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Nguyen HH, Do DV, To KG, Doan HTN, Oddy WH. The Effect of Dietary Patterns on Reducing Falls and Falls Risk in Adults: A Systematic Review. Curr Nutr Rep 2024; 13:15-22. [PMID: 38194079 DOI: 10.1007/s13668-023-00516-6] [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] [Accepted: 12/21/2023] [Indexed: 01/10/2024]
Abstract
PURPOSE OF REVIEW Falls are a major global public health issue and the second cause of unintentional injury death. Nutrition may be an important factor for falls prevention in adults, but most previous studies examined the associations between single nutrients and falls. The use of dietary patterns is an alternative method to measure whole diet and its relationship with health outcomes. Therefore, we aimed to systematically review all evidence relating to dietary pattern impacts on falls and/or falls risk in adults. RECENT FINDINGS This systematic review was registered on the PROSPERO (CRD42020171987). Four databases (Medline, Embase, Cochrane Library, CINAHL Complete) were used for searching potential articles on 18th December 2021 and updated the search on 10th July 2023. We included any quantitative study reporting associations between dietary patterns and falls and/or falls risk in healthy adults ≥ 18 years and publishing in English as full text and peer-reviewed. Of 2866 potential articles, five studies (two cross-sectional, three cohorts) were included for the evidence synthesis. The risk of bias was low in cohort studies. Dietary patterns were derived using both "a priori" or "empirical" approaches, and self-report questionnaires used for falls/falls risk in most studies. Associations between dietary patterns and falls/falls risk were inconsistent results by sex and study design. The effect of dietary patterns on reducing falls/falls risk is not clear in the included studies, so this association needs to be confirmed in future research.
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Affiliation(s)
- Hoa H Nguyen
- University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang Street, District 5, Ho Chi Minh City, Vietnam.
- VISA Faculty Fellow, University of North Carolina, Chapel Hill, USA.
- Australia Awards Fellowships, University of Sydney, Australia sponsored by the DFAT, Sydney, Australia.
- The Post-doc Fellowship, University of Emory, USA sponsored by the NIH, Atlanta, USA.
| | - Dung V Do
- University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang Street, District 5, Ho Chi Minh City, Vietnam
| | - Kien G To
- University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang Street, District 5, Ho Chi Minh City, Vietnam
| | - Han T N Doan
- University of Medicine and Pharmacy at Ho Chi Minh City, 217 Hong Bang Street, District 5, Ho Chi Minh City, Vietnam
| | - Wendy H Oddy
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, 7000 TAS, Australia
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Mackenzie L, Le VT, Nguyen DMN, Dao THP. The Vietnamese version of the Home Falls and Accidents Screening Tool (HOME FAST) - A preliminary study of validity and inter-rater reliability. Front Public Health 2023; 11:1170000. [PMID: 37228736 PMCID: PMC10203153 DOI: 10.3389/fpubh.2023.1170000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 04/18/2023] [Indexed: 05/27/2023] Open
Abstract
Introduction The Vietnamese Home Falls and Accidents Screening Tool (HOME FAST) was developed to measure the number of home hazards present in the homes of older Vietnamese people and the risk of falls. Methods The HOME FAST and the HOME FAST manual were translated into Vietnamese by an independent translator and underwent backward translation by local health professionals into English to evaluate the accuracy of the translation. A panel of 14 Vietnamese health professionals evaluated the validity of the HOME FAST translation and rated the clarity and cultural relevance of each item. Ratings were evaluated using the content validity index (CVI). Reliability in ratings of the HOME FAST was evaluated using intra-class correlations (ICC), and ratings took place within the homes of two older Vietnamese people by six assessors. Results In all, 22 out of 25 Vietnamese HOME FAST items were considered to have met content validity standards using the CVI. The ICC for home visit one was 0.94 (95% CI 0.87-0.97) and for home visit two was ICC 0.95 (95% CI 0.91-0.98) indicating high reliability. Discussion and conclusion Bathroom items showed the most inconsistency in ratings indicating cultural differences in bathing activities. Descriptors of HOME FAST items will be reviewed for use in Vietnam to account for cultural and environmental differences. A larger pilot study is planned with older people living in the community in Vietnam to include calendar ascertainment of falls to determine if home hazards are associated with falling.
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Affiliation(s)
- Lynette Mackenzie
- Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Darlington, NSW, Australia
| | - Van Thanh Le
- Rehabilitation Department, Faculty of Nursing and Medical Technology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Doan Mai Ngoc Nguyen
- Rehabilitation Department, Faculty of Nursing and Medical Technology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Thy Hoang Phuong Dao
- Rehabilitation Department, Faculty of Nursing and Medical Technology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
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To Q, Huynh VA, Do D, Do V, Congdon N, Meuleners L, Vandelanotte C, Hong H, Nguyen H, To K. Falls and Physical Activity among Cataract Patients in Vietnam. Ophthalmic Epidemiol 2021; 29:70-77. [PMID: 33627039 DOI: 10.1080/09286586.2021.1893341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To investigate the relationship between falls, physical activity, and other socio-demographic and visual factors among cataract patients in Ho Chi Minh City, Vietnam. METHODS A cross-sectional study was conducted between April and November 2018. Patients presenting to two hospitals with age-related unilateral or bilateral cataract, aged ≥50 years, literate, and scheduled for a first-eye cataract surgery were recruited. The International Physical Activity Questionnaires short form was used to measure physical activity. Visual disability score was self-reported using the Catquest-9SF. The number of falls in the last 12 months prior to data collection were self-reported. Visual acuity and contrast sensitivity were measured using standard protocols. RESULTS A total of 340 patients had complete data, the majority of whom were women (62.4%), living with a spouse (66.5%), had an education level of Grade 5 or below (68.2%), and a monthly income from medium to high (58.5%). Average age was 65.7 years. A total of 135 falls were reported in the last 12 months with 27.6% reporting ≥1 fall and 7.1% ≥2 falls. Persons with high (adjusted Prevalence Ratio (aPR) = 2.4, 95%CI = 1.2, 4.7) and low (aPR = 2.4, 95%CI = 1.2, 4.6) physical activity levels had more falls compared to those with moderate levels. Women (aPR = 1.7, 95%CI = 1.04, 2.7) and those with medium income (aPR = 2.9, 95%CI = 1.2, 6.9) were more likely to fall. Poor binocular logMAR visual acuity with habitual correction (aPR = 2.3, 95%CI = 1.1, 4.6) and poor visual disability scores (aPR = 1.4, 95%CI = 1.02, 2.0) were associated with falling. CONCLUSION Patients with a moderate level of physical activity were less likely to fall compared to those with low or high levels although this U-shape relationship needs to be further investigated in prospective interventional trials. Men and those with high monthly income, better visual acuity and visual disability score were also less likely to fall. Cataract patients might be advised to maintain a moderate level of physical activity while waiting for surgery. Strategies to prevent falls may also prioritise cataract surgery for women and those with lower income.
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Affiliation(s)
- Quyen To
- Postdoctoral Research Fellow, Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Australia.,School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.,Physical Activity Research Group, Appleton Institute, Central Queensland University, Australia
| | - Van-Anh Huynh
- Faculty of Public Health, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Dung Do
- Faculty of Public Health, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Vu Do
- Military Hospital 175, Ho Chi Minh City, Vietnam
| | - Nathan Congdon
- Centre for Public Health, Queen's University Belfast, Belfast, UK.,Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Lynn Meuleners
- School of Population and Global Health, University of Western, Australia
| | - Corneel Vandelanotte
- Physical Activity Research Group, Appleton Institute, Central Queensland University, Australia.,Research Professor, Physical Activity Research Group Leader, Appleton Institute School of Health, Medical and Applied Sciences, Central Queensland University, Australia
| | - Hiep Hong
- University Medical Center, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Ho Nguyen
- Trung Vuong Hospital, Ho Chi Minh City, Vietnam
| | - Kien To
- Faculty of Public Health, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
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Visual Impairment Prevalence, Causes, and Role of Healthcare Access: A Systematic Review and Meta-Analysis in Iran. J Ophthalmol 2021; 2020:4710328. [PMID: 33489330 PMCID: PMC7803184 DOI: 10.1155/2020/4710328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 10/28/2020] [Accepted: 11/06/2020] [Indexed: 11/18/2022] Open
Abstract
Purpose Healthcare access is one of the determinants of visual impairment (VI), as a public health problem. The objective of this study was to estimate VI prevalence, related causes, and its correlation with access to physicians in Iran. Methods : This systematic review and meta-analysis include observational studies published in Iran. PubMed, Web of Science, Scopus, Google Scholar, and local databases were systematically searched by using the MeSH headings. Data on the provincial distribution of physicians, as an index of access to healthcare, was retrieved. A random-effect meta-analysis was performed to assess. Results Eight articles were included. The pooled prevalence of blindness, low vision, and VI was 0.80% (95% CI: 0.61–0.99%), 2.92% (95% CI: 2.40–3.44%), and 5.57% (95% CI: 4.71–6.43%). Refractive errors were the most common causes of VI based on PVA with the pooled prevalence of 54.6% (95% CI: 43.4–65.8%). Based on BCVA, we found that the pooled prevalence of cataracts was 37.4% (95% CI: 29.5–45.3%) as the most common cause of VI. The results of metaregression showed that the greater number of general practitioners (GPs) (P value = 0.01) and pharmacists (P value = 0.024) per population were associated with a lower prevalence of blindness. Conclusion Some of the main causes of visual impairment in Iran are preventable. Access to healthcare services may lead to early diagnosis of preventable causes of VI. Further well-designed studies and national surveys should be conducted to provide accurate data from different regions of Iran.
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Tabatabaei HR, Ahmadipour H. Fall-Risk Assessment in the Elderly Using the Persian Version of Fall-Risk Screening Tool: A Population-Based Study. Int J Prev Med 2020; 11:153. [PMID: 33209223 PMCID: PMC7643577 DOI: 10.4103/ijpvm.ijpvm_198_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 10/14/2019] [Indexed: 10/27/2022] Open
Abstract
Background Falling is a serious challenge for public health and a leading cause of morbidity and mortality among the elderly. This study conducted to evaluate the psychometric properties of the Persian version of fall risk screening tool (P-FRST). Methods A cross-sectional study carried out from September 2018 to March 2019 on 537 elders who referred to urban health centers in Kerman, Iran. Demographic data recorded and fall-risk assessment was performed using P-FRST and the timed up and go test (TUG). The maximum possible score is 33 for P-FRST and score ≥18 is considered as high risk. The time ≥12 s in TUG test considered as a risk for falling. Data analyzed by SPSS using t-test, analysis of variance, and linear regression. Results The mean age of participants was 67.18 ± 6.93. According to P-FRST, 22% of the elderly were high risk and 62% had a moderate risk for falling. The mean score for falling risk was significantly higher in the females, illiterates, income <10 million IRRLs, and the unemployed. Conclusions Due to the risk of falling in the elderly, it is suggested that in the comprehensive health care for the elderly, to assess the risk of falling, especially in high-risk groups, so that preventive interventions can be made.
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Affiliation(s)
- Hoorasa Razavi Tabatabaei
- Department of Community and Family Medicine, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Habibeh Ahmadipour
- Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Abstract
Spain is considered the healthiest nation in the world, due to lifepromoting aspects such as good diet, care facilities and a favourable family environment. However, although increased life expectancy is an indicator of development, it may have a negative impact on the other two variables of health service efficiency, namely health expenditure per capita and its relative weight in Gross Domestic Product.
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Campagna G, Chamberlain P, Orengo-Nania S, Biggerstaff K, Khandelwal S. Ophthalmic Conditions Associated with Inpatient Falls among Veterans. Optom Vis Sci 2018; 95:1114-1119. [DOI: 10.1097/opx.0000000000001312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Krishnaiah S, Ramanathan RV. Impact of blindness due to cataract in elderly fallers: findings from a cross-sectional study in Andhra Pradesh, South India. BMC Res Notes 2018; 11:773. [PMID: 30373667 PMCID: PMC6206731 DOI: 10.1186/s13104-018-3883-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Accepted: 10/25/2018] [Indexed: 11/30/2022] Open
Abstract
Objective To estimate the prevalence of falls, frequency of falls, injury due to falls and to explore the relationship between cataract-related blindness and falls in older patients above or equal to 50 years of age. Results A cross-sectional study was conducted to investigate the relationship between cataract related blindness and risk of fall. Details about any fall in the previous 12 months and systemic illness history were collected through a personal interview. Overall, 70 (18.3%; 95% confidence intervals (CI) 14.4%, 22.2%) of the 382 patients investigated had experienced falls. The history of recurrent falls were more commonly seen in patients with bilateral cataract (p = 0.023). The mean presenting Logarithm of the Minimum Angle of Resolution (LogMAR) visual acuity was significantly higher in fallers when compared to non-fallers: 0.81 ± 0.41 versus 0.65 ± 0.31 (p = 0.001). The prevalence of falls was significantly higher in patients with bilateral cataract blind; adjusted odds ratio (OR): 1.76 (p = 0.042). Timely diagnosis and surgical intervention in patients with bilateral blindness due to cataract may help prevent falls in older patients in Andhra Pradesh, South India.
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Affiliation(s)
- Sannapaneni Krishnaiah
- Department of Community Outreach Services, Sankara Eye Foundation-India, Coimbatore, Tamil Nadu, India.
| | - Ramani V Ramanathan
- Department of Community Outreach Services, Sankara Eye Foundation-India, Coimbatore, Tamil Nadu, India
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Liu S, Zhu Y, Chen W, Wang L, Zhang X, Zhang Y. Demographic and socioeconomic factors influencing the incidence of ankle fractures, a national population-based survey of 512187 individuals. Sci Rep 2018; 8:10443. [PMID: 29992987 PMCID: PMC6041313 DOI: 10.1038/s41598-018-28722-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 06/27/2018] [Indexed: 12/01/2022] Open
Abstract
This study aimed to investigate the population-based incidence rate of ankle fracture and associated risk factors in China. All the data on ankle fractures were available from the China National Fracture Survey (CNFS) conducted between January and May in 2015. All eligible household members were sampled from 8 provinces, 24 urban cities and 24 rural counties in China, using stratified random sampling and the probability proportional to size method. Questionnaires were sent to every participant for data collection and quality control was accomplished by our quality control team members. A total of 512187 valid questionnaires were collected and relevant data were abstracted and analyzed. One hundred and ninety patients sustained 193 ankle fractures in 2014, indicating the incidence rate was 37.1 (95% CI, 31.8–42.4)/100,000 person-year. Alcohol consumption, living alone and average sleep time <7 h/d were identified as independent risk factors for ankle fracture in both males and females. Previous history of fracture was identified as significant risk factor of ankle fracture in females but not in males. Therefore, specific public health policies focusing on decreasing alcohol consumption and encouraging individuals to obtain sufficient sleep should be implemented. Individuals living alone should focus more on healthcare, especially in those with previous fracture.
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Affiliation(s)
- Song Liu
- Department of Orthopaedic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, P.R. China.,Key laboratory of biomechanics of Hebei Province, Shijiazhuang, Hebei, 050051, P.R. China
| | - Yanbin Zhu
- Department of Orthopaedic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, P.R. China.,Key laboratory of biomechanics of Hebei Province, Shijiazhuang, Hebei, 050051, P.R. China
| | - Wei Chen
- Department of Orthopaedic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, P.R. China.,Key laboratory of biomechanics of Hebei Province, Shijiazhuang, Hebei, 050051, P.R. China
| | - Lin Wang
- Department of Orthopaedic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, P.R. China.,Key laboratory of biomechanics of Hebei Province, Shijiazhuang, Hebei, 050051, P.R. China
| | - Xiaolin Zhang
- Department of statistics and epidemiology, Hebei Medical University, Shijiazhuang, Hebei, 050000, P.R. China
| | - Yingze Zhang
- Department of Orthopaedic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, P.R. China. .,Key laboratory of biomechanics of Hebei Province, Shijiazhuang, Hebei, 050051, P.R. China.
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Eto M, Miyauchi S. Falls After Ophthalmological Surgery Experience Among the Community-Dwelling Elderly in Japan. J Community Health Nurs 2017; 34:1-9. [PMID: 28156145 DOI: 10.1080/07370016.2017.1260977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Community-dwelling elderly are likely to fall even after ophthalmological surgery. To identify the association between falls and ophthalmological surgery and screening experiences among the community-dwelling elderly in Japan, a cross-sectional descriptive study examined 159 community-dwelling people aged ≥ 65 years about an extensive physical assessment, health status, experience of falls, and ophthalmic situations. In this city, the study identified an association between falls and both ophthalmological surgery experience and voluntary attendance at ophthalmic screening among the community-dwelling elderly. Japanese public health nurses should be a bridge between community-dwelling elderly and ophthalmologists in the community to promote attendance at ophthalmic screening.
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Affiliation(s)
- Maki Eto
- a Department of Public Health Nursing , Ube Frontier University , Ube , Japan
| | - Shinji Miyauchi
- b Department of Linguistics , Oita University of Nursing and Health Sciences , Oita , Japan
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Romli MH, Tan MP, Mackenzie L, Lovarini M, Suttanon P, Clemson L. Falls amongst older people in Southeast Asia: a scoping review. Public Health 2017; 145:96-112. [PMID: 28359399 DOI: 10.1016/j.puhe.2016.12.035] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 11/07/2016] [Accepted: 12/20/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The older population in the Southeast Asian region is accelerating and is expected to surpass the proportion of the ageing population in North America and Europe in the future. This study aims to identify the research literature related to falls among older people in Southeast Asia, to examine current practice and discuss the future direction on falls prevention and interventions in the region. STUDY DESIGN A scoping review design was used. METHODS A systematic literature search was conducted using the Medline, CINAHL, AMED, Ageline, PsycINFO, Web of Sciences, Scopus, Thai-Journal Citation Index, MyCite and trial registries databases. RESULTS Thirty-seven studies and six study protocols were included, from Thailand, Malaysia, Singapore, Vietnam, Indonesia and the Philippines. One-sixth of the studies involved interventions, while the remainder were observational studies. The observational studies mainly determined the falls risk factors. The intervention studies comprised multifactorial interventions and single interventions such as exercises, educational materials and visual correction. Many of the studies replicated international studies and may not have taken into account features unique to Southeast Asia. CONCLUSION Our review has revealed studies evaluating falls and management of falls in the Southeast Asian context. More research is required from all Southeast Asian countries to prepare for the future challenges of managing falls as the population ages.
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Affiliation(s)
- M H Romli
- Discipline of Occupational Therapy, Faculty of Health Sciences, Cumberland Campus, University of Sydney, 75 East Street, Lidcombe, NSW 2141, Australia; Department of Nursing and Rehabilitation, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia.
| | - M P Tan
- Ageing and Age Associated Disorders Research Group, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| | - L Mackenzie
- Discipline of Occupational Therapy, Faculty of Health Sciences, Cumberland Campus, University of Sydney, 75 East Street, Lidcombe, NSW 2141, Australia.
| | - M Lovarini
- Discipline of Occupational Therapy, Faculty of Health Sciences, Cumberland Campus, University of Sydney, 75 East Street, Lidcombe, NSW 2141, Australia.
| | - P Suttanon
- Faculty of Allied Health Sciences, Thammasat University, 99 Moo 18 Paholyothin Road, Klong Luang, Rangsit, Prathumthani 12120, Thailand.
| | - L Clemson
- Discipline of Occupational Therapy, Faculty of Health Sciences, Cumberland Campus, University of Sydney, 75 East Street, Lidcombe, NSW 2141, Australia.
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Meuleners LB, Hobday MB. A Population-Based Study Examining Injury in Older Adults with and without Dementia. J Am Geriatr Soc 2017; 65:520-525. [DOI: 10.1111/jgs.14523] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Lynn B. Meuleners
- Curtin-Monash Accident Research Centre; Faculty of Health Sciences; Curtin University; Perth Western Australia Australia
| | - Michelle B. Hobday
- Curtin-Monash Accident Research Centre; Faculty of Health Sciences; Curtin University; Perth Western Australia Australia
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Guerado E, Sandalio RM, Caracuel Z, Caso E. Understanding the pathogenesis of hip fracture in the elderly, osteoporotic theory is not reflected in the outcome of prevention programmes. World J Orthop 2016; 7:218-228. [PMID: 27114929 PMCID: PMC4832223 DOI: 10.5312/wjo.v7.i4.218] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 12/10/2015] [Accepted: 01/04/2016] [Indexed: 02/06/2023] Open
Abstract
Hip fractures are an acute and worsening public health problem. They mainly affect elderly people, a population group that is highly vulnerable to disease and accidents, and to falls in particular. Although it has been suggested that osteoporosis is the cause of hip fractures, they mainly occur after a fall has been suffered. The underlying causes of a fall are not related to osteoporosis, although pharmaceutical companies have coined the term “osteoporotic fracture” for hip fractures in the elderly. Drug treatments for osteoporosis have not diminished the frequency of these injuries, nor have they prevented the occurrence of a subsequent fracture. Since pharmaceutical interests require osteoporosis to be considered a disease, rather than a normal condition of senescence, they go further by assuming that treatment for osteoporosis is essential, and that this policy will diminish the incidence of hip fractures. On the other hand, the origin and treatment of conditions that may be conducive to provoking falls are very difficult to elucidate. In this paper, we consider some of the medical and social problems that arise in this area, as well as conflicts of interest regarding the aetiopathogenesis and prevention of hip fracture, and propose a new paradigm for the prevention of falls.
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Supuk E, Alderson A, Davey CJ, Green C, Litvin N, Scally AJ, Elliott DB. Dizziness, but not falls rate, improves after routine cataract surgery: the role of refractive and spectacle changes. Ophthalmic Physiol Opt 2015; 36:183-90. [PMID: 26549158 PMCID: PMC4949987 DOI: 10.1111/opo.12243] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 08/14/2015] [Indexed: 12/01/2022]
Abstract
Purpose To determine whether dizziness and falls rates change due to routine cataract surgery and to determine the influence of spectacle type and refractive factors. Methods Self‐reported dizziness and falls were determined in 287 patients (mean age of 76.5 ± 6.3 years, 55% females) before and after routine cataract surgery for the first (81, 28%), second (109, 38%) and both eyes (97, 34%). Dizziness was determined using the short‐form of the Dizziness Handicap Inventory. Six‐month falls rates were determined using self‐reported retrospective data. Results The number of patients with dizziness reduced significantly after cataract surgery (52% vs 38%; χ2 = 19.14,p < 0.001), but the reduction in the number of patients who fell in the 6‐months post surgery was not significant (23% vs 20%; χ2 = 0.87, p = 0.35). Dizziness improved after first eye surgery (49% vs 33%, p = 0.01) and surgery on both eyes (58% vs 35%, p < 0.001), but not after second eye surgery (52% vs 45%, p = 0.68). Multivariate logistic regression analyses found significant links between post‐operative falls and change in spectacle type (increased risk if switched into multifocal spectacles). Post‐operative dizziness was associated with changes in best eye visual acuity and changes in oblique astigmatic correction. Conclusions Dizziness is significantly reduced by first (or both) eye cataract surgery and this is linked with improvements in best eye visual acuity, although changes in oblique astigmatic correction increased dizziness. The lack of improvement in falls rate may be associated with switching into multifocal spectacle wear after surgery.
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Affiliation(s)
- Elvira Supuk
- Bradford School of Optometry and Vision Science, University of Bradford, West Yorkshire, UK
| | - Alison Alderson
- Bradford School of Optometry and Vision Science, University of Bradford, West Yorkshire, UK
| | - Christopher J Davey
- Bradford School of Optometry and Vision Science, University of Bradford, West Yorkshire, UK
| | - Clare Green
- Ophthalmology Department, Bradford Teaching Hospitals Foundation Trust, West Yorkshire, UK
| | - Norman Litvin
- Ophthalmology Department, Bradford Teaching Hospitals Foundation Trust, West Yorkshire, UK
| | - Andrew J Scally
- Faculty of Health Studies, University of Bradford, West Yorkshire, UK
| | - David B Elliott
- Bradford School of Optometry and Vision Science, University of Bradford, West Yorkshire, UK
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