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Leroy V, Martinet V, Nunkessore O, Dentel C, Durand H, Mockler D, Puisieux F, Fougère B, Chen Y. The Nebulous Association between Cognitive Impairment and Falls in Older Adults: A Systematic Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2628. [PMID: 36767992 PMCID: PMC9915123 DOI: 10.3390/ijerph20032628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/22/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND In older people, dementia is a well-established risk factor for falls. However, the association and the causal relationship between falls and the earlier stages of cognitive impairment remains unclear. The purpose of the study was to review the literature data on the association between falls and cognitive impairment, no dementia, including Mild Cognitive Impairment. METHODS According to PRISMA guidelines, we searched five electronic databases (EMBASE, Web of Science, Medline, CINAHL, and PsychINFO) for articles published between January 2011 and August 2022 on observational studies of older people with a cognitive assessment and/or cognitive impairment diagnosis and a recording of falls. Their quality was reviewed according to the STROBE checklist. RESULTS We selected 42 of the 4934 initially retrieved publications. In 24 retrospective studies, a statistically significant association between falls and cognitive status was found in only 15 of the 32 comparisons (47%). Of the 27 cross-sectional analyses in prospective studies, only eight (30%) were positive and significant. We counted four longitudinal analyses, half of which suggested a causal relationship between falls and cognitive impairment. The investigational methods varied markedly from one study to another. CONCLUSION It is still not clear whether falls are associated with cognitive impairment, no dementia. Data in favor of a causal relationship are scarce. Further studies are needed to clarify their relationship.
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Affiliation(s)
- Victoire Leroy
- Division of Geriatric Medicine, Tours University Hospital, 37000 Tours, France
- EA 7505 (Education, Ethics, Health), University of Medicine of Tours, 37000 Tours, France
- Memory Clinic, Tours University Hospital, 37000 Tours, France
| | - Valérie Martinet
- Department of Geriatrics, Saint-Pierre Hospital, ULB, 1000 Brussels, Belgium
| | | | | | - Hélène Durand
- Department of Neurology, Hautepierre Hospital, Strasbourg University Hospital, 67200 Strasbourg, France
| | - David Mockler
- Medical Library, Trinity Centre for the Health Sciences, St James’ Hospital, D08 W9RT Dublin, Ireland
| | - François Puisieux
- Department of Gerontology, Lille University Hospital, 59000 Lille, France
- EA2694, Lille University, 59000 Lille, France
| | - Bertrand Fougère
- Division of Geriatric Medicine, Tours University Hospital, 37000 Tours, France
- EA 7505 (Education, Ethics, Health), University of Medicine of Tours, 37000 Tours, France
| | - Yaohua Chen
- Department of Gerontology, Lille University Hospital, 59000 Lille, France
- INSERM UMR-S 1172, Vascular and Degenerative Cognitive Disorders, University of Lille, 59000 Lille, France
- Global Brain Health Institute, Trinity College Dublin, D02 PN40 Dublin, Ireland
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Blanco‐Blanco J, Albornos‐Muñoz L, Costa‐Menen MÀ, García‐Martínez E, Rubinat‐Arnaldo E, Martínez‐Soldevila J, Moreno‐Casbas MT, Bays‐Moneo AB, Gea‐Sánchez M. Prevalence of falls in noninstitutionalized people aged 65−80 and associations with sex and functional tests: A multicenter observational study. Res Nurs Health 2022; 45:433-445. [PMID: 35735212 PMCID: PMC9543892 DOI: 10.1002/nur.22249] [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: 03/20/2021] [Revised: 05/14/2022] [Accepted: 05/30/2022] [Indexed: 11/09/2022]
Abstract
Falls have a considerable impact on the functional prognosis of older adults. The main focus of this multicenter, retrospective, observational study was to examine the prevalence of falls in Spanish people aged 65−80 years still living at home. The secondary aims included examining the overall sociodemographic and clinical variables associated with a history of falls and then stratifying these findings by sex. We also aimed to determine the differences between sexes with regard to the history and consequences of falls and to evaluate associations between fall history and functional performance tests. The 747 older adults had all participated in the otago exercise program, which is a progressive home program of strength, balance, and endurance exercises. They were recruited by nurses in 21 primary care centers in 10 Spanish provinces between September 2017 to December 2018. The participants' mean age was 72.2 (SD: 4.3) years, and 67% were women. We recorded sociodemographic and clinical variables, functional performance test results, and any falls and/or injuries in the last 12 months. We found that 32% had fallen, 36% of those had fallen more than once, and 48% had sustained injuries when they fell. The bivariate analysis showed that women had more than twice the odds of falling than men and that living alone and being obese or overweight increased the odds of a fall, although living alone was not associated with falls in the multivariable analysis. Our results could guide the development of risk‐specific fall prevention programs to prevent disabilities in older people.
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Affiliation(s)
- Joan Blanco‐Blanco
- Department of Nursing and Physiotherapy University of Lleida Lleida Spain
- Group for the Study of Society Health Education and Culture, GESEC University of Lleida Lleida Spain
- Health Care Research Group GRECS, Biomedical Research Institute of Lleida IRB‐Lleida Lleida Spain
| | - Laura Albornos‐Muñoz
- Unidad de Investigación en Cuidados y Servicios de Salud (Investén‐isciii), REDISSEC, Instituto de Salud Carlos III Madrid Spain
| | - Maria Àngels Costa‐Menen
- Department of Nursing and Physiotherapy University of Lleida Lleida Spain
- Health Care Research Group GRECS, Biomedical Research Institute of Lleida IRB‐Lleida Lleida Spain
- CAP Onze de Setembre, ICS Lleida Spain
| | - Ester García‐Martínez
- Department of Nursing and Physiotherapy University of Lleida Lleida Spain
- Group for the Study of Society Health Education and Culture, GESEC University of Lleida Lleida Spain
- Health Care Research Group GRECS, Biomedical Research Institute of Lleida IRB‐Lleida Lleida Spain
| | - Esther Rubinat‐Arnaldo
- Department of Nursing and Physiotherapy University of Lleida Lleida Spain
- Group for the Study of Society Health Education and Culture, GESEC University of Lleida Lleida Spain
- Health Care Research Group GRECS, Biomedical Research Institute of Lleida IRB‐Lleida Lleida Spain
| | - Jordi Martínez‐Soldevila
- Department of Nursing and Physiotherapy University of Lleida Lleida Spain
- Group for the Study of Society Health Education and Culture, GESEC University of Lleida Lleida Spain
- Health Care Research Group GRECS, Biomedical Research Institute of Lleida IRB‐Lleida Lleida Spain
| | - María Teresa Moreno‐Casbas
- Unidad de Investigación en Cuidados y Servicios de Salud (Investén‐isciii), CIBERFES, Instituto de Salud Carlos III Madrid Spain
| | | | - Montserrat Gea‐Sánchez
- Department of Nursing and Physiotherapy University of Lleida Lleida Spain
- Group for the Study of Society Health Education and Culture, GESEC University of Lleida Lleida Spain
- Health Care Research Group GRECS, Biomedical Research Institute of Lleida IRB‐Lleida Lleida Spain
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Rocha P, Baixinho CL, Marques A, Henriques A. Safety-Promoting Interventions for the Older Person with Hip Fracture on Returning Home: A Protocol for a Systematic Review. J Pers Med 2022; 12:654. [PMID: 35629077 PMCID: PMC9142881 DOI: 10.3390/jpm12050654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/18/2022] [Accepted: 04/13/2022] [Indexed: 01/14/2023] Open
Abstract
Ageing and physical frailty associated with decrease in muscle and bone mass lead to the older persons' vulnerability and increased risk of falling. It is estimated that one in every ten falls in this age group results in a fracture, leading to a downward spiral in their health status, causing greater dependence, with a progressive functional decline that makes it difficult to return to their functional and social status prior to the fracture. The aim of this study is to identify the available evidence on the interventions that promote the safety of older people with hip fracture after hospital discharge. A search will be performed in MEDLINE and CINAHL databases. Randomised and controlled studies that focus on functional assessment, performance in activities of daily living, level of concern about falls, risk and prevalence of falls, injuries secondary to falls, re-fracture rate and health-related quality of life in hip fracture patients will be included. Two authors will perform the study selection, data extraction, and quality assessment independently. Any disagreements will be resolved through discussion with a third researcher. Methodological quality of the included trials will be evaluated by the Cochrane risk-of-bias criteria, and the Standards for Reporting Interventions in Controlled Trials.
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Affiliation(s)
- Paula Rocha
- Local Health Unit of Guarda, 6300-749 Guarda, Portugal
- PhD Student of University of Lisbon, 1649-004 Lisboa, Portugal
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), 1900-160 Lisboa, Portugal; (C.L.B.); (A.H.)
| | - Cristina Lavareda Baixinho
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), 1900-160 Lisboa, Portugal; (C.L.B.); (A.H.)
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, 2411-901 Leiria, Portugal
- Nursing School of Lisbon, 1900-160 Lisboa, Portugal
| | - Andréa Marques
- Nursing School of Coimbra, Health Sciences Research Unit: Nursing (UICISA:E), 3000-232 Coimbra, Portugal;
- Department of Rheumatology, Centro Hospitalar e Universitário de Coimbra, 3000-071 Coimbra, Portugal
| | - Adriana Henriques
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), 1900-160 Lisboa, Portugal; (C.L.B.); (A.H.)
- Nursing School of Lisbon, 1900-160 Lisboa, Portugal
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Ferreira R, Baixinho CL, Ferreira ÓR, Nunes AC, Mestre T, Sousa L. Health Promotion and Disease Prevention in the Elderly: The Perspective of Nursing Students. J Pers Med 2022; 12:jpm12020306. [PMID: 35207794 PMCID: PMC8876286 DOI: 10.3390/jpm12020306] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 02/06/2023] Open
Abstract
Health promotion and disease prevention are closely linked to health literacy. Therefore, intervention to increase individuals’ knowledge is essential if action is to be taken to promote a healthy lifestyle with support from health professionals for decision making on choices leading to behavioral change. Taking into account the growing aging population, nurses and nursing students have to develop interventions to promote health and prevent disease in these people, in order to keep them healthy and with quality of life. This study aims to understand how nursing students’ experiences in a clinical teaching context contributed to the development of their competencies in the promotion of health and prevention of disease in the elderly. Method: Qualitative, exploratory, and descriptive study carried out with ten students about to finish a graduate nursing course in a higher education institution in the South of Portugal. This study was carried out through narratives, one of the most common data collection procedures in social and health investigations. The content analysis technique, more specifically the thematic categorical analysis, was used for data analysis. The study received authorization from the Ethics Committee of the institution where it took place. Results: Three categories were found: “Strategies to promote health and prevent disease in the elderly”, “Health improvements from the implementation of the strategies to promote health and prevent disease in the elderly”, and “The impact your participation in these strategies to promote health and prevent disease in the elderly had on your formative process”. Conclusion: The students developed competencies during their clinical teaching experiences through the implementation of strategies of health promotion and disease prevention adapted to/focused on the needs of the elderly.
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Affiliation(s)
- Rogério Ferreira
- Comprehensive Health Research Centre, 1150-082 Lisboa, Portugal; (R.F.); (L.S.)
- Polytechnic Institute of Beja, 7800-000 Beja, Portugal; (A.C.N.); (T.M.)
| | - Cristina Lavareda Baixinho
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, 2410-541 Leiria, Portugal
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, 1600-190 Lisboa, Portugal;
- Correspondence:
| | - Óscar Ramos Ferreira
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, 1600-190 Lisboa, Portugal;
| | - Ana Clara Nunes
- Polytechnic Institute of Beja, 7800-000 Beja, Portugal; (A.C.N.); (T.M.)
| | - Teresa Mestre
- Polytechnic Institute of Beja, 7800-000 Beja, Portugal; (A.C.N.); (T.M.)
| | - Luís Sousa
- Comprehensive Health Research Centre, 1150-082 Lisboa, Portugal; (R.F.); (L.S.)
- S. João de Deus Higher School of Nursing, University of Évora, 7000-811 Évora, Portugal
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Pecce Bento A, Costa Pereira L, Ramos Garcia K, Ramos Ferreira LF, da Silva EV, Karnikowski M. Inclusion of Potentially Inappropriate Medicines for the Older Adults in the Brazilian Consensus in Accordance with International Criteria. Clin Interv Aging 2022; 17:151-161. [PMID: 35210761 PMCID: PMC8859540 DOI: 10.2147/cia.s318578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/15/2021] [Indexed: 11/23/2022] Open
Abstract
AIM The use of potentially inappropriate medications (PIM) can impair the safety and effectiveness of pharmacotherapy in the older adults. Thus, several countries have lists and criteria to indicate these drugs, in order to promote the safety of prescription and the rational use of drugs in geriatric practice. OBJECTIVE This study sought to contribute to the inclusion of PIM for the older adults in the Brazilian criterion (BCPIM/2016) - current list used in Brazil and reference in Latin American countries - through expert approval, comparing convergences with international AGS lists BEERS/2019, STOPP/START/2015, PRISCUS/2010 and EU (7)-PIM List/2015. METHODS This is a critical analysis of potentially inappropriate medications for use in the older adults present in the list of Brazilian criteria, together with their absence of some drugs that are on international lists (BEERS/2019; Priscus/2010; Stopp/Start/2015; EU7-PIM list/2015). This study was subdivided in 6 stages: selection of national criteria, classification of drugs according to Anatomic Therapeutic Chemical, comparison between BCPIM/2016 with international lists, selection of drugs not included in the Brazilian list, selection of experts for evaluation and suggestions about drugs not included in the Brazilian list and the synthesis of the analysis carried out by the specialists. RESULTS We cataloged 66 drugs marketed in Brazil that are on international lists, but not in the Brazilian consensus, of which 24 were validated by experts as necessary for inclusion in this consensus, considering the risks and benefits in health care for the older adults. However, the lists have divergences and similarities between them. We observed that eight drugs were common to all criteria studied, mainly related to the nervous system. CONCLUSION The results suggest the need for periodic validation of PIM against research clinics, new drugs and the inclusion of this agenda by the Ministry of Health in the revision of the National List of Essential Drugs and other Clinical Protocols and Therapeutic Prescription Guidelines for the older adults.
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Affiliation(s)
- Andréa Pecce Bento
- Sciences and Health Technologies Program, University of Brasilia, Brasilia, DF, Brazil
| | | | - Kerolyn Ramos Garcia
- Sciences and Health Technologies Program, University of Brasilia, Brasilia, DF, Brazil
| | | | | | - Margô Karnikowski
- Sciences and Health Technologies Program, University of Brasilia, Brasilia, DF, Brazil
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Gait Ability and Muscle Strength in Institutionalized Older Persons with and without Cognitive Decline and Association with Falls. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111543. [PMID: 34770057 PMCID: PMC8583290 DOI: 10.3390/ijerph182111543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/28/2021] [Accepted: 10/30/2021] [Indexed: 12/31/2022]
Abstract
Falls are a complex problem, given their multifactorial nature, the comorbidities involved, and due to the dependency of older persons living in nursing homes. Risk, fear of falling, falls themselves, and their recurrence are the main factors behind fragility fractures, lack of independence, and increases in pain prevalence, and other comorbidities in older populations. The objectives of the present quantitative and longitudinal study were: (a) to characterize the cognitive state and fall frequency of older persons living in nursing homes; (b) to analyze the relationship between cognitive status and some fall risk factors; and (c) to associate cognitive decline, gait ability, and muscle strength of the examined institutionalized older persons with fall occurrence and recurrence over 12 months. The participants were 204 older persons who lived in Portuguese nursing homes, and data were collected from January 2019 to February 2020 by consulting medical records and applying the following instruments: the Mini-Mental State Examination, Timed Up and Go Test, and Medical Research Council Manual Muscle Testing Scale. Fall prevalence, assessed in two periods, 12 months apart, was similar in both samples (with and without cognitive decline) and close to 42%, and the annual recurrence rate was 38.3%. Older persons with no cognitive decline showed an association between gait speed and occurrence of first fall and recurrent fall (p < 0.05). Muscle strength and use of gait aid devices were not related to falls and their recurrence, regardless of mental state.
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Caçador C, Teixeira-Lemos E, Oliveira J, Pinheiro J, Mascarenhas-Melo F, Ramos F. The Relationship between Nutritional Status and Functional Capacity: A Contribution Study in Institutionalised Portuguese Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073789. [PMID: 33916422 PMCID: PMC8038576 DOI: 10.3390/ijerph18073789] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 03/30/2021] [Accepted: 04/01/2021] [Indexed: 12/02/2022]
Abstract
Demographic aging of the population allied with the new family structures and societal dynamics is generating an increasing demand for institutions for older adults. Nutritional status is a key health determinant that impacts the quality of life among older adults. Hence, the aim of the present study was to evaluate the relationship between nutritional status and nutritional risk, functional capacity, and cognition in institutionalised Portuguese older adults by a cross-sectional study in 15 institutions. Nutritional status (body mass index (BMI), waist circumference (WC), nutritional risk (mini nutritional assessment (MNA)), degree of functional independence (Barthel index (BI)), and cognitive ability (mini mental state examination (MMSE)) were assessed. Of the 214 older adults evaluated, 28.0% were at risk of malnutrition, 69.6% were mildly functional dependent, and 39.3% presented minor cognitive impairment. The risk of malnutrition increased functional dependence and cognitive impairment. The MNA score, but not the BMI or WC, was related to disability and deficits in cognition. A differential interdependence was found between nutritional, cognitive, and functional status. Strategies to improve self-care and well-being in nursing homes should consider a correct diet and a closer evaluation of nutritional risk to preserve cognition, independence, and autonomy.
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Affiliation(s)
- Catarina Caçador
- Faculty of Pharmacy, University of Coimbra, 3000-548 Coimbra, Portugal;
| | - Edite Teixeira-Lemos
- Agrarian Scholl-IPV and CERNAS-IPV Research Centre, Polytechnic Institute of Viseu, 3504-510 Viseu, Portugal; (E.T.-L.); (J.O.)
| | - Jorge Oliveira
- Agrarian Scholl-IPV and CERNAS-IPV Research Centre, Polytechnic Institute of Viseu, 3504-510 Viseu, Portugal; (E.T.-L.); (J.O.)
| | - João Pinheiro
- Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal;
| | - Filipa Mascarenhas-Melo
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Coimbra, 3000-548 Coimbra, Portugal;
| | - Fernando Ramos
- Faculty of Pharmacy, University of Coimbra, 3000-548 Coimbra, Portugal;
- REQUIMTE/LAQV, R. D. Manuel II, Apartado 55142, 4051-401 Porto, Portugal
- Correspondence:
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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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Naharci MI, Tasci I. Frailty status and increased risk for falls: The role of anticholinergic burden. Arch Gerontol Geriatr 2020; 90:104136. [PMID: 32563737 DOI: 10.1016/j.archger.2020.104136] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 05/19/2020] [Accepted: 06/02/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE OF THE STUDY Frailty leads to serious adverse outcomes including falls. The relationship between frailty and falls has not been evaluated in the context of the side effects of drugs with anticholinergic properties. The aim of this study was to examine the potential association of anticholinergic burden (ACB) with the risk of falls among frail older adults. DESIGN AND METHODS Community-dwelling older adults were consecutively selected from the geriatrics outpatient clinic. Based on a fall history in the last 12 months, the participants were grouped as fallers and non-fallers. Frailty status was assessed by Fried's phenotype method. Exposure to anticholinergic medications was estimated using the ACB scale, and the participants were classified into ACB_0 (none), ACB_1 (possible) and ACB_2+ (definite). RESULTS The study included 520 older adults (mean age 77.7 years, 62.7 % female), with a fall prevalence of 25.8 % 12 months past. The proportions of frailty and pre-frailty were 33.1 % and 57.4 %, respectively. After adjustment for study confounders, receiving at least 1 drug with either possible or definite anticholinergic properties was independently associated to falls in frail [OR = 3.84 (1.48-9.93), p = 0.006] and pre-frail participants [OR = 2.71 (1.25-5.89); p = 0.012], but not in robust subjects. Moreover, ACB was significantly associated with the frailty components on adjusted analysis (p's<0.05). IMPLICATIONS Current study showed that the use of any drugs with possible or definite anticholinergic properties was associated with an increased risk of falls in frail older adults. The results emphasize the importance of medication management with respect to fall prevention in these patients.
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Affiliation(s)
- Mehmet Ilkin Naharci
- University of Health Sciences, Gulhane Faculty of Medicine & Gulhane Training and Research Hospital, Division of Geriatrics, Ankara, 06010, Turkey.
| | - Ilker Tasci
- University of Health Sciences, Gulhane Faculty of Medicine & Gulhane Training and Research Hospital, Department of Internal Medicine, Ankara, Turkey
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Tavares GMS, Pacheco BP, Gottlieb MGV, M�ller DVK, Santos GM. Interaction between cognitive status, fear of falling, and balance in elderly persons. Clinics (Sao Paulo) 2020; 75:e1612. [PMID: 33146348 PMCID: PMC7561071 DOI: 10.6061/clinics/2020/e1612] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 07/14/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Evaluate the cognitive function and its relationship with balance, history of falls, and fear of falling in the elderly. METHODS We evaluated 250 elderly persons aged at least 60 years, who answered a sociodemographic questionnaire about the occurrence of falls in the last year. The cognitive function, balance, and fear of falling were assessed using the Mini-Mental State Examination (MMSE), Berg Balance Scale (BBS), and Falls Efficacy Scale (FES-I) scores, respectively. Participants were allocated into two groups based on the Mini-Mental State Examination (MMSE) score, the Group with Possible Cognitive Decline (GPCD) and the group with no cognitive decline (GNCD). We performed Student's t-test and Pearson's correlation for independent samples. RESULTS The Group with Possible Cognitive Decline (GPCD) showed lower balance (p=0.003) and greater fear of falling (p=0.008) (BBS=50.98±4.68; FES-I=26.06±8.78) compared to the GNCD (BBS=52.53±3.047; FES-I=23.21±7.74). CONCLUSION Elderly persons with cognitive decline have lower balance, greater fear of falling, and greater recurrence of falls.
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Baixinho CL, Dixe MDA. Practices and behaviors of professionals after falls in institutionalized elderly with and without cognitive decline. Dement Neuropsychol 2020; 14:62-68. [PMID: 32206200 PMCID: PMC7077869 DOI: 10.1590/1980-57642020dn14-010010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 12/21/2019] [Indexed: 02/07/2023] Open
Abstract
Falls are a major problem in nursing homes due to their high prevalence and impact on the functioning of elderly. OBJECTIVE This study aims to: a) construct and validate a scale for assessing the practices and behaviors of professionals from nursing homes after falls in elderly; b) describe practices and behaviors after falls; and c) associate practices and behaviors with professionals' length of experience, training and age. METHODS This is a correlational study, conducted in a sample of 152 professionals from six nursing homes. The study adhered to all of the Declaration of Helsinki principles. RESULTS The scale constructed has a Cronbach's alpha of 0.938. The 12 items of the scale are grouped into two factors. The most expressive indicators are the communication of fall episodes that result in severe injuries (4.64 ± 0.812) and the communication of falls that result in injuries and need intervention from health technicians (4.61 ± 0.832). We found no significant statistical difference between length of professional experience, training and age when associated with professional practices and behaviors after falls in elderly (p > 0.05). CONCLUSION Future studies should investigate the association of post-fall professional practices and behaviors with fear of another fall, fall recurrence, and changes in functioning of the elderly following a fall.
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Affiliation(s)
- Cristina Lavareda Baixinho
- School of Health Sciences, Centre for Innovative Care and Health
Technology (ciTechCare), Polytechnic Institute of Leiria (IPLeiria), Leiria,
Portugal
- The Health Sciences Research Unit: Nursing, Nursing School of
Coimbra, Coimbra, Portugal
| | - Maria dos Anjos Dixe
- The Health Sciences Research Unit: Nursing, Nursing School of
Coimbra, Coimbra, Portugal
- Escola Superior de Saúde, Instituto Politécnico de Leiria,
Portugal
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