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Wang Y, Leng S, Jin Y, Tang X, Zhu X, An L. Successful ageing is associated with falls among older adults in India: a large population based across-sectional study based on LASI. BMC Public Health 2024; 24:1682. [PMID: 38914970 PMCID: PMC11197243 DOI: 10.1186/s12889-024-19181-7] [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: 10/29/2023] [Accepted: 06/18/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Falls are common in the elderly and can lead to adverse consequences, like injuries, hospitalization, disability even mortality. Successful ageing emerged in sight to assess physical, psychological and social status of older adults. This study is conducted to explore the association between them in a large Indian community-dwelling population. METHODS Data were based on the wave 1 survey of the Longitudinal Ageing Study in India (LASI). People aged 60 and above with complete information were included. The elderly met five standards including absence of chronic diseases, freedom from disability, high cognitive ability, free from depressive symptoms and active social engagement, were classified into successful agers. The assessment of falls, fall-related injuries and multiple falls depended on interview. Multivariate logistic regression was conducted to find the associations between falls, fall-injury, multiple falls and successful ageing after adjusting both socio-demographic and biological covariates. The log-likelihood ratio test was calculated interactions in subgroups. RESULTS 31,345 participants in LASI were finally included in our study. Of them, 20.25% reported fall, and 25% were classified into successful agers. After full adjustment, successful ageing was negatively associated with falls (OR 0.70; 95%CI 0.65-0.76) and multiple falls (OR 0.70; 95%CI 0.63-0.78). And the association did not show the significance in older adults with fall-related injuries (OR 0.86; 95%CI 0.72-1.04). CONCLUSIONS Successful ageing was negatively associated with falls and multiple falls, but not fall-related injuries in older people in India. Future studies are demanded to explore the causal relationship and to reveal the underlying mechanism.
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Affiliation(s)
- Yujing Wang
- Department of Emergency and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Siqi Leng
- Sleep Medicine Center, Mental Health Center, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Dian Xin Nan Jie 28#, Chengdu, 610041, China
| | - Yuming Jin
- Department of Urology, Institute of Urology and National clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - Xiangdong Tang
- Sleep Medicine Center, Mental Health Center, Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Dian Xin Nan Jie 28#, Chengdu, 610041, China
| | - Xian Zhu
- Department of Emergency and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Lina An
- Department of Geriatrics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Older Adults with Hypertension: Prevalence of Falls and Their Associated Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168257. [PMID: 34444005 PMCID: PMC8392439 DOI: 10.3390/ijerph18168257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 07/29/2021] [Accepted: 07/30/2021] [Indexed: 01/04/2023]
Abstract
Falls are prominent health issues among older adults. Among hypertensive older adults, falls may have a detrimental effect on their health and wellbeing. The purpose of this study is to determine the prevalence of falls among hypertensive older adults and to identify the associated factors that contribute to their falls. This was a cross-sectional study conducted among two hundred and sixty-nine hypertensive older adults who were selected via systematic random sampling in two primary health clinics in Kuala Terengganu, Malaysia. Data on their socio-demographic details, their history of falls, medication history and clinical characteristics were collected. Balance and gait were assessed using the Performance Oriented Mobility Assessment (POMA). It was found that 32.2% of participants reported falls within a year. Polypharmacy (adjusted OR 2.513, 95% CI 1.339, 4.718) and diuretics (adjusted OR 2.803, 95% CI 1.418, 5.544) were associated with an increased risk of falls. Meanwhile, a higher POMA score (adjusted OR 0.940, 95% CI 0.886, 0.996) and the number of antihypertensives (adjusted OR 0.473, 95% CI 0.319, 0.700) were associated with a low incidence of falling among hypertensive older adults. Falls are common among hypertensive older adults. Older adults who are taking diuretics and have a polypharmacy treatment plan have a higher incidence of falls. However, older adults taking a higher number of anti-hypertensive medications specifically were not associated with an increased prevalence of falls.
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Crutzen S, Abou J, Smits SE, Baas G, Hugtenburg JG, Heringa M, Denig P, Taxis K. Older people's attitudes towards deprescribing cardiometabolic medication. BMC Geriatr 2021; 21:366. [PMID: 34134649 PMCID: PMC8207766 DOI: 10.1186/s12877-021-02249-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 04/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Overtreatment with cardiometabolic medication in older patients can lead to major adverse events. Timely deprescribing of these medications is therefore essential. Self-reported willingness to stop medication is usually high among older people, still overtreatment with cardiometabolic medication is common and deprescribing is rarely initiated. An important barrier for deprescribing reported by general practitioners is the patients' unwillingness to stop the medication. More insights are needed into the influence of patients' characteristics on their attitudes towards deprescribing and differences in these attitudes between cardiometabolic medication groups. METHODS A survey in older people using cardiometabolic medication using the revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire was performed. Participants completed the general rPATD and an adapted version for four medication groups. Linear and ordinal logistic regression were used to assess the influence of age, sex, therapeutic area and number of medications used on the patients' general attitudes towards deprescribing. Univariate analysis was used to compare differences in deprescribing attitudes towards sulfonylureas, insulins, antihypertensive medication and statins. RESULTS Overall, 314 out of 1143 invited participants completed the survey (median age 76 years, 54% female). Most participants (80%) were satisfied with their medication and willing to stop medications if their doctor said it was possible (88%). Age, sex and therapeutic area had no influence on the general attitudes towards deprescribing. Taking more than ten medicines was significantly associated with a higher perceived medication burden. Antihypertensive medication and insulin were considered more appropriate than statins, and insulin was considered more appropriate than sulfonylureas not favouring deprescribing. CONCLUSIONS The majority of older people using cardiometabolic medication are willing to stop one of their medicines if their doctor said it was possible. Health care providers should take into account that patients perceive some of their medication as more appropriate than other medication when discussing deprescribing.
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Affiliation(s)
- Stijn Crutzen
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
- Universitair Medisch Centrum Groningen, Petra Denig Clinical Pharmacy and Pharmacology, EB70, Postbus 30.001, Hanzeplein1, 9700 RB, Groningen, The Netherlands.
| | - Jamila Abou
- Department of Clinical Pharmacology and Pharmacy, Amsterdam UMC, location VUMC, Amsterdam, The Netherlands
| | - Sanne E Smits
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Gert Baas
- SIR Institute for Pharmacy Practice and Policy, Theda Mansholtstraat 5B, 2331 JE, Leiden, The Netherlands
| | - Jacqueline G Hugtenburg
- Department of Clinical Pharmacology and Pharmacy, Amsterdam UMC, location VUMC, Amsterdam, The Netherlands
| | - Mette Heringa
- SIR Institute for Pharmacy Practice and Policy, Theda Mansholtstraat 5B, 2331 JE, Leiden, The Netherlands
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Petra Denig
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Katja Taxis
- Unit of PharmacoTherapy, Epidemiology and Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands
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Fisher L, Fisher A, Smith PN. Helicobacter pylori Related Diseases and Osteoporotic Fractures (Narrative Review). J Clin Med 2020; 9:E3253. [PMID: 33053671 PMCID: PMC7600664 DOI: 10.3390/jcm9103253] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 09/28/2020] [Accepted: 10/07/2020] [Indexed: 02/06/2023] Open
Abstract
Osteoporosis (OP) and osteoporotic fractures (OFs) are common multifactorial and heterogenic disorders of increasing incidence. Helicobacter pylori (H.p.) colonizes the stomach approximately in half of the world's population, causes gastroduodenal diseases and is prevalent in numerous extra-digestive diseases known to be associated with OP/OF. The studies regarding relationship between H.p. infection (HPI) and OP/OFs are inconsistent. The current review summarizes the relevant literature on the potential role of HPI in OP, falls and OFs and highlights the reasons for controversies in the publications. In the first section, after a brief overview of HPI biological features, we analyze the studies evaluating the association of HPI and bone status. The second part includes data on the prevalence of OP/OFs in HPI-induced gastroduodenal diseases (peptic ulcer, chronic/atrophic gastritis and cancer) and the effects of acid-suppressive drugs. In the next section, we discuss the possible contribution of HPI-associated extra-digestive diseases and medications to OP/OF, focusing on conditions affecting both bone homeostasis and predisposing to falls. In the last section, we describe clinical implications of accumulated data on HPI as a co-factor of OP/OF and present a feasible five-step algorithm for OP/OF risk assessment and management in regard to HPI, emphasizing the importance of an integrative (but differentiated) holistic approach. Increased awareness about the consequences of HPI linked to OP/OF can aid early detection and management. Further research on the HPI-OP/OF relationship is needed to close current knowledge gaps and improve clinical management of both OP/OF and HPI-related disorders.
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Affiliation(s)
- Leon Fisher
- Department of Gastroenterology, Frankston Hospital, Peninsula Health, Melbourne 3199, Australia
| | - Alexander Fisher
- Department of Geriatric Medicine, The Canberra Hospital, ACT Health, Canberra 2605, Australia;
- Department of Orthopedic Surgery, The Canberra Hospital, ACT Health, Canberra 2605, Australia;
- Australian National University Medical School, Canberra 2605, Australia
| | - Paul N Smith
- Department of Orthopedic Surgery, The Canberra Hospital, ACT Health, Canberra 2605, Australia;
- Australian National University Medical School, Canberra 2605, Australia
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Comment on "Association Between Acetylcholinesterase Inhibitors and Osteoporotic Fractures in Alzheimer's Patients". J Am Med Dir Assoc 2020; 21:706-707. [PMID: 32334774 DOI: 10.1016/j.jamda.2020.02.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 02/14/2020] [Accepted: 02/15/2020] [Indexed: 11/22/2022]
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Hong Z, Xu L, Zhou J, Sun L, Li J, Zhang J, Hu F, Gao Z. The Relationship between Self-Rated Economic Status and Falls among the Elderly in Shandong Province, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062150. [PMID: 32213856 PMCID: PMC7143219 DOI: 10.3390/ijerph17062150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 03/09/2020] [Accepted: 03/11/2020] [Indexed: 01/24/2023]
Abstract
(1) Background: Older people are more vulnerable and likely to have falls and the consequences of these falls place a heavy burden on individuals, families and society. Many factors directly or indirectly affect the prevalence of falls. The aims of this study were to understand the prevalence and risk factors of falls among the elderly in Shandong, China; the relationship between economic level and falls was also preliminary explored. (2) Methods: Using a multi-stage stratified sampling method, 7070 elderly people aged 60 and over were selected in Shandong Province, China. General characteristics and a self-rated economic status were collected through face to face interviews. Chi-square tests, rank sum tests and two logistic regression models were performed as the main statistical methods. (3) Results: 8.59% of participants reported that they had experienced at least one fall in the past half year. There was a significant difference in experienced falls regarding gender, residence, marital status, educational level, smoking, drinking, hypertension, diabetes, coronary disease, and self-reported hearing. The worse the self-rated economic status, the higher the risk of falling, (poor and worried about livelihood, OR = 3.60, 95%; CI = 1.76–7.35). (4) Conclusions: Women, hypertension, diabetes and self-reported hearing loss were identified as the risk factors of falls in the elderly. The difference of economic level affects the falls of the elderly in rural and urban areas. More fall prevention measures should be provided for the elderly in poverty.
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Affiliation(s)
- Zhuang Hong
- School of Public Health, Shandong University, Jinan 250012, China; (Z.H.); (L.S.); (J.L.); (J.Z.); (F.H.); (Z.G.)
- NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan 250012, China
| | - Lingzhong Xu
- School of Public Health, Shandong University, Jinan 250012, China; (Z.H.); (L.S.); (J.L.); (J.Z.); (F.H.); (Z.G.)
- NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan 250012, China
- Correspondence:
| | - Jinling Zhou
- School of Medicine and Health Management, Shandong University, Jinan 250012, China;
| | - Long Sun
- School of Public Health, Shandong University, Jinan 250012, China; (Z.H.); (L.S.); (J.L.); (J.Z.); (F.H.); (Z.G.)
- NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Jiajia Li
- School of Public Health, Shandong University, Jinan 250012, China; (Z.H.); (L.S.); (J.L.); (J.Z.); (F.H.); (Z.G.)
- NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan 250012, China
| | - Jiao Zhang
- School of Public Health, Shandong University, Jinan 250012, China; (Z.H.); (L.S.); (J.L.); (J.Z.); (F.H.); (Z.G.)
- NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan 250012, China
| | - Fangfang Hu
- School of Public Health, Shandong University, Jinan 250012, China; (Z.H.); (L.S.); (J.L.); (J.Z.); (F.H.); (Z.G.)
- NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan 250012, China
| | - Zhaorong Gao
- School of Public Health, Shandong University, Jinan 250012, China; (Z.H.); (L.S.); (J.L.); (J.Z.); (F.H.); (Z.G.)
- NHC, Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan 250012, China
- Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan 250012, China
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