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Lin WQ, Liao YX, Wang JY, Luo LY, Yuan LX, Sun SY, Xu Y, Sun MY, Wang C, Zhou Q, Liu XY, Liu H. Associations between type 2 diabetes mellitus and risk of falls among community-dwelling elderly people in Guangzhou, China: a prospective cohort study. BMC Geriatr 2024; 24:717. [PMID: 39210251 PMCID: PMC11363668 DOI: 10.1186/s12877-024-05314-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 08/19/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Several studies have demonstrated that older adults with type 2 diabetes mellitus (T2DM) have a higher risk of falls compared to those without T2DM, which may lead to disability and a lower quality of life. While, limited prospective studies have quantified the associations in southern China. We conducted a longitudinal cohort study to quantify the associations between T2DM and falls and investigate the risk factors of falls among community-dwelling elderly people in Guangzhou, China. METHODS The population-based study included 8800 residents aged 65 and over in 11 counties of Guangzhou at baseline in 2020 and then prospectively followed up through 2022. Of 6169 participants had complete follow-up and were included in the present study. A fall event was identified by self-reported. The Cox regression was applied to quantify the associations between T2DM and falls, and hazard ratios (HRs) were calculated to the factors associated with falls among participants. RESULTS The median follow-up time for participants was 2.42 years. During the follow-up period, the incidence of falls among all participants was 21.96%. After adjusting for covariates in Cox regression models, T2DM remained a significant risk factor for falls, with HR of 1.781 (95% CI: 1.600-1.983) in the unadjusted covariates model and 1.757 (1.577-1.957) in the adjusted covariates model. Female (1.286, 1.136-1.457), older age (≥ 80: 1.448, 1.214-1.729), single marital status (1.239, 1.039-1.477), lower education level (primary school and below: 1.619, 1.004-1.361), hypertension (1.149, 1.026-1.286) and stroke (1.619, 1.176-2.228) were associated with a higher risk of falls, whereas everyday physical exercise (0.793, 0.686-0.918) was associated with a lower risk of falls. CONCLUSION Falls are common, with risks between T2DM and falls quantified and several factors investigated in the longitudinal cohort study among community-dwelling elderly people in Guangzhou, China. Targeted action on the risk factors may reduce the burden of falls in elderly people with T2DM in the future.
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Affiliation(s)
- Wei-Quan Lin
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou, Guangzhou, 510440, China
- Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China
| | - Ying-Xin Liao
- School of Public Health, Guangzhou Medical University, Guangzhou, 511436, China
| | - Jing-Ya Wang
- Institute of Applied Health Research, University of Birmingham, Birmingham, B152TT, UK
| | - Li-Ying Luo
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou, Guangzhou, 510440, China
| | - Le-Xin Yuan
- Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China
| | - Si-Yu Sun
- School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Yue Xu
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou, Guangzhou, 510440, China
| | - Min-Ying Sun
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou, Guangzhou, 510440, China
| | - Chang Wang
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou, Guangzhou, 510440, China
| | - Qin Zhou
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou, Guangzhou, 510440, China
| | - Xiang-Yi Liu
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou, Guangzhou, 510440, China
| | - Hui Liu
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou, Guangzhou, 510440, China.
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Bueno Yáñez O, Calvo Aguirre JJ, Uranga Zaldua J, Alustiza Navarro J, Ugartemendia Yerobi M. [Alusti test as a premonitory variable of adverse health events in a nursing home. Two-years follow-up]. Rev Esp Geriatr Gerontol 2024; 59:101476. [PMID: 38417197 DOI: 10.1016/j.regg.2024.101476] [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: 07/31/2023] [Revised: 01/25/2024] [Accepted: 01/29/2024] [Indexed: 03/01/2024]
Abstract
INTRODUCTION Functional capacity is a good indicator of health, quality of life, and a good predictor of morbimortality. It is a priority to functionally assess the geriatric population through objective, precise, and simple instruments. The Alusti Test in its two versions, complete (TA) and abbreviated (TAA), is a scale that meets these criteria. OBJECTIVE To determine the usefulness of the Alusti Test as a predictor of adverse health events: falls, hospitalizations, cognitive deterioration, and mortality in the elderly institutionalized population, with a two-year follow-up. MATERIAL AND METHODS This observational study's sample included 176 persons admitted to a nursing home for 32months, with a mean age of 85.5years. The TA was performed on 138 and the TAA on 38. RESULTS The ratio of falls is much higher in residents with mild dependence than in those with total dependence (P<.001). Hospitalizations increase as the results of the Alusti Test are more favorable. The risk of hospitalization in dependent patients is 50% lower (P<.001) than in those with preserved mobility. Cognitive impairment is similar in all the populations with some mild-moderate level of functional dependence and decreases in the population with preserved mobility. Categorization as total and mild/severe dependence is related to a 3-4times higher mortality at six months follow-up. CONCLUSIONS A higher mild-moderate level of dependence on the AT correlates with a lower risk of falls, a lower rate of hospitalization, and a higher risk of mortality at six months.
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Affiliation(s)
- Olga Bueno Yáñez
- Osakidetza, Centro de Salud Beraun, Errenteria, Guipúzcoa, España
| | | | | | | | - Maider Ugartemendia Yerobi
- Departamento de Enfermería, Facultad de Medicina y Enfermería, Universidad del País Vasco UPV/EHU, San Sebastián, España.
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Rodríguez-Suárez CA, González-de la Torre H, Hernández-De Luis MN, Fernández-Gutiérrez DÁ, Martínez-Alberto CE, Brito-Brito PR. Effectiveness of a Standardized Nursing Process Using NANDA International, Nursing Interventions Classification and Nursing Outcome Classification Terminologies: A Systematic Review. Healthcare (Basel) 2023; 11:2449. [PMID: 37685482 PMCID: PMC10487812 DOI: 10.3390/healthcare11172449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/31/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open
Abstract
The decision-making in clinical nursing, regarding diagnoses, interventions and outcomes, can be assessed using standardized language systems such as NANDA International, the Nursing Interventions Classification and the Nursing Outcome Classification; these taxonomies are the most commonly used by nurses in informatized clinical records. The purpose of this review is to synthesize the evidence on the effectiveness of the nursing process with standardized terminology using the NANDA International, the Nursing Interventions Classification and the Nursing Outcome Classification in care practice to assess the association between the presence of the related/risk factors and the clinical decision-making about nursing diagnosis, assessing the effectiveness of nursing interventions and health outcomes, and increasing people's satisfaction. A systematic review was carried out in Medline and PreMedline (OvidSP), Embase (Embase-Elsevier), The Cochrane Library (Wiley), CINAHL (EbscoHOST), SCI-EXPANDED, SSCI and Scielo (WOS), LILACS (Health Virtual Library) and SCOPUS (SCOPUS-Elsevier) and included randomized clinical trials as well as quasi-experimental, cohort and case-control studies. Selection and critical appraisal were conducted by two independent reviewers. The certainty of the evidence was assessed with the Grading of Recommendations Assessment, Development and Evaluation Methodology. A total of 17 studies were included with variability in the level and certainty of evidence. According to the outcomes, 6 studies assessed diagnostic decision-making and 11 assessed improvements in individual health outcomes. No studies assessed improvements in intervention effectiveness or population satisfaction. There is a need to increase studies with rigorous methodologies that address clinical decision-making about nursing diagnoses using NANDA International and individuals' health outcomes using the Nursing Interventions Classification and the Nursing Outcome Classification as well as implementing studies that assess the use of these terminologies for improvements in the effectiveness of nurses' interventions and population satisfaction with the nursing process.
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Affiliation(s)
- Claudio-Alberto Rodríguez-Suárez
- Research Support Unit, Insular Maternal and Child University Hospital Complex, Canary Health Service, 35016 Las Palmas de Gran Canaria, Spain
- Nursing Department, Faculty of Healthcare Science, Universidad de Las Palmas de Gran Canaria (ULPGC), 35016 Las Palmas de Gran Canaria, Spain
| | - Héctor González-de la Torre
- Research Support Unit, Insular Maternal and Child University Hospital Complex, Canary Health Service, 35016 Las Palmas de Gran Canaria, Spain
- Nursing Department, Faculty of Healthcare Science, Universidad de Las Palmas de Gran Canaria (ULPGC), 35016 Las Palmas de Gran Canaria, Spain
| | | | - Domingo-Ángel Fernández-Gutiérrez
- Primary Care Management of Tenerife, Canary Health Service, 38004 Santa Cruz de Tenerife, Spain; (D.-Á.F.-G.); (P.-R.B.-B.)
- Faculty of Healthcare Science, Universidad de La Laguna (ULL), 38200 Santa Cruz de Tenerife, Spain
| | | | - Pedro-Ruymán Brito-Brito
- Primary Care Management of Tenerife, Canary Health Service, 38004 Santa Cruz de Tenerife, Spain; (D.-Á.F.-G.); (P.-R.B.-B.)
- Faculty of Healthcare Science, Universidad de La Laguna (ULL), 38200 Santa Cruz de Tenerife, Spain
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Baixinho CL, Dixe MDA. Practices of caregivers when evaluating the risk of falls in the admission of older adults to nursing homes. Dement Neuropsychol 2020; 14:379-386. [PMID: 33354291 PMCID: PMC7735058 DOI: 10.1590/1980-57642020dn14-040008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Falls are a complex problem for the older population residing in nursing homes. Despite recommendations, many difficulties remain in the evaluation of and systematic information on fall risk factors.
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Affiliation(s)
- Cristina Lavareda Baixinho
- Nursing School of Lisbon, Nursing Research & Development Unit - Lisbon, Portugal.,Center for Innovative Care and Health Technology (ciTechcare) - Leiria, Portugal
| | - Maria Dos Anjos Dixe
- Center for Innovative Care and Health Technology (ciTechcare) - Leiria, Portugal.,Health School, Polytechnic of Leiria - Leiria, Portugal
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Baixinho CRSL, Dixe MDACR, Madeira C, Alves S, Henriques MA. Interobserver analysis of safety practices and behaviors adopted by elderly people to prevent falls. Rev Lat Am Enfermagem 2020; 28:e3268. [PMID: 32491125 PMCID: PMC7266635 DOI: 10.1590/1518-8345.3209.3268] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 02/07/2020] [Indexed: 01/10/2023] Open
Abstract
Objective: determine the psychometric properties of the safety practices and behaviors
dimension of the Scale of Practices and Behaviors of Institutionalized
Elderly People to Prevent Falls in a sample of elderly people with cognitive
decline. Method: methodological study, with a quantitative approach, to assess the
psychometric properties of the mentioned scale in a sample with 102 elderly
people with cognitive decline who lived in two long-term care institutions
for the public in this age group. Internal consistency evaluation was
carried out by calculating the Cronbach’s alpha coefficient; interobserver
reliability was expressed by Cohen’s kappa coefficient; and temporal
stability, by obtaining Spearman correlation. Compliance with all ethical
procedures was observed. Results: the dimension of safety practices and behaviors showed α = 0.895 for its 11
items. Seven out of the 11 items reached good to excellent agreement among
the experts for interobserver reliability. Kappa index values indicated that
the instrument is valid and reliable. Safety practices and behaviors were
influenced by institutionalization time, being at least 85 years old, and
gait skills. Conclusion: the results pointed out that the instrument has good reproducibility and is
valid and reliable, which allows its use in clinical practice in elderly
people with cognitive decline as well as in research.
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Affiliation(s)
| | | | - Carla Madeira
- Medicina, Hospital de VIla Franca de Xira, Vila Franca de Xira, VFX, Portugal
| | - Silvia Alves
- Unidade de Cuidados Intensivos, Hospital de VIla Franca de Xira, Vila Franca de Xira, VFX, Portugal
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Konda PR, Sharma PK, Gandhi AR, Ganguly E. Correlates of Cognitive Impairment among Indian Urban Elders. JOURNAL OF GERONTOLOGY & GERIATRIC RESEARCH 2018; 7:489. [PMID: 31406631 PMCID: PMC6690611 DOI: 10.4172/2167-7182.1000489] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Cognitive impairment among elderly is increasing owing to increases in life expectancy globally. The problem is multifactorial. The objective of the present paper was to study the correlates of cognitive impairment in an urban elderly population in India. METHODS A cross sectional study was conducted among 100 randomly selected urban elderly population. Data was collected upon household visits using a predesigned pretested questionnaire administered by a trained investigator. Measurements included cognitive function assessment using Mini Mental State Examination, depression assessment using Geriatric Depression Scale, blood pressure measurement and anthropometry. Cognitive impairment was defined at MMSE score <24. Logistic regression was done to identify independently associated factors with cognitive impairment. RESULTS Prevalence of cognitive impairment among elderly was 10%. Women had a higher prevalence than men. Higher age, no schooling, living single, lower weight, lower waist and hip ratios, difficulty in activities of daily living, poor self-reported health, bedridden and depression significantly associated with cognitive impairment. The independently associated factors upon logistic regression were increasing age, no schooling and bedridden status for past six months. CONCLUSION Although the current prevalence of cognitive impairment among Indian urban elderly is low, several associated factors exist in this population that may increase the burden in future. Geriatric health policy should address the modifiable risk factors to manage the problem of cognitive impairment and its consequent outcomes.
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Affiliation(s)
| | - Pawan Kumar Sharma
- Department of Community Medicine, Mediciti Institute of Medical Sciences, Ghanpur, Hyderabad, India
- Department of Epidemiology, University of Pittsburgh, and Share India, Fogarty International NIH, USA
| | - Atul R Gandhi
- Consultant Statistician & Chief Manager-Monitoring and Evaluation, EdelGive Foundation, Edelweiss House, Mumbai, India
| | - Enakshi Ganguly
- Department of Community Medicine, Mediciti Institute of Medical Sciences, Ghanpur, Hyderabad, India
- Department of Epidemiology, University of Pittsburgh, and Share India, Fogarty International NIH, USA
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Ferreira LMDBM, Jerez-Roig J, Andrade FLJPD, Oliveira NPDD, Araújo JRTD, Lima KCD. Prevalence of falls and evaluation of mobility among institutionalized elderly persons. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2016. [DOI: 10.1590/1981-22562016019.160034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Objective: The present study aimed to estimate the prevalence of falls among institutionalized elderly persons and identify associated factors. Method: A cross-sectional study of elderly residents of Care Facilities For the Elderly in Natal, Rio Grande do Norte, was carried out. The elderly persons could walk independently and did not have severe cognitive impairment. Data was obtained about the institution and socio-demographic and health information was collected. A physical examination was performed to evaluate frailty, mobility and balance (Timed up and go, Berg Balance Scale, Gait speed and Sitting-rising Test - SRT). Statistical analysis was performed using the Chi-squared Test for a 5% significance level. Results: Sixty-three elderly persons were within the search criteria. Of these 22.2% had fallen in the past year. Only the SRT was associated with these falls. Conclusion: It was concluded that the studied population has a low prevalence of falls, and the ability to perform less than 5 repetitions in the SRT was associated with episodes of falling.
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