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Asavamongkolkul A, Adulkasem N, Chotiyarnwong P, Vanitcharoenkul E, Chandhanayingyong C, Laohaprasitiporn P, Soparat K, Unnanuntana A. Prevalence of osteoporosis, sarcopenia, and high falls risk in healthy community-dwelling Thai older adults: a nationwide cross-sectional study. JBMR Plus 2024; 8:ziad020. [PMID: 38505534 PMCID: PMC10945715 DOI: 10.1093/jbmrpl/ziad020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 12/06/2023] [Accepted: 12/22/2023] [Indexed: 03/21/2024] Open
Abstract
Thailand has transitioned from an aging society to an aged society, which implies that the prevalence of age-related disorders will increase; however, epidemiological data specific to the prevalence of age-related degenerative musculoskeletal disorders among Thai older adults remain limited. Accordingly, the aim of this study was to investigate the prevalence of age-related musculoskeletal diseases, including osteoporosis, sarcopenia, and high falls risk among healthy community-dwelling Thai older adults. This cross-sectional nationwide study enrolled Thai adults aged ≥60 yr from 2 randomly selected provinces from each of the 6 regions of Thailand via stratified multistage sampling during March 2021 to August 2022. All enrolled participants were evaluated for BMD, skeletal muscle mass, grip strength, and gait speed. Osteoporosis was diagnosed according to the World Health Organization definition, and sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Falls risk was determined using the self-rated Fall Risk Questionnaire. A total of 2991 eligible participants were recruited. The mean age of participants was 69.2 ± 6.5 yr (range: 60-107), and 63.1% were female. The prevalence of osteoporosis, sarcopenia, and high falls risk was 29.7%, 18.1%, and 38.5%, respectively. Approximately one-fifth of subjects (19.1%) had at least 2 of 3 risk factors (ie, osteoporosis, sarcopenia, and high falls risk) for sustaining a fragility fracture, and 3.4% had all 3 risk factors. In conclusion, the results of this study revealed a high and increasing prevalence of osteoporosis, sarcopenia, and high falls risk in healthy community-dwelling Thai older adults. Since these conditions are all major risk factors for fragility fracture, modification of Thailand's national health care policy is urgently needed to address the increasing prevalence of these conditions among healthy community-dwelling older adults living in Thailand.
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Affiliation(s)
- Apichat Asavamongkolkul
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Nath Adulkasem
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Pojchong Chotiyarnwong
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Ekasame Vanitcharoenkul
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | | | - Panai Laohaprasitiporn
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Krabkaew Soparat
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Aasis Unnanuntana
- Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
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Wang K, Chen M, Zhang X, Zhang L, Chang C, Tian Y, Wang X, Li Z, Ji Y. The Incidence of Falls and Related Factors among Chinese Elderly Community Residents in Six Provinces. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14843. [PMID: 36429561 PMCID: PMC9690932 DOI: 10.3390/ijerph192214843] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 11/03/2022] [Accepted: 11/09/2022] [Indexed: 06/16/2023]
Abstract
This cross-sectional study classified the factors related to falls among residents ≥ 60 years old in China in order to provide evidence for the prevention of falls in the elderly. A total of 2994 participants were enrolled, and the correlations between social demography, physical health, self-health management awareness, family support, and fall risk were analyzed. Factors influencing falls were classified by location, cause, and the activity during falls. Suffering from osteoarthropathy (OR = 1.761, 95% CI: 1.234-2.513, p < 0.05), depression or anxiety (OR = 1.896, 95% CI: 1.331-2.700, p < 0.001), household size > 2 (OR = 1.806, 95% CI: 1.042-3.130, p < 0.05), and poor self-assessed health (OR = 1.478, 95% CI: 1.107-1.972, p < 0.01) were risk factors. Higher participation in community health programs (OR = 0.522, 95% CI: 0.298-0.912, p < 0.05) and spousal support (OR = 0.909, 95% CI: 0.841-0.981, p < 0.05) were protective factors. Falls were divided into the following categories: stairs/hallway (vision, attention problems), bath/toilet (vision, attention problems, slipping), indoor housework (dizziness, leg weakness), and outdoor activities (attention, surface problems). While acknowledging that the personal physical and mental health of the elderly may lead to falls, community support, accelerated transformation of housing, and the construction of barrier-free environments play an important role in reducing the risk of falls.
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Affiliation(s)
- Kun Wang
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Meijun Chen
- School of Public Health, The University of Hong Kong, Hong Kong 999077, China
| | - Xiaoyue Zhang
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Lanchao Zhang
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Chun Chang
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Yu Tian
- Xinjiekou Community Health Service Center of Xicheng District, Beijing 100035, China
| | - Xiaofeng Wang
- Ronghua Community Health Service Center of Beijing Economic-Technological Development Area, Beijing 100176, China
| | - Zhijing Li
- School of Health Humanities, Peking University Health Science Center, Beijing 100191, China
| | - Ying Ji
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing 100191, China
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Arphorn S, Ishimaru T, Lertvarayut T, Kiatkitroj K, Theppitak C, Manothum A, Hara K. Risk factors for occupational falls among middle-aged and elderly farm workers in Nan province, Thailand. J Agromedicine 2022; 27:402-408. [DOI: 10.1080/1059924x.2022.2040071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sara Arphorn
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Center of Excellence on Environmental Health and Toxicology, Bangkok, Thailand
| | - Tomohiro Ishimaru
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Teepapipat Lertvarayut
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Public Health, Faculty of Physical Education, Srinakharinwirot University, Nakhon Nayok, Thailand
| | - Kanpitcha Kiatkitroj
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Program of Occupational Health and Safety, Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
| | - Chalermsiri Theppitak
- Institute of Public Health, Suranaree University of Technology, Nakhon Ratchasima, Thailand
| | - Aniruth Manothum
- Faculty of Industrial Technology, Lampang Rajabhat University, Lampang, Thailand
| | - Kunio Hara
- Department of Occupational Safety and Health Management, School of Health Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
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Nualyong T, Siriphorn A. Accuracy of the figure of 8 walk test with and without dual-task to predict falls in older adults. J Bodyw Mov Ther 2022; 30:69-75. [DOI: 10.1016/j.jbmt.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 11/01/2021] [Accepted: 02/04/2022] [Indexed: 11/24/2022]
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Ashari A, Hamid TA, Hussain MR, Ibrahim R, Hill KD. Prevalence, Circumstances, and Risk Factors of Falls Among Community Dwelling Members of University of the Third Age. Front Public Health 2021; 9:610504. [PMID: 34900882 PMCID: PMC8652217 DOI: 10.3389/fpubh.2021.610504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 10/11/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Study aimed to identify the prevalence of falls and associated contributory factors among older Malaysians. Methods: A cross sectional study among community dwelling older adults aged 50 years and above. Self-administered questionnaires on history of falls in the previous 12 months, physical assessment and computerized and clinical measures of balance were assessed on a single occasion. Results: Forty nine (31.0%) participants fell, with 4.4% reported having multiple falls within the previous 12 months. Slips were the most prevalent cause of falls, accounting for 49% of falls. More than half (54.5%) of falls occurred in the afternoon while participants walked inside the home (32.7%), outside home (30.6%), and 36.7% were in community areas. More than half of respondents were identified as having turning instability. Step Test, turn sway, depression, physical activity level and edge contrast sensitivity were significantly worse for fallers (p < 0.05). Multiple logistic regression analysis showed that turning performance, visual acuity and back pain were significantly associated with falls risk, accounting for 72% of the variance of risk factors for falls among studied population. Conclusion: Falls are common among community dwelling older Malaysians. The findings provide information of falls and falls risk factors among community dwelling older adults in Malaysia. Future intervention studies should target locally identified falls risk factors. This study has highlighted the importance of instability during turning as an important fall risk factor.
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Affiliation(s)
- Asmidawati Ashari
- Department of Human Development and Family Studies, Faculty of Human Ecology, University Putra Malaysia, Serdang, Malaysia.,Laboratory of Social Gerontology, Malaysian Research Institute on Ageing MyAgeing™, University Putra Malaysia, Serdang, Malaysia.,School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Tengku Aizan Hamid
- Laboratory of Social Gerontology, Malaysian Research Institute on Ageing MyAgeing™, University Putra Malaysia, Serdang, Malaysia
| | - Mohd Rizal Hussain
- Laboratory of Social Gerontology, Malaysian Research Institute on Ageing MyAgeing™, University Putra Malaysia, Serdang, Malaysia
| | - Rahimah Ibrahim
- Department of Human Development and Family Studies, Faculty of Human Ecology, University Putra Malaysia, Serdang, Malaysia.,Laboratory of Social Gerontology, Malaysian Research Institute on Ageing MyAgeing™, University Putra Malaysia, Serdang, Malaysia
| | - Keith D Hill
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia.,School of Primary and Allied Health Care, Monash University, Melbourne, VIC, Australia
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Rivan NFM, Singh DKA, Shahar S, Wen GJ, Rajab NF, Din NC, Mahadzir H, Kamaruddin MZA. Cognitive frailty is a robust predictor of falls, injuries, and disability among community-dwelling older adults. BMC Geriatr 2021; 21:593. [PMID: 34696720 PMCID: PMC8543922 DOI: 10.1186/s12877-021-02525-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 10/04/2021] [Indexed: 12/20/2022] Open
Abstract
Background Cognitive frailty, a combination of physical frailty and cognitive impairment, is associated with functional decline in older adults. However, there is limited information if cognitive frailty predicts the incidence of falls, injuries, and disability. In this study, we aimed to determine the ability of cognitive frailty in predicting the incidence of falls, injuries and disability among multi-ethnic older adults in Malaysia at 5 years follow-up. Methods In this prospective cohort study, a total of 400 participants aged 60 years and above were successfully followed up at 5 years. Participants’ socio-demographic, medical history, psycho-social, physical, cognitive and dietary intake information was obtained. Cognitive frailty was defined as comorbid physical frailty (> 1 Fried criteria) and mild cognitive impairment (Petersen criteria). Univariate analysis was performed for all variables, followed by hierarchical binary logistic regression (BLR) analysis to identify the ability of CF in predicting the incidence of falls, injuries, and disability. The significant value was set at p < 0.05. Results Cognitive frailty was found to be associated with greater risk of adverse consequences after adjusting for covariates. Both cognitive frailty (Adjusted Odd ratio (Adj OR) = 2.98, 95% confidence interval (CI): 1.78–4.99, p < 0.05) and physical frailty (Adj OR = 2.88, 95% CI: 1.19–6.99, p < 0.05) were significant predictors of incidence of falls. Risk of injuries was also significantly increased with the presence of cognitive frailty (Adj OR = 3.06, 95% CI: 1.23–7.60, p < 0.05) and physical frailty (Adj OR = 3.04, 95% CI: 1.75–5.28, p < 0.05). In addition, cognitive frailty (Adj OR = 5.17, 95% CI: 1.11–24.21, p < 0.05) and physical frailty (Adj OR = 4.99, 95% CI: 1.11–22.57, p < 0.05) were shown to significantly predict the incidence of disability among older adults. Conclusion Cognitive frailty is a robust predictor of falls, injuries, and disability in older adults. Possible early multi-domain preventive and management strategies of cognitive frailty that contribute to adverse consequences are required to decrease further functional decline and promote independence in older adults.
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Affiliation(s)
- Nurul Fatin Malek Rivan
- Nutritional Sciences Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Devinder Kaur Ajit Singh
- Physiotherapy Programme & Centre for Healthy Ageing and Wellness (H-CARE), Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia.
| | - Suzana Shahar
- Dietetics Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Goh Jing Wen
- Physiotherapy Programme & Centre for Healthy Ageing and Wellness (H-CARE), Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Nor Fadilah Rajab
- Biomedical Science Programme, Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Health Psychology Programme and Centre of Rehabilitation Science, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Hazlina Mahadzir
- Internal Medicine & Geriatric Department, Pusat Perubatan Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Batu 9 Cheras, 56000, Kuala Lumpur, Malaysia
| | - Mohd Zul Amin Kamaruddin
- Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
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Birhanie G, Melese H, Solomon G, Fissha B, Teferi M. Fear of falling and associated factors among older people living in Bahir Dar City, Amhara, Ethiopia- a cross-sectional study. BMC Geriatr 2021; 21:586. [PMID: 34674654 PMCID: PMC8532299 DOI: 10.1186/s12877-021-02534-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 10/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fear of falling (FOF) is the most common public health problem, which can lead to loss of confidence, reducing physical and social activities, depression, loss of mobility, increased risk of falls, physical weakness, and strong negative impact on an older people's quality of life. However, studies in developing country were lacking, particularly in the study area. Therefore, the aim of the current study was to fill this gap in the study area in particular and the country in general. The purpose of the current study was to assess the prevalence and associated factors with fear of falling among older people 60 years and older who were living in Bahir Dar city, Ethiopia. METHODS A community based cross sectional study design was conducted with a total sample size of 527 participants and multistage random sampling technique was used to select the study participants. The fall efficacy scale tool was used to develop the questionnaire. Data were coded, cleaned and entered into SPSS version 23 for analysis. Multi-collinearity and model fitting were checked. In bivariate logistic regression analyses, variables with p-value< 0.25 were considered as potential candidates for multivariable logistic regression analyses. A variable with p-value< 0.05 at 95% CI was considered as statistically significant. Finally, the odds ratio and 95% confidence interval were estimated and interpreted. RESULTS A total of 481 participants was included in this study. The prevalence of fear of falling among the older people was 59.9% (95% CI; 55.7-64.4). Fear of falling was significantly associated with the following variables:- advanced age (AOR = 4.01, 95% CI; 1.65-9.74), female (AOR = 4.25, 95% CI; 2.25-8.01), lower education level (AOR = 2.77, 95% CI; 1.12-6.82), anxiety [AOR = 9.03, 95% CI; 4.78-17.07), confirmed medical conditions (AOR = 2.01, 95% CI; 1.03-3.91) and walking aids used (AOR = 13.82; 95% CI; 5.21-36.63). CONCLUSIONS A moderate prevalence of fear of falling was observed. The major associated factors were advanced age, being female, lower educational level, anxiety, confirmed medical conditions and walking aids used. Hence, we recommend the need of rehabilitation programs that enable healthy aging and further rigor research is recommended.
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Affiliation(s)
- Gebremeskel Birhanie
- Department of Physiotherapy, School of Medicine, College of Health Sciences, and Tibebe Giyon Specialized Hospital, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Haimanot Melese
- Department of Physiotherapy, School of Medicine, College of Health Sciences, and Ayder Comprehensive Specialized Hospital, Mekelle University, Mekelle, Ethiopia
| | - Gebrerufael Solomon
- Department of Physiotherapy, School of Medicine, College of Health Sciences, and Ayder Comprehensive Specialized Hospital, Mekelle University, Mekelle, Ethiopia
| | - Berihu Fissha
- Department of Physiotherapy, School of Medicine, College of Health Sciences, and Aksum Referral Hospital, Aksum University, Aksum, Ethiopia
| | - Molla Teferi
- Department of Public Health, School of Public Health, College of Health Sciences, and Ayder Comprehensive Specialized Hospital, Mekelle University, Mekelle, Ethiopia
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Muhammad T, Maurya P, Sharma P. Prevalence and correlates of bone and joint diseases and its association with falls among older adults in India: Evidence from LASI, 2017-18. Geriatr Nurs 2021; 42:1143-1150. [PMID: 34404017 DOI: 10.1016/j.gerinurse.2021.07.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 12/13/2022]
Abstract
This study explores the prevalence and correlates of bone and joint diseases and its association with falls among older adults in India. Data from the Longitudinal Aging Study in India (2017-18) were utilized for analysis (n = 31,464). Bivariate and logistic regression was used to fulfill the study objectives. The findings revealed that 19.71% of older adults had bone and joint disease, which was higher among women (22.79%) than men (16.25%). The strongest predictors of such diseases included being currently employed, physically inactive, having difficulties in performing functional activities and higher economic status. The fall in the last two years was reported by 12.63% of older adults, and bone and joints diseases were significantly associated with falls (AOR = 1.287; 95% CI: 1.117-1.483) after adjusting for several socio-demographic and health covariates. These findings imply that policymakers and providers must implement interventions designed to reduce the risk of those diseases and associated falls.
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Affiliation(s)
- T Muhammad
- Department of Population Policies and Programmes, International Institute for Population Sciences, Mumbai, Maharashtra 400088, India.
| | - Priya Maurya
- Department of Development Studies, International Institute for Population Sciences, Mumbai, Maharashtra 400088, India.
| | - Palak Sharma
- Department of Mathematical Demography and Statistics, International Institute for Population Sciences, Mumbai, Maharashtra 400088, India.
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Nawai A, Phongphanngam S, Khumrungsee M, Leveille SG. Factors associated with nutrition risk among community-dwelling older adults in Thailand. Geriatr Nurs 2021; 42:1048-1055. [PMID: 34256155 DOI: 10.1016/j.gerinurse.2021.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/03/2021] [Accepted: 06/08/2021] [Indexed: 11/30/2022]
Abstract
This study was to investigate socio-demographic, chronic conditions and health factors associated with nutrition risk among Thai community-dwelling older adults. This was a cross-sectional study, involving 330 participants aged ≥ 60 years living in low-income suburban Chiang Mai, Northern Thailand. Of the 330 participants, 54.8% were at nutritional risk based on the Mini Nutritional Assessment. Multivariate analysis indicated factors significantly associated with nutritional risk were: aged ≥80 years (OR:8.59, 95% CI = 2.94-25.11), low income (OR: 2.35, 95% CI = 1.15-4.78), living alone (OR: 2.02, 95% CI = 0.20-0.78), moderate to severe pain (OR: 5.88, 95% CI = 2.30-15.02), dyslipidemia (OR: 5.12, 95% CI = 2.23-11.77), osteoarthritis (OR: 2.49, 95% CI = 1.14-5.48), poor physical performance (OR: 1.49, 95% CI = 1.70-3.15), and ≥1 fall in the previous year (OR: 2.22, 95% CI = 1.21-4.07). Results point to the need for multifactorial interventions to reduce risk for geriatric nutrition problems. Further studies are needed to determine effective solutions to the problem of malnutrition among older adults.
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Affiliation(s)
- Ampicha Nawai
- Boromarajonani College of Nursing, Chiang Mai, Thailand.
| | | | | | - Suzanne G Leveille
- College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts, USA; Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA
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Accidental falls and associated factors among the elderly in Thailand: a national cross-sectional study in 2007, 2011, 2014 and 2017. JOURNAL OF HEALTH RESEARCH 2021. [DOI: 10.1108/jhr-07-2020-0308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose
This study assesses the prevalence of accidental falls in Thailand's older adult population and the contingent influences surrounding this prevalence.
Design/methodology/approach
Data were drawn from the Cross-Sectional National Surveys of Older Persons in Thailand, pooling of four survey datasets which took place in 2007, 2011, 2014 and 2017. Stratified two-stage sampling was employed. Interviews were conducted with sample sizes of 11,370, 11,061, 13,775 and 12,457 senior citizens, aged 60 and above, in the respective survey years. Further investigation was conducted on subjects who reported to be of good health and without any disability, yet experienced accidental falls. The prevalence of accidental falls was examined, and variable aspects concerning fall risk were assessed with probability-weighted multiple logistic regression.
Findings
The average prevalence of accidental falls from the four surveys was 4.7%. Significant risk factors identified were advanced age, being female, living in a rural residence, having worked in the previous 7 days, lack of/excessive exercise, alcohol consumption, smoking and having an outdoor lavatory.
Originality/value
Accidental falls tend to increase among community-dwelling seniors aged 60 and above. Falls increase with age and are more common among the women in that demographic. Findings suggest the need for government and local agencies to consider tailoring some public health approaches to the prevention of accidental falls. This study also highlights the necessity of proper work environment maintenance to prevent these falls.
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Balance Strategy Exercise versus Lower Limb-ROM Exercise for Reducing the Risk of Falls among Older People. NURSE MEDIA JOURNAL OF NURSING 2021. [DOI: 10.14710/nmjn.v11i1.33229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background: Falls are a significant health problem and the most common cause of injuries in older people. Different types of exercise have been recommended to prevent falls, including balance exercise and range of motion. However, there is a lack of evidence to compare the effect of the two exercises.Purpose: This study aimed to compare the effect of Balance Strategy Exercise (BSE) and Lower Limb-Range of Motion (ROM) exercise on reducing the risk of falls among older people living in long-term care facilities. Methods: This was a quasi-experimental study using a pre-post design without a control group. A total of 30 older adults from two nursing homes who met the inclusion and exclusion criteria participated in the study. A cluster randomization technique was used to assign the older people into either BSE or Lower-Limb ROM groups evenly. Treatment was given for 30 minutes per session, three sessions per week for three weeks. The risk of falls was measured using the Timed Up and Go (TUG) test. The paired t-test, Wilcoxon and Mann-Whitney U-test were used to analyze the data. Results: Results showed significant differences in the TUG scores before and after the intervention within both the BSE (p=0.001) and the Lower Limb-ROM group (p=0.001). However, the Lower Limb-ROM group demonstrated a significantly higher reduction in TUG score than the BSE group after the intervention (p=0.008).Conclusion: Lower Limb-ROM exercise is better to reduce the risk of falls among older people living in institutional care than BSE. This exercise can be applied as part of a fall prevention program in nursing homes.
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G R Neri S, S Oliveira J, B Dario A, M Lima R, Tiedemann A. Does Obesity Increase the Risk and Severity of Falls in People Aged 60 Years and Older? A Systematic Review and Meta-analysis of Observational Studies. J Gerontol A Biol Sci Med Sci 2021; 75:952-960. [PMID: 31750880 DOI: 10.1093/gerona/glz272] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Recent investigations suggest that obesity may be associated with an increased risk of falls; however, this theory has yet to be definitively confirmed. This systematic review and meta-analysis examined the strength of the association between obesity and falls, multiple falls, fall-related injuries, and fall-related fractures among older adults. METHODS MEDLINE, Embase, CINAHL, PsycINFO, SPORTDiscus, LILACS, and Web of Science databases were searched to identify observational studies that assessed the association between obesity and fall-related outcomes in participants aged 60 years and older. Two independent reviewers performed data extraction and quality assessment. Relative risks and 95% confidence intervals (CI) were pooled using random effect meta-analyses. RESULTS Thirty-one studies including a total of 1,758,694 participants were selected from 7,815 references. Pooled estimates showed that obese older adults have an increased risk of falls compared with nonobese counterparts (24 studies; relative risk: 1.16; 95% CI: 1.07-1.26; I2: 90%). Obesity was also associated with an increased risk of multiple falls (four studies; relative risk: 1.18; 95% CI: 1.08-1.29; I2: 0%). There was no evidence, however, of an association between obesity and fall-related injuries (seven studies; relative risk: 1.04; 95% CI: 0.92-1.18; I2: 65%). Fall-related fractures were reported in only one study, which demonstrated a lower risk of hip fracture with obesity (odds ratio: 0.65; 95% CI: 0.63-0.68). CONCLUSIONS Obesity increases the risk of falls and multiple falls in people aged 60 years and older; however, there is insufficient evidence of an association with fall-related injuries or fractures. Prevention and treatment of obesity may play a role in preventing falls in older age.
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Affiliation(s)
- Silvia G R Neri
- Faculty of Physical Education, University of Brasilia, Brazil
| | - Juliana S Oliveira
- Institute for Musculoskeletal Health, School of Public Health, Faculty of Medicine and Health, Australia
| | - Amabile B Dario
- Work Integrated Learning, Faculty of Health Sciences, The University of Sydney, Australia
| | - Ricardo M Lima
- Faculty of Physical Education, University of Brasilia, Brazil
| | - Anne Tiedemann
- Institute for Musculoskeletal Health, School of Public Health, Faculty of Medicine and Health, Australia
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Sahril N, Shahein NA, Yoep N, Mahmud NA, Sooryanarayana R, Maw Pin T, Muhamad NA, Ismail H. Prevalence and factors associated with falls among older persons in Malaysia. Geriatr Gerontol Int 2020; 20 Suppl 2:33-37. [PMID: 33370863 DOI: 10.1111/ggi.13980] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 05/18/2020] [Accepted: 05/31/2020] [Indexed: 11/29/2022]
Abstract
AIM Falls are a common problem among older people, leading to major morbidity and increased mortality. The study aimed to determine the prevalence of falls among older persons in Malaysia and its associated factors. METHODS Data were obtained from the National Health and Morbidity Survey 2018 (NHMS 2018), a cross-sectional study using stratified cluster sampling design. Older persons were defined as aged ≥60 years in this study. Descriptive and logistic regression analyses were conducted using SPSS version 25.0. RESULTS Overall, 14.1% (95% confidence interval [CI]: 12.46, 15.84) of older persons reported having experienced at least one fall during the past 12 months. Univariate analyses revealed an association between the history of falls with not being employed (odds ratio [OR]: 1.35 [95% CI: 1.03, 1.77]), diabetes mellitus (OR: 1.65 [95% CI: 1.33, 2.04]), limitation in activities of daily living (ADL) (OR: 1.90 [95% CI: 1.43, 2.54]) or instrumental ADL (OR: 1.47 [95% CI: 1.16, 1.84]). Multiple logistic regression revealed that falls were positively associated with those who had diabetes mellitus (OR: 1.55 [95% CI: 1.23, 1.94]) and limitation in ADL (OR: 1.56 [95% CI: 1.14, 2.15]); 43.9% of falls occurred outdoors. CONCLUSION One in six older Malaysian people experience at least one fall over a 12-month period. Diabetes mellitus and limitation in ADL were the factors associated with falls among older persons. A comprehensive and targeted program designed to reduce risk of falls is urgently needed. Future research should identify suitable programs for our setting to reduce the potential society burden of falls in older Malaysians. Geriatr Gerontol Int 2020; 20: 33-37.
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Affiliation(s)
- Norhafizah Sahril
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Nik Adilah Shahein
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Norzawati Yoep
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Nor Azna Mahmud
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Rajini Sooryanarayana
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia.,Family Health Development Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Tan Maw Pin
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nor Asiah Muhamad
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
| | - Hasimah Ismail
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Selangor, Malaysia
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14
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Carrasco C, Tomas‐Carus P, Bravo J, Pereira C, Mendes F. Understanding fall risk factors in community‐dwelling older adults: A cross‐sectional study. Int J Older People Nurs 2019; 15:e12294. [DOI: 10.1111/opn.12294] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 10/31/2019] [Accepted: 11/12/2019] [Indexed: 01/10/2023]
Affiliation(s)
| | - Pablo Tomas‐Carus
- Department of Sports and Health University of Évora Évora Portugal
- Comprehensive Health Research Center (CHRC) University of Évora Évora Portugal
| | - Jorge Bravo
- Department of Sports and Health University of Évora Évora Portugal
- Comprehensive Health Research Center (CHRC) University of Évora Évora Portugal
| | - Catarina Pereira
- Department of Sports and Health University of Évora Évora Portugal
- Comprehensive Health Research Center (CHRC) University of Évora Évora Portugal
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15
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Kulakci Altintas H, Korkmaz Aslan G. Incidence of falls among community-dwelling older adults in Turkey and its relationship with pain and insomnia. Int J Nurs Pract 2019; 25:e12766. [PMID: 31313430 DOI: 10.1111/ijn.12766] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 03/06/2019] [Accepted: 06/05/2019] [Indexed: 11/29/2022]
Abstract
AIM The aim of this study was to determine the incidence of falls among community-dwelling older adults and the impact of pain and insomnia on falls. METHODS This cross-sectional study recruited 659 older adults. Pain was assessed by the Geriatric Pain Measure, and insomnia was assessed by the Insomnia Severity Index. The history of falls was assessed within the last 12 months. Risk factors for falls were determined using logistic regression analysis. RESULTS The incidence of falls within the last year was 37.2%. Based on the analyses, pain and insomnia were found to be risk factors for falls. CONCLUSION In this study, falls were observed as a common problem among community-dwelling older adults, and pain and insomnia were determined as risk factors for falls. Therefore, pain and insomnia should be addressed when prevention of falls among community-dwelling older adults are planned by health care professionals including nurses.
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Simsek H, Erkoyun E, Akoz A, Ergor A, Ucku R. Falls, fear of falling and related factors in community‐dwelling individuals aged 80 and over in Turkey. Australas J Ageing 2019; 39:e16-e23. [DOI: 10.1111/ajag.12673] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 04/22/2019] [Accepted: 04/23/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Hatice Simsek
- Department of Public Health, Faculty of Medicine Dokuz Eylül University Izmir Turkey
| | - Erdem Erkoyun
- Department of Public Health, Faculty of Medicine Dokuz Eylül University Izmir Turkey
| | - Ali Akoz
- Department of Public Health, Faculty of Medicine Dokuz Eylül University Izmir Turkey
| | - Alp Ergor
- Department of Public Health, Faculty of Medicine Dokuz Eylül University Izmir Turkey
| | - Reyhan Ucku
- Department of Public Health, Faculty of Medicine Dokuz Eylül University Izmir Turkey
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Wright WG. Tonic Neuromuscular Processing Affects Postural Adaptation Differently in Aging and Parkinson's Disease. Front Neurol 2019; 9:1130. [PMID: 30719020 PMCID: PMC6348245 DOI: 10.3389/fneur.2018.01130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 12/10/2018] [Indexed: 11/13/2022] Open
Abstract
The combination of phasic and tonic neuromuscular processes are involved in the maintenance of normal upright posture. The latter is of particular importance in some pathologies, such as Parkinson's Disease (PD), which is known by one of its cardinal symptoms—tonic dysfunction (i.e., rigidity). Changes in tonic function may also occur during healthy aging. In this investigation, somatosensory input was manipulated by changing the support surface orientation for prolonged periods of quiet stance (QS). The aim was to shed light on how long-term tonic responses called postural lean after-effects are affected by aging and age-related neuropathology. Forty one participants were tested: 19 healthy young (25±5 years), 13 healthy older (63±8 years), and 9 adults with PD (63±5 years). Baseline conditions were eyes-closed QS on a stable surface or standing on an unstable, sway-referenced (SR) surface. Four experimental conditions combined two types of toes-up ramp tilt adaptation (120 s of toes-up static 7° tilt or sinusoidal 7° ± 3° tilt) with two types of post-adaptation (120 s of QS or SR). Results revealed postural after-effects during post-adaptation QS showing significant anterior COP shift for both young and older adults (p < 0.0001), but not PD (p > 0.06, n.s.). Compared to young, postural after-effects in older adults showed longer decay constants and did not return to baseline COP within the 120 s post-adaptation period (p < 0.05). Postural after-effects during SR, which appeared as toes-up surface tilt were highly significant in healthy populations (p = 0.001), but took longer to develop in PD. Younger adults showed significantly larger dorsiflexion (p < 0.01) and faster decay constants than older adults (p < 0.05). In summary, (1) postural after-effects decayed to baseline when post-tilt surface was stable but were retained and even grew larger post-adaptation in the SR surface conditions in all groups, (2) postural after-effects differed between healthy age groups, (3) PD showed less adaptation to surface changes. Differences in size and decay of after-effects between healthy and PD groups suggest tonic neuromuscular processes play a role in how adaptable postural control is to changing surface conditions and this is affected by healthy aging and basal ganglia function.
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Affiliation(s)
- W Geoffrey Wright
- Neuromotor Sciences Program, College of Public Health, Temple University, Philadelphia, PA, United States
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