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Silva JMM, da Silva Freitas JLG, Nóbrega JCL, Medeiros JB, Simões RFM, Olinda R, de Ferreira Santos JL, de Oliveira Duarte YA, Zatz M, Matheson D, Santos S, Menezes TN. Regional differences regarding the occurrence of falls and associated factors in two populations of Brazilian longevous people. BMC Geriatr 2022; 22:931. [PMID: 36460961 PMCID: PMC9719182 DOI: 10.1186/s12877-022-03630-2] [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: 07/02/2022] [Accepted: 11/17/2022] [Indexed: 12/03/2022] Open
Abstract
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.
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Affiliation(s)
- Jaíza M M Silva
- Public Health Program, Universidade Estadual da Paraíba (UEPB), Campina Grande, Brazil
| | | | | | | | | | - Ricardo Olinda
- Department of Statistics, Universidade Estadual da Paraíba (UEPB), Campina Grande, Brazil
| | | | | | - Mayana Zatz
- Human Genome Studies Center, Universidade de São Paulo (USP), São Paulo, Brazil
| | - David Matheson
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK
| | - Silvana Santos
- Public Health Program, Universidade Estadual da Paraíba (UEPB), Campina Grande, Brazil.
- Department of Biology, Universidade Estadual da Paraíba (UEPB), Campina Grande, Brazil.
| | - Tarciana Nobre Menezes
- Public Health Program, Universidade Estadual da Paraíba (UEPB), Campina Grande, Brazil
- Department of Physical Therapy, Universidade Estadual da Paraíba (UEPB), Campina Grande, Brazil
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Geritz J, Maetzold S, Steffen M, Pilotto A, Corrà MF, Moscovich M, Rizzetti MC, Borroni B, Padovani A, Alpes A, Bang C, Barcellos I, Baron R, Bartsch T, Becktepe JS, Berg D, Bergeest LM, Bergmann P, Bouça-Machado R, Drey M, Elshehabi M, Farahmandi S, Ferreira JJ, Franke A, Friederich A, Geisler C, Hüllemann P, Gierthmühlen J, Granert O, Heinzel S, Heller MK, Hobert MA, Hofmann M, Jemlich B, Kerkmann L, Knüpfer S, Krause K, Kress M, Krupp S, Kudelka J, Kuhlenbäumer G, Kurth R, Leypoldt F, Maetzler C, Maia LF, Moewius A, Neumann P, Niemann K, Ortlieb CT, Paschen S, Pham MH, Puehler T, Radloff F, Riedel C, Rogalski M, Sablowsky S, Schanz EM, Schebesta L, Schicketmüller A, Studt S, Thieves M, Tönges L, Ullrich S, Urban PP, Vila-Chã N, Wiegard A, Warmerdam E, Warnecke T, Weiss M, Welzel J, Hansen C, Maetzler W. 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. BMC Geriatr 2020; 20:45. [PMID: 32028945 PMCID: PMC7006407 DOI: 10.1186/s12877-020-1445-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 01/27/2020] [Indexed: 12/22/2022] Open
Abstract
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.
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Affiliation(s)
- Johanna Geritz
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Sara Maetzold
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Maren Steffen
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Andrea Pilotto
- Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Brescia, Italy
| | - Marta F. Corrà
- Neurology Department, Centro Hospitalar do Porto, Porto, Portugal
| | - Mariana Moscovich
- Movement Disorders Unit, Neurology Service, Internal Medicine Department, Hospital de Clínicas, Federal University of Paraná, Curitiba, Brazil
| | - Maria C. Rizzetti
- Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Brescia, Italy
| | - Barbara Borroni
- Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Brescia, Italy
| | - Alessandro Padovani
- Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Brescia, Italy
| | - Annekathrin Alpes
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Corinna Bang
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Igor Barcellos
- Movement Disorders Unit, Neurology Service, Internal Medicine Department, Hospital de Clínicas, Federal University of Paraná, Curitiba, Brazil
| | - Ralf Baron
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Thorsten Bartsch
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Jos S. Becktepe
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Daniela Berg
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Lu M. Bergeest
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Philipp Bergmann
- Department of Internal Medicine I, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Raquel Bouça-Machado
- Instituto de Medicina Molecular, Lisbon, Portugal. CNS-Campus Neurológico Sénior, Torres Vedras, Portugal. Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Michael Drey
- Medical Clinic and Policlinic IV, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Morad Elshehabi
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Susan Farahmandi
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Joaquim J. Ferreira
- Instituto de Medicina Molecular, Lisbon, Portugal. CNS-Campus Neurológico Sénior, Torres Vedras, Portugal. Laboratory of Clinical Pharmacology and Therapeutics, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Andre Franke
- Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Anja Friederich
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Corinna Geisler
- Institute of Human nutrition, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Philipp Hüllemann
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Janne Gierthmühlen
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Oliver Granert
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Sebastian Heinzel
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Maren K. Heller
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Markus A. Hobert
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | | | - Björn Jemlich
- Third Medical Clinic for Gastroenterology/Rheumatology, Städtisches Krankenhaus Kiel, Kiel, Germany
| | - Laura Kerkmann
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Stephanie Knüpfer
- Department of Urology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Katharina Krause
- Department of Internal Medicine I, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Maximilian Kress
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Sonja Krupp
- Research Group Geriatrics Lübeck, Red Cross Hospital Geriatric Centre, Lübeck, Germany
| | - Jennifer Kudelka
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Gregor Kuhlenbäumer
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Roland Kurth
- Department of Psychiatry and Psychotherapy, ZIP, Centre for Integrative Psychiatry, Kiel, Germany
| | - Frank Leypoldt
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Corina Maetzler
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Luis F. Maia
- Neurology Department, Centro Hospitalar do Porto, Porto, Portugal
| | - Andreas Moewius
- Department of Neurology, Ruhr-University Bochum, St. Josef-Hospital, Bochum, Germany
| | - Patricia Neumann
- Department of Neurology, Asklepios Klinik Barmbek, Hamburg, Germany
| | - Katharina Niemann
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | | | - Steffen Paschen
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Minh H. Pham
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
- Digital Signal Processing and System Theory, Faculty of Engineering, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Thomas Puehler
- Department of Cardiac and Vascular Surgery, Universitätsklinikum Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Franziska Radloff
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Christian Riedel
- Department of Radiology and Neuroradiology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Marten Rogalski
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Simone Sablowsky
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Elena M. Schanz
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Linda Schebesta
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
- Department of Cardiac and Vascular Surgery, Universitätsklinikum Schleswig-Holstein Campus Kiel, Kiel, Germany
| | | | - Simone Studt
- Department of Psychiatry and Psychotherapy, ZIP, Centre for Integrative Psychiatry, Kiel, Germany
| | - Martina Thieves
- Geriatric Clinic, Städtisches Krankenhaus Kiel, Kiel, Germany
| | - Lars Tönges
- Department of Neurology, Ruhr-University Bochum, St. Josef-Hospital, Bochum, Germany
| | - Sebastian Ullrich
- Third Medical Clinic for Gastroenterology/Rheumatology, Städtisches Krankenhaus Kiel, Kiel, Germany
| | - Peter P. Urban
- Department of Neurology, Asklepios Klinik Barmbek, Hamburg, Germany
| | - Nuno Vila-Chã
- Neurology Department, Centro Hospitalar do Porto, Porto, Portugal
| | - Anna Wiegard
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Elke Warmerdam
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
- Digital Signal Processing and System Theory, Faculty of Engineering, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Tobias Warnecke
- Department of Neurology, University Hospital Muenster, Muenster, Germany
| | - Michael Weiss
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Julius Welzel
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Clint Hansen
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Walter Maetzler
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
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