Factors associated with falls in older adults with cataracts

Regional differences regarding the occurrence of falls and associated factors in two populations of Brazilian longevous people

BACKGROUND

Few studies have explored regional asymmetries and their implications for health policies regarding episodes of falls among the population of ≥80 years old in continental and developing countries like Brazil with deep inequalities and sociocultural differences.

OBJECTIVE

To evaluate the occurrence of falls and their association with functional capacity and nutritional status in the longest oldest-old living in two municipalities in the Northeast and Southeast of Brazil.

METHODS

This is a cross-sectional study, with primary data collection in which were included in the research seniors aged 80 years or more, of both sexes, belonging to two Brazilian municipalities of discrepant socioeconomic aspects. The dependent variable was the occurrence of falls in the last year. The independent variables were grouped into demographic aspects, functional capacity and nutritional status. To identify variables that contribute to the occurrence of falls, the multiple logistic regression model, adopts a significance level of 5%.

RESULTS

The sample was composed of 415 oldest-old adults. From the total, 32.3% reported having fallen in the last year, 24.7% in Brejo dos Santos and 37.8% in São Paulo. Among the former population, the mean value of walking speed for those who had falls was 0.27 m/s and for those who had no occurrence of falls was 0.33 m/s; and, among the seniors from São Paulo, the mean values were 0.51 m/s and 0.58 m/s, respectively. Significant correlations between walking speed and falls were verified for both populations, showing that the lower the walking speed, the higher the predisposition to falls. In the final regression model, the occurrence of falls was associated with moderate balance (OR = 5.28; CI: 1.11-25.18) among the longevous people Brejo dos Santos and with very poor functional performance (OR = 16.09; CI:1.46-177.06) among those from São Paulo.

CONCLUSION

The results pointed out a lower prevalence of falls in longevous people from Brejo dos Santos than in those from São Paulo and differences regarding the associated factors, showing heterogeneity between the two populations; indicating the need for public policies and effective programmes aimed at preventing falls based on the maintenance or increase of functional capacity.

Factors associated with the occurrence of falls among older people with and without cataracts: Structural equation modelling analysis

AIMS AND OBJECTIVES

To identify the frequency of falls among older people with and without cataracts and to verify the association of sociodemographic, clinical and behavioural variables with the number of falls among community-dwelling older adults according to self-reported cataracts.

BACKGROUND

Although the literature on the topic is vast, no studies were found that described the explanatory factors for the relationship between sociodemographic, clinical and behavioural variables with the occurrence of falls in older people, with and without cataracts, through models previously tested in mediation analysis.

DESIGN AND METHOD

This is a cross-sectional and quantitative study guided by the STROBE, conducted with two groups: older people with (268) and without cataracts (689). For analysing the data, the path analysis was performed.

RESULTS

The occurrence of falls among the older people with cataracts was higher than in the group without cataracts. In both groups, frailty and depressive symptoms were directly associated with a higher occurrence of falls. Among older people with cataracts, the lowest physical performance score and the highest sedentary behaviour were directly associated with the highest number of falls. Among the older people without cataract, the youngest age, the highest number of morbidities and functional disability for instrumental activities of daily living were directly associated with the occurrence of falls.

CONCLUSION

The older people with cataracts have a higher frequency of falls. The factors associated with the occurrence of falls differ between the older people with and without cataracts.

RELEVANCE TO CLINICAL PRACTICE

The expanded understanding of the factors associated with falls among community-dwelling older adults, differentiating those with and without cataracts, guides the health professional in the development and implementation of measures to reduce the occurrence of these events.

Motor, cognitive and mobility deficits in 1000 geriatric patients: protocol of a quantitative observational study before and after routine clinical geriatric treatment - the ComOn-study

BACKGROUND

Motor and cognitive deficits and consequently mobility problems are common in geriatric patients. The currently available methods for diagnosis and for the evaluation of treatment in this vulnerable cohort are limited. The aims of the ComOn (COgnitive and Motor interactions in the Older populatioN) study are (i) to define quantitative markers with clinical relevance for motor and cognitive deficits, (ii) to investigate the interaction between both motor and cognitive deficits and (iii) to assess health status as well as treatment outcome of 1000 geriatric inpatients in hospitals of Kiel (Germany), Brescia (Italy), Porto (Portugal), Curitiba (Brazil) and Bochum (Germany).

METHODS

This is a prospective, explorative observational multi-center study. In addition to the comprehensive geriatric assessment, quantitative measures of reduced mobility and motor and cognitive deficits are performed before and after a two week's inpatient stay. Components of the assessment are mobile technology-based assessments of gait, balance and transfer performance, neuropsychological tests, frailty, sarcopenia, autonomic dysfunction and sensation, and questionnaires to assess behavioral deficits, activities of daily living, quality of life, fear of falling and dysphagia. Structural MRI and an unsupervised 24/7 home assessment of mobility are performed in a subgroup of participants. The study will also investigate the minimal clinically relevant change of the investigated parameters.

DISCUSSION

This study will help form a better understanding of symptoms and their complex interactions and treatment effects in a large geriatric cohort.