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Mahmud M, Muscatello DJ, Rahman MB, Osborne NJ. Association between socioeconomic deprivation and bone health status in the UK biobank cohort participants. Osteoporos Int 2024; 35:1573-1584. [PMID: 38806788 PMCID: PMC11364661 DOI: 10.1007/s00198-024-07115-3] [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: 09/27/2023] [Accepted: 04/27/2024] [Indexed: 05/30/2024]
Abstract
The effect of deprivation on total bone health status has not been well defined. We examined the relationship between socioeconomic deprivation and poor bone health and falls and we found a significant association. The finding could be beneficial for current public health strategies to minimise disparities in bone health. PURPOSE Socioeconomic deprivation is associated with many illnesses including increased fracture incidence in older people. However, the effect of deprivation on total bone health status has not been well defined. To examine the relationship between socioeconomic deprivation and poor bone health and falls, we conducted a cross-sectional study using baseline measures from the United Kingdom (UK) Biobank cohort comprising 502,682 participants aged 40-69 years at recruitment during 2006-2010. METHOD We examined four outcomes: 1) low bone mineral density/osteopenia, 2) fall in last year, 3) fracture in the last five years, and 4) fracture from a simple fall in the last five years. To measure socioeconomic deprivation, we used the Townsend index of the participant's residential postcode. RESULTS At baseline, 29% of participants had low bone density (T-score of heel < -1 standard deviation), 20% reported a fall in the previous year, and 10% reported a fracture in the previous five years. Among participants experiencing a fracture, 60% reported the cause as a simple fall. In the multivariable logistic regression model after controlling for other covariates, the odds of a fall, fracture in the last five years, fractures from simple fall, and osteopenia were respectively 1.46 times (95% confidence interval [CI] 1.42-1.49), 1.26 times (95% CI 1.22-1.30), 1.31 times (95% CI 1.26-1.36) and 1.16 times (95% CI 1.13-1.19) higher for the most deprived compared with the least deprived quantile. CONCLUSION Socioeconomic deprivation was significantly associated with poor bone health and falls. This research could be beneficial to minimise social disparities in bone health.
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Affiliation(s)
- Mafruha Mahmud
- School of Population Health, University of New South Wales, Sydney, Australia.
| | | | - Md Bayzidur Rahman
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
- Kirby Institute, UNSW, Kensington, Australia
- The School of Medicine, The University of Notre Dame, Sydney, Australia
| | - Nicholas John Osborne
- School of Population Health, University of New South Wales, Sydney, Australia
- School of Public Health, The University of Queensland, Herston, QLD, 4006, Australia
- European Centre for Environment and Human Health, University of Exeter, Truro, TR1 3HD, UK
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2
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Gandham A, Gregori G, Johansson L, Larsson BAM, Johansson H, Harvey NC, Vandenput L, McCloskey E, Kanis JA, Litsne H, Axelsson K, Lorentzon M. Sarcopenia definitions and their association with injurious falls in older Swedish women from the Sahlgrenska University Hospital Prospective Evaluation of Risk of Bone fractures (SUPERB) study. Osteoporos Int 2024:10.1007/s00198-024-07196-0. [PMID: 39105786 DOI: 10.1007/s00198-024-07196-0] [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: 03/01/2024] [Accepted: 07/15/2024] [Indexed: 08/07/2024]
Abstract
Associations between different sarcopenia definitions and the risk of injurious falls were investigated in 75-80-year-old women in the Swedish SUPERB cohort. Only sarcopenia according to the Sarcopenia Definitions and Outcomes Consortium (SDOC) definition was associated with incident injurious falls with and without fractures in older women. PURPOSE To investigate the association between three commonly used sarcopenia definitions and the risk of injurious falls in a population of older Swedish women. METHODS A total of 2,883 75-80-year-old women with complete data on relevant sarcopenia definitions from the Swedish SUPERB cohort were studied. Sarcopenia was defined based on the Sarcopenia Definitions and Outcomes Consortium (SDOC: low handgrip strength and gait speed), revised European Working Group on Sarcopenia in Older People (EWGSOP2: low appendicular lean mass index (ALMI, dual-energy X-ray absorptiometry (DXA)-derived), appendicular lean mass (kg)/height (m2), hand grip strength (kg), or low chair stand time (s)), and Asian Working Group for Sarcopenia (AWGS: low ALMI and hand grip strength (kg) or low gait speed (m/s)). Questionnaires captured the occurrence of falls in the past 12 months. Incident injurious falls were identified using national registers. Cox regression (hazard ratios (HR) and 95% confidence intervals (CI)) analyses were performed without adjustment and after adjustment for age, body mass index, previous falls, and the Charlson comorbidity index. RESULTS During a median (IQR) follow-up time of 7.06 (6.2-7.9) years, there were 491 injurious falls without fracture and 962 injurious falls when also including falls resulting in a fracture. Sarcopenia according to EWGSOP2 and AWGS was not associated with an increased risk of injurious falls. Individuals with sarcopenia defined by SDOC had a higher risk of injurious falls with and without fracture (HR 2.11; 95% CI, 1.63-2.73 and HR, 2.16; 95% CI, 1.55-3.02, respectively). CONCLUSION Sarcopenia definitions confined to muscle function and strength such as SDOC, rather than including DXA-determined ALMI (EWGSOP2 and AWGS), are associated with incident injurious falls with and without fractures in older women.
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Affiliation(s)
- Anoohya Gandham
- Mary MacKillop Institute for Health Research, Australian Catholic University, Victoria, 3000, Australia.
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
| | - Giulia Gregori
- Sahlgrenska Osteoporosis Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Lisa Johansson
- Sahlgrenska Osteoporosis Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Department of Orthopedics, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Berit A M Larsson
- Sahlgrenska Osteoporosis Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Närhälsan Sisjön Health Centre, Sisjön, Sweden
| | - Helena Johansson
- Mary MacKillop Institute for Health Research, Australian Catholic University, Victoria, 3000, Australia
- Sahlgrenska Osteoporosis Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Liesbeth Vandenput
- Mary MacKillop Institute for Health Research, Australian Catholic University, Victoria, 3000, Australia
| | - Eugene McCloskey
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK
- MRC Versus Arthritis Centre for Integrated Research in Musculoskeletal Ageing, Mellanby Centre for Musculoskeletal Research, University of Sheffield, Sheffield, UK
| | - John A Kanis
- Mary MacKillop Institute for Health Research, Australian Catholic University, Victoria, 3000, Australia
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK
| | - Henrik Litsne
- Sahlgrenska Osteoporosis Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Kristian Axelsson
- Sahlgrenska Osteoporosis Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- n Västra Götaland, Geriatric Medicine, Institute of, Regio, Medicine, Sahlgrenska University Hospital, Building K, 6Th Floor, 431 80, Mölndal, Sweden
| | - Mattias Lorentzon
- Mary MacKillop Institute for Health Research, Australian Catholic University, Victoria, 3000, Australia.
- Sahlgrenska Osteoporosis Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
- Region Västra Götaland, Geriatric Medicine, Institute of Medicine, Sahlgrenska University Hospital, Building K, 6Th Floor, 431 80, Mölndal, Sweden.
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3
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Alsayed Hassan DA, Chivese T, Syed MA, Alhussaini NWZ. Prevalence and factors associated with falls in older adults in a Middle Eastern population: a retrospective cross-sectional study. Public Health 2024; 233:54-59. [PMID: 38848620 DOI: 10.1016/j.puhe.2024.04.011] [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: 10/06/2023] [Revised: 03/24/2024] [Accepted: 04/05/2024] [Indexed: 06/09/2024]
Abstract
OBJECTIVE The main objective was to determine the prevalence of falls and associated factors in older adults living in Qatar. STUDY DESIGN Cross-sectional study. METHODS This is a cross-sectional study of older adults aged ≥60 years with at least one encounter with primary health care corporation (PHCC) in Qatar during the period 2017-2022. Data on documented falls, demographic variables, and medical comorbidities were extracted from all PHCCs in Qatar. Descriptive and inferential statistics were used to address the aim of the study. RESULTS A total of 68,194 older adults had at least one encounter with PHCC. The median age was 65.0 years, 58.9% were males, and 32.6% were Qatari nationality. A higher percentage of falls was found in individuals with hypertension (80%), diabetes (74.2%), and dyslipidemia (48.9%), which were also the most prevalent comorbidities. The prevalence of falls was 6.7% (95% CI 6.6-6.9). Compared to individuals aged 60-69 years, individuals aged 70-79, 80-89, and 90-99 had increased odds of falls by 1.6 (95% CI 1.5, 1.8), 2.5 (95% CI 2.2, 2.8), and 2.6 (95% CI 2.0, 3.3), respectively. Females and individuals of Qatari nationality had increased odds of fall by 1.5 (95% CI 1.4, 1.6) and 1.2 (95% CI 1.1, 1.3), respectively. Orthostatic hypotension, syncope, Parkinson's disease, and hip arthritis showed the strongest associations with falls. CONCLUSIONS Given the growing population of older adults in the Middle East and North African region, falls is a public health concern. The risk factors identified in this study suggest the need for proactive healthcare strategies tailored to the unique needs of older adult populations.
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Affiliation(s)
| | - T Chivese
- College of Medicine, Qatar University, QU Health, Doha, Qatar
| | - M A Syed
- Primary Health Care Corporation, Doha, Qatar
| | - N W Z Alhussaini
- College of Health Sciences, Qatar University, QU Health, Doha, Qatar
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Gavras A, Batsis JA. Medical weight loss in older persons with obesity. Clin Obes 2024:e12684. [PMID: 38924367 DOI: 10.1111/cob.12684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 05/16/2024] [Accepted: 05/24/2024] [Indexed: 06/28/2024]
Abstract
The prevalence of individuals with obesity or overweight has steadily increased over the past decades both worldwide, and in the United States. This trend is also evident in the older adult population, which has experienced a continuous rise in the number of individuals with overweight or obesity. This is relevant due to the impact of obesity in older adults' quality of life, physical function, morbidity, and healthcare costs. This review aims to provide practical guidance and currently available approaches for healthcare professionals in managing this population. Both non-pharmacological methods such as intensive behavioural therapy, nutritional interventions, and physical activity, as well as anti-obesity medications, are discussed, with a focus on their potential positive and negative effects in older adults. Additionally, bariatric therapy is evaluated, including current procedures available and the associated results and risks in the older population.
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Affiliation(s)
- Alessandro Gavras
- Division of Geriatric Medicine, Department of Medicine, University of Verona, Verona, Italy
- Division of Geriatric Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - John A Batsis
- Division of Geriatric Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Gunay Ucurum S, Uzunlar H, Kirmizi M, Altas EU, Ozer Kaya D. Comparative analysis of postural stability and risk of falling and developing disability among overweight and obese women over 40 years. J Bodyw Mov Ther 2024; 38:549-553. [PMID: 38763607 DOI: 10.1016/j.jbmt.2024.03.045] [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: 03/28/2023] [Revised: 03/05/2024] [Accepted: 03/14/2024] [Indexed: 05/21/2024]
Abstract
BACKGROUND Increased body mass index (BMI) adversely affects the mechanics of the musculoskeletal system. It is known that obese people have poorer postural stability and mobility-related outcomes compared to normal weight people, but there is limited research comparing overweight and class 1 obese people, two consecutive and prevalent BMI categories. AIMS To compare postural stability, functional mobility, and risk of falling and developing disability between overweight and obese women, and to investigate the relationship of BMI and body weight with the outcomes. METHODS Thirty women with class 1 obesity and 30 overweight women were included. Standing postural stability with eyes-open and eyes-closed and stability limits were assessed using the Prokin system. The Timed Up and Go Test (TUG) was used to assess functional mobility and risk of falling (≥11 s) and developing disability (≥9 s). RESULTS The average center of pressure displacements on the y-axis (COPY) obtained during quiet standing with both eyes-open and eyes-closed were higher in obese women than overweight women (p < 0.05) and the effect sizes were moderate for the results. The COPY values in the eyes-open and eyes-closed conditions were correlated with BMI (r = 0.295 and r = 0.285, p < 0.05). Furthermore, the COPX value in the eyes-open condition and the TUG score were correlated with body weight (r = 0.274 and r = 0.257, p < 0.05). CONCLUSIONS Obese women had poorer static standing stability in the anteroposterior direction than overweight women, while functional mobility and risk of falling and developing disability did not differ. Furthermore, BMI and body weight were related to poorer static standing stability.
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Affiliation(s)
- Sevtap Gunay Ucurum
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey.
| | - Hilal Uzunlar
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey; Department of Sports Management, Faculty of Sports Sciences, Hitit University, Corum, Turkey.
| | - Muge Kirmizi
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey.
| | - Elif Umay Altas
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Bakırcay University, Izmir, Turkey.
| | - Derya Ozer Kaya
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey.
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Conceição ASGG, Sant Ana LFG, Mattar GP, de Fátima R Silva M, Ramos AR, Oliveira AM, Carvalho CL, Gonçalves OR, Varotto BLR, Martinez LD, Leduc V, Fonseca LM, Forlenza OV. Balance and Gait: Associations With Cognitive Impairment and Dementia in Individuals With Down Syndrome. Alzheimer Dis Assoc Disord 2023; 37:349-356. [PMID: 37788381 DOI: 10.1097/wad.0000000000000580] [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: 11/30/2022] [Accepted: 08/14/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND Atypical aging in Down syndrome (DS) is associated with neuropathological characteristics consistent with Alzheimer disease. Gait abnormalities have been shown to be associated with an increased risk of dementia for the general population. The aim of this study was to determine whether gait disorders are associated with worse cognitive performance and dementia in adults with DS. METHODS We evaluated 66 individuals with DS (≥20 y of age), divided into 3 groups: stable cognition, prodromal dementia, and dementia (presumed Alzheimer disease). Each individual was evaluated with the Performance-Oriented Mobility Assessment (POMA), Timed Up and Go test, and Cambridge Examination for Mental Disorders of Older People with Down's Syndrome and Others with Intellectual Disabilities (CAMDEX-DS), in addition to a comprehensive clinical protocol to ascertain the occurrence of medical or psychiatric comorbidities. RESULTS The score on the POMA-Gait subscale score and body mass index were found to be independent predictors of prodromal dementia and dementia ( P <0.001 for both). With the exception of perception, all cognitive domains correlated with the POMA-Total score ( P <0.05). CONCLUSION A lower POMA-Gait score increases the chance of prodromal dementia and dementia in adults with DS. Unlike other research, in this study higher body mass index was also found to increase the chance of prodromal dementia and dementia. In those individuals, applying the POMA could facilitate the early diagnosis of dementia, help identify fall risks, and promote the adoption of geriatric interventions focused on improving functional mobility.
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Affiliation(s)
| | - Lívea F G Sant Ana
- Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry
| | - Guilherme P Mattar
- Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry
| | - Maria de Fátima R Silva
- Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry
- Old Age Research Group, Department and Institute of Psychiatry
| | - Andressa R Ramos
- Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry
| | | | - Claudia L Carvalho
- Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry
| | | | - Bruna L R Varotto
- Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry
| | - Luana D Martinez
- Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry
| | - Vinícius Leduc
- Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry
| | - Luciana M Fonseca
- Dental Team, Instituto de Psiquiatria do, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, Brazil
- Department of Community and Behavioral Health, Washington State University, Pullman, WA
| | - Orestes V Forlenza
- Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry
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Oh M, Ylitalo KR. Association of Cardiovascular Disease and Physical Activity Phenotypes with Falls among Midlife and Older Adults: 2018 Behavioral Risk Factor Surveillance System. AMERICAN JOURNAL OF HEALTH EDUCATION 2023. [DOI: 10.1080/19325037.2022.2163008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Rietdyk S, Ambike S, Amireault S, Haddad JM, Lin G, Newton D, Richards EA. Co-occurrences of fall-related factors in adults aged 60 to 85 years in the United States National Health and Nutrition Examination Survey. PLoS One 2022; 17:e0277406. [PMID: 36346815 PMCID: PMC9642892 DOI: 10.1371/journal.pone.0277406] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/25/2022] [Indexed: 11/09/2022] Open
Abstract
A broad set of factors are associated with falling (e.g., age, sex, physical activity, vision, health), but their co-occurrence is understudied. Our objectives were to quantify the number and pattern of co-occurring fall-related factors. Data were obtained from the U.S. National Health and Nutrition Examination Survey (N = 1,957, 60–85 years). Twenty fall-related factors were included (based on previous research), covering a wide range including cognitive, motor, sensory, health, and physical activity measures. The number and pattern of co-occurring fall-related factors were quantified with logistic regression and cluster analyses, respectively. Most participants (59%) had ≥4 fall-risk factors, and each additional risk factor increased the odds of reporting difficulty with falling by 1.28. The identified clusters included: (1) healthy, (2) cognitive and sensory impaired, and (3) health impaired. The mean number of co-occurring fall-related factors was 3.7, 3.8, and 7.2, for clusters 1, 2, and 3, respectively (p<0.001). These observations indicate that co-occurrence of multiple fall-risk factors was common in this national sample of U.S. older adults and the factors tended to aggregate into distinct clusters. The findings support the protective effect of physical activity on fall-risk, the association between gait speed and falls, and the detrimental effect of health-related factors on difficulty with falls (e.g., arthritis, prescription medications). Cluster analyses revealed a complex interplay between sex and BMI that may alter the role of BMI in the etiology of falls. Cluster analyses also revealed a large detrimental effect of health-related factors in cluster 3; it is important to extend current fall interventions (typically focused on balance, flexibility, strength, cognitive, fear factors) to include health-related interventions that target factors such as BMI and arthritis.
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Affiliation(s)
- Shirley Rietdyk
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana, United States of America
- Center on Aging and the Life Course, Purdue University, West Lafayette, Indiana, United States of America
- * E-mail:
| | - Satyajit Ambike
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana, United States of America
- Center on Aging and the Life Course, Purdue University, West Lafayette, Indiana, United States of America
| | - Steve Amireault
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana, United States of America
- Center on Aging and the Life Course, Purdue University, West Lafayette, Indiana, United States of America
| | - Jeffrey M. Haddad
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana, United States of America
- Center on Aging and the Life Course, Purdue University, West Lafayette, Indiana, United States of America
| | - Guang Lin
- Data Science Consulting Service, Purdue University, West Lafayette, Indiana, United States of America
- Department of Mathematics, Purdue University, West Lafayette, Indiana, United States of America
- Department of Statistics, Purdue University, West Lafayette, Indiana, United States of America
- Department of Mechanical Engineering, Purdue University, West Lafayette, Indiana, United States of America
| | - David Newton
- Data Science Consulting Service, Purdue University, West Lafayette, Indiana, United States of America
- Department of Statistics, Purdue University, West Lafayette, Indiana, United States of America
| | - Elizabeth A. Richards
- Center on Aging and the Life Course, Purdue University, West Lafayette, Indiana, United States of America
- School of Nursing, Purdue University, West Lafayette, Indiana, United States of America
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Slagel IC, Hatcher V, Romanowski KS, Skeete DA, Galet C. Frailty in mid-life predicts outcome following trauma. Eur J Trauma Emerg Surg 2022; 49:1071-1078. [PMID: 36266479 DOI: 10.1007/s00068-022-02145-0] [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: 08/15/2022] [Accepted: 10/14/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Midlife adults (50-64 y) are at risk for falls and subsequent injury; yet current guidance on fall screening only pertains to older adults (> 65 y). Herein, we evaluated whether frailty was predictive of readmission for falls in midlife trauma patients. STUDY DESIGN This was a retrospective cohort study of trauma midlife patients admitted for traumatic injuries from 2010 to 2015. Demographics, injury data, fall history, and post-index readmission for falls were collected from medical records. Frailty scores were calculated retrospectively using the Canadian Study of Health and Aging Clinical Frailty Scale (CSHA-CFS). The association between frailty and outcomes was assessed. p < 0.05 was considered significant. RESULTS A total of 326 midlife patients were included, 54% were considered fit, 33.7% pre-frail, and 12.3% frail. Compared to their fit and pre-frail counterparts, frail patients were more likely to be female (67.5% vs. 46.3% vs. 36.3%, p < 0.001), have a history of fall (22.5% vs. 15.5% vs. 6.2%, p < 0.001), and to have suffered a ground level fall on index admission (52.5% vs. 20% vs. 5.7%, p < 0.001). Controlling for age, BMI, gender, race, and fall history, frailty was associated with readmission of midlife adults for falls (OR = 1.82 [1.23-2.69]; p = 0.003) and discharge to skilled nursing facilities (OR = 26.86 [8.03-89.81], p < 0.001). CONCLUSIONS Pre-injury frailty may be an effective tool to predict risk of readmission for fall and discharge disposition in midlife trauma patients.
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Affiliation(s)
- Isaac C Slagel
- Division of Acute Care Surgery, Department of Surgery, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Victor Hatcher
- Division of Vascular Surgery, Department of Surgery, University of Iowa, Iowa City, IA, USA
| | - Kathleen S Romanowski
- Division of Burn Surgery, Department of Surgery, University of California, Davis, Sacramento, CA, USA
| | - Dionne A Skeete
- Division of Acute Care Surgery, Department of Surgery, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Colette Galet
- Division of Acute Care Surgery, Department of Surgery, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA.
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Karvonen-Gutierrez CA, Hood MM, Moroi S, Musch DC, Kumar N, Wood SD. Disparities in Vision Impairment and Eye Diseases among Early Late-Life Women: The Study of Women's Health Across the Nation, Michigan Site. Semin Ophthalmol 2022; 37:887-894. [PMID: 35612528 PMCID: PMC9807405 DOI: 10.1080/08820538.2022.2072689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 04/11/2022] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To quantify the burden of vision impairment (VI) and ocular conditions among early late-life women. METHODS Women (n = 254, mean age 66.0 years) participated in a comprehensive vision assessment. Visual acuity (VA) and ocular disorders (diabetic retinopathy, macular degeneration, hypertensive retinopathy, glaucoma and cataracts) were defined clinically. Race, economic strain and education were self-reported. RESULTS The prevalence of presenting VI (VA 20/40 or worse) was 11.0% and 75% of that was correctable (best-corrected VI 2.8%). Black women and those with greater economic strain or less education had a higher prevalence of presenting VI. These disparities were no longer present after considering best-corrected VI. Ocular disease prevalence ranged from 3.3% (age-related macular degeneration) to 30.2% (hypertensive retinopathy), but most participants were unaware of their ocular diagnosis. CONCLUSION The discordance of presenting versus best-corrected VI and lack of knowledge of ocular conditions suggests a need for increased vision services. Access to optimal vision correction may attenuate differences across sociodemographic groups.
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Affiliation(s)
| | - Michelle M Hood
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Sayoko Moroi
- Department of Ophthalmology and Visual Sciences, Havener Eye Institute, the Ohio State University Wexner Medical Center, Columbus, OH, USA
- Department of Ophthalmology and Visual Sciences, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - David C Musch
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Department of Ophthalmology and Visual Sciences, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Navasuja Kumar
- Department of Ophthalmology and Visual Sciences, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
- Department of Internal Medicine, Division of Geriatrics and Palliative Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Sarah Dougherty Wood
- Department of Ophthalmology and Visual Sciences, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
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Salari N, Darvishi N, Ahmadipanah M, Shohaimi S, Mohammadi M. Global prevalence of falls in the older adults: a comprehensive systematic review and meta-analysis. J Orthop Surg Res 2022; 17:334. [PMID: 35765037 PMCID: PMC9238111 DOI: 10.1186/s13018-022-03222-1] [Citation(s) in RCA: 59] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 06/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With increasing life expectancy, declining mortality, and birth rates, the world's geriatric population is increasing. Falls in the older people are one of the most common and serious problems. Injuries from falls can be fatal or non-fatal and physical or psychological, leading to a reduction in the ability to perform activities of daily living. The aim of this study was to determine the prevalence of falls in the older people through systematic review and meta-analysis. METHODS In this systematic review and meta-analysis, the data from studies on the prevalence of falls in the older people in the world were extracted in the databases of Scopus, Web of Science (WoS), PubMed and Science Direct, and Google Scholar, Magiran and Scientific Information Database (SID) without any time limit until August 2020. To analyze the eligible studies, the stochastic effects model was used, and the heterogeneity of the studies with the I2 index was investigated. Data analysis was conducted with Comprehensive Meta-Analysis software (Version 2). RESULTS In the review of 104 studies with a total sample size of 36,740,590, the prevalence of falls in the older people of the world was 26.5% (95% CI 23.4-29.8%). The highest rate of prevalence of falls in the older people was related to Oceania with 34.4% (95% CI 29.2-40%) and America with 27.9% (95% CI 22.4-34.2%). The results of meta-regression indicated a decreasing trend in the prevalence of falls in the older people of the world by increasing the sample size and increasing the research year (P < 0.05). CONCLUSION The problem of falls, as a common problem with harmful consequences, needs to be seriously considered by policymakers and health care providers to make appropriate plans for preventive interventions to reduce the rate of falls in the older people.
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Affiliation(s)
- Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Niloofar Darvishi
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Melika Ahmadipanah
- Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shamarina Shohaimi
- Department of Biology, Faculty of Science, University Putra Malaysia, Serdang, Selangor, Malaysia
| | - Masoud Mohammadi
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran.
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12
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Arphorn S, Ishimaru T, Lertvarayut T, Kiatkitroj K, Theppitak C, Manothum A, Hara K. Risk factors for occupational falls among middle-aged and elderly farm workers in Nan province, Thailand. J Agromedicine 2022; 27:402-408. [DOI: 10.1080/1059924x.2022.2040071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sara Arphorn
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Center of Excellence on Environmental Health and Toxicology, Bangkok, Thailand
| | - Tomohiro Ishimaru
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Teepapipat Lertvarayut
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Public Health, Faculty of Physical Education, Srinakharinwirot University, Nakhon Nayok, Thailand
| | - Kanpitcha Kiatkitroj
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Program of Occupational Health and Safety, Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
| | - Chalermsiri Theppitak
- Institute of Public Health, Suranaree University of Technology, Nakhon Ratchasima, Thailand
| | - Aniruth Manothum
- Faculty of Industrial Technology, Lampang Rajabhat University, Lampang, Thailand
| | - Kunio Hara
- Department of Occupational Safety and Health Management, School of Health Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
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13
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Blackwood J, Suzuki R, Karczewski H. Perceived Neighborhood Walkability is Associated with Recent Falls in Urban Dwelling Older Adults. J Geriatr Phys Ther 2022; 45:E8-E15. [PMID: 33734155 PMCID: PMC8687612 DOI: 10.1519/jpt.0000000000000300] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE In rural communities, perceptions of neighborhood walkability, the rating of how easy it is to walk in an area, influence engagement in physical activity outside the home. This has not been studied in older adults residing in urban settings. Additionally, it is not known how perceived walkability is associated with falls. Therefore, the purpose of this study was to first describe the perceptions of neighborhood walkability in urban-dwelling older adults based on recent fall history and then examine associations between recent falls and neighborhood walkability constructs after controlling for fall risk factors. METHODS Urban-dwelling older adults (N = 132) 65 years and older without cognitive dysfunction or uncontrolled comorbidity completed a survey assessing health status, physical activity, and walkability using the Neighborhood Environment Walkability Scale-Abbreviated. Group assignment was based on recent fall history. Between-group comparisons of demographic and walkability constructs were completed using analysis of variance. Logistic regression was used to examine associations between walkability constructs and recent falls after controlling for covariates. RESULTS AND DISCUSSION Poorer perception of land use was significantly associated with recent falls. Questions assessing the ease of walking to a store or transit stop may be valuable in understanding fall risk in older adults living in urban settings. CONCLUSIONS Perceptions of neighborhood walkability are lower in urban-dwelling older adults with a history of falling.
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Affiliation(s)
| | - Rie Suzuki
- Public Health and Health Sciences Department, University of Michigan-Flint, Flint
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14
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Seth N, Seal A, Ruchin P, McGirr J. The Accuracy of Self-Perception of Obesity in a Rural Australian Population: A Cross-Sectional Study. J Prim Care Community Health 2022; 13:21501319221115256. [PMID: 35997321 PMCID: PMC9421221 DOI: 10.1177/21501319221115256] [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] [Indexed: 11/17/2022] Open
Abstract
Introduction: Obesity is a major public health concern. Accurate perception of body weight
may be critical to the successful adoption of weight loss behavior. The aim
of this study was to determine the accuracy of self-perception of BMI
class. Methods: Patients admitted to the acute medical service in one regional hospital
completed a questionnaire and classified their weight as: “underweight,”
“normal,” “overweight,” or “obese.” Reponses were compared to clinically
measured BMIs, based on the WHO Classification. Patients were also
questioned about health-related behavior. Data were analyzed via Pearson’s
Chi-squared test. Results: Almost 70% of the participating patient population (n = 90) incorrectly
perceived their weight category, with 62% underestimating their weight. Only
34% of patients who were overweight and 14% of patients with obesity
correctly identified their weight status. Two-thirds of patients who were
overweight and one-fifth of patients with obesity considered themselves to
be “normal” or “underweight.” Patients with obesity were 6.5-fold more
likely to misperceive their weight status. Amongst patients with
overweight/obesity, those who misperceived their weight were significantly
less likely to have plans to lose weight. Almost 60% had not made any recent
health behavior changes. This is one of the first regional Australian
studies demonstrating that hospitalized patients significantly misperceive
their weight. Conclusion: Patients with overweight/obesity had significantly higher rates of weight
misperception and the majority had no intention to lose weight or to
undertake any health behavior modification. Given the association between
weight perception and weight reduction behavior, it introduces barriers to
addressing weight loss and reducing the increasing prevalence of obesity in
rural Australia. It highlights that doctors have an important role in
addressing weight misperception.
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Affiliation(s)
- Nimish Seth
- Surgical Resident, Alfred Health, Melbourne, VIC, Australia
| | - Alexa Seal
- School of Medicine Sydney, Rural Clinical School, The University of Notre Dame Australia, Wagga Wagga, NSW, Australia
| | - Peter Ruchin
- School of Medicine Sydney, Rural Clinical School, The University of Notre Dame Australia, Wagga Wagga, NSW, Australia.,The University of New South Wales, Sydney, NSW, Australia.,Calvary Hospital Riverina, Wagga Wagga, NSW, Australia.,Mater Hospital, North Sydney, NSW, Australia.,Wagga Wagga Base Hospital, Wagga Wagga, NSW, Australia
| | - Joe McGirr
- School of Medicine Sydney, Rural Clinical School, The University of Notre Dame Australia, Wagga Wagga, NSW, Australia.,State Member of Parliament, Wagga Wagga, NSW, Australia
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15
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Predicting Falls Among Community-Dwelling Older Adults: A Demonstration of Applied Machine Learning. Comput Inform Nurs 2021; 39:273-280. [PMID: 33208628 DOI: 10.1097/cin.0000000000000688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Data science skills are increasingly needed by informatics nurses and nurse scientists, but techniques such as machine learning can be daunting for those with clinical, rather than computer science or technical, backgrounds. With the increasing quantity of publicly available population-level datasets, identification of factors that predict clinical outcomes is possible using machine learning algorithms. This study demonstrates how to apply a machine learning approach to nursing-relevant questions, specifically an approach to predict falls among community-dwelling older adults, based on data from the 2014 Behavioral Risk Factor Surveillance System. A random forest algorithm, a common approach to machine learning, was compared to a logistic regression model. Explanations of how to interpret the models and their associated performance characteristics are included to serve as a tutorial to readers. Machine learning methods constitute an increasingly important approach for nursing as population-level data are increasingly being made available to the public.
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16
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G R Neri S, S Oliveira J, B Dario A, M Lima R, Tiedemann A. Does Obesity Increase the Risk and Severity of Falls in People Aged 60 Years and Older? A Systematic Review and Meta-analysis of Observational Studies. J Gerontol A Biol Sci Med Sci 2021; 75:952-960. [PMID: 31750880 DOI: 10.1093/gerona/glz272] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Recent investigations suggest that obesity may be associated with an increased risk of falls; however, this theory has yet to be definitively confirmed. This systematic review and meta-analysis examined the strength of the association between obesity and falls, multiple falls, fall-related injuries, and fall-related fractures among older adults. METHODS MEDLINE, Embase, CINAHL, PsycINFO, SPORTDiscus, LILACS, and Web of Science databases were searched to identify observational studies that assessed the association between obesity and fall-related outcomes in participants aged 60 years and older. Two independent reviewers performed data extraction and quality assessment. Relative risks and 95% confidence intervals (CI) were pooled using random effect meta-analyses. RESULTS Thirty-one studies including a total of 1,758,694 participants were selected from 7,815 references. Pooled estimates showed that obese older adults have an increased risk of falls compared with nonobese counterparts (24 studies; relative risk: 1.16; 95% CI: 1.07-1.26; I2: 90%). Obesity was also associated with an increased risk of multiple falls (four studies; relative risk: 1.18; 95% CI: 1.08-1.29; I2: 0%). There was no evidence, however, of an association between obesity and fall-related injuries (seven studies; relative risk: 1.04; 95% CI: 0.92-1.18; I2: 65%). Fall-related fractures were reported in only one study, which demonstrated a lower risk of hip fracture with obesity (odds ratio: 0.65; 95% CI: 0.63-0.68). CONCLUSIONS Obesity increases the risk of falls and multiple falls in people aged 60 years and older; however, there is insufficient evidence of an association with fall-related injuries or fractures. Prevention and treatment of obesity may play a role in preventing falls in older age.
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Affiliation(s)
- Silvia G R Neri
- Faculty of Physical Education, University of Brasilia, Brazil
| | - Juliana S Oliveira
- Institute for Musculoskeletal Health, School of Public Health, Faculty of Medicine and Health, Australia
| | - Amabile B Dario
- Work Integrated Learning, Faculty of Health Sciences, The University of Sydney, Australia
| | - Ricardo M Lima
- Faculty of Physical Education, University of Brasilia, Brazil
| | - Anne Tiedemann
- Institute for Musculoskeletal Health, School of Public Health, Faculty of Medicine and Health, Australia
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17
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Ylitalo KR, Karvonen-Gutierrez CA, Sternfeld B, Pettee Gabriel K. Association of Physical Activity and Physical Functioning Phenotypes With Fall Risk Among Women. J Aging Health 2021; 33:409-417. [PMID: 33517822 DOI: 10.1177/0898264320988405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Objective: Physical activity (PA) may slow aging-related declines in physical functioning (PF), but the relationship of PA and falls is not well understood. This study examined the association of PA and PF with falls. Methods: The Study of Women's Health Across the Nation participants (n = 1597; age: 65.1 years ± 2.7) reported PF and PA in 2012-2013 and falls in 2016-2017. Four phenotypes were identified: high PA-high PF, high PA-low PF, low PA-high PF, and low PA-low PF. Results: One-third (29.3%) reported ≥1 fall. Women with low PA-low PF (RR = 1.32; 95% CI: 1.06, 1.66) and with high PA-low PF (RR = 1.37; 95% CI: 1.07, 1.74) were more likely to fall than high PA-high PF. Over time, women with worsening PF had increased fall risk (RR = 1.43; 95% CI: 1.17, 1.74), but women who increased PA did not. Discussion: Poor PF increases the risk of falls, regardless of PA. However, increasing PA does not necessarily increase fall risk, reinforcing the importance of PA engagement.
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18
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Hermenegildo-López Y, Sandoval-Insausti H, Donat-Vargas C, Banegas JR, Rodríguez-Artalejo F, Guallar-Castillón P. General and central obesity operate differently as predictors of falls requiring medical care in older women: a population-based cohort study in Spain. Age Ageing 2021; 50:213-219. [PMID: 32857126 DOI: 10.1093/ageing/afaa164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES to examine the association of general and abdominal obesity with falls, falls requiring medical care and falls with fractures in older women. DESIGN a population-based prospective cohort of 1,185 women aged ≥60 in Spain, followed up from 2008 to 2010 through 2012. MEASURES weight, height and waist circumference were measured at baseline using standardised techniques. Participants were classified according to body mass index as normal weight (<25), overweight (25-29.9) and general obesity (≥30). Abdominal obesity was defined as waist circumference >88 cm. In 2012, participants reported the falls experienced in the previous year. Logistic regression models were mutually adjusted for general and abdominal obesity and for main confounders. RESULTS in this cohort of older women, a total of 336 women experienced falls, 168 of them had falls requiring medical care and 64 falls with fractures. For falls, no association was found with general obesity nor abdominal obesity. However, compared with normal weight, overweight women had a decreased risk for falls requiring medical care [odds ratio (OR) 0.57; 95% confidence interval (CI) 0.34-0.94] and for falls with fractures (OR 0.27; 95% CI 0.12-0.63). The corresponding values for general obesity were 0.44 (0.24-0.81) and 0.30 (0.11-0.82). Abdominal obesity was positively associated with falls requiring medical care (OR 1.82; 95% CI 1.12-2.94) and falls with fractures (OR 2.75; 95% CI 1.18-6.44). CONCLUSIONS in older women, general obesity may protect from falls requiring medical care and falls with fractures. On the contrary, abdominal obesity increased the risk of suffering from types of falls.
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Affiliation(s)
- Ygor Hermenegildo-López
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- Transfusion Center of the Community of Madrid, Madrid, Spain
| | - Helena Sandoval-Insausti
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Carolina Donat-Vargas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Jose Ramón Banegas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Pilar Guallar-Castillón
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
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19
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Abstract
The population worldwide is aging and prevalence of obesity in this population is increasing. The range of consequences that effect these at-risk patients include increased risk of falls, fractures, reduced quality of life, and cognitive decline. This article describes the epidemiology of obesity, risks and benefits of weight loss, and importance of treating obesity to help promote healthy aging. Health care professionals should encourage older adults with obesity to implement healthy lifestyle behaviors including exercise and diet routine. Treating obesity in older adults mitigates the significant public health crisis, and reduces health care utilization and risk of long-term adverse events.
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Affiliation(s)
- Meredith N Roderka
- Section of Weight & Wellness, Department of Medicine, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756, USA
| | - Sadhana Puri
- Geisel School of Medicine, 1 Rope Ferry Road, Hanover, NH 03755, USA
| | - John A Batsis
- Section of Weight & Wellness, Department of Medicine, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756, USA; Geisel School of Medicine, 1 Rope Ferry Road, Hanover, NH 03755, USA; The Dartmouth Institute for Health & Clinical Practice, 1 Medical Center Drive, Lebanon, NH 03756, USA; Dartmouth Centers for Health and Aging Hitchcock Loop Road, Lebanon, NH 03766, USA; Section of General Internal Medicine, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756, USA.
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20
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Ylitalo KR, Strotmeyer ES, Pettee Gabriel K, Lange-Maia BS, Avis NE, Karvonen-Gutierrez CA. Peripheral Nerve Impairment and Recurrent Falls Among Women: Results From the Study of Women's Health Across the Nation. J Gerontol A Biol Sci Med Sci 2020; 75:2020-2027. [PMID: 31549141 DOI: 10.1093/gerona/glz211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Falls and related injuries are important public health concerns yet underappreciated in early aging. This study examined the association of peripheral nerve impairment (PNI) with fall outcomes in early old aged women (60-72 years). METHODS Women (n = 1,725; mean age 65.1 ± 2.7 years) from the longitudinal cohort Study of Women's Health Across the Nation completed a PNI questionnaire on presence, frequency, and severity of symptoms, and 10- and 1.4-g monofilament testing in 2016-2017. PNI was defined as four or more self-reported symptoms or monofilament insensitivity. Recurrent falls (two or more) and recurrent fall injuries (two or more falls with one or more injuries) in the previous 12 months were assessed via questionnaire. Poisson regression was used to generate risk ratios (RRs) and corresponding 95% confidence intervals (CIs) for the fall outcomes, adjusting for covariates. RESULTS Approximately 12.3% of participants reported two ore more falls, 7.6% reported recurrent falls with injury, and 15.8% reported four or more PNI symptoms. Women with recurrent falls were more likely to report four or more PNI symptoms compared to women without recurrent falls (32.1% vs 13.5%; p < .001). One quarter (25.6%) of participants had four or more PNI symptoms or monofilament insensitivity; after adjusting for covariates, women with either symptoms or insensitivity were more likely to report recurrent falls compared to women with neither (RR = 1.64; 95% CI: 1.24, 2.17). CONCLUSIONS These findings suggest that PNI may identify those at high risk for falls, particularly among women during early late life. Neuropathy screening instruments such as symptom questionnaires or monofilament testing are easy to implement and may have utility for fall risk assessment.
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Affiliation(s)
- Kelly R Ylitalo
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, Texas
| | - Elsa S Strotmeyer
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania
| | - Kelley Pettee Gabriel
- Department of Epidemiology, Human Genetics, and Environmental Sciences, UTHealth School of Public Health - Austin Campus, Texas.,Department of Women's Health, Dell Medical School, Chicago, Illinois.,Department of Kinesiology and Health Education, The University of Texas at Austin, Chicago, Illinois
| | - Brittney S Lange-Maia
- Department of Preventive Medicine, Center for Community Health Equity, Rush University Medical Center, Chicago, Illinois
| | - Nancy E Avis
- Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina
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21
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Karvonen-Gutierrez CA, Ylitalo KR, Peng MQ. Midlife falls are associated with increased risk of mortality in women: Findings from the National Health and Nutrition Examination Survey III. Arch Gerontol Geriatr 2020; 91:104206. [PMID: 32763757 PMCID: PMC7854835 DOI: 10.1016/j.archger.2020.104206] [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: 04/20/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Falls are a public health concern for older adults but are also common among midlife adults. However, the consequences of falls occurring during midlife are not well understood. METHODS This investigation assessed the relationship between falls and mortality among midlife adults using survey data from the Third National Health and Nutrition Examination Survey (n = 1,295), linked to the National Death Index. The relationship between recurrent falls (≥2 falls) in the past year and 10-year death rate was assessed using survey-weighted Cox regression. RESULTS Nearly 20 % of adults who died within 10 years of their interview date were recurrent fallers at the time of interview. For women only, recurrent fallers had more than 4-fold increased hazard of death within 10 years compared to non-recurrent fallers (HR = 4.41; 95 % CI:2.24,8.68). CONCLUSIONS Findings suggest that midlife women are particularly vulnerable to adverse outcomes following recurrent falls. Fall prevention efforts should include efforts targeted at midlife women.
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Affiliation(s)
| | - Kelly R Ylitalo
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, United States
| | - Mia Q Peng
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, United States
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22
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Gadelha AB, Neri SGR, Vainshelboim B, Ferreira AP, Lima RM. Dynapenic abdominal obesity and the incidence of falls in older women: a prospective study. Aging Clin Exp Res 2020; 32:1263-1270. [PMID: 31489597 DOI: 10.1007/s40520-019-01318-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 08/10/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Dynapenic abdominal obesity (D/AO) has been associated with negative outcomes in older people, including trait of falls. AIMS To assess the association between D/AO and the incidence of falls over 18 months in older community-dwelling women. METHODS A total of 201 older women (67.97 ± 6.02 years; 27.70 kg/m2) underwent waist circumference measurement, and had handgrip strength assessed using a hydraulic dynamometer. Dynapenia was classified using the lower tertile of handgrip strength, while abdominal obesity was considered as a waist circumference > 88 cm. D/AO was the combination of both aforementioned criteria. Volunteers were classified into four groups: normal, abdominal obesity, dynapenic, and D/AO. Participants were then tracked by phone calls for ascertainment of falls during a follow-up period of 18 months. Chi-square and multivariable Cox proportional regressions were conducted. RESULTS The overall incidence of falls over the follow-up was 27.5%; and for normal, dynapenic, abdominal obesity, and D/AO were 14.7%, 17.2%, 27.5%, and 40.4% (X2 = 8.341; P = 0.039), respectively. D/AO was associated with a higher risk of falls (hazard ratio: 3.595 [95% CI: 1.317-9.815], even after adjustments for age, body mass index, physical activity level, regular use of medications, peripheral sensation, chronic diseases, and history of lower-limbs pain. CONCLUSIONS D/AO is more closely related to falls than either dynapenia or abdominal obesity alone, and is independently associated with an increased incidence of falls in older women. These results provide support for the concept that the combined evaluation of muscle strength and central obesity may be clinically relevant in this population.
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Affiliation(s)
- André Bonadias Gadelha
- Department of Physical Education and Sports, Federal Institute of Education, Science and Technology Goiano, Rod. Geraldo Silva Nascimento, Km-2,5, Zona Rural, Urutaí, Goiás, 75790-000, Brazil.
| | - Silvia G R Neri
- Faculdade de Educação Física, University of Brasília, Campus Darcy Ribeiro, Asa Norte, Brasília, 70910-900, Distrito Federal, Brazil
| | - Baruch Vainshelboim
- Master of Cancer Care Program, School of Health Sciences, Saint Francis University, Loretto, PA, USA
| | | | - Ricardo M Lima
- Faculdade de Educação Física, University of Brasília, Campus Darcy Ribeiro, Asa Norte, Brasília, 70910-900, Distrito Federal, Brazil
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23
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Neri SGR, Harvey LA, Tiedemann A, Gadelha AB, Lima RM. Obesity and falls in older women: Mediating effects of muscle quality, foot loads and postural control. Gait Posture 2020; 77:138-143. [PMID: 32036318 DOI: 10.1016/j.gaitpost.2020.01.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 12/12/2019] [Accepted: 01/24/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Obesity is associated with an increased risk of falls in older women. However, it is not certain whether factors commonly associated with obesity and falls mediate this risk. RESEARCH QUESTION Do lower-limb muscle quality, foot loads and postural control mediate the relationship between obesity and falls in women aged 60 years and older? METHODS At baseline, 246 female participants underwent obesity screening (BMI≥30 kg/m²), and measurements of muscle quality (isokinetic dynamometer and dual-energy X-ray absorptiometry), foot loads (pressure platform) and postural balance (force platform). Incident falls were recorded at the end of the 18-month follow-up period via participant recall. To test whether, and to what extent, biomechanical factors mediated the relationship between obesity and falls, the Natural Indirect Effects (NIE), Natural Direct Effect (NDE) and proportion mediated were calculated using the counterfactual approach. Significance level was set at p < .05. RESULTS 204 participants (83 %) completed the follow-up. As expected, obesity was associated with a higher risk of being a faller (RR: 2.13, 95 % CI: 1.39-3.27). Using the counterfactual approach, only specific torque (NIE: 1.11, 95 % CI: 1.01-1.38) and flatfoot (NIE: 1.10, 95 % CI: 1.01-1.32) were significant mediators of the relationship between obesity and falls. Specific torque and flatfoot mediated 19 % and 21 % of the relationship, respectively. SIGNIFICANCE Lower-limb muscle quality (specific torque) and foot loads (flatfoot) mediate the relationship between obesity and falls in older women. The inclusion of muscle strengthening and podiatry interventions as part of a fall prevention program may benefit this population.
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Affiliation(s)
- Silvia G R Neri
- Faculty of Physical Education, University of Brasilia, Brazil.
| | - Lara A Harvey
- Neuroscience Research Australia, University of New South Wales, Australia
| | - Anne Tiedemann
- Institute for Musculoskeletal Health, The University of Sydney, Australia
| | - André B Gadelha
- Faculty of Physical Education, University of Brasilia, Brazil
| | - Ricardo M Lima
- Faculty of Physical Education, University of Brasilia, Brazil
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24
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Falls Experiences and Prevention Preferences of Adults in Mid-life. J Community Health 2019; 44:1160-1167. [PMID: 31280430 DOI: 10.1007/s10900-019-00703-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Falls prevention research and practice has focused primarily on older adults, yet healthy and productive aging does not begin at age 65. To help fill this gap in knowledge, the purpose of this study was to explore the falls experiences and prevention program preferences of adults in mid-life who had experienced falls or near falls. A qualitative study using content analysis was used. Multiple coders were employed to increase the reliability of the findings. Results revealed three major themes with regard to falls experiences including precursors to falls, physical implications, and functional implications. For prevention preferences, themes included a continuum of interest, convenience is key, money matters, people you trust prompt action, and preventing future injury. Study results reveal new insights regarding the falls experiences and prevention preferences of adults in mid-life and can serve as a starting point to inform prevention programs targeting this population.
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25
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Cognitive Function Is Associated With Mobility in Community Dwelling Older Adults With a History of Cardiovascular Disease. Cardiopulm Phys Ther J 2019. [DOI: 10.1097/cpt.0000000000000095] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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26
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Rosic G, Milston AM, Richards J, Dey P. Fear of falling in obese women under 50 years of age: a cross-sectional study with exploration of the relationship with physical activity. BMC OBESITY 2019; 6:7. [PMID: 30867933 PMCID: PMC6398230 DOI: 10.1186/s40608-019-0230-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 01/10/2019] [Indexed: 12/19/2022]
Abstract
Background An understanding of capacity for physical activity in obese populations should help guide interventions to promote physical activity. Fear of falling is a phenomenon reported in the elderly, which is associated with reduced mobility and lower physical activity levels. However, although falls are reportedly common in obese adults, fear of falling and its relationship with activity has not been investigated in younger obese populations. Methods In a cross-sectional study, fear of falling was measured in 63 women aged 18 to 49 years, with mean BMI 42.1 kg/m2 (SD 10.3) using the Modified Falls Efficacy (MFES), the Consequences of Falling (COF) and the Modified Survey of Activities and Fear of Falling in the Elderly (MSAFFE) scales. The choice of scales was informed by prior qualitative interviews with obese younger women. Physical activity levels were measured at the same time using the International Physical Activity Questionnaire. The mean score for fear of falling scales, with 95% confidence intervals, were estimated. Chi-square tests and t-tests were used to explore differences in age, body mass index and fear of falling scores between fallers and non-fallers. For each fear of falling scale, binomial logistic regression was used to explore its relationship with physical activity. Results Mean scores suggested high levels of fear of falling: MFES [mean 7.7 (SD 2.7); median 8.5]; COF [mean 31.3 (SD 9.4)]; MSAFFE [mean 25.9 (SD 8.7); median 23]. Scores were significantly worse in fallers (n = 42) compared to non-fallers (n = 21). MFES and MSAFFE were independently associated with lower levels of physical activity [odds ratio = 0.65, 95% Cl 0.44 to 0.96 and odds ratio = 1.14, 95% CI 1.01 to 1.28 respectively], when adjusted for age, BMI and depression. Conclusions This study confirms that fear of falling is present in obese women under 50 years of age. It suggests that it is associated with low levels of physical activity. These novel findings warrant further research to understand capacity for physical and incidental activity in obese adults in both genders and suggest innovative interventions to promote lifestyle changes and/or consideration of falls prevention in this population.
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Affiliation(s)
- Gilly Rosic
- 1Nepean Blue Mountains Family Metabolic Health Service, Nepean Clinical School, Kingswood, New South Wales and University of Sydney, Sydney, Australia
| | - Anne M Milston
- 2Faculty of Health and Wellbeing, University of Central Lancashire, Preston, Lancashire UK
| | - Jim Richards
- 3Allied Health Research Unit, University of Central Lancashire, Preston, Lancashire UK
| | - Paola Dey
- 4Faculty of Health and Social Care, Edge Hill University, Road, Ormskirk, St Helens, Lancashire L39 4QP UK
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Abstract
Falls pose substantial challenges to health care institutions. This review aims to provide a synthesis and critique of studies that investigated fall injury risk factors and to identify significant risk factors that predispose patients to injurious falls. A comprehensive literature search was conducted in PubMed, COCHRANE, Embase, Cumulative Index to Nursing and Allied Heath Literature, and Scopus. Additional records were searched through Google Scholar and bibliographies of the retrieved articles. Twenty-three primary research studies were included. Demographic, intrinsic, and extrinsic factors have been identified. Demographics include age, gender, and marital status. Intrinsic factors include body mass index, medication, and preexisting conditions, and extrinsic factors include environmental factors. Several factors were found to be inconclusive. These factors should be considered and examined further. Future research may evaluate interventions focusing on targeted risk factors of injurious falls. Clinical guidelines addressing the factors in this review may be considered after further testing and research.
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Gadelha AB, Neri SGR, Bottaro M, Lima RM. The relationship between muscle quality and incidence of falls in older community-dwelling women: An 18-month follow-up study. Exp Gerontol 2018; 110:241-246. [PMID: 29935953 DOI: 10.1016/j.exger.2018.06.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 06/14/2018] [Accepted: 06/18/2018] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Important components that might mediate the relationship between aging and falls are reduced muscle strength and mass. Although muscle-related phenotypes have been linked to falls in older people, the role of muscle quality has yet to be examined. AIM To investigate the relationship between muscle quality and incidence of falls over an 18-month follow-up in older community-dwelling women. METHODS A total of 167 women (68.1 ± 6.2 years) underwent quadriceps isometric peak torque and thigh-muscle thickness assessments using isokinetic dynamometer and ultrasound, respectively. Muscle quality was considered as the ratio between maximal strength and muscle thickness. Participants were tracked by phone calls for ascertainment of falls during the follow-up period. Cox proportional regressions and X2 tests were performed, with statistical significance set at P < 0.05. RESULTS A total of 139 volunteers were successful tracked over the follow-up period. The overall incidence of fall was 23.4% (95% CI: 16.5-31.0). Rate of fallers among individuals with low-muscle quality (57.7%) was higher than in those with normal muscle quality (15.3%) (X2 = 21.132; P < 0.001). The proportion of multiple fallers was also significantly higher (X2 = 11.029; P < 0.001) among volunteers with low-muscle quality when compared to those with normal muscle quality (14.8% and 3.6%, respectively). The presence of low-muscle quality was associated with a significantly greater risk of falls over the follow-up (hazard ratio: 4.619; 95% CI: 2.302-9.269). CONCLUSION Low-muscle quality is associated with a higher incidence of falls in older women. These findings provide support for the concept that muscle quality is a clinically meaningful assessment among older people.
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Affiliation(s)
- André Bonadias Gadelha
- College of Physical Education, University of Brasília, Brasília, Distrito Federal, Brazil.
| | | | - Martim Bottaro
- College of Physical Education, University of Brasília, Brasília, Distrito Federal, Brazil
| | - Ricardo M Lima
- College of Physical Education, University of Brasília, Brasília, Distrito Federal, Brazil
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Carlsson LMS, Sjöholm K, Ahlin S, Jacobson P, Andersson-Assarsson JC, Karlsson Lindahl L, Maglio C, Karlsson C, Hjorth S, Taube M, Carlsson B, Svensson PA, Peltonen M. Long-term incidence of serious fall-related injuries after bariatric surgery in Swedish obese subjects. Int J Obes (Lond) 2018; 43:933-937. [PMID: 29795467 PMCID: PMC6252168 DOI: 10.1038/s41366-018-0097-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 03/14/2018] [Accepted: 04/04/2018] [Indexed: 12/13/2022]
Abstract
Obesity increases risk of falling, but the effect of bariatric surgery on fall-related injuries is unknown. The aim of this study was therefore to study the association between bariatric surgery and long-term incidence of fall-related injuries in the prospective, controlled Swedish Obese Subjects study. At inclusion, body mass index was ≥ 34 kg/m2 in men and ≥38 kg/m2 in women. The surgery per-protocol group (n = 2007) underwent gastric bypass (n = 266), banding (n = 376), or vertical banded gastroplasty (n = 1365), and controls (n = 2040) received usual care. At the time of analysis (31 December 2013), median follow-up was 19 years (maximal 26 years). Fall-related injuries requiring hospital treatment were captured using data from the Swedish National Patient Register. During follow-up, there were 617 first-time fall-related injuries in the surgery group and 513 in the control group (adjusted hazard ratio 1.21, 95% CI, 1.07-1.36; P = 0.002). The incidence differed between treatment groups (P < 0.001, log-rank test) and was higher after gastric bypass than after usual care, banding and vertical banded gastroplasty (adjusted hazard ratio 0.50-0.52, P < 0.001 for all three comparisons). In conclusion, gastric bypass surgery was associated with increased risk of serious fall-related injury requiring hospital treatment.
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Affiliation(s)
- Lena M S Carlsson
- Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Kajsa Sjöholm
- Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
| | - Sofie Ahlin
- Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Catholic University of the Sacred Heart, Rome, Italy
| | - Peter Jacobson
- Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | | | - Linda Karlsson Lindahl
- Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Cristina Maglio
- Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Wallenberg Centre for molecular and translational medicine, University of Gothenburg, Gothenburg, Sweden
| | - Cecilia Karlsson
- Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Global Medicines Development, AstraZeneca Gothenburg, Mölndal, Sweden
| | - Stephan Hjorth
- Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Magdalena Taube
- Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Björn Carlsson
- Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,CVMD Translational Medicine Unit, Early Clinical Development, IMED Biotech Unit, AstraZeneca Gothenburg, Mölndal, Sweden
| | - Per-Arne Svensson
- Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Institute of Health and Care Sciences, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Markku Peltonen
- National Institute for Health and Welfare, Helsinki, Finland
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Kwon SC, Han BH, Kranick JA, Wyatt LC, Blaum CS, Yi SS, Trinh-Shevrin C. Racial and Ethnic Difference in Falls Among Older Adults: Results from the California Health Interview Survey. J Racial Ethn Health Disparities 2018; 5:271-278. [PMID: 28411329 PMCID: PMC5641225 DOI: 10.1007/s40615-017-0367-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 03/31/2017] [Accepted: 04/03/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND Research suggests that fall risk among older adults varies by racial/ethnic groups; however, few studies have examined fall risk among Hispanics and Asian American older adults. METHODS Using 2011-2012 California Health Interview Survey data, this study examines falling ≥2 times in the past year by racial/ethnic groups (Asian Americans, Hispanics, and Blacks) aged ≥65, adjusting for socio-demographic characteristics, body mass index, co-morbidities, and functional limitations. A secondary analysis examines differences in fall risk by English language proficiency and race/ethnicity among Asian Americans and Hispanics. RESULTS Asian Americans were significantly less likely to fall compared to non-Hispanic whites, individuals with ≥2 chronic diseases were significantly more likely to fall than individuals with <2 chronic diseases, and many functional limitations were significantly associated with fall risk, when adjusting for all factors. African Americans and Hispanics did not differ significantly from non-Hispanic whites. Analysis adjusting for race/ethnicity and English language proficiency found that limited English proficient Asian Americans were significantly less likely to fall compared to non-Hispanic whites, individuals with ≥2 chronic diseases were significantly more likely to fall than individuals with <2 chronic diseases, and all functional limitations were significantly associated with fall risk, when adjusting for all factors. No differences were found when examining by racial/ethnic and English proficient/limited English proficient groups. CONCLUSION Further research is needed to explore factors associated with fall risks across racial/ethnic groups. Culturally relevant and targeted interventions are needed to prevent falls and subsequent injuries in the increasingly diverse aging population in the USA.
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Affiliation(s)
- Simona C Kwon
- Department of Population Health, New York University School of Medicine, 550 First Avenue VZN, New York, NY, 10016, USA
| | - Benjamin H Han
- Division of Geriatric Medicine and Palliative Care, Department of Medicine, New York University School of Medicine, New York, NY, USA
| | - Julie A Kranick
- Department of Population Health, New York University School of Medicine, 550 First Avenue VZN, New York, NY, 10016, USA
| | - Laura C Wyatt
- Department of Population Health, New York University School of Medicine, 550 First Avenue VZN, New York, NY, 10016, USA.
| | - Caroline S Blaum
- Division of Geriatric Medicine and Palliative Care, Department of Medicine, New York University School of Medicine, New York, NY, USA
| | - Stella S Yi
- Department of Population Health, New York University School of Medicine, 550 First Avenue VZN, New York, NY, 10016, USA
| | - Chau Trinh-Shevrin
- Department of Population Health, New York University School of Medicine, 550 First Avenue VZN, New York, NY, 10016, USA
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Neri SGR, Gadelha AB, Pereira JC, Gutierres Filho PJB, Lima RM. Obesity is associated with reduced postural control in community-dwelling older adults: a systematic review. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2018. [DOI: 10.1080/21679169.2018.1442496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
| | - André Bonadias Gadelha
- College of Physical Education, University of Brasília, Brasília, DF, Brazil
- Mauá Institute of Research and Education, Vicente Pires, DF, Brazil
| | - Juscélia Cristina Pereira
- College of Physical Education, University of Brasília, Brasília, DF, Brazil
- Department of Education, Federal Institute of Triângulo Mineiro, Paracatu, MG, Brazil
| | | | - Ricardo M. Lima
- College of Physical Education, University of Brasília, Brasília, DF, Brazil
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32
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Abstract
Obesity in older adults affects not only morbidity and mortality but, importantly, quality of life and the risk of institutionalization. Weight loss interventions can effectively lead to improved physical function. Diet-alone interventions can detrimentally affect muscle and bone physiology and, without interventions to affect these elements, can lead to adverse outcomes. Understanding social and nutritional issues facing older adults is of utmost importance to primary care providers. This article will also discuss the insufficient evidence related to pharmacotherapy as well as providing an overview of using physiologic rather than chronologic age for identifying suitable candidates for bariatric surgery.
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Affiliation(s)
- John A Batsis
- Section of General Internal Medicine, Geisel School of Medicine at Dartmouth, The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756, USA.
| | - Alexandra B Zagaria
- Section of General Internal Medicine, Geisel School of Medicine at Dartmouth, The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756, USA
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33
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Fall prevalence, time trend and its related risk factors among elderly people in China. Arch Gerontol Geriatr 2017; 73:294-299. [DOI: 10.1016/j.archger.2017.08.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 08/21/2017] [Accepted: 08/26/2017] [Indexed: 11/21/2022]
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