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Coltman A, Ojeda T, Ashafa M, Pertel D, McCauley S. The Global Malnutrition Composite Score: Impacting malnutrition care. Nutr Clin Pract 2024. [PMID: 38824274 DOI: 10.1002/ncp.11162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 05/03/2024] [Accepted: 05/10/2024] [Indexed: 06/03/2024] Open
Abstract
The presence and impact of malnutrition in adult hospitalized patients has been well documented by a significant body of literature. However, current malnutrition care practices often vary widely and frequently lack standardization. The Global Malnutrition Composite Score (GMCS), the first nutrition-related electronic clinical quality measure, is intended to evaluate the quality of malnutrition care provided to inpatient adults. This measure aims to aid in standardizing malnutrition care through performance measurement. The four components of the measure (nutrition screening, nutrition assessment, malnutrition diagnosis, and nutrition care plans) follow the well-established Nutrition Care Process and encourage the use of standardized terminology. Facilities with high-performance scores on the GMCS are likely to experience improved outcomes associated with high-quality malnutrition care.
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Affiliation(s)
- Anne Coltman
- Commission on Dietetic Registration, Chicago, Illinois, USA
| | - Tamaire Ojeda
- Commission on Dietetic Registration, Chicago, Illinois, USA
| | | | - Donna Pertel
- Commission on Dietetic Registration, Chicago, Illinois, USA
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Khatib SE, Malham CB, Andrieu S, Strumia M, Cestac P, Salameh P. Fall risk factors among poly-medicated older Lebanese patients in primary care settings: a secondary cross-sectional analysis of the "MGPIDP-L project". BMC Geriatr 2024; 24:327. [PMID: 38600461 PMCID: PMC11008041 DOI: 10.1186/s12877-024-04951-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 04/04/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Falling is a major concern for the health of older adults and significantly affects their quality of life. Identifying the various risk factors and the differences between older patients can be challenging. The objective of this study was to identify the risk factors for falls among polymedicated community-dwelling older Lebanese patients following a medication review. METHODS In this analytical cross-sectional study, we examined the risk factors for falls in 850 patients aged ≥ 65 years who were taking ≥ 5 medications daily. The study involved conducting a medication review over the course of a year in primary care settings and using multivariate logistic regression analysis to analyze the data. RESULTS Our results showed that 106 (19.5%) of the 850 included patients had fallen at least once in the three months prior to the medication review. Loss of appetite and functional dependence were identified as the most significant predictors of falls ORa = 3.020, CI [2.074-4.397] and ORa = 2.877, CI [1.787-4.632], respectively. Other risk factors for falls included drowsiness ORa = 2.172, CI [1.499-3.145], and the use of beta-blockers ORa = 1.943, CI [1.339-2.820]. CONCLUSION Our study highlights the importance of addressing multiple risk factors for falls among Lebanese older adults and emphasizes the need for customized interventions and ongoing monitoring to prevent falls and improve health outcomes. This study sheds light on a critical issue in the Lebanese older population and provides valuable insight into the complex nature of falls among poly-medicated Lebanese community-dwelling older adults. TRIAL REGISTRATION 2021REC-001- INSPECT -09-04.
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Affiliation(s)
- Sarah El Khatib
- Paul Sabatier University III, 31063, Toulouse, France.
- Aging and Research Team, Center for Epidemiology and Research in POPulation Health (CERPOP), Toulouse University, Inserm, Paul Sabatier University, Faculty of Medecine, 37 Allées J.Guesde, 31000, Toulouse, France.
| | - Carmela Bou Malham
- Paul Sabatier University III, 31063, Toulouse, France
- Aging and Research Team, Center for Epidemiology and Research in POPulation Health (CERPOP), Toulouse University, Inserm, Paul Sabatier University, Faculty of Medecine, 37 Allées J.Guesde, 31000, Toulouse, France
| | - Sandrine Andrieu
- Paul Sabatier University III, 31063, Toulouse, France
- Aging and Research Team, Center for Epidemiology and Research in POPulation Health (CERPOP), Toulouse University, Inserm, Paul Sabatier University, Faculty of Medecine, 37 Allées J.Guesde, 31000, Toulouse, France
- Department of Pharmacy, Toulouse University Hospitals, Purpan Hospital, 31059, Toulouse, France
| | - Mathilde Strumia
- Paul Sabatier University III, 31063, Toulouse, France
- Aging and Research Team, Center for Epidemiology and Research in POPulation Health (CERPOP), Toulouse University, Inserm, Paul Sabatier University, Faculty of Medecine, 37 Allées J.Guesde, 31000, Toulouse, France
- Department of Pharmacy, Toulouse University Hospitals, Purpan Hospital, 31059, Toulouse, France
| | - Philippe Cestac
- Paul Sabatier University III, 31063, Toulouse, France
- Aging and Research Team, Center for Epidemiology and Research in POPulation Health (CERPOP), Toulouse University, Inserm, Paul Sabatier University, Faculty of Medecine, 37 Allées J.Guesde, 31000, Toulouse, France
- Department of Pharmacy, Toulouse University Hospitals, Purpan Hospital, 31059, Toulouse, France
| | - Pascale Salameh
- School of Medicine, Lebanese American University, Byblos, 1401, Lebanon
- University of Nicosia Medical School, 1065, Nicosia, Cyprus
- Faculty of Pharmacy, Lebanese University, Hadath, 1100, Lebanon
- Institut National de Santé Publique, Epidémiologie Clinique Et Toxicologie INSPECT-LB), Beirut, 1100, Lebanon
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Wegener EK, Kayser L. Smart health technologies used to support physical activity and nutritional intake in fall prevention among older adults: A scoping review. Exp Gerontol 2023; 181:112282. [PMID: 37660762 DOI: 10.1016/j.exger.2023.112282] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/24/2023] [Accepted: 08/31/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Falls are the second leading cause of accidental injury deaths globally. Older age is a key risk factors for falls. Besides older age, physical inactivity and malnutrition are identified risk factors for falls. Smart health technologies might offer a sustainable solution to prevent falls by supporting physical activity and nutritional status. OBJECTIVE The aim is to identify, describe, and synthesize knowledge, and identify knowledge gaps on the use of existing smart health technologies to support health behaviour in relation to physical activity and nutrition, among older (65+) in risk of falling. METHODS A scoping review was conducted following the PRISMA-ScR. Searches were carried out in PubMed, Scopus, and Embase using search strings on the themes; smart health technology, physical activity, nutrition, behaviour, falls and older. Identified literature was screened. Data from the included studies was extracted and synthesized. RESULTS 2948 studies were obtained through searches. 18 studies were included. Various smart health technologies are used for fall prevention to support physical activity among older, including software and applications for smart phones, TV, and tablet. Three gaps were identified: use of smart health technologies to support nutrition in fall prevention. Inclusion of relevant stakeholders and fall prevention in low-and middle-income countries. CONCLUSIONS Smart health technology can offer sustainable and cost-effective fall prevention in the future. More knowledge is needed on the use of smart health technologies to support nutritional status for fall prevention, and studies involving older with physical and cognitive conditions, and studies on measures for fall prevention in low- and middle-income countries is needed.
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Affiliation(s)
- Emilie Kauffeldt Wegener
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353 Copenhagen, Denmark.
| | - Lars Kayser
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353 Copenhagen, Denmark
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Rau Y, Amtsfeld J, Reimers N, Matrisch L, Frese J, Schulz AP. The development, incidence and treatment trends of trochanteric fractures in Germany: a cohort study. J Orthop Surg Res 2023; 18:491. [PMID: 37430277 PMCID: PMC10331963 DOI: 10.1186/s13018-023-03981-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 07/04/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Hip fractures are a major public health problem worldwide and can lead to disability, increased mortality, and reduced quality of life. We aim to provide a nationwide epidemiological analysis of trochanteric and subtrochanteric fractures and their respective surgical treatments. METHODS Data were retrieved from the national database of the German Department of the Interior. ICD-10-GM and OPS data from the period of 2006 to 2020 were analysed and all patients with trochanteric and subtrochanteric fractures as their main diagnosis, who were treated in a German hospital, were included. Patients were grouped by age and gender and linear regression was performed where suitable to calculate statistically significant correlations between variables and incidences. RESULTS 985,104 pertrochanteric fractures and 178,810 subtrochanteric fractures were reported during the analysed period. We calculated a mean incidence of 80.08 ± 6.34 for pertrochanteric and 14.53 ± 1.50 for subtrochanteric fractures per million inhabitants. In both fracture types, a distinct dependence of incidence on age can be determined. Incidence rates equally rise in both sexes through the age groups with an increase of about 288-fold from those under the age of 60 to those over the age of 90 in pertrochanteric fractures, and about 123-fold in subtrochanteric fractures. Intramedullary nailing was the most common kind of treatment for both fracture types with augmentative cerclages on the rise throughout the whole period. Plate and dynamic compression screws were decreasing in frequency over the analysed period in both fractures. CONCLUSIONS We provided incidence data on per- and subtrochanteric fractures and their treatment. We calculated an economic impact of approximately 1.563 billion € per year in Germany. With regards to recent literature on costs of treatment and our findings regarding the implementation and utilization of different treatment methods, we conclude that the reinforcement of nationwide prevention programs is a relevant step in lessening the economic burden. We welcome the increased utilisation of intramedullary nailing as many studies show beneficiary outcomes and cost effectiveness in most of the included fracture types.
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Affiliation(s)
- Yannick Rau
- Faculty of Medicine, Universität zu Lübeck, Lübeck, Germany.
- Zentrum Klinische Forschung, BG Klinikum Hamburg, Hamburg, Germany.
| | - Jasper Amtsfeld
- Chair of Technology Management, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Nils Reimers
- Stryker Trauma GmbH, Schoenkirchen, Germany
- Queensland University of Technology, Brisbane City, Australia
| | | | - Jasper Frese
- Zentrum Klinische Forschung, BG Klinikum Hamburg, Hamburg, Germany
- Department of Trauma Surgery, Orthopaedics and Sports Traumatology, BG Klinikum Hamburg, Hamburg, Germany
| | - Arndt-Peter Schulz
- Faculty of Medicine, Universität zu Lübeck, Lübeck, Germany
- Zentrum Klinische Forschung, BG Klinikum Hamburg, Hamburg, Germany
- Department of Trauma Surgery, Orthopaedics and Sports Traumatology, BG Klinikum Hamburg, Hamburg, Germany
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Ardaneh M, Fararouei M, Hassanzadeh J. Falls leading to fracture and nutrition among older adults: a case-control study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:18. [PMID: 36915191 PMCID: PMC10009923 DOI: 10.1186/s41043-023-00361-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES Injurious falls, especially those leading to bone fracture, are major causes of death and disability among older people. Our aim was to measure the association of nutritional factors and physical activity with falls leading to fracture among Iranian older adults. METHODS This is the second phase of a previously published case-control study on 300 patients and 590 controls. RESULTS In addition to the socio-economic factors that were reported before, our results revealed that consumption of fish, vegetables, fruits, and nuts reduced the risk of falling, whereas consumption of cheese, red meat, and sweets raised the risk of falls among the participants. CONCLUSION The results of our study suggested that diets rich in fish meat fruits and vegetables should be encouraged in the everyday life of older adults. We suggest health officials to take these important results into consideration when planning protective measures.
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Affiliation(s)
- Mahdieh Ardaneh
- Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran
| | - Mohammad Fararouei
- Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran.
| | - Jafar Hassanzadeh
- Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran
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Association of Sonographic Sarcopenia and Falls in Older Adults Presenting to the Emergency Department. J Clin Med 2023; 12:jcm12041251. [PMID: 36835787 PMCID: PMC9968231 DOI: 10.3390/jcm12041251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/22/2023] [Accepted: 01/30/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND AND OBJECTIVE To determine the association between point-of-care-ultrasonography (POCUS)-measured sarcopenia and grip strength, as well as the history of prior-year falls among older adults admitted to the emergency department observation unit (EDOU). MATERIALS AND METHODS This cross-sectional observational study was conducted over 8 months at a large urban teaching hospital. A consecutive sample of patients who were 65 years or older and admitted to the EDOU were enrolled in the study. Using standardized techniques, trained research assistants and co-investigators measured patients' biceps brachii and thigh quadriceps muscles via a linear transducer. Grip strength was measured using a Jamar Hydraulic Hand Dynamometer. Participants were surveyed regarding their history of falls in the prior year. Logistic regression analyses assessed the relationship of sarcopenia and grip strength to a history of falls (the primary outcome). RESULTS Among 199 participants (55% female), 46% reported falling in the prior year. The median biceps thickness was 2.22 cm with an Interquartile range [IQR] of 1.87-2.74, and the median thigh muscle thickness was 2.91 cm with an IQR of 2.40-3.49. A univariate logistic regression analysis demonstrated a correlation between higher thigh muscle thickness, normal grip strength, and history of prior-year falling, with an odds ratio [OR] of 0.67 (95% conference interval [95%CI] 0.47-0.95) and an OR of 0.51 (95%CI 0.29-0.91), respectively. In multivariate logistic regression, only higher thigh muscle thickness was correlated with a history of prior-year falls, with an OR of 0.59 (95% CI 0.38-0.91). CONCLUSIONS POCUS-measured thigh muscle thickness has the potential to identify patients who have fallen and thus are at high risk for future falls.
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Smith ML, Ory MG. Multi-directional nature of falls among older adults: A rationale for prevention and management. Front Public Health 2023; 11:1117863. [PMID: 36895692 PMCID: PMC9989446 DOI: 10.3389/fpubh.2023.1117863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 01/31/2023] [Indexed: 02/23/2023] Open
Affiliation(s)
- Matthew Lee Smith
- School of Public Health, Texas A&M University, College Station, TX, United States
| | - Marcia G Ory
- School of Public Health, Texas A&M University, College Station, TX, United States
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Ferreira CR, Mascarenhas-Melo F, Rodrigues AR, Lima MJR, Pinheiro JP, Chaves C, Teixeira-Lemos E, Bell V. Characterisation of institutionalised Portuguese older adult fallers: is there a place for pharmacist intervention? A preliminary study. Pharm Pract (Granada) 2022; 20:2717. [PMID: 36793917 PMCID: PMC9891778 DOI: 10.18549/pharmpract.2022.4.2717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/17/2022] [Indexed: 12/14/2022] Open
Abstract
Background Falls are a major public health issue, given their prevalence and social impact. Older adults living in long-term care facilities (LTCF) are at greater risk of injury resulting from a fall due to multiple factors, such as nutritional, functional/cognitive impairment, postural instability, polypharmacy, and the presence of potentially inappropriate medications (PIMs). Medication management in LTCF is complex and often sub-optimal and might be crucial for falls. Pharmacist intervention is important, since they have a unique knowledge of medication. However, studies mapping the impact of pharmaceutical activities in Portuguese LTC settings are scarce. Objective This study aims to assess the characteristics of older adult fallers living in LTFCs and examine the relationship between falling and several factors in this population. We also intend to explore the prevalence of PIMs and their relationship with the occurrence of falls. Methods The study was conducted in two long-term care facilities for elderly people, in the central region of Portugal. We included patients aged 65 and older with no reduced mobility or physical weakness and with the ability to understand spoken and written Portuguese. The following information was assessed: sociodemographic characteristics, comorbidities, polypharmacy, fear of falling, functional, nutritional and cognitive status. PIMs were evaluated according to the Beers criteria (2019). Results A total of 69 institutionalised older adults, 45 women and 24 men, with a mean age of 83.14 ± 8.87 years were included. The prevalence of falls was 21.74% Out of these, 46.67% (n=7) fell once, 13.33% (n=2) fell twice, and 40% (n=6) fell 3 or more times. Fallers were mainly women, had lower levels of education, were well nourished, had moderate to severe levels of dependence, and displayed moderate cognitive impairment. All adult fallers had a fear of falling. The main comorbidities of this population were related to the cardiovascular system. Polypharmacy was present in every patient, and at least one PIM was identified in 88.41% of the subjects. Fear of falling (FOF) and cognitive impairment (in subjects with 1 to 11 years of education) showed statistically significant associations with the occurrence of falls (p=0.005 and p=0.05, respectively). No significant differences were found between fallers and non-fallers for any other factors. Conclusions This present study is a preliminary contribution to characterise a group of older adult fallers living in Portuguese LTCFs and demonstrated that fear of falling and cognitive impairment are associated with the occurrence of falls in this population. The high prevalence of polypharmacy and PIMs emphasises the need for tailored interventions featuring the collaboration of a pharmacist to optimise medication management in this population.
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Affiliation(s)
- Carina Ramos Ferreira
- Pharmacist, Laboratory of Social Pharmacy and Public Health, Faculty of Pharmacy of the University of Coimbra, University of Coimbra, Coimbra, Portugal.
| | - Filipa Mascarenhas-Melo
- Pharmacist, PhD, Drug Development and Technology Laboratory, Faculty of Pharmacy of the University of Coimbra, University of Coimbra, Coimbra, Portugal; REQUIMTE/LAQV, Group of Pharmaceutical Technology, Faculty of Pharmacy of the University of Coimbra, University of Coimbra, Coimbra, Portugal.
| | - Ana Rita Rodrigues
- Pharmacist, PhD student, Laboratory of Social Pharmacy and Public Health, Faculty of Pharmacy of the University of Coimbra, University of Coimbra, Coimbra, Portugal.
| | - Maria João Reis Lima
- Pharmacist, PhD, ESAV, CERNAS-IPV Research Centre, Polytechnic Institute of Viseu, Portugal.
| | - João Páscoa Pinheiro
- MD, PhD, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal.
| | - Claúdia Chaves
- ND, MSN, PhD, Nursing Department, ESSV, Centre for Studies in Education and Innovation (CI&DEI), Polytechnic Institute of Viseu, Portugal.
| | - Edite Teixeira-Lemos
- Pharmacist, MSc, PhD, CERNAS-IPV Research Centre, Polytechnic Institute of Viseu, Portugal.
| | - Victoria Bell
- Pharmacist, MSc, PhD, Laboratory of Social Pharmacy and Public Health, Faculty of Pharmacy of the University of Coimbra, University of Coimbra, Coimbra, Portugal.
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Falling Short: The Contribution of Central Insulin Receptors to Gait Dysregulation in Brain Aging. Biomedicines 2022; 10:biomedicines10081923. [PMID: 36009470 PMCID: PMC9405648 DOI: 10.3390/biomedicines10081923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 11/23/2022] Open
Abstract
Insulin resistance, which manifests as a reduction of insulin receptor signaling, is known to correlate with pathological changes in peripheral tissues as well as in the brain. Central insulin resistance has been associated with impaired cognitive performance, decreased neuronal health, and reduced brain metabolism; however, the mechanisms underlying central insulin resistance and its impact on brain regions outside of those associated with cognition remain unclear. Falls are a leading cause of both fatal and non-fatal injuries in the older population. Despite this, there is a paucity of work focused on age-dependent alterations in brain regions associated with ambulatory control or potential therapeutic approaches to target these processes. Here, we discuss age-dependent alterations in central modalities that may contribute to gait dysregulation, summarize current data supporting the role of insulin signaling in the brain, and highlight key findings that suggest insulin receptor sensitivity may be preserved in the aged brain. Finally, we present novel results showing that administration of insulin to the somatosensory cortex of aged animals can alter neuronal communication, cerebral blood flow, and the motivation to ambulate, emphasizing the need for further investigations of intranasal insulin as a clinical management strategy in the older population.
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Bouzid W, Tavassoli N, Berbon C, Qassemi S, Bounes V, Azema O, Shourick J, Nourhashémi F. Impact of a personalised care plan for the elderly calling emergency medical services after a fall at home: The RISING-DOM multi-centre randomised controlled trial protocol. BMC Geriatr 2022; 22:182. [PMID: 35246053 PMCID: PMC8894840 DOI: 10.1186/s12877-022-02850-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 02/16/2022] [Indexed: 11/25/2022] Open
Abstract
Background A growing number of emergency calls are made each year for elderly people who fall. Many of them are not taken to hospital or are rapidly discharged from the Emergency Department (ED). Evidence shows that, with no further support, this vulnerable population is particularly at risk of injuries, dependency and death. This study aims to determine the effectiveness of a comprehensive geriatric assessment and a tailored intervention in the elderly calling on an Emergency Medical Service (EMS) for a fall at home, but not conveyed to the ED or rapidly discharged from it (less than 24 h from hospitalisation), to the time to institutionalisation or death. Methods Rising-Dom is a two-arm randomised (ratio 1:1), interventional, multi-centre and open study. Community-dwelling elderly people (≥ 70 years) who call an EMS for a fall at home are recruited. The intervention group receives home visits by a nurse with a comprehensive fall risk assessment and a personalised intervention care plan with a planned follow-up (six nurse home visits and five nurse phone calls). Subjects enrolled in the usual care-control group continue to receive their routine care for the prevention or treatment of diseases. Primary (time to institutionalisation or death) and secondary (unscheduled hospitalisations, additional EMS calls relating to falls, functional decline and quality of life) outcome data will be collected for both groups through five phone calls made by Clinical Research Associates (CRA) blind to the participants’ group during the follow-up period (24-months). Twelve hospital centres in the South-West of France are participating in the study as study sites. The inclusion period started in October 2019 and will end in March 2022. By the end of this period, 1,190 subjects are expected to be enrolled. Discussion Studies on elderly home falls have rarely concerned people who were not taken to hospital. The Rising-Dom intervention scheme should enhance understanding of features related to this vulnerable population and investigate the impact of a nurse care at home on delaying death and institutionalisation. Trial registration Clinicaltrials.gov identifier: NCT04132544. Registration date: 18/10/2019. Sponsor: University Hospital, Toulouse. https://www.clinicaltrials.gov/ct2/show/NCT04132544?term=rising-dom&draw=2&rank=1
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Affiliation(s)
- Wafa Bouzid
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
| | - Neda Tavassoli
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Caroline Berbon
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Soraya Qassemi
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Vincent Bounes
- Pôle Médecine d'Urgence, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Olivier Azema
- Observatoire Régional Des Urgences d'Occitanie (ORU Occitanie), Hôpital La Grave, Place Lange, 31300, Toulouse, France
| | - Jason Shourick
- Unité de Soutien Méthodologique À La Recherche (USMR), Service d'Epidémiologie Clinique Et de Santé Publique, CHU de Toulouse, Toulouse, France.,CERPOP, UMR 1295, INSERM - Université de Toulouse III, Toulouse, France
| | - Fati Nourhashémi
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,CERPOP, UMR 1295, INSERM - Université de Toulouse III, Toulouse, France
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Affiliation(s)
- Melissa Tam
- Food, Nutrition, Dietetics and Health Kansas State University Manhattan Kansas USA
| | - Kadri Koppel
- Food, Nutrition, Dietetics and Health Kansas State University Manhattan Kansas USA
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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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Factors associated with falls in older women with breast cancer: the use of a brief geriatric screening tool in clinic. Breast Cancer Res Treat 2020; 184:445-457. [PMID: 32794062 DOI: 10.1007/s10549-020-05862-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 08/06/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Unintentional falls and breast cancer are common among older women, but the associations between them are understudied. We aimed to identify factors associated with falls in older women with breast cancer. METHODS We retrospectively reviewed clinical records of older women with breast cancer at Duke Medical Center who had completed the Senior Adult Oncology Program geriatric assessment. Characteristics were compared between women had had at least one fall in the past year and those who did not. Pearson's Chi-square tests and t tests were used for comparison of groups' characteristics. Logistic regression determined factors associated with falling. RESULTS We identified 425 women, age 76.2 years (range 65-89 years), at the time of the assessment. 118 (27.8%) women reported a fall in the prior year. Age, race, ethnicity, and time since diagnosis (all p > 0.05) were similar between groups. In univariate analyses, metastatic disease (p = 0.023) and history of endocrine therapy (p = 0.042) were more common among women who fell. Women who fell had lower systolic (p = 0.001), diastolic (p < 0.001) blood pressures, and SpO2 (p = 0.018). Women who had fallen had a higher Charlson Comorbidity Index (CCI: p = 0.033), and were more likely to report using a walking aide (p < 0.001), nutritional issues (p = 0.006), and depression symptoms (p = 0.038). In multivariate analysis, falling was associated with low DBP (OR 0.93; p = 0.0017), low SpO2 (OR 0.79; p = 0.0169), a higher CCI (OR 1.23; p = 0.0076), and depression symptoms (OR 1.61; p = 0.039). CONCLUSIONS Among older women with breast cancer, depressive symptoms, higher comorbidity level, and vital sign measurements were associated with having fallen.
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Leuchtmann AB, Handschin C. Pharmacological targeting of age-related changes in skeletal muscle tissue. Pharmacol Res 2020; 154:104191. [PMID: 30844535 PMCID: PMC7100900 DOI: 10.1016/j.phrs.2019.02.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 02/27/2019] [Accepted: 02/28/2019] [Indexed: 12/25/2022]
Abstract
Sarcopenia, the age-related loss of skeletal muscle mass and function, increases the risk of developing chronic diseases in older individuals and is a strong predictor of disability and death. Because of the ongoing demographic transition, age-related muscle weakness is responsible for an alarming and increasing contribution to health care costs in Western countries. Exercise-based interventions are most successful in preventing the decline in skeletal muscle mass and in preserving or ameliorating functional capacities with increasing age. However, other treatment options are still scarce. In this review, we explore currently applied nutritional and pharmacological approaches to mitigate age-related muscle wasting, and discuss potential future therapeutic avenues.
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Affiliation(s)
- Aurel B Leuchtmann
- Biozentrum, University of Basel, Klingelbergstrasse 50/70, CH-4056, Basel, Switzerland
| | - Christoph Handschin
- Biozentrum, University of Basel, Klingelbergstrasse 50/70, CH-4056, Basel, Switzerland.
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15
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Johnson S, McLeod B, Gupta S, McLeod K. Impact of a home-based nutrition and exercise intervention in improving functional capacity associated with falls among rural seniors in Canada. QUALITY IN AGEING AND OLDER ADULTS 2018. [DOI: 10.1108/qaoa-11-2017-0044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
A six-month randomized controlled trial was conducted to examine the impact of a home-based nutrition and exercise intervention on functional capacity to prevent falls among rural seniors. The paper aims to discuss this issue.
Design/methodology/approach
Men and women (n=134), aged 60 and older were assigned to one of four groups: exercise, nutrition, exercise-nutrition, and control. Participants in the exercise and exercise-nutrition groups performed a home-based exercise program (Home Support Exercise Program), and the nutrition and exercise-nutrition groups received a liquid nutritional supplement (Ensure®) for six months. Participants were assessed at baseline and six months on functional mobility, balance, flexibility and endurance.
Findings
There were significant group differences over time for functional reach and the Timed Up and Go test, with significant differences existing between exercise and nutrition-exercise, and exercise and nutrition groups respectively. Overall, the exercise group out-performed the other groups in terms of functional capacity and psychological well-being.
Research implications
Improvement of functional health among rural seniors is achievable through the delivery of a home-based intervention focusing on exercise and nutrition.
Practical implications
The study also shows that the effective delivery of an intervention to successfully address a fundamental and persistent problem is possible using existing resources; however, it requires a commitment of focus and energy over considerable time.
Social implications
The approach and findings helps seniors to age in place in a rural context. It shows feasibility of delivering a practical intervention in the rural setting through the health care infrastructure of home care.
Originality/value
Apart from the rural context, the study was innovative at many levels. Specifically, this intervention addressed a significant health issue (functional capacity, falls and injuries), involved frail rural seniors (often hard to reach through community-based programs), provided a feasible intervention (multiple component exercise program), used existing infrastructure (e.g. home care), and espoused community development principles (active involvement of community partners, researchers, and trainees). As well, the study had built-in mechanisms for monitoring and support through the involvement of home service workers who received training. This approach created a strong research to practice connection (another innovation) and was critical for the credibility of the investigation, as well as the sustainability of the intervention. Another innovation was the inclusion of a population health perspective as the study framework. From the population health perspective, this research addressed several determinants of health in rural and urban areas that include: physical environment (intervention within people’s home and rural context), social environment and social support networks (through existing infrastructures of home support workers), health services (availability of health promotion strategy delivered through the health care system) and personal health practices and coping skills (exercise).
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Eggersdorfer M, Akobundu U, Bailey RL, Shlisky J, Beaudreault AR, Bergeron G, Blancato RB, Blumberg JB, Bourassa MW, Gomes F, Jensen G, Johnson MA, Mackay D, Marshall K, Meydani SN, Tucker KL. Hidden Hunger: Solutions for America's Aging Populations. Nutrients 2018; 10:E1210. [PMID: 30200492 PMCID: PMC6165209 DOI: 10.3390/nu10091210] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 08/24/2018] [Accepted: 08/30/2018] [Indexed: 02/07/2023] Open
Abstract
The global population, including the United States, is experiencing a demographic shift with the proportion of older adults (aged ≥ 65 years) growing faster than any other age group. This demographic group is at higher risk for developing nutrition-related chronic conditions such as heart disease and diabetes as well as infections such as influenza and pneumonia. As a result, an emphasis on nutrition is instrumental for disease risk reduction. Unfortunately, inadequate nutrient status or deficiency, often termed hidden hunger, disproportionately affects older adults because of systematic healthcare, environmental, and biological challenges. This report summarizes the unique nutrition challenges facing the aging population and identifies strategies, interventions, and policies to address hidden hunger among the older adults, discussed at the scientific symposium "Hidden Hunger: Solutions for America's Aging Population", on March 23, 2018.
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Affiliation(s)
- Manfred Eggersdorfer
- DSM Nutritional Products AG, Human Nutrition and Health, 4002 Basel, Switzerland.
- Department of Healthy Ageing, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands.
| | | | - Regan L Bailey
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA.
| | - Julie Shlisky
- The Sackler Institute for Nutrition Science, The New York Academy of Sciences, New York, NY 10007, USA.
| | | | - Gilles Bergeron
- The Sackler Institute for Nutrition Science, The New York Academy of Sciences, New York, NY 10007, USA.
| | - Robert B Blancato
- National Coordinator, Defeat Malnutrition Today, Washington, DC 20006, USA.
| | - Jeffrey B Blumberg
- Jean Mayer USDA Human Nutrition Research Center on Aging and Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA.
| | - Megan W Bourassa
- The Sackler Institute for Nutrition Science, The New York Academy of Sciences, New York, NY 10007, USA.
| | - Filomena Gomes
- The Sackler Institute for Nutrition Science, The New York Academy of Sciences, New York, NY 10007, USA.
| | - Gordon Jensen
- Larner College of Medicine, University of Vermont, Burlington, VT 05405, USA.
| | - Mary Ann Johnson
- Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE 68583, USA.
| | - Douglas Mackay
- Council for Responsible Nutrition, Washington, DC 20036, USA.
| | | | - Simin Nikbin Meydani
- Jean Mayer USDA Human Nutrition Research Center on Aging and Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA.
| | - Katherine L Tucker
- Biomedical & Nutritional Sciences Department, University of Massachusetts Lowell, Lowell, MA 01854, USA.
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