to obtain nationally representative data. Health-related quality of life was measured with the EuroQol Five-Dimension and consisted of mobility, self-care, usual activity, pain/discomfort, and anxiety/depression. Results Among women aged 19-64, the prevalence of injury experience was 5.9%. Women's injury experience varied by age, subjective health perception, menstruation details, osteoporosis status, and osteoarthritis status. The following injury experience-related factors were significantly associated with health-related quality of life: self-care (odds ratio [OR] = 0.32, 95% confidence interval [CI]: 0.17-0.60), usual activity (OR = 0.43, 95% CI: 0.27-0.70), and pain/discomfort (OR = 0.56, 95% CI: 0.44-0.72). Conclusion Health-related quality of life among adult women was significantly associated with injury experience. The results of this study highlight risk factors for injury that are associated with aging, such as menopause, osteoporosis, and osteoarthritis. Accurate assessments of pain and discomfort, as well as daily activities, are essential for designing effective interventions for injured women. Tailored training and education can promote self-management and improve outcomes for recovery.
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Affiliation(s)
| | - Insil Jang
- Department of Nursing, Chung-Ang University, Seoul, Republic of Korea
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Sawa R, Doi T, Tsutsumimoto K, Nakakubo S, Kurita S, Kiuchi Y, Nishimoto K, Shimada H. Overlapping status of frailty and fear of falling: an elevated risk of incident disability in community-dwelling older adults. Aging Clin Exp Res 2023; 35:1937-1944. [PMID: 37337077 DOI: 10.1007/s40520-023-02474-z] [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: 03/04/2023] [Accepted: 06/11/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Although overlapping frailty and fear of falling (FoF) are likely to increase with population aging, the combined effect of frailty and FoF on incident disability is not yet well understood. AIMS The purpose of this study is to examine whether frailty combined with FoF increased the risk of incident disability in older adults. Our secondary purpose was to clarify the synergistic effect of frailty and FoF on incident disability. METHODS This is a prospective study. Participants were 9372 older adults (mean age 73.5 years). Frailty status was assessed using the Japanese Cardiovascular Health Study index, and FoF was measured using two closed questions. Incident disability was prospectively monitored by their long-term care insurance records. RESULTS During the follow-up period (mean duration 23.4 months), 487 (5.2%) participants developed disability. The proportion of incident disability linearly increased according to FoF level regardless of baseline frailty status. Frail participants with FoF had a higher risk of incident disability than those with frailty only or neither (adjusted hazard ratio [HR] 2.63, 95% confidence interval [CI] 1.95-3.54). Frailty in combination with excessive FoF further increased the risk of incident disability (adjusted HR 4.30, 95% CI 2.56-7.23) although no synergistic effect was observed (relative excessive risk due to interaction 1.69, 95% CI - 0.55, 3.93). CONCLUSION The overlapping status of frailty and FoF, especially excessive FoF, increases the risk of incident disability in older adults.
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Affiliation(s)
- Ryuichi Sawa
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, 3-2-12 Hongo Bunkyo-Ku, Tokyo, 113-0033, Japan.
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi, 474-8511, Japan.
| | - Takehiko Doi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi, 474-8511, Japan
| | - Kota Tsutsumimoto
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi, 474-8511, Japan
| | - Sho Nakakubo
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi, 474-8511, Japan
| | - Satoshi Kurita
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi, 474-8511, Japan
| | - Yuto Kiuchi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi, 474-8511, Japan
| | - Kazuhei Nishimoto
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi, 474-8511, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi, 474-8511, Japan
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Vo MTH, Thonglor R, Moncatar TJR, Han TDT, Tejativaddhana P, Nakamura K. Fear of falling and associated factors among older adults in Southeast Asia: a systematic review. Public Health 2023; 222:215-228. [PMID: 36229238 DOI: 10.1016/j.puhe.2022.08.012] [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: 03/05/2022] [Revised: 07/27/2022] [Accepted: 08/14/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVES The aim of this study was to provide a comprehensive overview of the prevalence, measurement scales, related factors and interventions for fear of falling (FOF) among older adults in Southeast Asia. STUDY DESIGN This was a systematic review. METHODS Published research studies on FOF among older adults were searched using the following databases: PubMed, Cochrane Library, Scopus, ASEAN Citation Index, Thai Journal Citation Index, Malaysian Journal Citation Report and Google Scholar. All observational and experimental studies investigating FOF among community-dwelling older adults in Southeast Asia were eligible. A narrative synthesis was used to describe the findings. The Joanna Briggs Institute checklist was used to assess the quality and risk of bias of the included studies. RESULTS A total of 15 observational studies and three experimental studies were included after screening 2112 titles and abstracts. These studies, published between 2011 and 2021, were conducted in Malaysia, Singapore, Thailand and Vietnam. The FOF prevalence ranged from 21.6% to 88.2%. The most commonly used FOF assessment tool was the Falls Efficacy Scale-International. Well-reported related factors of FOF were female sex, advanced age, balance impairment and fall history. All experimental studies utilising single- or multi-component interventions comprised an exercise approach. Limited studies have considered environmental factors. CONCLUSIONS Various related factors of FOF and the interventions implemented were revealed. Public health researchers and policymakers should consider the factors related to FOF in practical FOF intervention and prevention strategies. Further evidence on FOF issues is required to understand the multidimensional characteristics of FOF, specifically the environmental aspects of older adults in Southeast Asia.
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Affiliation(s)
- M T H Vo
- Department of Global Health Entrepreneurship, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; ASEAN Institute for Health Development, Mahidol University, 999 Salaya, Phutthamonthon, Nakhon Pathom 73170, Thailand
| | - R Thonglor
- Department of Global Health Entrepreneurship, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; Faculty of Public Health, Naresuan University, Phitsanulok 65000, Thailand
| | - T J R Moncatar
- College of Public Health, University of the Philippines Manila, Manila, Philippines
| | - T D T Han
- Faculty of Public Health, Hue University of Medicine and Pharmacy, Hue University, Hue 530000, Viet Nam
| | - P Tejativaddhana
- ASEAN Institute for Health Development, Mahidol University, 999 Salaya, Phutthamonthon, Nakhon Pathom 73170, Thailand
| | - K Nakamura
- Department of Global Health Entrepreneurship, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; WHO Collaborating Centre for Healthy Cities and Urban Policy Research, Tokyo, Japan.
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Wu S, Li G, Shi B, Ge H, He Q. The association between physical activity and fear of falling among community-dwelling older women in China: the mediating role of physical fitness. Front Public Health 2023; 11:1241668. [PMID: 37645705 PMCID: PMC10461811 DOI: 10.3389/fpubh.2023.1241668] [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: 06/17/2023] [Accepted: 07/24/2023] [Indexed: 08/31/2023] Open
Abstract
Background This study aimed to explore the association between physical activity (PA) and fear of falling (FOF) and to determine whether this relationship was mediated by physical fitness (PF) in community-dwelling older women. Methods For this cross-sectional study, a total of 1,108 older women were recruited. Moderate-to-vigorous physical activity (MVPA) and light physical activity (LPA) were objectively measured by accelerometers. Physical fitness indicators including body mass index (BMI), forced vital capacity, choice reaction time, grip strength, sit and reach, and five times sit-to-stand were measured. FOF was evaluated by the Chinese version of the activities-specific balance confidence scale. A stepwise linear regression model analysis was used for mediation analysis, and bootstrap analysis was used to verify the mediation effects. Result The Pearson correlation coefficient results suggested that MVPA was significantly and negatively correlated with FOF while LPA was not correlated with FOF. Logistic regression analysis suggested a significant association between MVPA, BMI, forced vital capacity, choice reaction time, sit and reach, grip strength, five times sit-to-stand, and FOF. The mediation analysis showed a negative relationship between MVPA and FOF. BMI completely mediated the relationship between MVPA and FOF while sit and reach, five times sit-to-stand, and forced vital capacity partially mediated the relationship between MVPA and FOF. Conclusion Accumulation of more daily MVPA was associated with reducing the odds of FOF in community-dwelling older women. PF indicators fully or partially mediate the relationship between MVPA and FOF. Therefore, more intervention efforts should focus on the promotion of MVPA to improve PF and thus reduce FOF among older women.
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Affiliation(s)
| | | | | | | | - Qiang He
- School of Physical Education, Shandong University, Jinan, China
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17
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Cuvelier C, Hars M, Zamorani-Bianchi MP, Herrmann FR, Wieczorkiewicz CD, Zekry D, Gold G, Trombetti A. Hypnosis to reduce fear of falling in hospitalized older adults: a feasibility randomized controlled trial. Pilot Feasibility Stud 2023; 9:139. [PMID: 37559112 PMCID: PMC10410891 DOI: 10.1186/s40814-023-01366-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 07/18/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Fear of falling is associated with numerous negative health outcomes in older adults and can limit the rehabilitation process. Hypnosis is now recognized as an effective treatment for a variety of conditions, especially anxiety and pain, which can be integrated safely with conventional medicine. The objective of this study was to assess the feasibility and acceptability of a hypnosis intervention in hospitalized older adults to reduce fear of falling. METHODS In this feasibility randomized controlled trial, 32 older patients, hospitalized in geriatric rehabilitation wards, were randomly allocated (1:1 ratio) to either an intervention group (hypnosis, 2 sessions, one per week, plus usual rehabilitation program) or a control group (usual rehabilitation program only). Clinical assessors and statistician were blinded to group allocation. Primary outcomes were recruitment rate, retention rate, and adherence to the intervention. Exploratory outcomes, analyzed according to the intention-to-treat principle, included impact of hypnosis on fear of falling (assessed by a new scale perform-FES), functional status, in-hospital falls, and length of hospital stay. RESULTS Recruitment rate was 1.3 patients per week. The recruitment of the population sample was achieved in 5.5 months. The retention rate did not differ significantly between groups and a good adherence to the hypnosis intervention was achieved (77% of patients received the full intervention). No adverse event related to the hypnosis intervention was observed. Regarding exploratory clinical outcomes, no differences were found between groups on any outcome. CONCLUSION Hypnosis is feasible and well accepted in a geriatric hospitalized population undergoing rehabilitation. Further pilot work should be conducted, with an increased number of hypnosis sessions, before conducting a full-scale trial to conclude whether, or not, hypnosis is effective to reduce fear of falling. TRIAL REGISTRATION NCT04726774.
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Affiliation(s)
- Clémence Cuvelier
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
| | - Mélany Hars
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Maria Pia Zamorani-Bianchi
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
| | - François R Herrmann
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Catherine Ducharne Wieczorkiewicz
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Dina Zekry
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Gabriel Gold
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
| | - Andrea Trombetti
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland.
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
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Thøgersen-Ntoumani C, Kritz M, Grunseit A, Chau J, Ahmadi M, Holtermann A, Koster A, Tudor-Locke C, Johnson N, Sherrington C, Paudel S, Maher C, Stamatakis E. Barriers and enablers of vigorous intermittent lifestyle physical activity (VILPA) in physically inactive adults: a focus group study. Int J Behav Nutr Phys Act 2023; 20:78. [PMID: 37403160 PMCID: PMC10321001 DOI: 10.1186/s12966-023-01480-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 06/20/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Vigorous Intermittent Lifestyle Physical Activity (VILPA) refers to brief bouts of vigorous intensity physical activity performed as part of daily living. VILPA has been proposed as a novel concept to expand physical activity options among the least active. As a nascent area of research, factors which impede or encourage VILPA in physically inactive adults are yet to be explored. Such information is pertinent in the design of future interventions. We examined the barriers and enablers of VILPA among physically inactive adults using the Capability, Opportunity, Motivation, Behavior (COM-B) model as a conceptual framework. METHODS We recruited a sample of self-identified physically inactive middle-aged and older adults (N = 78) based in Australia to take part in 19 online focus groups across three age groups: young-middle (age 35-44), middle (age 45-59) and old (age 60-76). We analyzed interviews using a critical realist approach to thematic analysis. Identified barriers and enablers were subsequently mapped onto the COM-B model components. RESULTS The data generated 6 barriers and 10 enablers of VILPA that corresponded to COM-B concepts. Barriers included physical limitations (physical capability), perceptions of aging, need for knowledge (psychological capability), environmental constraints (physical opportunity), perceptions of effort and energy, and fear (automatic motivation). Enablers included convenience, reframing physical activity as purposeful movement, use of prompts and reminders (physical opportunity), normalization of taking the active option, gamification (social opportunity), sense of achievement, health improvements, personally salient rewards (reflective motivation), identity fit, and changing from effortful deliberation to habitual action (automatic motivation). CONCLUSION The barriers and enablers of VILPA span capability, opportunity, and motivation beliefs. Promoting the time-efficient nature and simplicity of VILPA requiring no equipment or special gym sessions, the use of prompts and reminders at opportune times, and habit formation strategies could capitalize on the enablers. Addressing the suitability of the small bouts, the development of specific guidelines, addressing safety concerns, and explicating the potential benefits of, and opportunities to do, VILPA could ameliorate some of the barriers identified. Future VILPA interventions may require limited age customization, speaking to the potential for such interventions to be delivered at scale.
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Affiliation(s)
- C. Thøgersen-Ntoumani
- Danish Center for Motivation and Behavior Science (DRIVEN), Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - M. Kritz
- Curtin School of Population Health, Curtin University, Perth, Australia
| | - A. Grunseit
- School of Public Health, University of Technology Sydney, Sydney, Australia
| | - J. Chau
- Department of Health Sciences, Macquarie University, Sydney, Australia
| | - M. Ahmadi
- Mackenzie Wearables Research Hub, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - A. Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - A. Koster
- School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - C. Tudor-Locke
- College of Health and Human Services, University of North Carolina Charlotte, Charlotte, USA
| | - N. Johnson
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - C. Sherrington
- School of Public Health, University of Sydney, Sydney, Australia
| | - S. Paudel
- School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - C. Maher
- Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - E. Stamatakis
- Mackenzie Wearables Research Hub, Charles Perkins Centre, University of Sydney, Sydney, Australia
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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19
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Gadhvi C, Bean D, Rice D. A systematic review of fear of falling and related constructs after hip fracture: prevalence, measurement, associations with physical function, and interventions. BMC Geriatr 2023; 23:385. [PMID: 37353752 PMCID: PMC10288814 DOI: 10.1186/s12877-023-03855-9] [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: 09/15/2022] [Accepted: 02/28/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Hip fracture is a common and debilitating injury amongst older adults. Fear of falling (FoF) and related constructs (balance confidence and falls efficacy) may impede rehabilitation after hip fracture. An updated systematic review to synthesize existing literature on FoF after hip fracture is needed. This review focussed on four research questions: In the hip fracture population: (1) What is the prevalence of FoF?; (2) What FoF assessment tools are validated? (3) What is the relationship between FoF and physical function?; (4) What interventions are effective for reducing FoF? METHODS A systematic search was undertaken in EBSCO Health, Scopus and PsychINFO in January 2021 (and updated December 2022) for articles on FoF after hip fracture. Data in relation to each research question was extracted and analysed. The quality of the studies was appraised using the 'Risk of Bias Tool for Prevalence Studies', 'COSMIN Risk of Bias checklist for Patient-reported outcome measures', modified version of the 'Appraisal Tool for Cross-sectional studies', and the 'Cochrane Risk of Bias 2' tools for each research question, respectively. RESULTS 36 studies (37 articles) with 5099 participants were included (mean age 80.2 years and average 78% female). Prevalence rates for FoF after hip fracture ranged between 22.5% and 100%, and prevalence tended to decrease as time progressed post hip fracture. The 'Falls Efficacy Scale - International' (FES-I) and 'Fear of Falling Questionnaire - Revised' (FFQ-R) were found to be reliable, internally consistent, and valid tools in hip fracture patients. FoF after hip fracture was consistently associated with measures of physical function including balance, gait speed, composite physical performance measures and self-reported function. Ten of 14 intervention studies were considered high risk of bias. Exercise-based interventions with or without a psychological component were not effective in reducing FoF after hip fracture compared to a control condition. CONCLUSION FoF is prevalent after hip fracture and is consistently associated with poorer physical function. Only two instruments (FES-I and FFQ-R) have been validated for measuring FoF in the hip fracture population. However, there remains a need for larger, higher quality randomised controlled trials targeting FoF after hip fracture in order to guide clinical practice. TRIAL REGISTRATION PROSPERO registration: CRD42020221836.
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Affiliation(s)
- Chandini Gadhvi
- Health & Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
- Allied Health - Physiotherapy, Te Whatu Ora Health New Zealand - Te Toka Tumai, Auckland, New Zealand
| | - Debbie Bean
- Health & Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand.
- Department of Anaesthesiology & Perioperative Medicine, Te Whatu Ora Health New Zealand - Waitematā, Auckland, New Zealand.
| | - David Rice
- Health & Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
- Department of Anaesthesiology & Perioperative Medicine, Te Whatu Ora Health New Zealand - Waitematā, Auckland, New Zealand
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20
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You L, Guo L, Li N, Zhong J, Er Y, Zhao M. Association between multimorbidity and falls and fear of falling among older adults in eastern China: a cross-sectional study. Front Public Health 2023; 11:1146899. [PMID: 37275486 PMCID: PMC10234124 DOI: 10.3389/fpubh.2023.1146899] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/18/2023] [Indexed: 06/07/2023] Open
Abstract
Background Growing evidence has reported an association between multimorbidity and falls and fear of falling (FOF) in older adults, however, the results regarding this association from China are limited. Our study aimed to investigate the association between multimorbidity and falls and FOF in older adults in eastern China. Methods We conducted a cross-sectional study in Zhejiang Province, Eastern China, which recruited a provincial representative sample of adults aged ≥ 60 years. A structured questionnaire including demographic characteristics, chronic diseases, history of falls in the past 12 months, and FOF, was administered by all participants. The exposure variable was multimorbidity, which was defined as the presence of two or more chronic diseases and medical conditions in the same individual. The outcomes included a history of falls and FOF. Multivariate logistic regression was used to evaluate the association between multimorbidity and falls and FOF in older adults. Results In total of 7,774 participants were included in the analysis, among whom 3,898 (50.1%) were female, with a mean ± standard deviation age is 72.9 ± 8.4 years. Multimorbidity was associated with the increased risk of falling in older adults [adjusted odds ratio (OR), 1.99; 95% confidence interval (CI):1.55-2.36]. The ORs for having experienced single fall and repeated falls were 1.85 (95% CI: 1.42-2.42) and 3.45 (95% CI: 1.47-6.97), respectively, with multimorbidity compared with those without chronic diseases. The older adults with multimorbidity were more likely to report FOF compared with those without chronic diseases (adjusted OR, 1.49; 95%CI:1.30-1.70). Moreover, the association between multimorbidity and FOF remained significant in the older adults with a history of fall (OR, 1.57; 95%CI:1.04-2.38). Conclusion The association between multimorbidity and falls and FOF is significant in the Chinese population and the effects of multimorbidity on falls and FOF do not vary according to the frequency and history of falls in older adults.
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Affiliation(s)
- Liuqing You
- Zhejiang Provincial Center for Disease Control and Prevention, Zhejiang, China
| | - Lihua Guo
- Zhejiang Provincial Center for Disease Control and Prevention, Zhejiang, China
| | - Na Li
- Zhejiang Provincial Center for Disease Control and Prevention, Zhejiang, China
| | - Jieming Zhong
- Zhejiang Provincial Center for Disease Control and Prevention, Zhejiang, China
| | - Yuliang Er
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ming Zhao
- Zhejiang Provincial Center for Disease Control and Prevention, Zhejiang, China
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21
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Korenhof SSA, van Grieken AA, Franse CCB, Tan SSSS, Verma AA, Alhambra TT, Raat HH. The association of fear of falling and physical and mental Health-Related Quality of Life (HRQoL) among community-dwelling older persons; a cross-sectional study of Urban Health Centres Europe (UHCE). BMC Geriatr 2023; 23:291. [PMID: 37179319 PMCID: PMC10182691 DOI: 10.1186/s12877-023-04004-y] [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: 06/24/2022] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND The share of people over 80 years in the European Union is estimated to increase two-and-a-half-fold from 2000 to 2100. A substantial share of older persons experiences fear of falling. This fear is partly associated with a fall in the recent past. Because of the associations between fear of falling, avoiding physical activity, and the potential impact of those on health, an association between fear of falling and low health-related quality of life, is suggested. This study examined the association of fear of falling with physical and mental Health-Related Quality of Life (HRQoL) among community-dwelling older persons in five European countries. METHODS A cross-sectional study was conducted using baseline data of community-dwelling persons of 70 years and older participating in the Urban Health Centers Europe project in five European countries: United Kingdom, Greece, Croatia, the Netherlands and Spain. This study assessed fear of falling with the Short Falls Efficacy Scale-International and HRQoL with the 12-Item Short-Form Health Survey. The association between low, moderate or high fear of falling and HRQoL was examined using adjusted multivariable linear regression models. RESULTS Data of 2189 persons were analyzed (mean age 79.6 years; 60.6% females). Among the participants, 1096 (50.1%) experienced low fear of falling; 648 (29.6%) moderate fear of falling and 445 (20.3%) high fear of falling. Compared to those who reported low fear of falling in multivariate analysis, participants who reported moderate or high fear of falling experienced lower physical HRQoL (β = -6.10, P < 0.001 and β = -13.15, P < 0.001, respectively). In addition, participants who reported moderate or high fear of falling also experienced lower mental HRQoL than those who reported low fear of falling (β = -2.31, P < 0.001 and β = -8.80, P < 0.001, respectively). CONCLUSIONS This study observed a negative association between fear of falling and physical and mental HRQoL in a population of older European persons. These findings emphasize the relevance for health professionals to assess and address fear of falling. In addition, attention should be given to programs that promote physical activity, reduce fear of falling, and maintain or increase physical strength among older adults; this may contribute to physical and mental HRQoL.
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Affiliation(s)
- Sophie S A Korenhof
- Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - Amy A van Grieken
- Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - Carmen C B Franse
- Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - Siok Swan S S Tan
- Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands
- Inholland University of Applied Sciences, Rotterdam, the Netherlands
| | - Arpana A Verma
- Manchester Urban Collaboration On Health, Centre for Epidemiology, Division of Population Health, Health Services Research and Primary Care, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
| | - Tamara T Alhambra
- Polibienestar Research Institute, University of Valencia, Valencia, Spain
| | - Hein H Raat
- Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, the Netherlands.
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22
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Ferris J, Zwier J, Carender WJ, Sienko KH. Differences between physical therapist ratings, self-ratings, and posturographic measures when assessing static balance exercise intensity. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1096171. [PMID: 37250428 PMCID: PMC10213890 DOI: 10.3389/fresc.2023.1096171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 03/22/2023] [Indexed: 05/31/2023]
Abstract
Introduction In order for balance therapy to be successful, the training must occur at the appropriate dosage. However, physical therapist (PT) visual evaluation, the current standard of care for intensity assessment, is not always effective during telerehabilitation. Alternative balance exercise intensity assessment methods have not previously been compared to expert PT evaluations. The aim of this study was therefore to assess the relationship between PT participant ratings of standing balance exercise intensity and balance participant self-ratings or quantitative posturographic measures. Methods Ten balance participants with age or vestibular disorder-related balance concerns completed a total of 450 standing balance exercises (three trials each of 150 exercises) while wearing an inertial measurement unit on their lower back. They provided per-trial and per-exercise self-ratings of balance intensity on a scale from 1 (steady) to 5 (loss of balance). Eight PT participants reviewed video recordings and provided a total of 1,935 per-trial and 645 per-exercise balance intensity expert ratings. Results PT ratings were of good inter-rater reliability and significantly correlated with exercise difficulty, supporting the use of this intensity scale. Per-trial and per-exercise PT ratings were significantly correlated with both self-ratings (r = 0.77-0.79) and kinematic data (r = 0.35-0.74). However, the self-ratings were significantly lower than the PT ratings (difference of 0.314-0.385). Resulting predictions from self-ratings or kinematic data agreed with PT ratings approximately 43.0-52.4% of the time, and agreement was highest for ratings of a 5. Discussion These preliminary findings suggested that self-ratings best indicated two intensity levels (i.e., higher/lower) and sway kinematics were most reliable at intensity extremes.
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Affiliation(s)
- Jamie Ferris
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, United States
| | - Jonathan Zwier
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, United States
| | - Wendy J. Carender
- Michigan Balance Vestibular Testing and Rehabilitation, Department of Otolaryngology, Michigan Medicine, Ann Arbor, MI, United States
| | - Kathleen H. Sienko
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, United States
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Mejía ST, Su TT, Washington FC, Golinski S, Sosnoff JJ. Everyday Experiences of Physical Function and Awareness of Fall Risk in Older Adulthood. Innov Aging 2023; 7:igad037. [PMID: 37273259 PMCID: PMC10237285 DOI: 10.1093/geroni/igad037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Indexed: 06/06/2023] Open
Abstract
Background and Objectives Falls, the leading cause of death and disability among older adults, occur in daily life when the demands of daily activities surpass the ability to maintain balance. An estimated 30% of older adults misestimate their physical function, placing them at greater risk of falling. This study examined how experiences of physical function are linked to awareness of fall risk in daily life. Research Design and Methods For 30 consecutive days following a fall-risk assessment, 41 older adults (observations = 1,135; 56% women; age: 65-91) self-assessed objective and subjective fall risk using a custom smartphone application. Alignment of objective and subjective fall risk was indexed as awareness of fall risk. Postural sway was measured by the application. Physical and mobility symptoms and fear of falling were reported daily. Results At baseline, 49% of participants misestimated their fall risk. Awareness of fall risk varied from day to day and fall risk was misestimated on 40% of days. Multilevel multinomial models showed individual differences in the level of daily symptoms to increase the tendency to misestimate fall risk. Daily symptoms and fear of falling increased awareness of high fall risk, but daily symptoms threatened awareness of low fall risk. Discussion and Implications Findings suggest that misestimation of fall risk is common in older adulthood and informed by appraisals of physical function. Fall prevention strategies could support older adults in understanding their everyday physical function and provide tools to adjust the demands of activities in daily life.
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Affiliation(s)
- Shannon T Mejía
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois Urbana-Champaign, Champaign, Illinois, USA
| | - Tai-Te Su
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois Urbana-Champaign, Champaign, Illinois, USA
| | - Faith C Washington
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois Urbana-Champaign, Champaign, Illinois, USA
| | - Sean Golinski
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois Urbana-Champaign, Champaign, Illinois, USA
| | - Jacob J Sosnoff
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, School of Health Professions, Landon Center on Aging, University of Kansas Medical Center, Kansas City, Kansas, USA
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Espírito Santo J, Hita-Contreras F, Marques de Loureiro NE, Brandão Loureiro V, Aibar-Almazán A, Carcelén-Fraile MDC, Ortiz-Quesada R. Associations between the impact of menopausal symptoms and fall-related self-efficacy. Menopause 2023; 30:421-426. [PMID: 36727788 DOI: 10.1097/gme.0000000000002151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To analyze the association between the severity of menopausal symptoms and two important fall risk factors, namely balance confidence and fear of falling, among Portuguese and Spanish postmenopausal women 65 years or older. METHODS A cross-sectional, observational study was conducted on 363 women (66.21 ± 9.00 y) from several Portuguese and Spanish locations. The Menopause Rating Scale was used to evaluate the severity of menopausal symptoms, while the Falls Efficacy Scale-International and Activities-specific Balance Confidence Scale-16 items were used to assess balance confidence and fear of falling, respectively. Anxiety and depression (evaluated by the Hospital Anxiety and Depression Scale), age, time since the onset of menopause, body mass index, history of falls, osteoporosis, smoking habit, physical activity level, and nocturia were considered as potential confounders. Independent associations were analyzed after adjusting for potential confounding variables. Student's t test, bivariate correlations, and multivariate linear regression analysis were performed. RESULTS A total of 363 women (66.21 ± 9.00 y) participated in the study, 192 from Portugal and 171 from Spain. Linear regression analysis indicates that more severe menopausal symptoms at a somatovegetative level (beta coefficient [β] = -0.25; 95% confidence interval [95% CI], -2.09 to -0.81; P = <0.001), a higher body mass index (β = -0.16; 95% CI, -1.22 to -0.22; P = 0.005), and osteoporosis (β = 0.14; 95% CI, 1.36 to 10.08; P = 0.010) were associated with lower balance confidence values. On the other hand, a higher score in the Menopause Rating Scale somatovegetative domain (β = 0.22; 95% CI, 0.27-0.79; P = <0.001), depression (β = 0.36; 95% CI, 0.59-1.08; P = <0.001), and years after the menopause onset (β = 0.15; 95% CI, 0.04-0.22; P = 0.006) were linked to increased fear of falling. CONCLUSIONS The findings of our study show that, after taking into account possible confounders, increased severity of menopausal symptoms at a somatic level was associated with heightened fear of falling and diminished balance confidence.
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Affiliation(s)
| | - Fidel Hita-Contreras
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén. Jaén, Spain
| | | | | | - Agustín Aibar-Almazán
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén. Jaén, Spain
| | | | - Raúl Ortiz-Quesada
- Department of Anatomy and Embryology, Faculty of Medicine, University of Granada, Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
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Filipovič Hrast M, Sendi R, Kerbler B. Person-Environment Fit in Urban Neighbourhoods in Slovenia: Challenges and Coping Strategies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5139. [PMID: 36982047 PMCID: PMC10049062 DOI: 10.3390/ijerph20065139] [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: 02/01/2023] [Revised: 03/09/2023] [Accepted: 03/13/2023] [Indexed: 06/18/2023]
Abstract
A poor person-environment fit may bring various negative effects to older people's independence and physical and psychological well-being. The presented study is especially valuable as it explores the challenges of living in cities in a country located in central and eastern Europe; namely, a less researched area when it comes to the quality of life of older people dwelling in an urban environment. The research questions that were explored are (1) what environmental pressures have people identified in the urban environment in Slovenia; and (2) what strategies have they used to deal with them? The study is based on 22 interviews with older people and three focus groups, that were then analysed using a thematic analysis approach. The study results identify a number of environmental pressures, which were divided into structural housing pressures, structural neighbourhood pressures, and formal and informal pressures. The analysis shows important behavioural responses, such as strategies of using formal and informal help, moving away from environmental pressures, mobility, actively involved in changing the environment, as well as attitudinal adaptation strategies, such as acceptance, resilience, using distraction, modesty and planning for the future. We further emphasize how these coping strategies are linked to individual and community capabilities, which function as a conversion factor.
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Affiliation(s)
| | - Richard Sendi
- Urban Planning Institute of the Republic of Slovenia, 1000 Ljubljana, Slovenia
| | - Boštjan Kerbler
- Urban Planning Institute of the Republic of Slovenia, 1000 Ljubljana, Slovenia
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The association of subjective vision with objectively measured intensity-specific physical activity and bout-specific sedentary behavior among community-dwelling older adults in Japan. Jpn J Ophthalmol 2023; 67:164-174. [PMID: 36708419 DOI: 10.1007/s10384-023-00977-w] [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: 07/04/2022] [Accepted: 11/17/2022] [Indexed: 01/29/2023]
Abstract
PURPOSE Visual impairment is a possible cause of physical frailty. Reduced physical activity (PA) may be involved in the pathway from visual impairment to physical frailty, although the association between vision and objectively measured PA among older adults remains unclear. This study examined the sex-specific association of subjective vision with intensity-specific PA and bout-specific sedentary behavior (SB) among community-dwelling, older Japanese adults. STUDY DESIGN Cross-sectional study METHODS: This study used data from the Neuron to Environmental Impact across Generations study analyzing older adults (527 participants, aged 65-84 years) living in rural areas of Niigata Prefecture, Japan. Subjective vision was assessed by use of a questionnaire. Intensity-specific PA (light-intensity PA and moderate-to-vigorous PA [MVPA]), bout-specific SB, and daily step count were objectively evaluated by use of an accelerometer. The association of subjective vison with PA and SB, stratified by sex, was analyzed by means of general regression analyses, with adjustment for covariates. RESULTS The data of 512 participants (men: 46.9%; with poor subjective vision: 22.9%) were analyzed. Poor subjective vision was significantly associated with log MVPA (partial regression coefficient = -0.261, P = .013) and log steps (partial regression coefficient = -0.164; P = .021) among women, whereas a tendency of an association was observed with prolonged SB time among men (partial regression coefficient: 39.1; P = .073). CONCLUSION Older Japanese women with poor subjective vision performed less MVPA and had fewer step counts than those of participants with good subjective vision, and men with poor subjective vision had longer prolonged SB, which may all accelerate the process to physical frailty.
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Frailty, falls and poor functional mobility predict new onset of activity restriction due to concerns about falling in older adults: a prospective 12-month cohort study. Eur Geriatr Med 2023; 14:345-351. [PMID: 36739560 PMCID: PMC10113287 DOI: 10.1007/s41999-023-00749-2] [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: 08/11/2022] [Accepted: 01/23/2023] [Indexed: 02/06/2023]
Abstract
PURPOSE Concerns about falling are common in older adults and often cause activity restriction. This can lead to physical deconditioning, falls and social isolation. However, not every concerned older adult will restrict their activities. This 12-month longitudinal study investigated the physical and psychosocial factors that predict the new onset of activity restriction due to concerns about falling in older people. METHODS Participants were 543 older adults (Mage = 80.3 ± 4.4 years, range: 75-98) who did not report activity restriction due to concerns about falling at Timepoint-1 (negative response to the following question: "Do concerns about falling stop you going out-and-about?"). Participants completed a battery of physical and psychological assessments at Timepoint-1. Using binary logistic regression, we then assessed which of these variables predicted whether participants reported having started restricting their activity due to concerns about falling at the 12-month follow-up (Timepoint 2). RESULTS 10.1% of the sample started to restrict activity due to concerns about falling at Timepoint 2. Three key predictors significantly predicted activity restriction group status at 12-month follow-up: greater frailty at Timepoint-1 (Fried Frailty Index; OR = 1.58, 95% CI 1.09-2.30), experiencing a fall between Timepoint-1 and 2 (OR = 2.22, 95% CI 1.13-4.38) and poorer functional mobility at Timepoint-1 (Timed up and Go; OR = 1.08, 95% CI 1.01-1.15). CONCLUSIONS Frailty, experiencing a fall and poorer functional mobility all predicted the onset of activity restriction due to concerns about falling. Clinicians working in balance and falls-prevention services should regularly screen for frailty, and patients referred to frailty services should likewise receive tailored treatment to help prevent the development of activity restriction due to concerns about falling.
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dos Santos EPR, Ohara DG, Patrizzi LJ, de Walsh IAP, Silva CDFR, da Silva Neto JR, Oliveira NGN, Matos AP, Iosimuta NCR, Pinto ACPN, Pegorari MS. Investigating Factors Associated with Fear of Falling in Community-Dwelling Older Adults through Structural Equation Modeling Analysis: A Cross-Sectional Study. J Clin Med 2023; 12:545. [PMID: 36675475 PMCID: PMC9867366 DOI: 10.3390/jcm12020545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 01/12/2023] Open
Abstract
The scientific literature mentions the existence of factors associated with fear of falling in older adults. However, the direct and indirect paths of its predictors have not yet been fully explored. This study aimed to analyze the socioeconomic, clinical, and health factors directly and indirectly associated with fear of falling in community-dwelling older adults. This is a cross-sectional study conducted in older adults (n = 410 - 70.11 ± 7.22 years). Clinical and health-condition data were collected, as were data on fear of falling using the Falls Efficacy Scale International-Brazil (FES-I Brazil). It was found that being female and having a higher number of self-reported morbidities, worse physical performance, and a higher number of depressive symptoms were directly associated with greater fear of falling. Regarding indirect associations, physical inactivity, mediated by a greater number of morbidities, worse physical performance, and a greater number of depressive symptoms, was associated with greater fear of falling. In addition, worse self-rated health, mediated by a greater number of depressive symptoms, as well as older age, mediated by worse physical performance, were associated with the outcome. This study provides information on the predictors directly and indirectly associated with fear of falling, expanding current understanding of this relationship.
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Affiliation(s)
- Elane Priscila Rosa dos Santos
- Department of Biological and Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá 68903-419, Brazil
| | - Daniela Gonçalves Ohara
- Department of Applied Physiotherapy, Federal University of Triângulo Mineiro, Boulevard Frei Paulino, no 30, Abadia, Uberaba 38025-180, Brazil
| | - Lislei Jorge Patrizzi
- Department of Applied Physiotherapy, Federal University of Triângulo Mineiro, Boulevard Frei Paulino, no 30, Abadia, Uberaba 38025-180, Brazil
- Postgraduate Program in Physical Therapy, Federal University of Triângulo Mineiro, Boulevard Frei Paulino, no30, Abadia, Uberaba 38025-180, Brazil
| | - Isabel Aparecida Porcatti de Walsh
- Department of Applied Physiotherapy, Federal University of Triângulo Mineiro, Boulevard Frei Paulino, no 30, Abadia, Uberaba 38025-180, Brazil
- Postgraduate Program in Physical Therapy, Federal University of Triângulo Mineiro, Boulevard Frei Paulino, no30, Abadia, Uberaba 38025-180, Brazil
| | - Caroline de Fátima Ribeiro Silva
- Department of Biological and Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá 68903-419, Brazil
| | - José Ribeiro da Silva Neto
- Postgraduate Program in Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km–02, Jardim Marco Zero, Macapá 68903-419, Brazil
| | - Nayara Gomes Nunes Oliveira
- Department of Nursing in Education and Community Health, Federal University of Triângulo Mineiro, Boulevard Frei Paulino, no 30, Abadia, Uberaba 38025-180, Brazil
| | - Areolino Pena Matos
- Department of Biological and Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá 68903-419, Brazil
- Postgraduate Program in Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km–02, Jardim Marco Zero, Macapá 68903-419, Brazil
| | - Natalia Camargo Rodrigues Iosimuta
- Department of Biological and Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá 68903-419, Brazil
- Postgraduate Program in Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km–02, Jardim Marco Zero, Macapá 68903-419, Brazil
| | - Ana Carolina Pereira Nunes Pinto
- Department of Biological and Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá 68903-419, Brazil
| | - Maycon Sousa Pegorari
- Department of Applied Physiotherapy, Federal University of Triângulo Mineiro, Boulevard Frei Paulino, no 30, Abadia, Uberaba 38025-180, Brazil
- Postgraduate Program in Physical Therapy, Federal University of Triângulo Mineiro, Boulevard Frei Paulino, no30, Abadia, Uberaba 38025-180, Brazil
- Postgraduate Program in Health Sciences, Federal University of Amapá, Road Juscelino Kubitschek, Km–02, Jardim Marco Zero, Macapá 68903-419, Brazil
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Auais M, Angermann H, Grubb M, Thomas C, Feng C, Chu CH. The effectiveness and cost-effectiveness of clinical fracture-risk assessment tools in reducing future osteoporotic fractures among older adults: a structured scoping review. Osteoporos Int 2023; 34:823-840. [PMID: 36598523 DOI: 10.1007/s00198-022-06659-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 12/20/2022] [Indexed: 01/05/2023]
Abstract
UNLABELLED This scoping review described the use, effectiveness, and cost-effectiveness of clinical fracture-risk assessment tools to prevent future osteoporotic fractures among older adults. Results show that the screening was not superior in preventing all osteoporosis-related fractures to usual care. However, it positively influenced participants' perspectives on osteoporosis, may have reduced hip fractures, and seemed cost-effective. PURPOSE We aim to provide a synopsis of the evidence about the use of clinical fracture-risk assessment tools to influence health outcomes, including reducing future osteoporotic fractures and their cost-effectiveness. METHODS We followed the guidelines of Arksey and O'Malley and their modifications. A comprehensive search strategy was created to search CINAHL, Medline, and Embase databases until June 29, 2021, with no restrictions. We critically appraised the quality of all included studies. RESULTS Fourteen studies were included in the review after screening 2484 titles and 68 full-text articles. Four randomized controlled trials investigated the effectiveness of clinical fracture-risk assessment tools in reducing all fractures among older women. Using those assessment tools did not show a statistically significant reduction in osteoporotic fracture risk compared to usual care; however, additional analyses of two of these trials showed a trend toward reducing hip fractures, and the results might be clinically significant. Four studies tested the impact of screening programs on other health outcomes, and participants reported positive results. Eight simulation studies estimated the cost-effectiveness of using these tools to screen for fractures, with the majority showing significant potential savings. CONCLUSION According to the available evidence to date, using clinical fracture-risk assessment screening tools was not more effective than usual care in preventing all osteoporosis-related fractures. However, using those screening tools positively influenced women's perspectives on osteoporosis, may have reduced hip fracture risk, and could potentially be cost-effective. This is a relatively new research area where additional studies are needed.
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Affiliation(s)
- Mohammad Auais
- School of Rehabilitation Therapy, Queen's University, Louise Acton Building, 31 George St., Kingston, ON, K7L 3N6, Canada.
| | - Hannah Angermann
- School of Rehabilitation Therapy, Queen's University, Louise Acton Building, 31 George St., Kingston, ON, K7L 3N6, Canada
| | - Megan Grubb
- School of Rehabilitation Therapy, Queen's University, Louise Acton Building, 31 George St., Kingston, ON, K7L 3N6, Canada
| | - Christine Thomas
- School of Rehabilitation Therapy, Queen's University, Louise Acton Building, 31 George St., Kingston, ON, K7L 3N6, Canada
| | - Chengying Feng
- School of Rehabilitation Therapy, Queen's University, Louise Acton Building, 31 George St., Kingston, ON, K7L 3N6, Canada
| | - Charlene H Chu
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
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Klima D, Austin N, Avila K, Savoy A, Rhoten N, Wehland E, Weimert J, Wolfe J. Student coaching in a rural community fall prevention program: An exploratory study. GERONTOLOGY & GERIATRICS EDUCATION 2023; 44:88-101. [PMID: 35848602 DOI: 10.1080/02701960.2022.2098285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Falls are a significant cause of disability internationally. The purpose of this exploratory study was to examine the effectiveness of a community fall prevention program, Stepping On (SO), using nine student physical therapists and program faculty in a rural setting. A mixed-methods design was utilized. Students partnered with older adults to master exercises, demonstrate floor recovery techniques, and manage community navigation in line with program fidelity. A descriptive survey assessed program outcomes. Students participated in a follow-up focus group to discuss perspectives on their role in the program. One hundred and seventeen community-dwelling older adults (mean age: 75.2 ± 8.5) completed the program. Participants who lived alone were likely to limit their activities because of fear of falling (p = .045). Following SO most subjects (87.7%) described having a better understanding of falls and their causes, with a plan to arise from the floor (82.6%). Focus group themes underscored students' opportunity to facilitate, reinforce safety during mobility activities, and motivate participants. Furthermore, an increased awareness of other professions' contribution to fall prevention was noted. Following a community fall prevention program, older adults have a better understanding of fall prevention and plan for floor recovery. In turn, student coaching skills are reinforced.
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Affiliation(s)
- Dennis Klima
- Department of Physical Therapy, University of Maryland Hazel Hall, Maryland, USA
| | - Nathan Austin
- Department of Physical Therapy, University of Maryland Hazel Hall, Maryland, USA
| | - Katherine Avila
- Department of Physical Therapy, University of Maryland Hazel Hall, Maryland, USA
| | - Aspen Savoy
- Department of Physical Therapy, University of Maryland Hazel Hall, Maryland, USA
| | - Nicholas Rhoten
- Department of Physical Therapy, University of Maryland Hazel Hall, Maryland, USA
| | - Emily Wehland
- Department of Physical Therapy, University of Maryland Hazel Hall, Maryland, USA
| | - Jessica Weimert
- Department of Physical Therapy, University of Maryland Hazel Hall, Maryland, USA
| | - Jesstine Wolfe
- Department of Physical Therapy, University of Maryland Hazel Hall, Maryland, USA
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Kim KI, Im SC, Kim K. Effects of trunk stabilization exercises using laser pointer visual feedback in patients with chronic stroke: A randomized controlled study. Technol Health Care 2023; 31:471-483. [PMID: 36120797 DOI: 10.3233/thc-220100] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Many previous studies have cited the importance of trunk stabilization exercises in patients with stroke. However, the evidence for optimal trunk stabilization exercises for patients with stroke is still lacking. OBJECTIVE To investigate the effects of laser pointer visual feedback in trunk stabilization exercises that are important for improving trunk dysfunction in patients with stroke. METHODS In total, 30 patients with chronic stroke were randomly assigned to experimental and control groups. The experimental group underwent a traditional stroke rehabilitation program and trunk stabilization exercises using laser pointer visual feedback. The control group underwent a traditional stroke rehabilitation program and trunk stabilization exercises without visual feedback. Pre- and postintervention results after 6 weeks were evaluated using the Berg Balance Scale, static and dynamic plantar pressure, 10-m walk test, and the Korean version of the Fall Efficacy Scale. The results were analyzed using a general linear repeated measurement model. RESULTS Both groups showed significant improvements in BBS scores, static plantar pressure, dynamic plantar pressure, 10 MWT, and K-FES scores after 6 weeks of intervention (P< 0.05). Compared to the control group, significant improvements were observed in the experimental group in the Berg Balance Scale scores, dynamic paretic posterior plantar pressure, 10-m walk test, and Korean version of the Fall Efficacy Scale scores (P< 0.025). CONCLUSION Our results demonstrated the effectiveness of visual feedback during trunk stabilization exercises for resolving trunk dysfunction in patients with stroke. Trunk stabilization exercises using laser pointer visual feedback have been found to be more effective in balance, walking, and fall efficacy in patients with stroke.
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Baltes M, Herber OR, Meyer G, Stephan A. Fear of falling from the perspective of affected persons-A systematic review and qualitative meta-summary using Sandelowski and Barroso's method. Int J Older People Nurs 2023; 18:e12520. [PMID: 36443646 DOI: 10.1111/opn.12520] [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: 09/12/2021] [Revised: 09/28/2022] [Accepted: 10/29/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Fear of falling (FoF) affects a large number of older people, whether they have a history of falls or not. This has an impact on their lives. FoF is a potentially modifiable factor, which has been identified as one of the most important threats to older people's autonomy. OBJECTIVES To gain a comprehensive understanding of the phenomenon, we conducted a systematic review and meta-summary. The available evidence from qualitative research exploring how people experience FoF and how FoF affects daily living was aggregated. METHODS We followed the approach by Sandelowski and Barroso (2007) as a method to aggregate knowledge based on an exhaustive literature search. We searched the databases CINAHL, MEDLINE, PsycINFO and SSCI systematically for relevant articles as well as grey literature until September 2020. Out of the included studies, findings were extracted, edited, grouped and abstracted into meta-findings. Finally, the manifest frequency effect size of each abstracted meta-finding was calculated. RESULTS Out of 2978 identified studies, 15 met our inclusion criteria, which were published between 1993 and 2017 and included a total of 276 participants. We extracted 578 findings, and the abstraction process resulted in 183 meta-findings. We identified three main topics: 'Triggers and reasons for FoF identified by affected people', 'Consequences attributed to FoF' and 'Strategies to manage FoF in daily life'. CONCLUSION Our findings demonstrate that FoF has a far-reaching impact on the lives of those affected. With the aggregation of the existing qualitative data with the application of the frequency effect size, we were able to identify three areas of particular importance to those affected: (1) controlling the risk, (2) creating a safe environment and (3) staying independent. Implications for practice these three areas of particular importance to those affected should be taken into account when revisiting or creating new interventions to prevent or reduce FoF.
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Affiliation(s)
- Marion Baltes
- Institute for Health and Nursing Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.,Uniklinik RWTH Aachen, Aachen, Germany
| | - Oliver Rudolf Herber
- School of Nursing Science, Faculty of Health, Witten/Herdecke University, Witten, Germany.,Institute of General Practice (ifam), Centre for Health and Society (chs), Medical Faculty of the Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Gabriele Meyer
- Institute for Health and Nursing Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Astrid Stephan
- Institute for Health and Nursing Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.,Uniklinik RWTH Aachen, Aachen, Germany
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Abstract
OBJECTIVE Determine whether race predicts fear of falling (FOF) in older adults with a history of previous fall(s) while controlling for mobility performance, activity of daily living (ADL) independence, age, gender, and education. METHODS We examined predictors of FOF among community-dwelling older adults using data from two longitudinal randomized controlled trials that implemented fall prevention programs for community-dwelling older adults. RESULTS Two hundred fifty-nine participants were included in the analysis; 145 reported low FOF, while 59 reported high FOF. After controlling for mobility performance, ADL independence, and sociodemographic factors, Black older adults were more likely to report FOF (OR = 2.17) compared to White older adults. Overall, older adults with lower mobility performance/functioning scores were more likely to have FOF (OR = 0.08). CONCLUSIONS Older adults (aged ≥65 years) who are at higher risk, based on a prior history of fall(s), are more susceptible to developing FOF, as evidenced by the older adults within this study, due to limited mobility performance and functioning. CLINICAL IMPLICATIONS Black older adults may be at greater risk of FOF than their White counterparts based on previous fall history and level of functional mobility. Incorporating measures of objective performance-based function along with measures of psychological factors are viable methods to identify and address FOF within Black older adult populations.
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Affiliation(s)
- Selena E. Washington
- Department of Occupational Science and Occupational Therapy, Saint Louis University Health Sciences Center, Saint Louis, MO, USA
| | - Makenna Snyder
- Program in Occupational Therapy, Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
| | - Yi-Ling Hu
- Institute of Gerontology, Wayne State University Eugene Applebaum College of Pharmacy and Health Sciences, Detroit, MI, USA
| | - Susan L. Stark
- Program in Occupational Therapy, Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
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Paul SS, Khalatbari-Soltani S, Dolja-Gore X, Clemson L, Lord SR, Harvey L, Tiedemann A, Close JCT, Sherrington C. Fall-related health service use in Stepping On programme participants and matched controls: a non-randomised observational trial within the 45 and Up Study. Age Ageing 2022; 51:6931847. [PMID: 36580389 PMCID: PMC9799214 DOI: 10.1093/ageing/afac272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Falls and fall-related health service use among older adults continue to increase. The New South Wales Health Department, Australia, is delivering the Stepping On fall prevention programme at scale. We compared fall-related health service use in Stepping On participants and matched controls. METHODS A non-randomised observational trial was undertaken using 45 and Up Study data. 45 and Up Study participants who did and did not participate in Stepping On were extracted in a 1:4 ratio. Rates of fall-related health service use from linked routinely collected data were compared between participants and controls over time using multilevel Poisson regression models with adjustment for the minimally sufficient set of confounders identified from a directed acyclic graph. RESULTS Data from 1,452 Stepping On participants and 5,799 controls were analysed. Health service use increased over time and was greater in Stepping On participants (rate ratios (RRs) 1.47-1.82) with a spike in use in the 6 months prior to programme participation. Significant interactions indicated differential patterns of health service use in participants and controls: stratified analyses revealed less fall-related health service use in participants post-programme compared to pre-programme (RRs 0.32-0.48), but no change in controls' health service use (RRs 1.00-1.25). Gender was identified to be a significant effect modifier for health service use (P < 0.05 for interaction). DISCUSSION Stepping On appeared to mitigate participants' rising fall-related health service use. Best practice methods were used to maximise this study's validity, but cautious interpretation of results is required given its non-randomised nature.
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Affiliation(s)
- Serene S Paul
- Address correspondence to: Serene S. Paul, Susan Wakil Health Building (D18), Western Ave, The University of Sydney, NSW 2006, Australia. Tel.: +61 2 9036 0477;
| | - Saman Khalatbari-Soltani
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia,ARC Centre of Excellence in Population Aging Research (CEPAR), The University of Sydney, Camperdown, NSW, Australia
| | - Xenia Dolja-Gore
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Lindy Clemson
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Stephen R Lord
- Neuroscience Research Australia, Randwick, NSW, Australia,School of Population Health, UNSW, Kensington, NSW, Australia
| | - Lara Harvey
- Neuroscience Research Australia, Randwick, NSW, Australia,School of Population Health, UNSW, Kensington, NSW, Australia
| | - Anne Tiedemann
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia,Institute for Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Jacqueline C T Close
- Neuroscience Research Australia, Randwick, NSW, Australia,Prince of Wales Hospital, SESLHD, Randwick NSW, Australia
| | - Cathie Sherrington
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia,Institute for Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
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Zak M, Makara-Studzińska M, Mesterhazy A, Mesterhazy J, Jagielski P, Januszko-Szakiel A, Sikorski T, Jaworski P, Miszczuk R, Brola W. Validation of FES-I and Short FES-I Scales in the Polish Setting as the Research Tools of Choice to Identify the Fear of Falling in Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16907. [PMID: 36554787 PMCID: PMC9779753 DOI: 10.3390/ijerph192416907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/07/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
Fear of falling is associated with a clear hazard to individual self-reliance, reduced physical activity, as well as a sense of shame and loss of self-confidence. The present study aimed to complete the applicable translation and validation protocol for the Falls Efficacy Scale-International (FES-I) tool, following its prior adaptation to ensure full compatibility with the Polish setting. The FES-I questionnaire, along with its abridged version, was translated in line with the recommended standards of the MAPI Institute, taking into account both the cultural fabric and pertinent language specifics of the country. The survey was attended by 740 individuals (N = 740; 463 women, 277 men), over 60 years old. All respondents were required to complete both the FES-I and FES-I (Short) questionnaires twice, following an intervening period, and subsequently had their responses statistically assessed. The FES-I questionnaire, along with its abridged version, may be recommended as an effective assessment tool for addressing the fear of falling issue among the older adults, consequently allowing the teams of attending physicians, physiotherapists, psychologists, or psychiatrists to complete an unambiguous diagnosis, with a view to helping the patients overcome this particular type of anxiety.
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Affiliation(s)
- Marek Zak
- Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, Ul. Zeromskiego 5, 25-369 Kielce, Poland
| | - Marta Makara-Studzińska
- Institute of Nursing and Midwifery, Department of Health Psychology, Faculty of Health Sciences, Collegium Medicum, Jagiellonian University, Ul. Kopernika 25, 31-501 Krakow, Poland
| | - Agnieszka Mesterhazy
- Institute of Nursing and Midwifery, Department of Health Psychology, Faculty of Health Sciences, Collegium Medicum, Jagiellonian University, Ul. Kopernika 25, 31-501 Krakow, Poland
| | - Jacek Mesterhazy
- Institute of Nursing and Midwifery, Department of Health Psychology, Faculty of Health Sciences, Collegium Medicum, Jagiellonian University, Ul. Kopernika 25, 31-501 Krakow, Poland
| | - Paweł Jagielski
- Department of Nutrition and Drug Research, Faculty of Health Sciences, Collegium Medicum, Jagiellonian University, Skawinska 8, 31-066 Krakow, Poland
| | - Aneta Januszko-Szakiel
- Institute of Information Studies, Faculty of Managment and Social Communication, Jagiellonian University, Ul. Lojasiewicza 4, 30-348 Krakow, Poland
| | - Tomasz Sikorski
- Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, Ul. Zeromskiego 5, 25-369 Kielce, Poland
| | - Piotr Jaworski
- Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, Ul. Zeromskiego 5, 25-369 Kielce, Poland
| | - Renata Miszczuk
- Institute of Pedagogy, Jan Kochanowski University, Ul. Zeromskiego 5, 25-369 Kielce, Poland
| | - Waldemar Brola
- Institute of Health Sciences, Collegium Medicum, Jan Kochanowski University, Ul. Zeromskiego 5, 25-369 Kielce, Poland
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Jun SS, Lee E. A longitudinal study of disability in activities of daily living and activity restriction‐induced fear of falling among Korean older people. Nurs Open 2022; 10:2946-2959. [PMID: 36480315 PMCID: PMC10077370 DOI: 10.1002/nop2.1538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 10/31/2022] [Accepted: 11/24/2022] [Indexed: 12/14/2022] Open
Abstract
AIM This study examined the effects of the fear of falling (FOF) alone and fear-associated activity restriction (FAR) on future activities of daily living (ADL) disability and analysed predictors of ADL disability among community-dwelling older people with and without FAR. DESIGN This prospective study involved secondary data analysis of the Korean Longitudinal Study of Aging. METHODS We obtained data from 5074 community-dwelling older adults. Generalized estimating equations were used to identify the predictors of changes in ADL disability between 2008 and 2018. RESULTS Compared with FOF alone, FAR was significantly related to changes in ADL disability. Being older, living with others and having poor self-rated health status were associated with future ADL disability in participants without FAR. Weakened grip strength and social engagement were associated with future ADL disability in those with FAR. Nurses must consider the impact of FAR on future ADL decline and implement tailored interventions. PATIENT OR PUBLIC CONTRIBUTION No Patient or Public Contribution.
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Affiliation(s)
- Seong Sook Jun
- College of Nursing, Pusan National University Yangsan‐si Gyeongsangnam‐do South Korea
| | - Eunyoung Lee
- College of Nursing, Pusan National University Yangsan‐si Gyeongsangnam‐do South Korea
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Cengiz DU, Demir İ, Demirel S, Can Çolak S, Emekçi T, Bayındır T. Investigation of the Relationship Between BPPV with Anxiety, Sleep Quality and Falls. Turk Arch Otorhinolaryngol 2022; 60:199-205. [PMID: 37456598 PMCID: PMC10339271 DOI: 10.4274/tao.2022.2022-8-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 12/26/2022] [Indexed: 07/18/2023] Open
Abstract
Objective To investigate the effects of dizziness on sleep quality and psychological status in patients with benign paroxysmal positional vertigo (BPPV) and to evaluate its relationship with falls. Methods A Demographic Data Form, a Visual Vertigo Analog Scale, the Falls Efficacy Scale - International (FES-I), the Hospital Anxiety and Depression Scale (HADS), and the Pittsburgh Sleep Quality Index (PSQI) were administered in 102 individuals diagnosed with BPPV by videonystagmography test. The same scales were applied to 75 healthy volunteers as the control group, and the two groups were compared. The BPPV group was divided into two groups as posterior canal and lateral canal BPPV. These two groups were compared among themselves and with the control group. Results A statistically significant difference was found between the BPPV and control groups, the lateral canal BPPV and posterior canal BPPV groups, the lateral canal BPPV and control groups, and the posterior canal BPPV and control groups in terms of total scores of the PSQI, the FES-I, and the HADS (p<0.001). In the regression model, the FES-I score was fully explained by the PSQI and HADS scores (p<0.001). Conclusion BPPV significantly affects sleep quality, psychological state, and the risk of fall. The negative effects of BPPV restrict daily living activities, affect the prognosis of the disease, and increase the risk of falling. Considering that psychiatric issues and sleep problems increase the risk of falling in individuals with BPPV, counseling services on this issue would reduce the incidence of falls and related injuries.
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Affiliation(s)
- Deniz Uğur Cengiz
- Department of Audiology, İnönü University Faculty of Health Sciences, Malatya, Turkey
| | - İsmail Demir
- Department of Audiology, İnönü University Faculty of Health Sciences, Malatya, Turkey
| | - Sümeyye Demirel
- Department of Audiology, Bingöl University Faculty of Health Sciences, Bingöl, Turkey
| | - Sanem Can Çolak
- Department of Audiology, İnönü University Faculty of Health Sciences, Malatya, Turkey
| | - Tuğba Emekçi
- Department of Audiology, University of Health Sciences Turkey, Gülhane Faculty of Health Sciences, Ankara, Turkey
| | - Tuba Bayındır
- Department of Otorhinolaryngology, İnönü University, Turgut Özal Medical Center, Malatya, Turkey
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Chang KC, Chen HS, Horng YS, Liou HH, Liang HW. Cross-cultural adaptation of the Taiwan Chinese version of the Falls Efficacy Scale-International for community-dwelling elderly individuals. BMC Geriatr 2022; 22:881. [DOI: 10.1186/s12877-022-03597-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 11/08/2022] [Indexed: 11/21/2022] Open
Abstract
Abstract
Background
The Falls Efficacy Scale-International (FES-I) is a commonly used questionnaire to evaluate concerns about falling. We adapted a Taiwan Chinese version (FES-ITC) and evaluated its reliability and validity in community-dwelling elderly individuals. The discriminative validity was tested in relation to several known risk factors for fear of falling (FOF).
Methods
The questionnaire was adapted through translation, back-translation, and expert review processes. A convenience sample of 135 community-dwelling elderly individuals (at least 60 years old) completed the adapted questionnaire, and 31 of them had a retest within 7–10 days. Cronbach’s α and an intraclass correlation coefficient (ICC) were used to evaluate the internal consistency and test–retest reliability. Principal component factor analysis was performed to assess the factor-construct validity. The discriminative validity was tested in relation to demographic features, fall-related history and performances on three functional tests: timed up and go, four-stage balance and 30-s chair stand tests. Effect sizes were computed. Correlation coefficients between physical functional performance and FES-ITC scores were computed. Receiver operating characteristic curves were used to determine the cutoff point for the score to differentiate high and low concern of falling.
Results
The FES-ITC questionnaire had high internal consistency (Cronbach’s α = 0.94) and excellent test–retest reliability (ICC = 0.94). Principal component factor analysis yielded a two-factor model, with several items requiring high demand on postural control loading on factor 2. FES-ITC scores discriminated individuals with different ages, reporting FOF, reporting falls in the past year and using walking aids. However, FES-ITC scores did not differ between the participants who were at risk of falling and those who were not at risk based on functional test performance and there was no correlation found between them.
Conclusion
The FES-ITC was highly reliable and had adequate construct and discriminative validity. The lack of correlation between FES-ITC scores and functional test performance implied the presence of FOF even in individuals with good functional performance. Further follow up studies are warranted to verify the predictive validity of the FES-ITC.
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Badrasawi M, Hamdan M, Vanoh D, Zidan S, ALsaied T, Muhtaseb TB. Predictors of fear of falling among community-dwelling older adults: Cross-sectional study from Palestine. PLoS One 2022; 17:e0276967. [PMCID: PMC9671337 DOI: 10.1371/journal.pone.0276967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 10/18/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction Fear of falling has serious implications for health and is an important threat to autonomy. The purpose of this cross-sectional study was to investigate risk factors for fear of falling among Palestinian older adults in Hebron district. Methods A cross-sectional study was conducted among Palestinians > 60 years living in Hebron, West Bank. The Falls Efficacy Scale-International was used to predict falls among Palestinian older adults. Moreover, socio-demographic data, medical history, lifestyle habits, body composition, nutritional status, cognitive status (using the Montreal cognitive assessment tool), and functional status (using activities of daily living and instrumental activities of daily living scale), the presence of depressive symptoms (using geriatric depression scale), and physical fitness performance (using senior fitness test) were collected through an interview-based questionnaire. Data were analyzed using univariate and multivariate approach. Results A total of 200 participants were included in the study; 137 (68.5%) females and 63 (31.5%) males. Mean age was 70.5 ± 5.7 years, ranged from 65 to 98 years old. Fear of falling was significantly higher among older adults with advanced aged, living in villages or camps, low educational level, and being married (p < 0.05). Functional status (ADL and IADL), physical fitness status (timed up and go), and depression symptoms were significantly related to fear of falling (p < 0.05). Conclusion High concern of falling is significantly associated with advanced age, low education level, being married, and living in villages or camps. ADLs were among the factors that had a significant relationship with increased fear of falling. Predictors of fear of falling among Palestinian older adults were IADL scores, body fat percentage, rapid gait speed, timed up and go test. Future studies could investigate further correlates of fear of falling among older adults.
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Affiliation(s)
- Manal Badrasawi
- Department of Nutrition and Food Technology, Faculty of Agriculture and Veterinary Medicine, An-Najah National University, Nablus, West Bank, Palestine
- * E-mail:
| | - May Hamdan
- Program of Health and Therapeutic Nutrition, Collage of Medicine and Health Sciences, Palestine Polytechnic University, Hebron, Palestine
| | - Divya Vanoh
- Dietetics Programme, School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Souzan Zidan
- Department of Nutrition and Food Technology, Faculty of Agriculture, Hebron University, Hebron, West Bank, Palestine
| | - Tasneem ALsaied
- Program of Health and Therapeutic Nutrition, Collage of Medicine and Health Sciences, Palestine Polytechnic University, Hebron, Palestine
| | - Tala B. Muhtaseb
- Program of Health and Therapeutic Nutrition, Collage of Medicine and Health Sciences, Palestine Polytechnic University, Hebron, Palestine
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A qualitative investigation exploring neighbourhood environment, risks and fear of falling, and fall prevention strategies among urban-dwelling older adults in a high-density city. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x22001209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Abstract
Falls in older adulthood can have serious consequences. It is therefore important to identify ways to prevent falls, particularly from the voice of older adults. Bottom-up qualitative exploration of the perspectives of older adults can provide rich insights that can help inform the development of effective fall prevention programmes. However, currently there is a dearth of such empirical data, especially among urban-dwelling older adults in high-density cities where fall rates are high. The current study aimed to examine qualitatively perceptions of neighbourhood physical environment in relation to falls, perceived risks and fear of falling, and strategies and behaviours for fall prevention in a sample of urban-dwelling older adults in the high-density city of Hong Kong. Face-to-face semi-structured in-depth interviews were conducted with 50 community-dwelling older adults. Interviews were transcribed verbatim and analysed using thematic analysis techniques. Five general themes were revealed: risks and circumstances of falls, consequences of falls, fear of falling and its consequences, neighbourhood environment, and strategies and behaviours of fall prevention. While older adults discussed the risks of falling and held a fear of falling, these beliefs were mixed. In addition to fall prevention strategies (e.g. keep balance), current findings highlighted the importance of establishing protective factors (e.g. flat and even walking paths) and reducing risk factors (e.g. neighbourhood clutter) in neighbourhood environments. For urban-dwelling older adults in high-density cities, current findings highlight the importance of focusing efforts at the built environment level in addition to strategies and behaviours of fall prevention at the individual level.
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McKay MA, Mensinger JL, Whitehouse CR. The Relationship of Fear of Falling and Quality of Life: The Mediating Effects of Frailty and Depression. J Community Health Nurs 2022; 39:251-261. [DOI: 10.1080/07370016.2022.2073792] [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]
Affiliation(s)
- Michelle A. McKay
- Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA
| | - Janell L. Mensinger
- Department of Clinical and School Psychology, Nova Southeastern University, Nova Southeastern, Fort Lauderdale, FL
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Alemdaroğlu-Gürbüz İ, İpek C, Bulut N, Karaduman A, Yılmaz Ö. The Impact of "Fear of Falling" on Physical Performance, Balance, and Ambulation in Duchenne Muscular Dystrophy. Neuropediatrics 2022; 53:330-337. [PMID: 36030791 DOI: 10.1055/s-0042-1750722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
OBJECTIVE The aim of this study was to investigate falls and the fear of falling (FOF) in children with Duchenne muscular dystrophy (DMD) and to determine the relationships between the FOF and physical performance, balance, and ambulation. METHODS Thirty-eight ambulatory children with DMD were included in the study. The functional level, falling history, FOF, physical performance, balance, and ambulation were assessed by using Brooke Lower Extremity Functional Classification, History of Falls Questionnaire, Pediatric Fear of Falling Questionnaire (Ped-FOF), timed performance tests, Timed "Up and Go" (TUG) test, and North Star Ambulatory Assessment (NSAA), respectively. RESULTS Of the 38 children (mean age: 9.00 ± 2.03 years) 97.4% had a history of serious fall last year and 62.2% were injured due to this fall. The Ped-FOF score was 13.79 ± 7.20. Weak to moderate relations were determined between Ped-FOF and functional level (r = 0.33), frequency of falls (r = 0.41), duration of climbing 4-steps (r = 0.38), TUG (r = 0.36), and NSAA (r = -0.32) (p < 0.05). CONCLUSION Ambulatory children with better performance scores had lower levels of FOF despite their history of serious falls and injuries. FOF tends to increase as the symptoms of the disease progresses. Investigating the history of falls and FOF from the earliest period will guide to take precautions and make necessary interventions on time in treatment programs.
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Affiliation(s)
- İpek Alemdaroğlu-Gürbüz
- Department of Physical Therapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Canan İpek
- Department of Physical Therapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Numan Bulut
- Department of Physical Therapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Ayşe Karaduman
- Physiotherapy and Rehabilitation Department, Faculty of Health Sciences, Lokman Hekim University, Ankara, Turkey
| | - Öznur Yılmaz
- Department of Physical Therapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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Chen Z, Zhong Q, Chen Y, Chen L, Peng H. The U-shaped association between hospitalization time and fall incidence in inpatients using publicly available data: A cross-sectional study in Japan. Nurs Open 2022; 10:1526-1535. [PMID: 36177862 PMCID: PMC9912438 DOI: 10.1002/nop2.1402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 10/17/2021] [Accepted: 09/14/2022] [Indexed: 11/10/2022] Open
Abstract
AIM To examine the association between the hospitalization time and fall incidence. DESIGN A secondary analysis using the Dryad Digital Repository public database. METHODS Data were extracted from the Fukushima Medical University Hospital cohort study between August 2008 and September 2009. The final analytic sample included 8,598 participants, 156 of who fell. The risk of fall incidents according to hospitalization time was estimated using logistic proportional hazards models, and restricted cubic splines with four knots model were developed. RESULTS The median hospitalization time was 9.00 (4.00, 17.00) days. The incidence of falls was 1.81% (N = 156). A U-shaped association between the hospitalization time and fall incidence, with an inflextion point of 8 days. We found a decreasing fall incidence as the hospitalization time increased from 0 to 8 days (OR 0.72 [0.62 ~ 0.83], p < .001); beyond 8 days, the fall incidence increased as the hospitalization time increased (OR 1.06 [1.04 ~ 1.09]).
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Affiliation(s)
- Zihong Chen
- Department of OncologyWuzhou Red Cross HospitalWuzhouChina
| | - Qiang Zhong
- Department of RadiotherapyWuzhou Red Cross HospitalWuzhouChina
| | - Yonghong Chen
- Department of OncologyWuzhou Red Cross HospitalWuzhouChina
| | - Lihua Chen
- Department of Intensive CareWuzhou Red Cross HospitalWuzhouChina
| | - Huanhuan Peng
- Department of CardiologyWuzhou Red Cross HospitalWuzhouChina
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Luo Y, Miyawaki CE, Valimaki MA, Tang S, Sun H, Liu M. Symptoms of anxiety and depression predicting fall-related outcomes among older Americans: a longitudinal study. BMC Geriatr 2022; 22:749. [PMID: 36100852 PMCID: PMC9472405 DOI: 10.1186/s12877-022-03406-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 08/23/2022] [Indexed: 12/02/2022] Open
Abstract
Background Anxiety and depressive symptoms are associated with fear of falling and fear of falling-related activity restrictions. However, it remains unknown whether anxiety or depressive symptoms alone could predict fear of falling and activity restrictions in older adults. We sought to determine if anxiety and depressive symptoms alone could be an independent predictor of fear of falling and activity restrictions in community-dwelling older adults. Methods This longitudinal analysis used waves 5 (time 1, [T1]) and 6 (time 2, [T2], 1 year from T1) data (N = 6376) from the National Health and Aging Trends Study. The Generalized Anxiety Disorder Scale 2 and Patient Health Questionnaire 2 were used to assess anxiety and depressive symptoms, respectively. Interview questions included demographics, health-related data, and fall worry levels (no fear of falling, fear of falling but no activity restrictions, and activity restrictions). Using multinomial logistic regression models, we examined whether anxiety and depressive symptoms (T1) predicted fear of falling and activity restrictions (T2). Results In wave 5 (T1, mean age: 78 years, 58.1% female), 10 and 13% of participants reported anxiety and depressive symptoms. About 19% of participants experienced fear of falling but not activity restrictions, and 10% of participants developed activity restrictions in wave 6 (T2), respectively. Participants with anxiety symptoms at T1 had a 1.33 times higher risk of fear of falling (95% CI = 1.02–1.72) and 1.41 times higher risk of activity restrictions (95% CI = 1.04–1.90) at T2. However, having depressive symptoms did not show any significance after adjusting for anxiety symptoms. Conclusions Anxiety symptoms seemed to be an independent risk factor for future fear of falling and activity restrictions, while depressive symptoms were not. To prevent future fear of falling and activity restrictions, we should pay special attention to older individuals with anxiety symptoms. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03406-8.
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Okoye EC, Akosile CO, Maruf FA, Onwuakagba IU, Ofojiha VO, Ani KU. Cross-Cultural Validation of Igbo Version of the Short Falls Efficacy Scale-International Among Community-Dwelling Older Adults. AGEING INTERNATIONAL 2022. [DOI: 10.1007/s12126-022-09505-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Freiberger E, Fabbietti P, Corsonello A, Lattanzio F, Artzi-Medvedik R, Kob R, Melzer I, Britting S. Transient versus stable nature of fear of falling over 24 months in community-older persons with falls- data of the EU SCOPE project on Kidney function. BMC Geriatr 2022; 22:698. [PMID: 35999522 PMCID: PMC9396801 DOI: 10.1186/s12877-022-03357-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 08/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fear of falling (FoF) is an important risk factor for falls among older people. The objectives of our investigations were: a.) to present characteristics of older community-dwelling (CD) fallers with persistent or transient FoF (P-FoF or T-FoF) over 12 months, and b.) to investigate clinical predictors of P-FoF and T-FoF and c.) to explore differences between P-FoF and T-FoF. METHODS Our series consisted of 389 older people reporting a fall or injurious fall at baseline and during 24 months follow-up participating in a multicenter prospective study. T-FoF was defined as participants reported "not at all" at baseline and "somewhat/fairly/very concerned" at follow-up, or "not at all" at follow-up, and "somewhat/fairly/very concerned" at baseline, and P-FoF was defined as participants answered "somewhat/fairly/very concerned" in both assessments at baseline and at follow-up. The association between risk factors and T-FoF or P-FoF was investigated by logistic regression analysis. RESULTS The mean age of fallers in our sample was 79.0 years (SD 6.0), and 54.2% were females. Out of 389 older adults with a fall history at baseline, 83 participants (21.3%) did not report any FoF over time, P-FoF and T-FoF were observed in 42.7% and 35.9% of participants, respectively. After adjusting for potential confounders (e.g. age, gender), osteoporosis (OR = 2.04, 95%CI = 1.03-4.05) and impaired physical performance (OR = 2.38, 95%CI = 1.12-5.03) were significant predictors of T-FoF vs No-FoF. Osteoporosis (OR = 2.68, 95%CI = 1.31-5.48), depressive symptoms (OR = 3.54, 95%CI = 1.23-10.1) and living alone (OR = 2.44, 95%CI = 1.17-5.06) were significantly associated with P-FoF vs No-FoF. When comparing T-FoF and P-FoF, female gender (OR = 1.95, 95%CI = 1.16-3.27), BMI (OR = 1.08, 95%CI = 1.02-1.14), overall comorbidity (OR = 1.07, 95%CI = 1.02-1.13) and depression (OR = 2.55, 95%CI = 1.33-4.88) were significant predictors of P-FoF. CONCLUSIONS T-FoF and P-FoF may be predicted by different sets of risk factors among older fallers. Thus, fallers should be screened for FoF especially when carrying specific risk factors, including female gender, osteoporosis, depression, living alone, impaired physical performance, BMI, comorbidity. These findings may be helpful in designing tailored intervention to blunt the risks related to consequence of FoF among older people experiencing falls. TRIAL REGISTRATION The SCOPE study was registered prospectively at clinicaltrials.gov (NCT02691546; 25/02/2016).
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Affiliation(s)
- Ellen Freiberger
- Department of Internal Medicine-Geriatrics, Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
| | - Paolo Fabbietti
- Italian National Research Center On Aging (IRCCS INRCA), Ancona, Fermo and Cosenza, Italy
| | - Andrea Corsonello
- Italian National Research Center On Aging (IRCCS INRCA), Ancona, Fermo and Cosenza, Italy
| | - Fabrizia Lattanzio
- Italian National Research Center On Aging (IRCCS INRCA), Ancona, Fermo and Cosenza, Italy
| | - Rada Artzi-Medvedik
- Department of Nursing, Recanati School for Community Health Professions at the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Maccabi Health Services, Israel; and Department of Nursing, Recanati School for Community Health Professions at the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Robert Kob
- Department of Internal Medicine-Geriatrics, Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Itshak Melzer
- Department of Physical Therapy, Recanati School for Community Health Professions at the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | | | - Sabine Britting
- Department of Internal Medicine-Geriatrics, Institute for Biomedicine of Aging (IBA), Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Melendo-Azuela EM, González-Vaca J, Cirera E. Fear of Falling in Older Adults Treated at a Geriatric Day Hospital: Results from a Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148504. [PMID: 35886360 PMCID: PMC9319707 DOI: 10.3390/ijerph19148504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/01/2022] [Accepted: 07/09/2022] [Indexed: 02/06/2023]
Abstract
(1) Background: The fear of falling (FOF) is a geriatric syndrome that causes a decrease in daily activities and personal autonomy. Its prevalence is highly variable as are the methodologies used to assess it. This study aimed at estimating the prevalence and describing the main determinants of FOF in older adults attending a geriatric day hospital. (2) Methods: Descriptive, cross-sectional study of individuals aged ≥70 years, who attended an ambulatory functional rehabilitation group in the metropolitan area of Barcelona. FOF was assessed using the Activities-Specific Balance Confidence (ABC) scale. Other recorded outcomes were: sex, age, marital status, living alone, level of education, degree of autonomy, pain, previous falls, visual acuity, and signs of depression. Prevalence was estimated overall and according to the possible determinants. (3) Results: The study included 62 individuals (66.1% women), with a prevalence of fear of falling of 38.7% (95% CI 26.2–51.2%). The identified determinants were pain (OR = 7.4, 95% CI 1.4–39.7), a history of falls (OR = 25.3, 95% CI 2.1–303.4), poor visual acuity (OR = 5.6, 95% CI 1.0–29.8), and signs of depression (OR = 19.3, 95% CI 1.4–264.3). (4) Conclusions: The prevalence and determinants of fear of falling in older adults attending geriatric day hospitals were similar to those described in those dwelling in the community.
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Affiliation(s)
- Eva M. Melendo-Azuela
- The Doctoral Programme in Comprehensive Care and Health Services, University of Vic-Central University of Catalonia, 08500 Vic, Spain
- Faculty of Medicine and Health Sciences, School of Nursing, University of Barcelona, 08007 Barcelona, Spain
- Correspondence:
| | - Julia González-Vaca
- Nursing Research Group (GRIN) from the IDIBELL Translational Medicine Area, University of Barcelona, 08007 Barcelona, Spain;
| | - Eva Cirera
- Sport and Physical Activity Research Group, Center for Health and Social Research, Department of Experimental Sciences and Methodology, Faculty of Health Sciences and Welfare, University of Vic-Central University of Catalonia, 08500 Vic, Spain;
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Associations between objectively measured pattern of physical activity, sedentary behavior and fear of falling in Chinese community-dwelling older women. Geriatr Nurs 2022; 46:80-85. [DOI: 10.1016/j.gerinurse.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/29/2022] [Accepted: 05/02/2022] [Indexed: 11/19/2022]
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Kalu ME, Bello-Haas VD, Griffin M, Boamah S, Harris J, Zaide M, Rayner D, Khattab N, Abrahim S, Richardson TK, Savatteri N, Wang Y, Tkachyk C. Cognitive, psychological and social factors associated with older adults' mobility: a scoping review of self-report and performance-based measures. Psychogeriatrics 2022; 22:553-573. [PMID: 35535013 DOI: 10.1111/psyg.12848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/21/2022] [Accepted: 04/25/2022] [Indexed: 11/28/2022]
Abstract
Although many factors have been associated with mobility among older adults, there is paucity of research that explores the complexity of factors that influence mobility. This review aims to synthesise the available evidence for factors comprising the cognitive, psychological, and social mobility determinants and their associations with mobility self-reported and performance-based outcomes in older adults (60 years). We followed Arksey and O'Malley's five stages of a scoping review and searched PubMed, EMBASE, PsychINFO, Web of Science, AgeLine, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature and Sociological Abstract databases. Reviewers in pairs independently conducted title, abstract, full-text screening and data extraction. We reported associations by analyses rather than articles because articles reported multiple associations for factors and several mobility outcomes. Associations were categorised as significantly positive, negative, or not significant. We included 183 peer-reviewed articles published in 27 countries, most of which were cross-sectional studies and conducted among community-dwelling older adults. The 183 articles reported 630 analyses, of which 381 (60.5%) were significantly associated with mobility outcomes in the expected direction. For example, older adults with higher cognitive functioning such as better executive functioning had better mobility outcomes (e.g., faster gait speed), and those with poor psychological outcomes, such as depressive symptoms, or social outcomes such as reduced social network, had poorer mobility outcomes (e.g., slower gait speed) compared to their counterparts. Studies exploring the association between cognitive factors, personality (a psychological factor) and self-reported mobility outcomes (e.g., walking for transportation or driving), and social factors and performance-based mobility outcomes in older adults are limited. Understanding the additive relationships between cognitive, psychological, and social factors highlights the complexity of older adults' mobility across different forms of mobility, including independence, use of assistive devices, transportation, and driving.
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Affiliation(s)
- Michael E Kalu
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Vanina Dal Bello-Haas
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Meridith Griffin
- Department of Health, Aging & Society, Faculty of Social Science, McMaster University, Hamilton, Ontario, Canada
| | - Sheila Boamah
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Jocelyn Harris
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Mashal Zaide
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Daniel Rayner
- Department of Health Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Nura Khattab
- Department of Kinesiology, Faculty of Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Salma Abrahim
- Department of Kinesiology, Faculty of Sciences, McMaster University, Hamilton, Ontario, Canada
| | | | | | - Yimo Wang
- Myodetox Markham, Markham, Ontario, Canada
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Biswas I, Adebusoye B, Chattopadhyay K. Risk factors for falls among older adults in India: A systematic review and meta-analysis. Health Sci Rep 2022; 5:e637. [PMID: 35774830 PMCID: PMC9213836 DOI: 10.1002/hsr2.637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 02/12/2022] [Accepted: 02/17/2022] [Indexed: 12/19/2022] Open
Abstract
Background and Aim Falls are common among older adults in India. Several primary studies on its risk factors have been conducted in India. However, no systematic review has been conducted on this topic. Thus, the objective of this systematic review was to synthesize the existing evidence on the risk factors for falls among older adults in India. Methods JBI and Preferred Reporting Items for Systematic Reviews and Meta-Analyse guidelines were followed, and two independent reviewers were involved in the process. This review included observational studies conducted among older adults (aged ≥ 60 years) residing in India, reporting any risk factor for falls as exposure and unintentional fall as the outcome. MEDLINE, EMBASE, PsycInfo, CINAHL, and ProQuest Dissertations and Theses were searched until September 24, 2020. Where possible, data were synthesized using random-effects meta-analysis. Results The literature search yielded 3445 records. Twenty-two studies met the inclusion criteria of this systematic review, and 19 studies were included in the meta-analysis. Out of the 22 included studies in the systematic review, 12 (out of 18) cross-sectional studies, two case-control studies, and two cohort studies met more than 70% criteria in the respective Joanna Briggs Institute (JBI) checklists. Risk factors for falls among older adults in India included sociodemographic factors, environmental factors, lifestyle factors, physical and/or mental health conditions, and medical interventions. Conclusions This systematic review and meta-analysis provided a holistic picture of the problem in India by considering a range of risk factors such as sociodemographic, environmental, lifestyle, physical and/or mental health conditions and medical intervention. These findings could be used to develop falls prevention interventions for older adults in India. Systematic Review and Meta‐Analysis Registration The systematic review and meta-analysis protocol was registered with PROSPERO (registration number-CRD42020204818).
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Affiliation(s)
- Isha Biswas
- Division of Epidemiology and Public Health, School of MedicineUniversity of NottinghamNottinghamUnited Kingdom
| | - Busola Adebusoye
- Division of Epidemiology and Public Health, School of MedicineUniversity of NottinghamNottinghamUnited Kingdom
| | - Kaushik Chattopadhyay
- Division of Epidemiology and Public Health, School of MedicineUniversity of NottinghamNottinghamUnited Kingdom
- The Nottingham Centre for Evidence‐Based Healthcare: A JBI Centre of ExcellenceNottinghamUnited Kingdom
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