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Moein S, Peterson EW, Rice LA. Factors associated with fear of falling and fall-related injuries among people who use wheelchairs and motorized mobility scooters: a cross-sectional study. Disabil Rehabil 2024:1-9. [PMID: 38910322 DOI: 10.1080/09638288.2024.2365984] [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: 01/04/2024] [Accepted: 06/05/2024] [Indexed: 06/25/2024]
Abstract
PURPOSE To identify the factors associated with the fear of falling (FOF) and fall-related injuries (FRI) among full-time wheelchair and motorized mobility scooter (WC/S) users with various health conditions. METHODS This cross-sectional study included participants (≥18 years old) who used WC/S for at least one year for ≥ 75% of mobility and had a history of ≥ 1 fall in the past three years. Logistic regression models identified factors associated with FOF (yes/no) and FRI (yes/no) during the past year. Data on demographics, prior falls, mental health, environmental accessibility, and WC/S usage were used as independent variables. RESULTS Among 156 participants, 96% reported at least one fall within the past year, among whom 94.6% reported FOF, and 74% reported FRI within the same period. FOF was associated with fall incidence in the past year (OR = 17.75, p = 0.001). FRI was associated with higher levels of anxiety (OR = 1.15, p = 0.003) and fewer hours of WC/S use per week (OR = 0.98, p = 0.012). CONCLUSION This study highlights the high prevalence of FOF and FRI among WC/S users who had falls. The findings emphasized the relation between prior fall experiences and FOF and underscored the significance of addressing anxiety symptoms and WC/S usage in relation to FRI.
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Affiliation(s)
- Sahel Moein
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Elizabeth W Peterson
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, USA
| | - Laura A Rice
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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Wang J, Li S, Hu Y, Ren L, Yang R, Jiang Y, Yu M, Liu Z, Wu Y, Dong Z, Zhang C, Dong W, Yao Y. The moderating role of psychological resilience in the relationship between falls, anxiety and depressive symptoms. J Affect Disord 2023; 341:211-218. [PMID: 37579882 DOI: 10.1016/j.jad.2023.08.060] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 07/30/2023] [Accepted: 08/11/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND There is a greater likelihood of anxiety and depression among older adults who suffer falls. This study examined the relationships of falls and severe falls with anxiety and depressive symptoms, and the moderating role of psychological resilience on these associations. METHODS Our study recruited participants from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), a nationally representative cohort study. A total of 11,857 participants included in the analysis. We used a linear regression model to investigate the relationship between falls/severe falls and anxiety/depressive symptoms, adjusting for a range of potential covariates and a bootstrapping sample test to examine the potential moderating role of psychological resilience in these relationships. RESULTS Older adults who suffered the falls have higher anxiety/depressive symptoms (β = 0.28 [0.23, 0.32] for anxiety symptoms, p < 0.001; β = 0.21 [0.16, 0.25] for depressive symptoms, p < 0.001), and those who suffered the severe falls have higher anxiety/depressive symptoms (β = 0.30 [0.24, 0.37] for anxiety symptoms, p < 0.001; β = 0.21 [0.15, 0.27] for depressive symptoms, p < 0.001), in the fully adjusted model. The relationship between falls/severe falls and anxiety/depressive symptoms was mitigated in participants with higher levels of psychological resilience. LIMITATIONS The present study is based on cross-sectional data, which limits the ability to infer causal relationships. CONCLUSIONS Falls/severe falls were positively associated with anxiety and depression, and that psychological resilience could moderate this association. Our findings suggest that psychological resilience may be an effective target for intervention and prevention of fall-related symptoms of anxiety and depression.
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Affiliation(s)
- Jingjing Wang
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China
| | - Shaojie Li
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China
| | - Yang Hu
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China
| | - Longbing Ren
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China
| | - Rui Yang
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China
| | - Yuling Jiang
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China
| | - Mingzhi Yu
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China
| | - Zhouwei Liu
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China
| | - Yifei Wu
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China
| | - Ziqi Dong
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China
| | - Chi Zhang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China
| | - Wentian Dong
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health, Peking University, Beijing, China; National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, China.
| | - Yao Yao
- China Center for Health Development Studies, Peking University, Beijing, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China.
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Feng Z, Chen Q, Li Y, Xue Z, Hao X. The association between falls and depressive symptoms among older adults: evidence from the China Health and Retirement Longitudinal Study. Front Public Health 2023; 11:1248551. [PMID: 38026352 PMCID: PMC10643149 DOI: 10.3389/fpubh.2023.1248551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/10/2023] [Indexed: 12/01/2023] Open
Abstract
Background Falls place a heavy burden on older adults and families, and there was little research on the relationship between falls and depressive symptoms among older adults in China. This study is designed to examine the association between falls and depressive symptoms in Chinese older adults. Methods This study was based on 9,539 data sets from the China Health and Retirement Longitudinal Study (CHARLS) in 2018. The 10-item Center for Epidemiologic Studies-Depression Scale (CESD-10) was used to access depressive symptoms in older adults. A logistic regression model was used to calculate multivariate odds ratios (ORs) and 95% confidence intervals (CIs) for falls and depressive symptoms, adjusted for possible confounders. The Classification and regression tree (CART) demonstrates the prediction of the target variable values based on other variables. Results In this study, 9,539 older people were selected: 60-69 years old accounted for 63.0%, 70-79 years old accounted for 29.7%, and 80 years old and above accounted for 7.3%. Male accounted for 49.7% and female for 50.3%. The rate of falls among older adults was 21.4%, and the rate of depressive symptoms was 33.9%. Adjusted ORs (OR = 1.37, 95% CI: 1.23, 1.53) showed a significant association between falls and depressive symptoms among older adults. Subgroup analysis revealed that this association was statistically significant across male (OR = 1.29, 95% CI: 1.23, 1.53) and female (OR = 1.42, 95% CI: 1.23, 1.64), 60-69 aged (OR = 1.38, 95% CI: 1.19, 1.60) and 70-79 aged (OR =1.42, 95% CI: 1.16, 1.74), rural (OR = 1.42, 95% CI: 1.25, 1.61), <15,000 CNY (OR = 1.35, 95% CI: 1.19, 1.54) and more than 25,000 CNY (OR = 1.42, 95% CI: 1.09, 1.85). Additionally, The CART model showed that the probability (73.0%) of falls was highest among older adults with depressive symptoms who self-rated poor health and female gender. Conclusions This cross-sectional study demonstrated a significant association between falls and depressive symptoms in Chinese older adults. The findings provide some evidence and support for risk monitoring, screening for depressive symptoms, and early prevention in the high-risk older population.
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Affiliation(s)
- Zhiqiang Feng
- School of Economics, Peking University, Beijing, China
- China National Health Development Research Center, Beijing, China
| | - Qi Chen
- China National Health Development Research Center, Beijing, China
| | - Yanjing Li
- China National Health Development Research Center, Beijing, China
| | - Zhen Xue
- China National Health Development Research Center, Beijing, China
| | - Xiaoning Hao
- China National Health Development Research Center, Beijing, China
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Kim JH, Song JH, Wee JH, Lee JW, Choi HG. Depressive Symptoms, Subjective Cognitive Decline, and Subjective Sleep Quality Are Associated with Slips and Falls: Data from the Community Health Survey in Korean Adults. Gerontology 2021; 68:518-528. [DOI: 10.1159/000518007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 06/19/2021] [Indexed: 11/19/2022] Open
Abstract
<b><i>Background:</i></b> Identifying the risk factors for falls among the elderly population is arguably one of the most imperative public health issues in the current aging society. <b><i>Objectives:</i></b> This study aimed to determine the associations between depressive symptoms, subjective cognitive decline (SCD), and poor subjective sleep quality and the risk of slips/falls in a Korean older population. <b><i>Methods:</i></b> This cross-sectional study involved 228,340 elderly individuals living in Korea. Measurements included self-reported depressive symptoms, SCD, and self-reported sleep quality. The risk of slips/falls was dichotomized depending on whether slips/falls had occurred during the past year, and the associations between different risk factors and slips/falls were explored. Multiple logistic regression was used to obtain the odds ratios (ORs) and 95% confidence intervals (CIs). Complex sampling methods were used to estimate the weighted value of each participant. <b><i>Results:</i></b> The risk of slips/falls was significantly associated with high levels of depressive symptoms (adjusted OR 1.06, 95% CI: 1.05–1.07) and SCD (adjusted OR 1.33, 95% CI: 1.19–1.50). Regarding each sleep quality component, the adjusted ORs for slips/falls were 1.85 for very poor sleep quality, 1.49 for long sleep latency, 1.04 for <5 h of sleep duration, 1.32 for low sleep efficiency, 2.78 for high sleep disturbance, 1.52 for the use of sleep medication ≥3 times a week, and 1.82 for high daytime dysfunction due to sleep problems compared to the respective good sleep conditions. <b><i>Conclusions:</i></b> Our results demonstrated that depressive symptoms, SCD, and poor subjective sleep quality are independent factors affecting the occurrence of slips/falls. Thus, efforts to manage depressive symptoms and cognitive decline early and to improve sleep quality can be an alternative strategy to decrease the likelihood of falls.
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Cohen JN, Seng E, Foley FW. Cognitive and motor slowing mediate the relationship between depression and falls in multiple sclerosis patients. Mult Scler Relat Disord 2021; 50:102808. [PMID: 33596493 DOI: 10.1016/j.msard.2021.102808] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 01/08/2021] [Accepted: 01/31/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Given the limited research concerning the relationship between depression and falls in multiple sclerosis (MS), this study aimed to examine the direct and indirect association between fall history and depressive symptoms. METHODS One hundred and forty seven MS patients had completed at least one neuropsychological assessment that included detailed information regarding fall history, as well as measures of depression, motor function, and cognitive processing speed. RESULTS Fall history was associated with higher depressive symptoms and poorer overall motor function. Higher self-reported depressive symptoms were associated with higher odds of falls in the last year (OR = 1.64, 95% CI 1.16, 2.31) in an age adjusted model. Cognitive and motor slowing serially mediated the relationship between depressive symptoms and fall history (estimate = 0.060, 95% CI = 0.01, 0.15). CONCLUSIONS With the extensive research on the cognitive and motor correlates of falls in MS, our findings suggest that depressive symptoms are also associated with falls in people with MS. Moreover, this study provides preliminary support for a pathway by which depressive symptoms are related to falls in part through their relationships with cognitive and motor slowing.
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Affiliation(s)
- Jenna N Cohen
- Ferkauf Graduate School of Psychology, Yeshiva University, 1300 Morris Park Avenue, Bronx, NY 10461, United States
| | - Elizabeth Seng
- Ferkauf Graduate School of Psychology, Yeshiva University, 1300 Morris Park Avenue, Bronx, NY 10461, United States; The Saul R Korey Department of Neurology, Albert Einstein College of Medicine, 1225 Morris Park Avenue, Van Etten Building, Bronx, NY 10461, United States
| | - Frederick W Foley
- Ferkauf Graduate School of Psychology, Yeshiva University, 1300 Morris Park Avenue, Bronx, NY 10461, United States; Holy Name Medical Center Multiple Sclerosis Center, 718 Teaneck Road, Teaneck, NJ 07666, United States.
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Naidu AS, Vasudev A, Burhan AM, Ionson E, Montero-Odasso M. Does Dual-Task Gait Differ in those with Late-Life Depression versus Mild Cognitive Impairment? Am J Geriatr Psychiatry 2019; 27:62-72. [PMID: 30420282 DOI: 10.1016/j.jagp.2018.10.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/15/2018] [Accepted: 10/16/2018] [Indexed: 01/19/2023]
Abstract
OBJECTIVES To compare the dual-task gait performance of older adults with Late-Life Depression (LLD) versus Mild Cognitive Impairment (MCI). DESIGN Cross-sectional study with three matched groups: LLD, MCI and non-depressed and cognitively intact (NDCI). SETTING LLD group participants were recruited from geriatric psychiatry clinics in London, Ontario. Matched participants meeting criteria for the MCI or NDCI groups were previously recruited for other research studies from geriatric clinics and the community. PARTICIPANTS Individuals aged 60-85 who met criteria for mild-moderate LLD (N=23) without a diagnosis of a neurocognitive disorder. MEASUREMENTS Participants completed questionnaires regarding mood, cognition and physical activity. Gait speed was recorded using an electronic walkway during simple and dual-task gait (walking while naming animals aloud). Dual-task cost (DTC) is the percentage change in gait speed between simple and dual-task gait. It is a clinically relevant indicator of fall risk and is strongly associated with cognitive decline. For comparison, 23 MCI and 23 NDCI participants, matched with respect to age, sex and comorbidities, were randomly selected from existing research databases. RESULTS Each group had 8 males and 15 females, with mean age of 69.0-69.6 years. The mean (±SD) DTC of the NDCI, LLD and MCI groups were statistically different at 2.4±11.4%, 11.8±9.9% and 22.2±16.7%, respectively. CONCLUSION Older adults with LLD perform worse on dual-task gait than NDCI; however, they are less impaired than those with MCI. The elevated DTC seen in LLD is likely because of underlying executive dysfunction that is less significant than in those with MCI.
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Affiliation(s)
- Anish S Naidu
- Gait and Brain Lab, Lawson Health Research Institute, London, ON; Parkwood Institute, St. Joseph's Health Care, London, ON; Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON
| | - Akshya Vasudev
- Gait and Brain Lab, Lawson Health Research Institute, London, ON; Parkwood Institute, St. Joseph's Health Care, London, ON; Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON; Division of Geriatric Psychiatry, Department of Psychiatry, University of Western Ontario, London, ON
| | - Amer M Burhan
- Gait and Brain Lab, Lawson Health Research Institute, London, ON; Parkwood Institute, St. Joseph's Health Care, London, ON; Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON; Division of Geriatric Psychiatry, Department of Psychiatry, University of Western Ontario, London, ON
| | - Emily Ionson
- Gait and Brain Lab, Lawson Health Research Institute, London, ON; Parkwood Institute, St. Joseph's Health Care, London, ON; Division of Geriatric Psychiatry, Department of Psychiatry, University of Western Ontario, London, ON
| | - Manuel Montero-Odasso
- Gait and Brain Lab, Lawson Health Research Institute, London, ON; Parkwood Institute, St. Joseph's Health Care, London, ON; Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON; Division of Geriatric Medicine, Department of Medicine, University of Western Ontario, London, ON.
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Briggs R, Kennelly SP, Kenny RA. Does baseline depression increase the risk of unexplained and accidental falls in a cohort of community-dwelling older people? Data from The Irish Longitudinal Study on Ageing (TILDA). Int J Geriatr Psychiatry 2018; 33:e205-e211. [PMID: 28766755 DOI: 10.1002/gps.4770] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 06/21/2017] [Accepted: 07/04/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND Depression independently increases the risk of falls in older people, but the mechanism for this relationship, as well as the specific falls type involved, remains unclear. Accidental falls (AFs) are due to slips or trips, while the cause of unexplained falls (UFs) is not immediately apparent and can include unrecognised syncope. METHOD This longitudinal study examines the relationship between baseline depression and subsequent falls, both accidental and unexplained, at 2-year follow-up in a cohort of community dwelling adults aged ≥50 years. Baseline depression was defined as a score ≥16 on The Centre for Epidemiological Studies Depression Scale. At follow-up, participants were assessed regarding falls since last interview. RESULTS One-third (228/647) of the depressed group had fallen at follow-up, compared with 22% (1388/6243) of the nondepressed group (P < .001). Multiple logistic regression models demonstrated that depression was associated with an odds ratio of 1.58 (1.31-1.89) P < .001; 1.24 (1.00-1.52), P = .046; and 1.89 (1.45-2.46), P < .001 for total falls, AFs and UFs, respectively, after controlling for relevant covariates. Participants with depression who fell were more likely to have prior falls, functional impairment and slower gait when compared with depressed participants who did not fall. DISCUSSION The risk of falls associated with depression in older adults is more marked for UFs, with the association for AFs approaching borderline significance only. This finding is important because UFs require focused clinical assessment with attention to potential causes such as cardiac arrhythmia or orthostatic hypotension.
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Affiliation(s)
- Robert Briggs
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin 2, Ireland.,Department of Medical Gerontology, Mercer's Institute for Successful Ageing, St. James Hospital, Dublin 8, Ireland.,Centre for Ageing, Neuroscience and the Humanities, Tallaght Hospital, Dublin 24, Ireland
| | - Sean P Kennelly
- Centre for Ageing, Neuroscience and the Humanities, Tallaght Hospital, Dublin 24, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin 2, Ireland.,Department of Medical Gerontology, Mercer's Institute for Successful Ageing, St. James Hospital, Dublin 8, Ireland
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Musich S, Wang SS, Ruiz J, Hawkins K, Wicker E. Falls-Related Drug Use and Risk of Falls Among Older Adults: A Study in a US Medicare Population. Drugs Aging 2017; 34:555-565. [PMID: 28580498 PMCID: PMC5488077 DOI: 10.1007/s40266-017-0470-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background Approximately one-third of community-dwelling older adults fall each year, and approximately 10% have falls requiring medical services. Among other factors, research studies have linked certain medications with an increased risk of falls. Objective The aim of this study was to examine the risk of falls relative to use patterns among new and continuing falls-related drug (FRD) users. Methods A 10% random sample, insured in AARP® Medicare Supplement and AARP Medicare Part D Rx plans, was utilized to define new and continuing FRD users. New users had a 12-month pre-period without FRD use, whereas continuing users had at least one FRD in the pre-period. Both groups had 12-month follow-up after initiating or continuing FRD use. Characteristics associated with the risk of falls for new and continuing users were determined using multivariate logistic regression models. Results Among insureds, 44% used at least one of the FRD classes. Of these, 29% were new users (N = 35,340) and 71% were continuing users (N = 121,488). Fall rates for the two subgroups were similar at 7 and 8%, respectively. Characteristics associated with the risk of falls were previous injurious fall, use of two or more classes of FRDs, older age, poorer health, and being female. New users were at higher risk than continuing users. Conclusion New users of FRDs were at highest risk of falls, and continuing users were at increased risk, especially with higher numbers of FRD classes. Both groups could benefit from falls awareness and prevention programs.
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Affiliation(s)
- Shirley Musich
- Advanced Analytics, Optum, 315 E. Eisenhower Parkway, Suite 305, Ann Arbor, MI, 48108, USA.
| | - Shaohung S Wang
- Advanced Analytics, Optum, 315 E. Eisenhower Parkway, Suite 305, Ann Arbor, MI, 48108, USA
| | - Joann Ruiz
- Medicare and Retirement, UnitedHealthcare Alliances, PO Box 9472, Minneapolis, MN, 55440, USA
| | - Kevin Hawkins
- Advanced Analytics, Optum, 315 E. Eisenhower Parkway, Suite 305, Ann Arbor, MI, 48108, USA
| | - Ellen Wicker
- , 601 E. Street, N.W., Washington, DC, 20049, USA
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Du Y, Wolf IK, Knopf H. Association of psychotropic drug use with falls among older adults in Germany. Results of the German Health Interview and Examination Survey for Adults 2008-2011 (DEGS1). PLoS One 2017; 12:e0182432. [PMID: 28792521 PMCID: PMC5549725 DOI: 10.1371/journal.pone.0182432] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 07/18/2017] [Indexed: 12/15/2022] Open
Abstract
Purpose To investigate the association of psychotropic drug use with falls among older adults in Germany based on data from the National Health Interview and Examination Survey for Adults 2008–2011 (DEGS1). Methods DEGS1 collected data on drug use in the past 7 days and on falls occurred in the last 12 months. Study participants were older adults aged 65–79 years with complete data on drug use and falls (N = 1,833). Odds ratio (OR) and 95% confidence intervals (95% CI) were derived from logistic regression models adjusting for potential confounders including socio-demographic characteristics, health-related behaviors (alcohol drinking), body mass index and health conditions (frailty, vision impairment, disability, polypharmacy, blood pressure) as well as use of potential falls-risk-increasing drugs. SPSS complex sample methods were used for statistical analysis. Results Compared to people without falls, people with falls (n = 370) had a higher psychotropic drug use (33.1% vs. 20.7%, p < .001). After adjusting for potential confounders, use of psychotropic drugs overall was associated with a higher risk of falls (OR 1.64, 95% CI 1.14–2.37). This was particularly true for the use of synthetic psychotropic drugs (1.57, 1.08–2.28), antidepressants overall (2.88, 1.63–5.09) or synthetic antidepressants (2.66, 1.50–4.73), specifically, selective serotonin reuptake inhibitors (SSRIs) (6.22, 2.28–17.0). Similar results were found for recurrent falls. Conclusions Use of psychotropic drugs overall, especially synthetic antidepressants like SSRIs, is associated with higher risks of falls and recurrent falls among community dwelling older adults aged 65–79 years in Germany.
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Affiliation(s)
- Yong Du
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin Germany
- * E-mail:
| | - Ingrid-Katharina Wolf
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin Germany
| | - Hildtraud Knopf
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin Germany
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Recurrent falls and its risk factors among older men living in the veterans retirement communities: A cross-sectional study. Arch Gerontol Geriatr 2017; 70:214-218. [DOI: 10.1016/j.archger.2017.02.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 02/01/2017] [Accepted: 02/01/2017] [Indexed: 11/19/2022]
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Renfro M, Bainbridge DB, Smith ML. Validation of Evidence-Based Fall Prevention Programs for Adults with Intellectual and/or Developmental Disorders: A Modified Otago Exercise Program. Front Public Health 2016; 4:261. [PMID: 27999771 PMCID: PMC5138240 DOI: 10.3389/fpubh.2016.00261] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 11/03/2016] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Evidence-based fall prevention (EBFP) programs significantly decrease fall risk, falls, and fall-related injuries in community-dwelling older adults. To date, EBFP programs are only validated for use among people with normal cognition and, therefore, are not evidence-based for adults with intellectual and/or developmental disorders (IDD) such as Alzheimer's disease and related dementias, cerebral vascular accident, or traumatic brain injury. BACKGROUND Adults with IDD experience not only a higher rate of falls than their community-dwelling, cognitively intact peers but also higher rates and earlier onset of chronic diseases, also known to increase fall risk. Adults with IDD experience many barriers to health care and health promotion programs. As the lifespan for people with IDD continues to increase, issues of aging (including falls with associated injury) are on the rise and require effective and efficient prevention. METHODS A modified group-based version of the Otago Exercise Program (OEP) was developed and implemented at a worksite employing adults with IDD in Montana. Participants were tested pre- and post-intervention using the Center for Disease Control and Prevention's (CDC) Stopping Elderly Accidents Deaths and Injuries (STEADI) tool kit. Participants participated in progressive once weekly, 1-h group exercise classes and home programs over a 7-week period. Discharge planning with consumers and caregivers included home exercise, walking, and an optional home assessment. RESULTS Despite the limited number of participants (n = 15) and short length of participation, improvements were observed in the 30-s Chair Stand Test, 4-Stage Balance Test, and 2-Minute Walk Test. Additionally, three individuals experienced an improvement in ambulation independence. Participants reported no falls during the study period. DISCUSSION Promising results of this preliminary project underline the need for further study of this modified OEP among adults with IDD. Future multicenter study should include more participants in diverse geographic regions with longer lengths of participation and follow-up.
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Affiliation(s)
- Mindy Renfro
- MonTECH/Rural Institute, University of Montana , Missoula, MT , USA
| | | | - Matthew Lee Smith
- College of Public Health, Institute of Gerontology, The University of Georgia, Athens, GA, USA; Texas A&M School of Public Health, College Station, TX, USA
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Gazibara T, Kisic-Tepavcevic D, Svetel M, Tomic A, Stankovic I, Kostic VS, Pekmezovic T. Health-related quality of life as a predictor of recurrent falling in Parkinson's disease: 1-year follow-up study. Psychogeriatrics 2016; 16:362-367. [PMID: 26756787 DOI: 10.1111/psyg.12178] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Revised: 10/09/2015] [Accepted: 10/26/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this study was to assess whether various domains related to health-related quality of life could be predictive of recurrent falls among persons with Parkinson's disease (PD) during a 1-year follow-up study. METHODS A total of 120 consecutive persons with PD who had denied falling in past 6 months were recruited at regular check-ups at the Department of Movement Disorders, Neurology Clinic, Clinical Center of Serbia in Belgrade, from 15 August 2011 to 15 December 2012. At baseline, study participants were clinically assessed. Health-related quality of life was evaluated with the generic 36-item Short Form Health Survey. Participants were prospectively followed for 1 year, and occurrence of falls was registered. RESULTS The median age of subjects was 60.0 years, with a median disease duration of 4.0 years. Of 120 persons with PD, 42 (35%) experienced falls during the 12-month study period, including 23 (19.2%) who fell repeatedly. After adjustment for gender, age, PD duration, levodopa dosage, Hoehn and Yahr stage, Unified Parkinson's Disease Rating Scale I-IV, Hamilton Depression Rating Scale, and Hamilton Anxiety Rating Scales, we identified the 36-item Short Form Health Survey domains of role physical (P = 0.033) and vitality (P = 0.019) as being associated with recurrent falls of persons with PD within the 1-year follow-up period. CONCLUSION Baseline 36-item Short Form Health Survey scores regarding both the physical and mental components of overall health may be related to recurrent falling among persons with PD. These HRQoL domains could be considered as potential markers for persons with PD who are prone to recurrent falls.
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Affiliation(s)
- Tatjana Gazibara
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Marina Svetel
- Clinic of Neurology, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Aleksandra Tomic
- Clinic of Neurology, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Iva Stankovic
- Clinic of Neurology, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Vladimir S Kostic
- Clinic of Neurology, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Tatjana Pekmezovic
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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Hammarlund CS, Hagell P, Westergren A. Fall Risk and Its Associated Factors among Older Adults without Home-Help Services in a Swedish Municipality. J Community Health Nurs 2016; 33:181-189. [DOI: 10.1080/07370016.2016.1227211] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Renfro M, Maring J, Bainbridge D, Blair M. Fall Risk Among Older Adult High-Risk Populations: a Review of Current Screening and Assessment Tools. CURRENT GERIATRICS REPORTS 2016. [DOI: 10.1007/s13670-016-0181-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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15
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Abstract
BACKGROUND Falls are highly frequent in older adults and are associated with increased morbidity and mortality. The present study was designed to assess the role of satisfaction with one's aging process as a predictor of the risk for falling over a four-year period and to identify potential mediators of this relationship. METHODS The Health and Retirement Study (HRS) is a US nationally representative sample of individuals over the age of 50 years and their spouse of any age. The present study was based on the 2008-2012 waves of the HRS. Analyses were restricted to 4,121 respondents over the age of 50 years, who had fall data in 2008 and 2012 and were eligible to complete the satisfaction with aging measure as part of the 2008 psychosocial questionnaire. RESULTS Overall, 38.1% of the sample reported having fallen at least once between 2006 and 2008 and 40.7% reported having fallen at least once between 2010 and 2012. Higher levels of satisfaction with aging in 2008 were found to be protective against falls assessed in 2012 (OR[95%CI] = 0.88[0.79-0.98]) even after adjustment for age, gender, education, ethnicity, medical status, functional status, cognitive functioning, walking speed, balance, vision, depressive symptoms, physical activities, and past falls. Bootstrap procedures have shown that the effect of satisfaction with aging on falls is partially accounted for through its effect on functional decline. CONCLUSIONS The findings point to the important role of satisfaction with aging as a potential protective mechanism against falls. The results call for the development of psychosocial interventions to reduce falls in older adults.
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Hatamabadi HR, Sum S, Tabatabaey A, Sabbaghi M. Emergency department management of falls in the elderly: A clinical audit and suggestions for improvement. Int Emerg Nurs 2015; 24:2-8. [PMID: 26048537 DOI: 10.1016/j.ienj.2015.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Revised: 05/09/2015] [Accepted: 05/17/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Falls are a major source of injury in the elderly and their incomplete management is a cause for concern by health systems. The present study looks at the current state of managing fall victims in Iran and offers suggestions for improvement. METHODS This was a clinical care audit comparing the state of current care with an institutionally approved optimum. Patients aged 60 years and over presenting with a fall were evaluated and deficiencies in their care were recorded and categorized. These were presented to an expert panel, where the Delphi method was used to come up with a list of actions to address the deficiencies. Furthermore an educational program was implemented based on these suggestions. Chi-squared and t-test were used to evaluate the efficacy of this program in improving treatment. Linear regression analysis was used to find factors affecting care. RESULTS Overall 431 cases were reviewed. The most common errors during clinical examination were: not performing Romberg test (92.75%) and lack of physiotherapy consultation (82.75%). The educational program had a modest effect on improving the clinical audit processes (β = 3.79; P < 0.001) and medical interventions (β = 2.004; P = 0.002); however, performing the correct diagnostic tests was worse after the program (β = -1.21; P = 0.008). CONCLUSION There is a wide gap between the care services delivered in the management of falls and international standards. Therefore, measures should be adopted to close this gap. Education may have a modest positive effect in this regard.
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Affiliation(s)
- Hamid Reza Hatamabadi
- Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Emergency Department, Emam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shima Sum
- Community Medicine, Babol University of Medical Sciences, Mazandaran, Iran.
| | - Ali Tabatabaey
- Emergency Department, Qom University of Medical Sciences and Health Services, Qom, Iran
| | - Mohammad Sabbaghi
- Emergency Department, Emam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Lavedán Santamaría A, Jürschik Giménez P, Botigué Satorra T, Nuin Orrio C, Viladrosa Montoy M. [Prevalence and associated factors of falls in community-dwelling elderly]. Aten Primaria 2014; 47:367-75. [PMID: 25510489 PMCID: PMC6983699 DOI: 10.1016/j.aprim.2014.07.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 05/19/2014] [Accepted: 07/09/2014] [Indexed: 12/11/2022] Open
Abstract
Objetivo Estimar la prevalencia de caídas e identificar los factores asociados a ellas en la población mayor comunitaria. Diseño Estudio descriptivo, transversal. Emplazamiento Atención Primaria de Salud, Lleida. Participantes Se incluyó a 640 personas de 75 o más años de edad, que disponían de tarjeta sanitaria y residían en viviendas unifamiliares, a través de un muestreo aleatorizado. Mediciones principales La fuente de datos proviene de la encuesta de fragilidad en Lleida (Encuesta FRALLE). Las variables utilizadas fueron la presencia de caídas en el último año, factores sociodemográficos, estado de salud, calidad de vida relacionada con la salud y miedo a caer. Resultados La prevalencia de caídas fue del 25,0% (IC 95% 24,8-25,1). Tras el análisis multivariado, la discapacidad básica (OR = 2,17; IC 95% 1,32-3,58), los síntomas depresivos (OR = 1,67; IC 95% 1,07-2,59) y el miedo a caer (OR = 2,53; IC 95% 1,63-3,94) fueron los únicos factores asociados de forma independiente a las caídas en el último año. Conclusiones Una de cada 4 personas mayores presentaron al menos una caída en el último año. Este estudio demuestra que el miedo a caer, los síntomas depresivos y la discapacidad básica son variables independientes asociadas a caídas previas. Estos 3 factores pueden dar lugar a una espiral favorecedora de caídas, pudiendo ser posibles objetivos para la actuación eficaz en el contexto de caídas.
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