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Aparecida Damasceno D, Ferreira Aleixo G, Barbosa Luciano J, Nogueira CM, Pinto JM. Factors Related to Recurrent Falls Among Older Adults Attending Primary Health Care: A Biopsychosocial Perspective. Exp Aging Res 2024; 50:348-359. [PMID: 36974688 DOI: 10.1080/0361073x.2023.2195293] [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: 04/04/2022] [Accepted: 02/24/2023] [Indexed: 03/29/2023]
Abstract
The objective of this study was to investigate factors related to recurrent falls among older adults attending primary health care, considering the biopsychosocial perspective. A representative sample of 201 older adults were interviewed in three Primary Health Care units randomly selected in a city in southeastern Brazil. Outcome included self-report of two or more falls in the past 12 months. Exposures included personal and environmental aspects, according to domains of International Classification of Functioning of the World Health Organization (ICF-WHO). Recurrent falls were reported by 24.4% of the participants. Associations with depressive symptoms (p = .003), having osteoporosis (p = .031), chronic musculoskeletal pain (p = .020), frailty (p = .013), sleep satisfaction (p < .001), and functional status (p < .001) were found. In logistic regression models, cognitive status, musculoskeletal pain, and functional status were predictors of recurrent falls; however, only sleep satisfaction remained significant in the final model. Strategies aimed at preventing recurrent falls in primary health care should consider assessments and interventions targeting sleep aspects among older adults.
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Affiliation(s)
| | - Gabriel Ferreira Aleixo
- Undergraduate Program in Physical Therapy, Federal University of Triangulo Mineiro, uberaba, Brazil
| | - Jean Barbosa Luciano
- Undergraduate Program in Physical Therapy, Federal University of Triangulo Mineiro, uberaba, Brazil
| | - Claudio Mardey Nogueira
- Graduate Program in Physical Therapy, Federal University of Triangulo Mineiro, Uberaba, Brazil
| | - Juliana Martins Pinto
- Laboratory of Physical Therapy and Public Health - Department of Physical Therapy - Institute of Health Science, Federal University of Triangulo Mineiro, Uberaba, Brazil
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Behtani L, Paromov D, Moïn-Darbari K, Houde MS, Bacon BA, Maheu M, Leroux T, Champoux F. Hearing Aid Amplification Improves Postural Control for Older Adults With Hearing Loss When Other Sensory Cues Are Impoverished. Trends Hear 2024; 28:23312165241232219. [PMID: 38356376 PMCID: PMC10868491 DOI: 10.1177/23312165241232219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 02/16/2024] Open
Abstract
Recent studies suggest that sound amplification via hearing aids can improve postural control in adults with hearing impairments. Unfortunately, only a few studies used well-defined posturography measures to assess balance in adults with hearing loss with and without their hearing aids. Of these, only two examined postural control specifically in the elderly with hearing loss. The present study examined the impact of hearing aid use on postural control during various sensory perturbations in older adults with age-related hearing loss. Thirty individuals with age-related hearing impairments and using hearing aids bilaterally were tested. Participants were asked to perform a modified clinical sensory integration in balance test on a force platform with and without hearing aids. The experiment was conducted in the presence of a broadband noise ranging from 0.1 to 4 kHz presented through a loudspeaker. As expected, hearing aid use had a beneficial impact on postural control, but only when visual and somatosensory inputs were both reduced. Data also suggest that hearing aid use decreases the dependence on somatosensory input for maintaining postural control. This finding can be of particular importance in older adults considering the reduction of tactile and proprioceptive sensitivity and acuity often associated with aging. These results provide an additional argument for encouraging early hearing aid fitting for people with hearing loss.
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Affiliation(s)
- L. Behtani
- School of Speech Language Pathology and Audiology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche de L’Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC, Canada
| | - D. Paromov
- School of Speech Language Pathology and Audiology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche de L’Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC, Canada
| | - K. Moïn-Darbari
- School of Speech Language Pathology and Audiology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - MS Houde
- School of Speech Language Pathology and Audiology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - BA Bacon
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - M. Maheu
- School of Speech Language Pathology and Audiology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Institut Universitaire Sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Pavillon Laurier, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montréal, QC, Canada
| | - T. Leroux
- School of Speech Language Pathology and Audiology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - F. Champoux
- School of Speech Language Pathology and Audiology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche de L’Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC, Canada
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The Effect of Nursing Discharge Planning Program to Prevent Recurrent Falls, Readmission, and Length of Hospital Stay in the Aged Patients. TOPICS IN GERIATRIC REHABILITATION 2022. [DOI: 10.1097/tgr.0000000000000377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Tse A, Ward S, McNeil J, Barker A, Cicuttini F, Fitzgibbon B, Hussain SM, Owen A, Wang YY, Wolfe R, Gilmartin-Thomas JFM. Severe low back or lower limb pain is associated with recurrent falls amongst older Australians. Eur J Pain 2022; 26:1923-1937. [PMID: 35862463 PMCID: PMC9546413 DOI: 10.1002/ejp.2013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 06/25/2022] [Accepted: 07/16/2022] [Indexed: 11/14/2022]
Abstract
Background Few studies have explored the impact of low back or lower limb pain severity on recurrent (≥2) falls in older adults. Objectives Investigate the association between the severity of low back or lower limb pain, and ≥2 falls or falls‐related injuries. Methods Community‐dwelling Australian males and females in the ASPREE Longitudinal Study of Older Persons (ALSOP), aged ≥70 years. Self‐reported, cross‐sectional questionnaire data regarding number of falls and falls‐related injuries in the last 12 months; and sites and severity of pain experienced on most days. Adjusted relative risks (RR) were estimated from multivariable Poisson regression models, for males and females separately. Results Of 14,892 ALSOP participants, 13% (n = 1983) reported ≥2 falls (‘recurrent fallers’) in the last 12 months. Males and females who reported severe low back, or severe lower limb pain on most days were more likely to report ≥2 falls in the last 12 months compared to those with mild pain (lower back: males RR = 1.70 and females RR = 1.5, p = 0.001; lower limb: males RR = 2.0, p < 0.001 and females RR = 1.4, p = 0.003). Female recurrent fallers who reported severe low back (RR = 1.3, p = 0.029) or lower limb (RR = 1.2, p = 0.024) pain on most days were more likely to report a falls‐related injury in the last 12 months compared to females with mild pain. Conclusion Severe low back or lower limb pain was associated with an increased likelihood of recurrent falls (males/females) or falls‐related injuries (females only). Assessment of severe low back and lower limb pain should be considered as a priority when undertaking falls‐risk evaluation. Significance Severe low back pain, or severe lower limb pain is associated with an increased likelihood of recurrent falls in older males and females, and an increased likelihood of falls‐related injuries in older female recurrent fallers. Assessment and management of severe low back and lower limb pain should be prioritized when undertaking falls‐risk assessment. Future longitudinal research is required to further interrogate this relationship and its underlying mechanisms.
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Affiliation(s)
- Amy Tse
- Aged Care Department, Bankstown-Lidcombe Hospital, New South Wales, Australia.,School of Health, University of New South Wales, New South Wales, Australia
| | - Stephanie Ward
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.,Centre for Healthy Brain Ageing, University of New South Wales, New South Wales, Australia.,Dept of Geriatric Medicine, Prince of Wales Hospital, New South Wales, Australia
| | - John McNeil
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Anna Barker
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.,Silver Chain, Victoria, Australia
| | - Flavia Cicuttini
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Bernadette Fitzgibbon
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Sultana Monira Hussain
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.,Department of Medical Education, Melbourne Medical School, The University of Melbourne, Victoria, Australia
| | - Alice Owen
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Yuan Yuan Wang
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Rory Wolfe
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Julia Fiona-Maree Gilmartin-Thomas
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.,Institute for Health & Sport, Victoria University, Victoria, Australia.,Australian Institute for Musculoskeletal Science, Victoria, Australia
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Sadeghi H, Jehu DA, Daneshjoo A, Shakoor E, Razeghi M, Amani A, Hakim MN, Yusof A. Effects of 8 Weeks of Balance Training, Virtual Reality Training, and Combined Exercise on Lower Limb Muscle Strength, Balance, and Functional Mobility Among Older Men: A Randomized Controlled Trial. Sports Health 2021; 13:606-612. [PMID: 33583253 PMCID: PMC8558995 DOI: 10.1177/1941738120986803] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Poor muscle strength, balance, and functional mobility have predicted falls in older adults. Fall prevention guidelines recommend highly challenging balance training modes to decrease falls; however, it is unclear whether certain modes are more effective. The purpose of this study was to determine whether traditional balance training (BT), virtual reality balance training (VR), or combined exercise (MIX) relative to a waitlist control group (CON) would provoke greater improvements in strength, balance, and functional mobility as falls risk factor proxies for falls in older men. HYPOTHESIS We hypothesized that 8 weeks of MIX will provoke the greatest improvements in falls risk factors, followed by similar improvements after BT and VR, relative to the CON. STUDY DESIGN Single-blinded randomized controlled trial NCT02778841 (ClinicalTrials.gov identifier). LEVEL OF EVIDENCE Level 2. METHODS In total, 64 community-dwelling older men (age 71.8 ± 6.09 years) were randomly assigned into BT, VR, MIX, and CON groups and tested at baseline and at the 8-week follow-up. The training groups exercised for 40 minutes, 3 times per week, for 8 weeks. Isokinetic quadriceps and hamstrings strength on the dominant and nondominant legs were primary outcomes measured by the Biodex Isokinetic Dynamometer. Secondary outcomes included 1-legged stance on firm and foam surfaces, tandem stance, the timed-up-and-go, and gait speed. Separate one-way analyses of covariance between groups were conducted for each outcome using baseline scores as covariates. RESULTS (1) MIX elicited greater improvements in strength, balance, and functional mobility relative to BT, VR, and CON; (2) VR exhibited better balance and functional mobility relative to BT and CON; and (3) BT demonstrated better balance and functional mobility relative to CON. CONCLUSION The moderate to large effect sizes in strength and large effect sizes for balance and functional mobility underline that MIX is an effective method to improve falls risk among older adults. CLINICAL RELEVANCE This study forms the basis for a larger trial powered for falls.
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Affiliation(s)
- Hassan Sadeghi
- Department of Biomechanics and Sports
Injuries, Faculty of Physical Education and Sports Sciences, Kharazmi University,
Tehran, Iran
- Department of Sports Studies, Faculty of
Educational Studies, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Deborah A. Jehu
- Aging, Mobility and Cognitive
Neuroscience Laboratory, Department of Physical Therapy, Faculty of Medicine,
University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Hip Health and Mobility,
Vancouver Coastal Health Research Institute, Vancouver, British Columbia,
Canada
- Djavad Mowafaghian Centre for Brain
Health, Vancouver Coastal Health Research Institute, Vancouver, British Columbia,
Canada
| | - Abdolhamid Daneshjoo
- Department of Sports Injuries and
Corrective Exercises, Faculty of Sports Sciences, Shahid Bahonar University of
Kerman, Kerman, Iran
| | - Elham Shakoor
- Department of Physical Education and
Sport Sciences, School of Education and Psychology, Shiraz University, Shiraz,
Iran
- Shiraz Geriatric Research Center,
Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Razeghi
- School of Rehabilitation Sciences,
Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Amani
- Faculty of Sports Science, Shomal
University, Amol, Iran
| | - Muhammad Nazrul Hakim
- Department of Biomedical Sciences,
Faculty of Medicine and Health Sciences, Universiti Putra, Serdang, Selangor,
Malaysia
| | - Ashril Yusof
- Centre for Sports and Exercise
Sciences, University of Malaya, Kuala Lumpur, Malaysia
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Jehu DA, Davis JC, Falck RS, Bennett KJ, Tai D, Souza MF, Cavalcante BR, Zhao M, Liu-Ambrose T. Risk factors for recurrent falls in older adults: A systematic review with meta-analysis. Maturitas 2020; 144:23-28. [PMID: 33358204 DOI: 10.1016/j.maturitas.2020.10.021] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/26/2020] [Accepted: 10/29/2020] [Indexed: 01/05/2023]
Abstract
Older adults who fall recurrently (i.e., 2 or more falls/year) are at risk of functional decline and mortality. Understanding which risk factors for recurrent falls are most important will inform secondary fall prevention strategies that can reduce recurrent falls risk. Thus, we conducted a systematic review with meta-analysis to determine the relative risk of recurrent falls for different types of falls risk factors. MEDLINE, EMBASE, PsycINFO, and CINAHL databases were searched on April 25, 2019 (Prospero Registration: CRD42019118888). We included peer-reviewed prospective studies which examined risk factors that contributed to recurrent falls in adults aged ≥ 60 years. Using the falls risk classification system of Lord and colleagues, we classified each risk factor into one of the following domains: 1) balance and mobility; 2) environmental; 3) psychological; 4) medical; 5) medication; 6) sensory and neuromuscular; or 7) sociodemographic. We calculated the summary relative risk (RR) for each domain and evaluated the risk of bias and quality of reporting. Twenty-two studies were included in this systematic review and meta-analysis. Four domains predicted recurrent falls: balance and mobility (RR:1.32;95 % CI:[1.10, 1.59]), medication (RR:1.53;95 % CI:[1.11, 2.10]), psychological (RR:1.35;95 % CI:[1.03, 1.78]), and sensory and neuromuscular (RR:1.51;95 % CI:[1.18, 1.92]). Each of these four domains can be viewed as a marker of frailty. The risk of bias was low, and the study quality was high (minimum:19/22). Older adults with markers of frailty are up to 53 % more likely to experience recurrent falls. Strategies that identify and resolve frailty markers should be a frontline approach to preventing recurrent falls.
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Affiliation(s)
- D A Jehu
- Aging, Mobility and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada; Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.
| | - J C Davis
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada; Social & Economic Change Laboratory, Faculty of Management, University of British Columbia-Okanagan Campus, Kelowna, British Columbia, Canada.
| | - R S Falck
- Aging, Mobility and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada; Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.
| | - K J Bennett
- Aging, Mobility and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada; Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.
| | - D Tai
- Aging, Mobility and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.
| | - M F Souza
- Aging, Mobility and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada; Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada; Universidade Federal do Vale do São Francisco, UNIVASF, Clinical Exercise Lab, LABEC, Department of Physical Education, Petrolina, PE, Brazil.
| | - B R Cavalcante
- Aging, Mobility and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada; Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada; Associated Graduate Program in Physical Education, University of Pernambuco, Recife, Brazil.
| | - M Zhao
- Aging, Mobility and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.
| | - T Liu-Ambrose
- Aging, Mobility and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada; Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.
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