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Alzahrani MS, Vennu V. Metabolic syndrome is associated with an increased risk of falls in the elderly. THE NATIONAL MEDICAL JOURNAL OF INDIA 2023; 36:370-373. [PMID: 38909297 DOI: 10.25259/nmji_944_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/24/2024]
Abstract
Numerous studies have investigated the causes of falls in the elderly. However, there is little information about metabolic syndrome (MS) as a risk factor for falls in older adults. No evaluations have given a qualitative overview of studies examining the relationship between MS and falls in the elderly. We did a literature search in electronic databases to look for studies that assessed a link between MS and falls among people over the age of 55 years. We found three studies of high quality. These included 2774 people with an average age of 72 years. Even after controlling for other risk factors, two studies found that MS was significantly associated with an older adult's 1.3-2.5-fold increased risk of falling. We found that MS and its independent components were strongly linked with falls among the elderly, even after correcting for numerous variables.
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Affiliation(s)
- Majed Saeed Alzahrani
- Department of Preventive Medicine, Preventive and Public Health Joint Program, Taif 11454, Makkah, Saudi Arabia
| | - Vishal Vennu
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, 10219 Riyadh 11433, ArRiyadh, Saudi Arabia
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Li Y, Hou L, Zhao H, Xie R, Yi Y, Ding X. Risk factors for falls among community-dwelling older adults: A systematic review and meta-analysis. Front Med (Lausanne) 2023; 9:1019094. [PMID: 36687461 PMCID: PMC9853191 DOI: 10.3389/fmed.2022.1019094] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 12/02/2022] [Indexed: 01/09/2023] Open
Abstract
Background and objective The prevalence of falls among older adults living in the community is ~30% each year. The impacts of falls are not only confined to the individual but also affect families and the community. Injury from a fall also imposes a heavy financial burden on patients and their families. Currently, there are different reports on the risk factors for falls among older adults in the community. A retrospective analysis was used in this study to identify risk factors for falls in community-dwelling older adults. This research aimed to collect published studies to find risk factors for falls in community-dwelling older adults. Methods We searched for literature from the founding of PubMed, EMBASE, the Cochrane Library, the Web of Science, the China National Knowledge Infrastructure (CNKI), the China Science and Technology Periodicals Database (VIP), and the Wanfang database until September 2022. The studies were selected using inclusion and exclusion criteria. We collected information from relevant studies to compare the impact of potential risk factors such as age, female gender, fear of falling, history of falls, unclear vision, depression, and balance disorder on falls among community-dwelling older adults. Results A total of 31 studies were included with 70,868 community seniors. A significant risk factor for falls in the community of older adults was dementia (2.01, 95% CI: 1.41-2.86), age (1.15, 95% CI: 1.09-1.22), female gender (1.52, 95% CI: 1.27-1.81), fear of falling (2.82, 95% CI: 1.68-4.74), history of falls (3.22, 95% CI: 1.98-5.23), vision unclear (1.56, 95% CI: 1.29-1.89), depression (1.23, 95% CI: 1.10-1.37), and balance disorder (3.00, 95% CI: 2.05-4.39). Conclusion This study provides preliminary evidence that falls among community-dwelling older adults are associated with factors such as age, female gender, fear of falling, history of falls, unclear vision, depression, and balance disorders. The results of this research may help improve clinician awareness, risk stratification, and fall prevention among community-dwelling older adults. Systematic review registration identifier INPLASY2022120080.
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Affiliation(s)
- Ying Li
- School of Nursing, Weifang University of Science and Technology, Weifang, Shandong, China
| | - Lingyu Hou
- Nursing Department, Peking University Shenzhen Hospital, Shenzhen, China
| | - Hanping Zhao
- School of Nursing, Weifang University of Science and Technology, Weifang, Shandong, China
| | | | - Yue Yi
- Department of Neurology, Shandong Guoxin Senior Care Group Laiwu Central Hospital, Jinan, China
| | - Xiaorong Ding
- Nursing Department, Peking University Shenzhen Hospital, Shenzhen, China
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Fahimfar N, Yousefi S, Noorali S, Gharibzadeh S, Sanjari M, Khalagi K, Mehri A, Shafiee G, Heshmat R, Nabipour I, Amini A, Darabi A, Heidari G, Larijani B, Ostovar A. The association of cardio-metabolic risk factors and history of falling in men with osteosarcopenia: a cross-sectional analysis of Bushehr Elderly Health (BEH) program. BMC Geriatr 2022; 22:46. [PMID: 35016617 PMCID: PMC8753863 DOI: 10.1186/s12877-021-02657-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 11/24/2021] [Indexed: 02/08/2023] Open
Abstract
Background Osteosarcopenia, defined as sarcopenia plus osteopenia/osteoporosis, may increase the risk of fractures and affects morbidity and mortality in the older population. Falling is also common in the elderly and increases the risk of fractures and mortality. We examined the association of cardio-metabolic risk factors with a history of falling in osteosarcopenic men. Methods We used the baseline data of the Bushehr Elderly Health (BEH) program. Osteosarcopenia was defined as having both sarcopenia (reduced skeletal muscle mass plus low physical performance and/or low muscle strength) and osteopenia/osteoporosis (T-score ≤ − 1.0). Falling was defined as a self-reported history of an unintentional down on the ground during the previous year before the study. We used logistic regression analysis to estimate the adjusted odds ratio (AOR) with a 95% Confidence Interval (CI) to quantify the associations. Results All elderly men diagnosed with osteosarcopenia (n = 341), with a mean age of 73.3(±7.4) years, were included. Almost 50(14.7%) participants reported falling. Age showed a positive association with falling (AOR: 1.09, 95%CI: 1.04–1.14). An increase of 10 mmHg in systolic blood pressure(SBP), reduces the odds of falling by 26%(AOR:0.74, 95%CI:0.62–0.89), while a positive association was detected for fasting plasma glucose (FPG), as 10 mg/dl increase in the FPG, raises the chance of falling by 14%(AOR = 1.14, 95%CI:1.06,1.23). Hypertriglyceridemia was inversely associated with falling (AOR = 0.33, 95% CI: 0.12, 0.89). Conclusions Falling is a major public health problem in rapidly aging countries, especially in individuals with a higher risk of fragility fractures. Older age-raised fasting plasma glucose and low SBP are associated with falling in osteosarcopenic patients. Considering the higher risk of fracture in osteosarcopenic men, comprehensive strategies are needed to prevent fall-related injuries in this high-risk population.
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Affiliation(s)
- Noushin Fahimfar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shakiba Yousefi
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sima Noorali
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Safoora Gharibzadeh
- Department of Epidemiology and Biostatistics, Pasteur Institute of Iran, Tehran, Iran
| | - Mahnaz Sanjari
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Khalagi
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Mehri
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Iraj Nabipour
- The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Azam Amini
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Amirhossein Darabi
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Gholamreza Heidari
- Deputy for Education, Ministry of health and medical education, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Abstract
INTRODUCTION The prevalence of metabolic syndrome has been reported to extremely vary depending on the gender, age, and ethnicity studied. Approximately, 25% of the worldwide adult population is affected by metabolic syndrome, indicating it as a significantly important public health challenge. Likewise, fragility fracture represents an important public health issue too, and the lifetime residual risk of its occurrence has been established in 50% in women and 30% in men over 50 years of age, respectively. Dysmobility syndrome summarizes a cluster of co-existing conditions such as osteoporosis, sarcopenia, obesity. Currently, clinical research focuses essentially on the cardiovascular risks associated with metabolic syndrome. Today, it is conceivable to incorporate all these conditions under a generic "disorder of energy metabolism." EVIDENCE ACQUISITION Animal and human studies suggest metabolic and dysmobility syndromes negatively impact on the risk for fragility fracture, contributing to increase the associated mortality rate. EVIDENCE SYNTHESIS In recent years, strong correlation between type 2 diabetes, a frequent constitutive part of metabolic syndrome and fragility fracture risk has been reported, but the possible molecular mechanisms by which it can occur are still to be defined. CONCLUSIONS Only very few human clinical studies faced these aspects, but they lack adequate endpoints for a good clinical practice in these subjects. Much more still needs to be done before appropriate therapeutic diagnostic pathways will be available for these patients at risk of bone and even generalized fragility. Suggestions for a future overall approach by generating global risk score for these conditions are given.
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Affiliation(s)
- Roberta Cosso
- Section of Bone and Mineral Diseases, San Giuseppe Hospital, Piancavallo, Verbania, Italy
| | - Alberto Falchetti
- Section of Bone and Mineral Diseases, San Giuseppe Hospital, Piancavallo, Verbania, Italy - .,Unit for Bone Metabolism Diseases and Diabetes, Laboratory of Endocrine and Metabolic Research, Istituto Auxologico Italiano IRCCS, Milan, Italy
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Rhynehart A, Dunlevy C, Hayes K, O'Connell J, O'Shea D, O'Malley E. The Association of Physical Function Measures With Frailty, Falls History, and Metabolic Syndrome in a Population With Complex Obesity. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:716392. [PMID: 36188769 PMCID: PMC9397832 DOI: 10.3389/fresc.2021.716392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/16/2021] [Indexed: 11/19/2022]
Abstract
Background: Frailty, falls and metabolic syndrome are known to be associated with poorer physical function. This study builds on available research by further investigating the relationship between physical function measures, including those comprising frailty, with metabolic syndrome (MetS) and falls, in the context of complex obesity. Methods: Participants were recruited from the national Level 3 weight management service in Ireland. A retrospective audit of data gathered at initial assessment was performed. Data included past medical history, blood tests, blood pressure measurement, anthropometrics, falls history, self-reported physical activity levels (PALs) and physical function measures, including hand grip strength (HGS), “timed up and go” (TUG), functional reach (FR), sit to stand (STS) and gait speed. A modified version of the Fried Frailty Index was employed. Results: Of the 713 participants, 65.1% (n = 464) were female and 34.9% (n = 249) were male with a mean age of 44.2 (±11.7) years and body mass index (BMI) of 50.6 kg/m2 (±8.2). Frailty was identified in 3.4% (n = 24), falls in 28.8% (n = 205) and MetS in 55.1% (n = 393). Frailty was associated with older age (53.8 ± 14.3 vs. 43.9 ± 11.5 years), poorer PALs (27.29 ± 46.3 vs. 101.1 ± 147.4 min/wk), reduced grip strength (17.7 ± 4.6 vs. 34.2 ± 11.0 Kg) longer STS (21.7 ± 6.6 vs. 13.7 ± 5.7 s), shorter functional reach (29.7 ± 7.9 vs. 37.9 ± 8.2 cm) and slower gait speed (0.6 ± 0.2 vs. 1.1 ± 0.5 m/s). Those reporting a falls history had a reduced FR (35.8 ± 8.9 vs. 38.3 ± 7.8 cm) and slower STS (15.4 ± 8.0 vs. 13.3 ± 4.7 s). Participants with MetS had lower PALs (83.2 ± 128.2 vs. 119.2 ± 157.6) and gait speed (1.1 ± 0.3 vs. 1.2 ± 0.7 m/s). There was no difference in BMI between fallers and non-fallers (51.34 ± 8.44 vs. 50.33 ± 8.13 Kg/m2, p = 0.138), nor between those with or without MetS. Significant associations were found between BMI and all physical function measures except the TUAG. Conclusion: The associations between frailty, falls and MetS and their combined impact on physical function in people living with obesity demonstrates the need for appropriate screening. Utilising grip strength and gait speed to identify frailty in those with obesity and metabolic syndrome could help target therapies aimed at improving strength, physical function and ultimately quality of life.
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Affiliation(s)
- Amanda Rhynehart
- Weight Management Service, St Columcille's Hospital, Dublin, Ireland
- *Correspondence: Amanda Rhynehart ;
| | - Colin Dunlevy
- Weight Management Service, St Columcille's Hospital, Dublin, Ireland
| | - Katie Hayes
- Weight Management Service, St Columcille's Hospital, Dublin, Ireland
| | - Jean O'Connell
- Weight Management Service, St Columcille's Hospital, Dublin, Ireland
- Obesity Research Group, St Vincent's University Hospital, Dublin, Ireland
| | - Donal O'Shea
- Weight Management Service, St Columcille's Hospital, Dublin, Ireland
- Obesity Research Group, St Vincent's University Hospital, Dublin, Ireland
| | - Emer O'Malley
- Weight Management Service, St Columcille's Hospital, Dublin, Ireland
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Stolt LROG, Kolish DV, Cardoso MRA, Tanaka C, Vasconcelos EFS, Pereira EC, Dellú MC, Pereira WMP, Aldrighi JM, Schmitt ACB. Accidental falls in middle-aged women. Rev Saude Publica 2020; 54:141. [PMID: 33331487 PMCID: PMC7726919 DOI: 10.11606/s1518-8787.2020054002579] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 06/05/2020] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of accidental falls in women and to identify possible associations of sociodemographic, clinical and lifestyle variables with falls, in 2007 and 2014. METHODS Two cross-sectional studies were performed, in 2007 and 2014, within the Projeto de Saúde de Pindamonhangaba (PROSAPIN – Pindamonhangaba Health Project), with women aged between 35 to 75 years. Probabilistic samples were selected among women living in the municipality and participating in the Health Family Strategy. Data collection included: face-to-face interview, anthropometric examination and blood test. The outcome variable “have you fallen in the last six months?” was raised during the interview. The prevalence of falls in 2007 and 2014 were estimated by score with a 95% confidence interval (95%CI). Multiple logistic regression models were constructed to identify the association of independent variables with the occurrence of falls for each year based on the odds ratio (OR). We used the Stata 14.0 software for statistical analysis. RESULTS The prevalence of accidental falls were: 17.6% (95%CI 14.9–20.5) in 2007 and 17.2% (95%CI 14.8–19.8) in 2014. In 2007, factors associated with falls were: aged 50–64 years (OR = 1.81; 95%CI 1.17–2.80), high school (OR = 1.76; 95%CI 1.06–2.93), hyperuricemia (OR = 3.74; 95%CI 2.17–6.44), depression (OR = 2.07; 95%CI 1.31–3.27), poor sleep (OR = 1.78; 95%CI 1.12–2.82) and daytime sleepiness (OR = 1.86; 95%CI 1.16–2.99). In 2014, they were: aged 50–64 years (OR = 1.64; 95%CI 1.04–2.58), hyperuricemia (OR = 1.91; 95%CI 1.07–3.43) and depression (OR = 1.56; 95%CI 1.02–2.38), plus metabolic syndrome (OR = 1.60; 95%CI 1.03–2.47) and musculoskeletal pain (OR = 1.81; 95%CI 1.03–3.18). CONCLUSIONS Falls occur significantly in women aged 50 years or over, indicating that they are not restricted to older adults and that there is a need to initiate preventive measures earlier. Both studies showed similar magnitudes of occurrence of accidental falls and reinforced their multifactorial nature. In addition, hyperuricemia may be a potential new factor associated with falls.
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Affiliation(s)
- Lígia Raquel Ortiz Gomes Stolt
- Universidade Federal da Paraíba. Departamento de Fisioterapia. João Pessoa, PB, Brasil.,Universidade de São Paulo. Faculdade de Medicina. Programa de Pós-Graduação em Ciências da Reabilitação. São Paulo, SP, Brasil
| | - Daniel Vieira Kolish
- Articulab - Ortopedia Moderna Especializada. Fisioterapeuta em reabilitação ortopédica e facilitador de processos de trabalho e desenvolvimento de projetos. São Paulo, SP, Brasil
| | - Maria Regina Alves Cardoso
- Universidade de São Paulo. Faculdade de Saúde Pública. Departamento de Epidemiologia. São Paulo, SP, Brasil
| | - Clarice Tanaka
- Universidade de São Paulo. Faculdade de Medicina. Programa de Pós-Graduação em Ciências da Reabilitação. São Paulo, SP, Brasil.,Universidade de São Paulo. Faculdade de Medicina. Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional. São Paulo, SP, Brasil.,Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. Laboratório de Investigação em Fisioterapia. São Paulo, SP, Brasil
| | | | | | | | | | - José Mendes Aldrighi
- Universidade de São Paulo. Faculdade de Saúde Pública. Departamento de Saúde Materno-Infantil. São Paulo, SP, Brasil
| | - Ana Carolina Basso Schmitt
- Universidade de São Paulo. Faculdade de Medicina. Programa de Pós-Graduação em Ciências da Reabilitação. São Paulo, SP, Brasil.,Universidade de São Paulo. Faculdade de Medicina. Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional. São Paulo, SP, Brasil
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Lin YC, Chang YH. Poor Appetite and Eating Difficulties Can Predict the Long-Term Risk of Falling: A Longitudinal Study in Middle-Aged and Older Adults. J Appl Gerontol 2020; 40:1465-1474. [PMID: 33267709 DOI: 10.1177/0733464820976439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES This study investigates whether self-reported nutritional status affects falling among middle-aged and older adults. METHOD We used 8-year follow-up data from the Taiwan Longitudinal Study on Aging. At baseline, respondents' appetite, changes in amount of food intake, and eating difficulties were assessed in a questionnaire-based survey in addition to anthropometric measurements (body mass index, mid-arm circumferences, and involuntary body weight loss). Their associations with falls in the follow-up were examined using multivariable log-binomial regression. RESULTS The study included 2,519 respondents aged 50 years and older. Poor appetite (prevalence ratio [PR] = 1.25, 95% confidence interval [CI] = [1.07, 1.46]) and eating difficulties (PR = 1.16, 95% CI = [1.02, 1.32]) significantly predicted falling 8 years later with adjustments for sociodemographics, health behaviors, comorbidities, and anthropometric measures by taking into account probabilities of follow-up. CONCLUSION Poor appetite and eating difficulties can predict falling in the long-term independent of anthropometric measurements among middle-aged and older adults.
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Affiliation(s)
- Yu-Chun Lin
- China Medical University Hospital, Taichung City, Taiwan
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Teoh RJJ, Mat S, Khor HM, Kamaruzzaman SB, Tan MP. Falls, frailty, and metabolic syndrome in urban dwellers aged 55 years and over in the Malaysian elders longitudinal research (MELoR) study - a cross-sectional Study. Postgrad Med 2020; 133:351-356. [PMID: 33143493 DOI: 10.1080/00325481.2020.1842026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVES While metabolic syndrome, falls, and frailty are common health issues among older adults which are likely to be related, the potential interplay between these three conditions has not previously been investigated. We investigated the relationship between metabolic syndrome with falls, and the role of frailty markers in this potential relationship, among community-dwelling older adults. METHODS Data from the first wave Malaysian Elders Longitudinal Research (MELoR) study comprising urban dwellers aged 55 years and above were utilized. Twelve-month fall histories were established during home-based, computer-assisted interviews which physical performance, anthropometric and laboratory measures were obtained during a hospital-based health check. Gait speed, exhaustion, weakness, and weight loss were employed as frailty markers. RESULTS Data were available for 1415 participants, mean age of 68.56 ± 7.26 years, 57.2% women. Falls and metabolic syndrome were present in 22.8% and 44.2%, respectively. After adjusting for age, sex, and multiple comorbidities, metabolic syndrome was significantly associated with falls in the sample population [odds ratio (OR): 1.33, 95% confidence interval (CI): 1.03; 1.72]. This relationship was attenuated by the presence of slow gait speed, but not exhaustion, weakness, or weight loss. CONCLUSION Metabolic syndrome was independently associated with falls among older adults, and this relationship was accounted for by the presence of slow gait speed. Future studies should determine the value of screening for frailty and falls with gait speed in older adults with metabolic syndrome as a potential fall prevention measure.
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Affiliation(s)
- Ru Jian Jonathan Teoh
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sumaiyah Mat
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Hui Min Khor
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Shahrul Bahyah Kamaruzzaman
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Maw Pin Tan
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Department of Medical Sciences, Faculty of Healthcare and Medical Sciences, Sunway University, Bandar Sunway, Malaysia
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Napoli N, Conte C, Pedone C, Strotmeyer ES, Barbour KE, Black DM, Samelson EJ, Schwartz AV. Effect of Insulin Resistance on BMD and Fracture Risk in Older Adults. J Clin Endocrinol Metab 2019; 104:3303-3310. [PMID: 30802282 PMCID: PMC6584125 DOI: 10.1210/jc.2018-02539] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 02/20/2019] [Indexed: 02/06/2023]
Abstract
CONTEXT Adults with type 2 diabetes (T2D) have higher fracture risk compared with nondiabetics, despite having higher bone mineral density (BMD). Insulin resistance (IR) has been associated with increased BMD. It is not known if IR increases fracture risk. OBJECTIVE We investigated the relationship among IR HOMA-IR, BMD, and incident nonspine fractures in nondiabetic individuals. DESIGN Participants included 2398 community-dwelling, nondiabetic older adults (age 74 ± 3 years, 53% women, 38% black) in the Health, Aging and Body Composition Prospective Cohort Study [median follow-up: 12 (interquartile range: 6) years]. RESULTS The cut-off values for the HOMA-IR quartiles were 1.05, 1.54, and 2.33. Total hip BMD was 0.104 g/cm2 higher in the fourth vs the first HOMA-IR quartile (P < 0.001). This difference was attenuated after adjustment for BMI (adjusted mean difference 0.007 g/cm2; P = 0.371). In unadjusted models, fracture risk was lower in those with higher HOMA-IR [hazard ratio (HR) 0.86 (95% CI 0.73 to 1.01) and 0.65 (95% CI 0.47 to 0.89) for the third and fourth quartile, respectively, vs the first quartile]. However, after adjustment for BMD and BMI, fracture risk was significantly higher in the third quartile (HR 1.19, 95% CI 1.00 to 1.41) and tended to be increased in the fourth quartile (HR 1.12, 95% CI 0.87 to 1.46) vs the first quartile. CONCLUSIONS Greater IR is associated with higher BMD in nondiabetic older adults. In contrast to the relationship between T2D and fracture risk, we did not find consistent evidence that greater IR is associated with increased fracture risk after adjustment for BMI and BMD.
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Affiliation(s)
- Nicola Napoli
- Division of Endocrinology and Diabetes, University Campus Bio-Medico di Roma, Rome, Italy
- Division of Bone Mineral Diseases, Washington University in Saint Louis, Saint Louis, Missouri
| | - Caterina Conte
- Vita-Salute San Raffaele University, Milan, Italy
- Clinical Transplant Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Claudio Pedone
- Geriatric Unit, University Campus Bio-Medico di Roma, Rome, Italy
| | - Elsa S Strotmeyer
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kamil E Barbour
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Dennis M Black
- Department of Medicine, University of California, San Francisco, San Francisco, California
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
| | - Elizabeth J Samelson
- Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
- Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Ann V Schwartz
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
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Metabolic Syndrome and Its Associations with Components of Sarcopenia in Overweight and Obese Older Adults. J Clin Med 2019; 8:jcm8020145. [PMID: 30691198 PMCID: PMC6406767 DOI: 10.3390/jcm8020145] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 01/20/2019] [Accepted: 01/24/2019] [Indexed: 12/25/2022] Open
Abstract
Ageing, obesity and the metabolic syndrome (MetS) may all contribute to poor muscle health (sarcopenia). This study aimed to determine the cross-sectional associations between MetS (International Diabetes Federation classification) and sarcopenia (revised European Working Group on Sarcopenia in Older People definition) in 84 overweight and obese older adults. Components of sarcopenia included muscle strength (hand grip and leg extension), physical performance (stair climb test and short physical performance battery (SPPB), including gait speed and repeated chair stands time), muscle mass (appendicular lean mass (ALM), dual-energy X-ray absorptiometry), muscle size (peripheral quantitative computed tomography-determined calf and forearm cross-sectional area (CSA)) and muscle quality (muscle density and strength normalised to lean mass). Waist circumference was associated with greater muscle size, but poorer leg extension strength, chair stands and stair climb time, gait speed, SPPB scores and muscle quality measures (all p < 0.05). MetS was positively associated with ALM and forearm muscle CSA, and negatively associated with muscle quality measures and chair stands time (all p < 0.05). MetS is associated with larger muscle size, yet poorer muscle quality in overweight and obese older adults. Assessments of muscle function and quality should be considered for obese older adults and those with MetS.
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Association of metabolic syndrome with falls in patients with Parkinson's disease. Clin Nutr 2017; 36:559-563. [DOI: 10.1016/j.clnu.2016.02.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 01/11/2016] [Accepted: 02/01/2016] [Indexed: 11/22/2022]
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Sousa LMM, Marques-Vieira CMA, Caldevilla MNGND, Henriques CMAD, Severino SSP, Caldeira SMA. Risk for falls among community-dwelling older people: systematic literature review. Rev Gaucha Enferm 2017; 37:e55030. [PMID: 28273251 DOI: 10.1590/1983-1447.2016.04.55030] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 10/17/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To identify the risk factors for falls of the community-dwelling elderly in order to update the Taxonomy II of NANDA International. METHOD A systematic literature review based on research using the following platforms: EBSCOHost®, CINAHL and MEDLINE, from December 2010 to December 2014. The descriptors used were (Fall* OR Accidental Fall) AND (Community Dwelling OR Community Health Services OR Primary health care) AND (Risk OR Risk Assessment OR Fall Risk Factors) AND (Fall* OR Accidental Fall) AND (Community Dwelling OR older) AND Nurs* AND Fall Risk Factors. RESULTS The sample comprised 62 studies and 50 risk factors have been identified. Of these risk factors, only 38 are already listed in the classification. CONCLUSIONS Two new categories of risk factors are proposed: psychological and socio-economical. New fall risk factors for the community-dwelling elderly have been identified, which can contribute to the updating of this nursing diagnosis of the Taxonomy II of NANDA International.
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Affiliation(s)
- Luís Manuel Mota Sousa
- Centro Hospital Lisboa Central, Polo Hospital Curry Cabral. Lisboa, Portugal
- Universidade Atlântica, Escola Superior de Saúde Atlântica. Barcarena, Oeiras, Portugal
| | | | | | - Cristina Maria Alves Dias Henriques
- Administração Regional de Saúde de Lisboa e Vale do Tejo, Equipa Coordenadora Regional da Rede Nacional de Cuidados Continuados Integrados. Lisboa, Portugal
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Jacobs JV. A review of stairway falls and stair negotiation: Lessons learned and future needs to reduce injury. Gait Posture 2016; 49:159-167. [PMID: 27427833 DOI: 10.1016/j.gaitpost.2016.06.030] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 05/27/2016] [Accepted: 06/23/2016] [Indexed: 02/02/2023]
Abstract
Stairways are a common location for falls, and they result in a disproportionate risk of death or severe injury. Stairway falls are a significant problem across the lifespan and are often coincident with risky behaviors during stair use. The mechanics of successful stair negotiation for healthy young and older adults have been well described. These studies imply that current stair design does not offer an optimal universal design to meet the needs of older adults or people with health conditions. In addition, impaired stair negotiation associates with more than impaired strength, including functional impairments of cognitive load, sensory function and central motor coordination. Identification of behavioral strategies or stairway environments that assist or hinder recovery from a loss of balance on stairs remains incomplete. Therefore, future studies should investigate the mechanisms of balance recovery on stairs as well as the effectiveness of environmental interventions to mitigate stairway falls and injuries. Potential areas for evaluation may include modifying stair dimensions, surfaces, handrails, visual cues, and removing distractors of attention. Studies should also evaluate combinatorial interventions on person-related factors, such as behavioral interventions to decrease risky behaviors during stair use as well as interventions on cognitive, sensory, and motor functions relevant to stair use. Moreover, future studies should take advantage of new technologies to record stair use outside the laboratory in order to identify people or locations at risk for stairway falls. Such studies would inform the potential for broad-spectrum programs that decrease the risk of stairway falls and injuries.
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Affiliation(s)
- Jesse V Jacobs
- Center for Physical Ergonomics, Liberty Mutual Research Institute for Safety, 71 Frankland Rd., Hopkinton, MA, 01748, USA.
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Zhang MH, Shen QH, Qin ZM, Wang QL, Chen X. Systematic tracking of disrupted modules identifies significant genes and pathways in hepatocellular carcinoma. Oncol Lett 2016; 12:3285-3295. [PMID: 27899995 PMCID: PMC5103943 DOI: 10.3892/ol.2016.5039] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 07/12/2016] [Indexed: 12/17/2022] Open
Abstract
The objective of the present study is to identify significant genes and pathways associated with hepatocellular carcinoma (HCC) by systematically tracking the dysregulated modules of re-weighted protein-protein interaction (PPI) networks. Firstly, normal and HCC PPI networks were inferred and re-weighted based on Pearson correlation coefficient. Next, modules in the PPI networks were explored by a clique-merging algorithm, and disrupted modules were identified utilizing a maximum weight bipartite matching in non-increasing order. Then, the gene compositions of the disrupted modules were studied and compared with differentially expressed (DE) genes, and pathway enrichment analysis for these genes was performed based on Expression Analysis Systematic Explorer. Finally, validations of significant genes in HCC were conducted using reverse transcription-quantitative polymerase chain reaction (RT-qPCR) analysis. The present study evaluated 394 disrupted module pairs, which comprised 236 dysregulated genes. When the dysregulated genes were compared with 211 DE genes, a total of 26 common genes [including phospholipase C beta 1, cytochrome P450 (CYP) 2C8 and CYP2B6] were obtained. Furthermore, 6 of these 26 common genes were validated by RT-qPCR. Pathway enrichment analysis of dysregulated genes demonstrated that neuroactive ligand-receptor interaction, purine and drug metabolism, and metabolism of xenobiotics mediated by CYP were significantly disrupted pathways. In conclusion, the present study greatly improved the understanding of HCC in a systematic manner and provided potential biomarkers for early detection and novel therapeutic methods.
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Affiliation(s)
- Meng-Hui Zhang
- Department of General Surgery, The Fourth Hospital of Jinan, Jinan, Shandong 250031, P.R. China
| | - Qin-Hai Shen
- Department of Medicine, Shandong Medical College, Jinan, Shandong 250002, P.R. China
| | - Zhao-Min Qin
- Department of Nursing, Shandong Medical College, Jinan, Shandong 250002, P.R. China
| | - Qiao-Ling Wang
- Department of Ophthalmology, The Second Hospital of Jinan, Jinan, Shandong 250022, P.R. China
| | - Xi Chen
- Department of Ophthalmology, The Ninth Hospital of Chongqing, Chongqing 400700, P.R. China
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Abstract
PURPOSE OF REVIEW The interaction between fall and fracture risk factors is an area of increasing clinical relevance, but little information is known about the age-specific issues in bone health unique to HIV-infected adults. The present review will focus on what is known about falls and fall risk factors among HIV-infected adults, and then review the association between decreased muscle, increased adiposity, and frailty with both low bone mineral density (BMD) and falls. RECENT FINDINGS The rate of falls among middle-aged HIV-infected adults is similar to that of HIV-uninfected adults 65 years and older. Many of the clinical factors that contribute to low BMD overlap with risk factors for falls, resulting in a high risk of a serious fall among older adults with the greatest risk for a fracture. Low muscle mass, increased adiposity and metabolic syndrome, physical function impairment and frailty, common among older HIV-infected adults, contribute to an increased risk for low BMD and falls, and subsequently, may increase the risk of fracture among HIV-infected older adults. SUMMARY Interventions with dual benefit on reducing fall risk and improving BMD are likely to have the greatest impact on fracture prevention in the older, HIV-infected adult.
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Affiliation(s)
- Kristine M Erlandson
- aUniversity of Colorado, Aurora, Colorado, USA bUniversity of Modena and Reggio Emilia, Modena, Italy cMcGill University, Montreal, Quebec, Canada
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Prevalence and correlates of metabolic syndrome and its components in elderly Korean adults. Exp Gerontol 2015; 84:107-112. [PMID: 26386155 DOI: 10.1016/j.exger.2015.09.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Revised: 08/27/2015] [Accepted: 09/15/2015] [Indexed: 11/24/2022]
Abstract
PURPOSE This study examined the determinants of the prevalence of factors related to five components of metabolic syndrome in the elderly. METHODS The study used raw data (2010-2012) from the Korea National Health and Nutrition Examination Survey-V. The 3971 study subjects were community-dwelling elderly adults aged over 65years. The criteria for the metabolic syndrome were based on those of the American Heart Association/National Heart, Lung and Blood Institute, and the waist circumference cutoff points for these factors were adapted from the standard suggested by the Korea Society for the Study of Obesity in 2005. RESULTS The overall prevalence of metabolic syndrome in Korean elderly adults was 43.6% (35.3% in men and 50.2% in women). Metabolic syndrome was 2.32 times more prevalent in women relative to men (95% confidence interval [CI]: 1.85-2.90, p<0.001), 1.26 times more prevalent in urban, relative to rural, residents (95% CI: 1.09-1.45, p=0.002), 1.43 times more prevalent in ex-smokers (95% CI: 1.14-1.80, p=0.002) and 1.45 times more prevalent in smokers (95% CI: 1.11-1.54, p=0.007) relative to nonsmokers, and 1.16 times more prevalent in sedentary, relative to active, subjects (95% CI: 1.02-1.32, p=0.028). CONCLUSION The results indicated that the prevalence of metabolic syndrome in elderly Korean adults was high, suggesting that the prevention and management of metabolic syndrome in the elderly should be addressed via individual components.
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İlhan B, Tufan F, Bahat G, Karan MA. Potential underdiagnosis of osteoporosis in repeated vertebral augmentation for new vertebral compression fractures. Clin Interv Aging 2015; 10:1475-6. [PMID: 26392757 PMCID: PMC4574814 DOI: 10.2147/cia.s93068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Birkan İlhan
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Istanbul, Turkey
| | - Fatih Tufan
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Istanbul, Turkey
| | - Gülistan Bahat
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Istanbul, Turkey
| | - Mehmet Akif Karan
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Istanbul, Turkey
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