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Crocker TF, Jordão M, Lam N, Ramiz R, Mirza L, Patel I, Ellwood A, Patetsini E, Ensor J, Forster A, Clegg A, Gladman J. Development of the Community-based complex Interventions to sustain Independence in Older People (CII-OP) typology: a qualitative synthesis of interventions in randomised controlled trials. Age Ageing 2024; 53:afae102. [PMID: 38796315 PMCID: PMC11127769 DOI: 10.1093/ageing/afae102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Indexed: 05/28/2024] Open
Abstract
INTRODUCTION Community-based services to sustain independence for older people have varying configurations. A typology of these interventions would improve service provision and research by providing conceptual clarity and enabling the identification of effective configurations. We aimed to produce such a typology. METHOD We developed our typology by qualitatively synthesising community-based complex interventions to sustain independence in older people, evaluated in randomised controlled trials (RCTs), in four stages: (i) systematically identifying relevant RCTs; (ii) extracting descriptions of interventions (including control) using the Template for Intervention Description and Replication; (iii) generating categories of key intervention features and (iv) grouping the interventions based on these categories. PROSPERO registration: CRD42019162195. RESULTS Our search identified 129 RCTs involving 266 intervention arms. The Community-based complex Interventions to sustain Independence in Older People (CII-OP) typology comprises 14 action components and 5 tailoring components. Action components include procedures for treating patients or otherwise intended to directly improve their outcomes; regular examples include formal homecare; physical exercise; health education; activities of daily living training; providing aids and adaptations and nutritional support. Tailoring components involve a process that may result in care planning, with multiple action components being planned, recommended or prescribed. Multifactorial action from care planning was the most common tailoring component. It involves individualised, multidomain assessment and management, as in comprehensive geriatric assessment. Sixty-three different intervention types (combinations) were identified. CONCLUSIONS Our typology provides an empirical basis for service planning and evidence synthesis. We recommend better reporting about organisational aspects of interventions and usual care.
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Affiliation(s)
- Thomas Frederick Crocker
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Magda Jordão
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Natalie Lam
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Ridha Ramiz
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Lubena Mirza
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Ismail Patel
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Alison Ellwood
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Eleftheria Patetsini
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Joie Ensor
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- Centre for Prognosis Research, Keele School of Medicine, Keele University, Keele, UK
| | - Anne Forster
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Andrew Clegg
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - John Gladman
- Centre for Rehabilitation and Ageing Research, Academic Unit of Injury, Inflammation and Recovery Sciences, University of Nottingham
- Health Care of Older People, Nottingham University Hospitals NHS Trust, Nottingham, UK
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Hager AGM, Mathieu N, Carrard S, Bridel A, Wapp C, Hilfiker R. Partially supervised exercise programmes for fall prevention improve physical performance of older people at risk of falling: a three-armed multi-centre randomised controlled trial. BMC Geriatr 2024; 24:311. [PMID: 38570773 PMCID: PMC10993430 DOI: 10.1186/s12877-024-04927-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 03/28/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Falls have a major impact on individual patients, their relatives, the healthcare system and related costs. Physical exercise programmes that include multiple categories of exercise effectively reduce the rate of falls and risk of falling among older adults. METHODS This 12-month, assessor-blinded, three-armed multicentre randomised clinical trial was conducted in adults aged ≥ 65 years identified as at risk of falling. Four hundred and five participants were randomly allocated into 3 groups: experimental group (n = 166) with the Test&Exercise partially supervised programme based on empowerment delivered with a tablet, illustrated manual and cards, reference group (n = 158) with the Otago partially supervised programme prescribed by a physiotherapist delivered with an illustrated manual and control group (n = 81) with the Helsana self-administrated programme delivered with cards. Experimental and reference groups received partially supervised programmes with 8 home sessions over 6 months. Control group received a self-administered program with a unique home session. The 3 groups were requested to train independently 3 times a week for 12 months. Primary outcome was the incidence rate ratio of self-reported falls over 12 months. Secondary outcomes were fear of falling, basic functional mobility and balance, quality of life, and exercise adherence. RESULTS A total of 141 falls occurred in the experimental group, 199 in the reference group, and 42 in the control group. Incidence rate ratios were 0.74 (95% CI 0.49 to 1.12) for the experimental group and 0.43 (95% CI 0.25 to 0.75) for the control group compared with the reference group. The Short Physical Performance Battery scores improved significantly in the experimental group (95% CI 0.05 to 0.86; P = 0.027) and in the reference group (95% CI 0.06 to 0.86; P = 0.024) compared with the control group. CONCLUSION The self-administered home-based exercise programme showed the lowest fall incidence rate, but also the highest dropout rate of participants at high risk of falling. Both partially supervised programmes resulted in statistically significant improvements in physical performance compared with the self-administered programme. TRIAL REGISTRATION NCT02926105. CLINICALTRIALS gov. Date of registration: 06/10/2016.
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Affiliation(s)
- Anne-Gabrielle Mittaz Hager
- School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland, Valais, Sion, Switzerland.
- School of Health Sciences, HES-SO Valais-Wallis, Rathaustrasse 25, 3941, Leukerbad, Switzerland.
| | - Nicolas Mathieu
- School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland, Valais, Sion, Switzerland
| | - Sophie Carrard
- School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland, Valais, Sion, Switzerland
| | - Alice Bridel
- Bern University of Applied Sciences, Department of Health Professions, Bern, Switzerland
| | - Christina Wapp
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Roger Hilfiker
- School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland, Valais, Sion, Switzerland
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Bjerk M, Flottorp SA, Pripp AH, Øien H, Hansen TM, Foy R, Close J, Linnerud S, Brovold T, Solli R, Olsen NR, Skelton DA, Rydwik E, Helbostad JL, Idland G, Kvæl L, Vieira E, Taraldsen K. Tailored implementation of national recommendations on fall prevention among older adults in municipalities in Norway (FALLPREVENT trial): a study protocol for a cluster-randomised trial. Implement Sci 2024; 19:5. [PMID: 38273325 PMCID: PMC10811923 DOI: 10.1186/s13012-024-01334-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/02/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Despite substantial research evidence indicating the effectiveness of a range of interventions to prevent falls, uptake into routine clinical practice has been limited by several implementation challenges. The complexity of fall prevention in municipality health care underlines the importance of flexible implementation strategies tailored both to general determinants of fall prevention and to local contexts. This cluster-randomised trial (RCT) investigates the effectiveness of a tailored intervention to implement national recommendations on fall prevention among older home-dwelling adults compared to usual practice on adherence to the recommendations in health professionals. METHODS Twenty-five municipalities from four regions in Norway will be randomised to intervention or control arms. Each municipality cluster will recruit up to 30 health professionals to participate in the study as responders. The tailored implementation intervention comprises four components: (1) identifying local structures for implementation, (2) establishing a resource team from different professions and levels, (3) promoting knowledge on implementation and fall prevention and (4) supporting the implementation process. Each of these components includes several implementation activities. The Consolidated Framework for Implementation Research (CFIR) will be used to categorise determinants of the implementation process and the Expert Recommendations for Implementing Change (ERIC) will guide the matching of barriers to implementation strategies. The primary outcome measure for the study will be health professionals' adherence to the national recommendations on fall prevention measured by a questionnaire. Secondary outcomes include injurious falls, the feasibility of the intervention, the experiences of the implementation process and intervention costs. Measurements will be carried out at baseline in August 2023, post-intervention in May 2024 and at a follow-up in November 2024. DISCUSSION This study will provide evidence on the effectiveness, intervention costs and underlying processes of change of tailored implementation of evidence-based fall prevention recommendations. TRIAL REGISTRATION The trial is registered in the Open Science Registry: https://doi.org/10.17605/OSF.IO/JQ9T5 . Registered: March 03, 2023.
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Affiliation(s)
- Maria Bjerk
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University (OsloMet), Oslo, Norway.
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway.
| | - Signe A Flottorp
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Are Hugo Pripp
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University (OsloMet), Oslo, Norway
- Oslo Centre of Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Henning Øien
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Tonya Moen Hansen
- Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Jacqueline Close
- Neuroscience Research Australia, Randwick, NSW, Australia
- Prince of Wales Hospital, SESLHD, Randwick, NSW, Australia
| | - Siv Linnerud
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University (OsloMet), Oslo, Norway
| | - Therese Brovold
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University (OsloMet), Oslo, Norway
| | - Rune Solli
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University (OsloMet), Oslo, Norway
| | - Nina Rydland Olsen
- Department of Health and Functioning, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Dawn A Skelton
- Research Centre for Health (ReaCH), Department of Physiotherapy and Paramedicine, School of Health & Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Elisabeth Rydwik
- Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Solna, Sweden
| | - Jorunn L Helbostad
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health, NTNU, Trondheim, Norway
| | - Gro Idland
- Agency for Health, Municipality of Oslo, Oslo, Norway
| | - Linda Kvæl
- Department of Housing and Ageing Research, Norwegian Social Research - NOVA, Oslo Metropolitan University (OsloMet), Oslo, Norway
| | - Edgar Vieira
- Department of Physical Therapy, Florida International University, Miami, FL, USA
| | - Kristin Taraldsen
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University (OsloMet), Oslo, Norway
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Orts-Cortés MI, Cabañero-Martínez MJ, Meseguer-Liza C, Arredondo-González CP, de la Cuesta-Benjumea C, Abad-Corpa E. Effectiveness of nursing interventions in the prevention of falls in older adults in the community and in health care settings: A systematic review and meta-analysis of RCT. ENFERMERIA CLINICA (ENGLISH EDITION) 2024; 34:4-13. [PMID: 38185371 DOI: 10.1016/j.enfcle.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 08/09/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE To estimate the effectiveness of fall prevention programs in people aged 65 years and older involving nursing professionals. METHODS We included available full-text randomized clinical trials on nurse-led prevention of falls in the community in people over 65 years of age and reporting the incidence of such falls. An extensive search was performed in 14 databases covering the period 2016-2018 for publications in English, French, Portuguese and Spanish. The quality of the papers was assessed independently and blindly by reviewers working in pairs using the risk of bias dominios of the Cochrane Collaboration. The hazard ratio was used as a measure of the effect size of the incidence of falls. A random-effects model was assumed for statistical analyses. The influence of moderator variables of the studies on the effect sizes was performed using ANOVAs and its 95% CI for each moderator category. RESULTS A total of 31 randomized clinical trials were selected with 25,551 participants. The most frequent type of intervention was education (57.1%), followed by multifactorial models (37.1%). The probability of falling was significantly reduced by 13% in the intervention groups compared to the control groups (RR+=0.87). Multifactorial (RR+=0.89) and education-based (RR=+0.84) interventions significantly reduced the probability of falls by 11% and 16%, respectively. CONCLUSIONS Discarding publication bias prevention programs carried out by nurses produce a significant 10% reduction in falls. Education-based and multifactorial interventions are the most effective when conducted by nurses.
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Affiliation(s)
- María Isabel Orts-Cortés
- Department of Nursing, University of Alicante, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Nursing and Healthcare Research Unit (Investén-ISCIII), CIBER of Frailty and Healthy Aging (CIBERFES) Instituto de Salud Carlos III, Madrid, Spain
| | - María José Cabañero-Martínez
- Department of Nursing, University of Alicante, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Cristóbal Meseguer-Liza
- Adjunct Professor of Nursing, University of Murcia, Nurse Murcia Health Service, Murcia, Spain
| | | | | | - Eva Abad-Corpa
- University of Murcia, Nurse, Murcia Health Service, IMIB-Arrixaca. Murcia, Nursing and Healthcare Research Unit (Investén-ISCIII), CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain.
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Ylitörmänen T, Nuotio MS, Kettunen H, Impinen A, Koivula R, Haikonen K. Trends of fall-related and other fatal injuries in older adults in Finland between 1998 and 2020. Eur J Public Health 2023; 33:1065-1070. [PMID: 37824274 PMCID: PMC10710353 DOI: 10.1093/eurpub/ckad177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND The number of falls and fall-related injuries will likely increase as the number of older adults expands. Increases in total deaths due to falls have been observed over Europe. Less is known about other injuries leading to death. To examine the incidence trends of fall-related and other fatal injuries among adults aged 65 or older in Finland. METHODS We analyzed open data from Statistics Finland's register on the causes of death of those aged ≥65 collected between 1998 and 2020 yielding a total of 32 150 deaths due to injury using Poisson regression and distributional comparisons chi-squared tests. RESULTS The most common injuries leading to death among people aged ≥65 in Finland were fall related. There has been an increase in the absolute number of fall-related and other injuries, but when adjusting for person-years in population, a significant decrease can be observed. The crude rates of deaths from fall-related injuries among males annually increased 1.1-4.4% from 1998 to 2020, while the changes in rates among females ranged between -2% and 1.6%. The crude rates of other injuries ranged between -0.5% to +3.8%. Recently (2018-20), nearly 40% of the cases in males and 25% of cases in females were not fall related but comprised other types of injury mechanisms such as traffic, poisoning and drowning. CONCLUSION Strengthening the implementation of preventive strategies is essential to prevent injuries. To reduce injury-related mortality and disability, improvement of acute and post-acute care for injured older patients is warranted.
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Affiliation(s)
- Tuija Ylitörmänen
- Department of Public Health and Welfare Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Maria S Nuotio
- Department of Geriatric Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Hanna Kettunen
- Department of Public Health and Welfare Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Antti Impinen
- Department of Public Health and Welfare Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Riitta Koivula
- Department of Public Health and Welfare Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Kari Haikonen
- Department of Public Health and Welfare Finnish Institute for Health and Welfare, Helsinki, Finland
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Dong Y, Zhang Y, Song K, Kang H, Ye D, Li F. What was the Epidemiology and Global Burden of Disease of Hip Fractures From 1990 to 2019? Results From and Additional Analysis of the Global Burden of Disease Study 2019. Clin Orthop Relat Res 2023; 481:1209-1220. [PMID: 36374576 PMCID: PMC10194687 DOI: 10.1097/corr.0000000000002465] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 09/29/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Hip fractures are associated with a high risk of death; among those who survive a hip fracture, many experience substantial decreases in quality of life. A comprehensive understanding of the epidemiology and burden of hip fractures by country, age, gender, and sociodemographic factors would provide valuable information for healthcare policymaking and clinical practice. The Global Burden of Disease (GBD) study 2019 was a global-level study estimating the burden of 369 diseases and injuries in 204 countries and territories. An exploration and additional analysis of the GBD 2019 would provide a clearer picture of the incidence and burden of hip fractures. QUESTIONS/PURPOSES Using data from the GBD 2019, we asked, (1) What are the global, regional, and national incidences of hip fractures, and how did they change over a recent 30-year span? (2) What is the global, regional, and national burden of hip fractures in terms of years lived with disability, and how did it change over that same period? (3) What is the leading cause of hip fractures? (4) How did the incidence and years lived with disability of patients with hip fractures change with age, gender, and sociodemographic factors? METHODS This was a cross-sectional study. Participant data were obtained from the GBD 2019 ( http://ghdx.healthdata.org/gbd-results-tool ). The GBD study is managed by the WHO, coordinated by the Institute of Health Metrics and Evaluation, and funded by the Bill and Melinda Gates Foundation. It estimates the burden of disease and injury for 204 countries by age, gender, and sociodemographic factors, and can serve as a valuable reference for health policymaking. All estimates and their 95% uncertainty interval (UI) were produced using DisMod-MR 2.1, a Bayesian meta-regression tool in the GBD 2019. In this study, we directly pulled the age-standardized incidence rate and years lived with disability rate of hip fractures by location, age, gender, and cause from the GBD 2019. Based on these data, we analyzed the association between the incidence rate and latitude of each country. Then, we calculated the estimated annual percentage change to represent trends from 1990 to 2019. We also used the Spearman rank-order correlation analysis to determine the correlation between the incidence or burden of hip fractures and the sociodemographic index, a composite index of the income per capita, average years of educational attainment, and fertility rates in a country. RESULTS Globally, hip fracture incidences were estimated to be 14.2 million (95% UI 11.1 to 18.1), and the associated years lived with disability were 2.9 million (95% UI 2.0 to 4.0) in 2019, with an incidence of 182 (95% UI 142 to 231) and 37 (95% UI 25 to 50) per 100,000, respectively. A strong, positive correlation was observed between the incidence rate and the latitude of each country (rho = 0.65; p < 0.001). From 1990 to 2019, the global incidence rate for both genders remained unchanged (estimated annual percentage change 0.01 [95% confidence interval -0.08 to 0.11]), but was slightly increased in men (estimated annual percentage change 0.11 [95% CI 0.01 to 0.2]). The years lived with disability rate decreased slightly (estimated annual percentage change 0.66 [95% CI -0.73 to -0.6]). These rates were standardized by age. Falls were the leading cause of hip fractures, accounting for 66% of all patients and 55% of the total years lived with disability. The incidence of hip fractures was tightly and positively correlated with the sociodemographic index (rho 0.624; p < 0.001), while the years lived with disability rate was slightly negatively correlated (rho -0.247; p < 0.001). Most hip fractures occurred in people older than 70 years, and women had higher incidence rate (189.7 [95% UI 144.2 to 247.2] versus 166.2 [95% UI 133.2 to 205.8] per 100,000) and years lived with disability (38.4 [95% UI 26.9 to 51.6] versus 33.7 [95% UI 23.1 to 45.5] per 100,000) than men. CONCLUSION Hip fractures are common, devastating to patients, and economically burdensome to healthcare systems globally, with falls being the leading cause. The age-standardized incidence rate has slightly increased in men. Many low-latitude countries have lower incidences, possibly because of prolonged sunlight exposure. Policies should be directed to promoting public health education about maintaining bone-protective lifestyles, enhancing the knowledge of osteoporosis management in young resident physicians and those in practice, increasing the awareness of osteoporosis screening and treatment in men, and developing more effective antiosteoporosis drugs for clinical use. LEVEL OF EVIDENCE Level III, prognostic study.
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Affiliation(s)
- Yimin Dong
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Yayun Zhang
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Kehan Song
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Honglei Kang
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Dawei Ye
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Feng Li
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
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Hayashi S, Misu Y, Sakamoto T, Yamamoto T. Cross-Sectional Analysis of Fall-Related Factors with a Focus on Fall Prevention Self-Efficacy and Self-Cognition of Physical Performance among Community-Dwelling Older Adults. Geriatrics (Basel) 2023; 8:geriatrics8010013. [PMID: 36648918 PMCID: PMC9887588 DOI: 10.3390/geriatrics8010013] [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: 11/30/2022] [Revised: 01/06/2023] [Accepted: 01/10/2023] [Indexed: 01/17/2023] Open
Abstract
This study aimed to determine how fall prevention self-efficacy and degree of deviation in self-cognition of physical performance, which have recently received attention for their potential to explain falls in combination with a wide variety of fall-related factors, as well as affect falls. Older adults using day-care services (n = 27 with six men, mean age: 81.41 ± 7.43 years) were included in this study. Fall history in the past year, the modified fall efficacy scale (MFES), and physical performance and cognition errors were examined by evaluating the functional reach test (FRT), the stepping over test, and the timed up and go test (TUG), along with a questionnaire. In the fall (n = 14) and non-fall (n = 13) groups, logistic regression analysis using Bayesian statistical methods was used to identify factors associated with falls. The odds ratios for the MFES ranged from 0.97 to 1.0, while those of cognition-error items ranged from 3.1 to 170.72. These findings suggested that deviation in self-cognition of physical performance, particularly overestimation of timed cognitive ability, was a factor with more explanatory power for fall history. Future studies should analyze differences by disease and age group, which were not clarified in this study, to identify more detailed fall risk factors.
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Affiliation(s)
- Shintaro Hayashi
- Graduate School of Rehabilitation, Kobe Gakuin University, Kobe 651-2180, Japan
- Department of Physical Therapy, Faculty of Rehabilitation, Morinomiya University of Medical Sciences, Osaka 559-8611, Japan
- Correspondence:
| | - Yuka Misu
- Graduate School of Rehabilitation, Kobe Gakuin University, Kobe 651-2180, Japan
| | - Toshimasa Sakamoto
- Department of Physical Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Kobe 651-2180, Japan
| | - Taisei Yamamoto
- Department of Physical Therapy, School of Health Sciences, Tokyo International University, Kawagoe 350-1197, Japan
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A community-based single fall prevention exercise intervention for older adults (STEADY FEET): Study protocol for a randomised controlled trial. PLoS One 2022; 17:e0276385. [PMID: 36264909 PMCID: PMC9584377 DOI: 10.1371/journal.pone.0276385] [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: 08/03/2022] [Accepted: 09/20/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Falls and fall-related injuries in older adults are a leading cause of disability and death. Evidence has shown the benefits of exercises in improving functional outcomes and reducing fall rates among community-dwelling older adults. However, there is lack of effective community-based single exercise intervention for a broad population of older adults who are at high risk for falls. We aim to evaluate the effectiveness of Steady Feet (SF), a 6-month tailored community fall prevention exercise programme for improving functional outcomes. SF classes are facilitated by community fitness instructors and an exercise video. The main outcome is between-group changes in short physical performance battery (SPPB) scores. Secondary outcomes include balance confidence, fear of falling, quality of life, fall rates, and cost effectiveness. METHODS We present the design of a 6-month randomised controlled trial of 260 older adults (≥ 60 years old). Individuals will be randomised in a 1:1 allocation ratio to the SF group or usual care group. Participants will be assessed at baseline, 3-month, and 6-month. Data on socio-demographics, co-morbidities, balance confidence, fear of falling, quality of life, physical activity level, rate of perceived exertion, fall(s) history, healthcare utilisation and cost, and satisfaction levels will be collected. Participants will also undergo functional assessments such as SPPB. Moreover, providers' satisfaction and feedback will be obtained at 3-month. DISCUSSION An effective community fall prevention programme may lead to improved functional outcomes and reduced fall rates. Findings will also help inform the implementation and scaling of SF nation-wide. TRIAL REGISTRATION Clinicaltrials.gov registration: NCT04801316. Registered on 15th March 2021.
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Guo X, Wang Y, Wang L, Yang X, Yang W, Lu Z, He M. Effect of a fall prevention strategy for the older patients: A quasi-experimental study. Nurs Open 2022; 10:1116-1124. [PMID: 36178024 PMCID: PMC9834535 DOI: 10.1002/nop2.1379] [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: 09/28/2021] [Revised: 03/02/2022] [Accepted: 09/06/2022] [Indexed: 01/19/2023] Open
Abstract
AIM To explore the effect of a fall prevention strategy on older patients based on the Patient Engagement Framework. DESIGN A longitudinal quasi-experimental quantitative design. METHODS Older patients who met the inclusion criteria were recruited from geriatric, oncology, neurology and cardiology departments of a teaching general hospital in China. Development of a fall prevention intervention strategy for older patients was based on the Patient Engagement Framework. Patients in the intervention group were given this fall prevention strategy (N = 58), and those in the control group were given conventional measures (N = 58). The following indicators were compared between the two groups after intervention: (a) number of falls; (b) Knowledge-Attitude-Practice (KAP) score; (c) Modified Fall Efficacy Scale score. RESULTS After the implementation of an intervention strategy in older patients, the number of falls decreased from 3 to 0; the score of KAP and Modified Fall Efficacy Scale was promoted (p < .05).
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Affiliation(s)
- Xiaobei Guo
- Nursing Department, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - Ying Wang
- Nursing Department, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - Lei Wang
- Nursing Department, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - Xueke Yang
- Nursing Department, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - Weimei Yang
- Internal Medicine, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - Zhihui Lu
- Nursing Department, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - Mei He
- Intensive Care Medicine, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
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10
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Leland NE, Lekovitch C, Martínez J, Rouch S, Harding P, Wong C. Optimizing Post-Acute Care Patient Safety: A Scoping Review of Multifactorial Fall Prevention Interventions for Older Adults. J Appl Gerontol 2022; 41:2187-2196. [PMID: 35618304 DOI: 10.1177/07334648221104375] [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: 11/17/2022] Open
Abstract
Accidental falls are preventable adverse events for older post-acute care (PAC) patients. Yet, due to the functional and medical care needs of this population, there is little guidance to inform multidisciplinary prevention efforts. This scoping review aims to characterize the evidence for multifactorial PAC fall prevention interventions. Of the 33 included studies, common PAC intervention domains included implementing facility-based strategies (e.g., staff education), evaluating patient-specific fall risk factors (e.g., function), and developing an individualized risk profile and treatment plan that targets the patient's constellation of fall risk factors. However, there was variability across studies in how and to what extent the domains were addressed. While further research is warranted, health system efforts to prevent accidental falls in PAC should consider a patient-centered multifactorial approach that fosters a culture of safety, addresses individuals' fall risk, and champions a multidisciplinary team.
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Affiliation(s)
- Natalie E Leland
- Department of Occupational Therapy, 6614University of Pittsburgh, Pittsburgh, PA, USA
| | - Cara Lekovitch
- Department of Occupational Therapy, 6614University of Pittsburgh, Pittsburgh, PA, USA
| | - Jenny Martínez
- Department of Occupational Therapy, 6559Jefferson College of Rehabilitation Sciences, Philadelphia, PA, USA
| | - Stephanie Rouch
- Department of Occupational Therapy, 6614University of Pittsburgh, Pittsburgh, PA, USA
| | - Patrick Harding
- Chan Division of Occupational Science and Occupational Therapy, 5116University of Southern California, Los Angeles, CA, USA
| | - Carin Wong
- Department of Sociology, 14669California State University Los Angeles, Los Angeles, CA, USA
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11
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Lima DP, de-Almeida SB, Bonfadini JDC, Carneiro AHS, de Luna JRG, de Alencar MS, Viana-Júnior AB, Rodrigues PGB, Pereira IDS, Roriz-Filho JDS, Sobreira-Neto MA, Braga-Neto P. Falls in Parkinson's disease: the impact of disease progression, treatment, and motor complications. Dement Neuropsychol 2022; 16:153-161. [PMID: 35720647 PMCID: PMC9173793 DOI: 10.1590/1980-5764-dn-2021-0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 08/10/2021] [Accepted: 10/09/2021] [Indexed: 11/22/2022] Open
Abstract
The prevalence of Parkinson's disease (PD) tends to increase worldwide in the coming decades. Thus, the incidence of falls is likely to increase, with a relevant burden on the health care system.
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Affiliation(s)
- Danielle Pessoa Lima
- Universidade Federal do Ceará, Departamento de Clínica Médica, Divisão de Neurologia, Fortaleza CE, Brazil.,Universidade Federal do Ceará, Departamento de Clínica Médica, Divisão de Geriatria, Fortaleza CE, Brazil.,Universidade de Fortaleza, Faculdade de Medicina, Fortaleza CE, Brazil.,Universidade Federal do Ceará, Hospital Universitário Walter Cantídio, Unidade de Pesquisa Clínica, Fortaleza CE, Brazil
| | - Samuel Brito de-Almeida
- Universidade Federal do Ceará, Hospital Universitário Walter Cantídio, Unidade de Pesquisa Clínica, Fortaleza CE, Brazil
| | - Janine de Carvalho Bonfadini
- Universidade Federal do Ceará, Departamento de Clínica Médica, Divisão de Neurologia, Fortaleza CE, Brazil.,Universidade Federal do Ceará, Departamento de Clínica Médica, Divisão de Geriatria, Fortaleza CE, Brazil.,Universidade Federal do Ceará, Hospital Universitário Walter Cantídio, Unidade de Pesquisa Clínica, Fortaleza CE, Brazil
| | | | - João Rafael Gomes de Luna
- Universidade Federal do Ceará, Departamento de Clínica Médica, Divisão de Geriatria, Fortaleza CE, Brazil
| | - Madeleine Sales de Alencar
- Universidade Federal do Ceará, Departamento de Clínica Médica, Divisão de Geriatria, Fortaleza CE, Brazil
| | - Antonio Brazil Viana-Júnior
- Universidade Federal do Ceará, Hospital Universitário Walter Cantídio, Unidade de Pesquisa Clínica, Fortaleza CE, Brazil
| | - Pedro Gustavo Barros Rodrigues
- Universidade Federal do Ceará, Hospital Universitário Walter Cantídio, Unidade de Pesquisa Clínica, Fortaleza CE, Brazil
| | - Isabelle de Sousa Pereira
- Universidade Federal do Ceará, Hospital Universitário Walter Cantídio, Unidade de Pesquisa Clínica, Fortaleza CE, Brazil
| | - Jarbas de Sá Roriz-Filho
- Universidade Federal do Ceará, Departamento de Clínica Médica, Divisão de Geriatria, Fortaleza CE, Brazil
| | - Manoel Alves Sobreira-Neto
- Universidade Federal do Ceará, Departamento de Clínica Médica, Divisão de Neurologia, Fortaleza CE, Brazil.,Universidade Federal do Ceará, Hospital Universitário Walter Cantídio, Unidade de Pesquisa Clínica, Fortaleza CE, Brazil.,Universidade Unichristus, Faculdade de Medicina, Fortaleza CE, Brazil
| | - Pedro Braga-Neto
- Universidade Federal do Ceará, Departamento de Clínica Médica, Divisão de Neurologia, Fortaleza CE, Brazil.,Universidade Federal do Ceará, Hospital Universitário Walter Cantídio, Unidade de Pesquisa Clínica, Fortaleza CE, Brazil.,Universidade Estadual do Ceará, Centro de Ciência da Saúde, Fortaleza CE, Brazil
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12
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Somasekhar PY, Wu N, Hung BY, Morley JE, Malmstrom TK. Validation of F3ALLS Assessment in Older Adults. J Nutr Health Aging 2022; 26:1042-1046. [PMID: 36519766 PMCID: PMC9470502 DOI: 10.1007/s12603-022-1841-5] [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: 06/13/2022] [Accepted: 08/22/2022] [Indexed: 01/04/2023]
Abstract
OBJECTIVES The study aimed to evaluate the brief F3ALLS assessment's validity in screening fall risk. DESIGN This is a cross sectional and longitudinal study. SETTING Participants were recruited from outpatient primary care clinics. PARTICIPANTS Older ambulatory adults ages 65-90 volunteered for this study. MEASUREMENTS Falls risk was measured with TGBA and F3ALLS questionnaires. A 6-month follow-up period assessed for falls using falls diaries and chart review. RESULTS Participants (n=97) were older adults ages 73.91±6.4, 68% (n=66) female. 31% of participants reported at least one fall at 6-months. F3ALLS scores were higher in participants who reported 1 or more falls at 6-months follow-up (3.23±1.5). Higher F3ALLS scores were associated with 6-month fall risk (OR=1.463, 95% CI=1.098-1.949). A score > 3 stratified patients as at risk of falling (AUC=0.77, P<.001; Sensitivity=0.65, Specificity=0.71). CONCLUSION The F3ALLS questionnaire adequately classifies person at risk versus not at risk for falls, and higher (worse) F3ALLS scores are associated with falls over 6 months.
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Affiliation(s)
- P Y Somasekhar
- Theodore K. Malmstrom, PhD, 1438 South Grand Boulevard, St. Louis, MO 63104, USA, 314-977-4814 (office),
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13
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Lopes LP, Nogueira IS, Dias JR, Baldissera VDA. Processo de cuidado para prevenção de quedas em idosos: teoria de intervenção práxica da enfermagem. ESCOLA ANNA NERY 2022. [DOI: 10.1590/2177-9465-ean-2021-0254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo analisar o processo de cuidado para prevenção de quedas em idosos na perspectiva teórica e metodológica da Teoria de Intervenção Práxica da Enfermagem em Saúde Coletiva. Métodos estudo transversal descritivo de abordagem qualitativa do tipo pesquisa-cuidado, realizado com participantes de um grupo de convivência de uma Unidade Básica de Saúde em Maringá-PR. Os dados foram coletados a partir de entrevistas semiestruturadas e analisados utilizando a Teoria de Intervenção Práxica da Enfermagem em Saúde Coletiva. Resultados realizou-se a captação e interpretação dos dados nas dimensões estrutural, particular e singular, seguido da avaliação de saúde e identificação dos principais riscos intrínsecos e extrínsecos para quedas dos idosos. Os principais diagnósticos e intervenções de enfermagem foram elencados segundo a CIPE®/CIPESC®. Conclusões e implicações para prática foi possível analisar o processo de cuidado na prevenção de quedas junto aos idosos por meio da perspectiva teórica e metodológica na Teoria de Intervenção Práxica da Enfermagem em Saúde Coletiva, sendo proposto um plano de intervenções de enfermagem.
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14
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The epidemiology of falls in Portugal: An analysis of hospital admission data. PLoS One 2021; 16:e0261456. [PMID: 34936669 PMCID: PMC8694436 DOI: 10.1371/journal.pone.0261456] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 12/02/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Falls are a common cause of injury and pose an increased risk of morbidity, mortality, and lifelong disability. Falls encompass a troublesome definition and can pose challenges in epidemiological studies. Data on fall-related hospital admissions in Portugal remain unpublished. This study aimed to examine the epidemiology of fall-related hospital admissions in the Portuguese population between 2010 and 2018. It also aimed to examine annual rates of fall-related hospital admissions using three methodological approaches. METHODS The Portuguese Hospital Morbidity Database was used to identify all cases resulting in one or more inpatient admission in public hospitals related to falls from 2010 to 2018. Fall-related hospital admissions were described by age groups, sex, geographical area of residence, and type of fall. Annual rates were computed using three approaches: i) based on the number of inpatient admissions with an ICD code of fall, ii) based on the number of patients admitted to inpatient care with an ICD code of fall, and iii) based on the number of inpatient admissions with a principal diagnosis of injury. RESULTS Between 2010 and 2018, 383,016 fall-related admissions occurred in 344,728 patients, corresponding to 2.1% of the total number of hospitalizations during the same period. Higher rates were seen among the younger (20-25) and the oldest age groups (+85), males until the age of 60, females from the age of 60, and areas of residence with a higher aging index. An overall rate of falls per 100,000 population was estimated at 414 (based on number of admissions), 373 (based on number of patients) and 353 (based on number of admissions with a principal diagnosis of injury). CONCLUSIONS This study provides an overall picture of the landscape of falls in a scarcely explored setting. The results aim to contribute to identifying appropriate preventive interventions and policies for these populations.
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15
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Lei DY, Cheng JH, Chen CM, Huang KP, James Chou C. Discussion of Teaching With Multiple Intelligences to Corporate Employees' Learning Achievement and Learning Motivation. Front Psychol 2021; 12:770473. [PMID: 34733224 PMCID: PMC8558210 DOI: 10.3389/fpsyg.2021.770473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 09/20/2021] [Indexed: 11/22/2022] Open
Abstract
The development of multiple intelligences used to focus on kindergartens and elementary schools as educational experts and officials considered that the development of students' multiple intelligences should be cultivated from childhood and slowly promoted to other levels. Nevertheless, the framework of multiple intelligences should not be simply promoted in kindergartens and elementary schools, but was also suitable in high schools, universities, and even graduate schools or in-service training. Taking employees in Southern Taiwan Science Park as the research subjects, total 314 employees in high-tech industry are preceded the 16-week (3 h per week for total 48 h) experimental teaching research. The research results show that (1) teaching with multiple intelligences would affect learning motivation, (2) teaching with multiple intelligences would affect learning achievement, and (3) learning motivation reveals remarkably positive effects on learning achievement. According to the results to proposed discussions, it is expected to help high-tech industry, when developing human resource potential, effectively well-utilize people's gifted uniqueness
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Affiliation(s)
- Di-Yu Lei
- Fuzhou University of International Studies and Trade, Fuzhou, China
| | - Jui-Hsi Cheng
- College of Business and Management, Xiamen Huaxia University, Fuzhou, China
| | - Chih-Ming Chen
- School of Business, Fuzhou Institute of Technology, Fuzhou, China
| | - Kai-Ping Huang
- Department of Business Administration, Social Enterprise Research Center, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Chiyang James Chou
- Master Program in Entrepreneurial Management, National Yunlin University of Science and Technology, Yulin, Taiwan
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16
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Sex Differences in Modifiable Fall Risk Factors. J Nurse Pract 2021. [DOI: 10.1016/j.nurpra.2021.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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17
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Dautzenberg L, Beglinger S, Tsokani S, Zevgiti S, Raijmann RCMA, Rodondi N, Scholten RJPM, Rutjes AWS, Di Nisio M, Emmelot-Vonk M, Tricco AC, Straus SE, Thomas S, Bretagne L, Knol W, Mavridis D, Koek HL. Interventions for preventing falls and fall-related fractures in community-dwelling older adults: A systematic review and network meta-analysis. J Am Geriatr Soc 2021; 69:2973-2984. [PMID: 34318929 PMCID: PMC8518387 DOI: 10.1111/jgs.17375] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 05/19/2021] [Accepted: 06/11/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To compare the effectiveness of single, multiple, and multifactorial interventions to prevent falls and fall-related fractures in community-dwelling older persons. METHODS MEDLINE, Embase, and Cochrane Central Register of Controlled Trials were systematically searched for randomized controlled trials (RCTs) evaluating the effectiveness of fall prevention interventions in community-dwelling adults aged ≥65 years, from inception until February 27, 2019. Two large RCTs (published in 2020 after the search closed) were included in post hoc analyses. Pairwise meta-analysis and network meta-analysis (NMA) were conducted. RESULTS NMA including 192 studies revealed that the following single interventions, compared with usual care, were associated with reductions in number of fallers: exercise (risk ratio [RR] 0.83; 95% confidence interval [CI] 0.77-0.89) and quality improvement strategies (e.g., patient education) (RR 0.90; 95% CI 0.83-0.98). Exercise as a single intervention was associated with a reduction in falls rate (RR 0.79; 95% CI 0.73-0.86). Common components of multiple interventions significantly associated with a reduction in number of fallers and falls rate were exercise, assistive technology, environmental assessment and modifications, quality improvement strategies, and basic falls risk assessment (e.g., medication review). Multifactorial interventions were associated with a reduction in falls rate (RR 0.87; 95% CI 0.80-0.95), but not with a reduction in number of fallers (RR 0.95; 95% CI 0.89-1.01). The following single interventions, compared with usual care, were associated with reductions in number of fall-related fractures: basic falls risk assessment (RR 0.60; 95% CI 0.39-0.94) and exercise (RR 0.62; 95% CI 0.42-0.90). CONCLUSIONS In keeping with Tricco et al. (2017), several single and multiple fall prevention interventions are associated with fewer falls. In addition to Tricco, we observe a benefit at the NMA-level of some single interventions on preventing fall-related fractures.
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Affiliation(s)
- Lauren Dautzenberg
- Department of Geriatric Medicine, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Shanthi Beglinger
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Sofia Tsokani
- Department of Primary Education, School of Education, University of Ioannina, Ioannina, Greece
| | - Stella Zevgiti
- Department of Primary Education, School of Education, University of Ioannina, Ioannina, Greece
| | - Renee C M A Raijmann
- Department of Geriatric Medicine, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Nicolas Rodondi
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Rob J P M Scholten
- Cochrane Netherlands/Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Anne W S Rutjes
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.,Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Marcello Di Nisio
- Department of Medicine and Ageing Sciences, University G. D'Annunzio, Chieti, Italy
| | - Marielle Emmelot-Vonk
- Department of Geriatric Medicine, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Andrea C Tricco
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.,Epidemiology Division and Institute for Health Policy, Management, and Evaluation, Dalla Lana School of Public Health and Institute for Health, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Sharon E Straus
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.,Epidemiology Division and Institute for Health Policy, Management, and Evaluation, Dalla Lana School of Public Health and Institute for Health, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Department of Geriatric Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sonia Thomas
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Lisa Bretagne
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Wilma Knol
- Department of Geriatric Medicine, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Dimitris Mavridis
- Department of Primary Education, School of Education, University of Ioannina, Ioannina, Greece.,Paris Descartes University, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - Huiberdina L Koek
- Department of Geriatric Medicine, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
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18
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Development of the Home Fall Hazard Checklist. Rehabil Res Pract 2021; 2021:5362197. [PMID: 34158978 PMCID: PMC8187056 DOI: 10.1155/2021/5362197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 05/18/2021] [Indexed: 11/17/2022] Open
Abstract
Objective Home hazard assessment is particularly important following a fracture as a means of preventing subsequent fractures. The purpose of this study was to evaluate current checklists and evidence on home hazard to develop a usable self-administered checklist that could be used by adults to assess home hazards. Design Review and observational, prospective study. Setting. Community dwelling. Participants. Nine adults (4 men, 5 women) were asked to review the checklist and provide feedback on whether items were relevant, comprehensive, and easy to understand. Intervention. A search for literature examining the causes of falls that focused on home hazards or behaviours was conducted, and causes were extracted. Using the combined list of home hazards, a draft checklist was created. The participants were asked to pilot the checklist through their home. Primary and Secondary Outcome. An initial iteration of the checklist was modified to reduce redundancy (by grouping certain items together), improve usability (by adding a “not applicable category”), and improve readability (by removing double-barrelled questions or rewriting certain items). Results This process resulted in 74 items in 10 areas. On average, it took 10 minutes for the participants to complete the home walk-through while filling out the checklist. Conclusion The fall hazard-home checklist is a new checklist designed to identify home fall hazards with the intended use of being either administered by self-report through memory or supported by a walk-about, and that could potentially be completed by a patient who has incurred a fall, fracture, a family member, or caregiver. Given the expense of home hazard assessments that involve a home visit, the validity of this method of detection warrants further investigation.
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19
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Ahmad Ainuddin H, Romli MH, Hamid TA, SF Salim M, Mackenzie L. An Exploratory Qualitative Study With Older Malaysian Stroke Survivors, Caregivers, and Healthcare Practitioners About Falls and Rehabilitation for Falls After Stroke. Front Public Health 2021; 9:611814. [PMID: 33987161 PMCID: PMC8110702 DOI: 10.3389/fpubh.2021.611814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 03/23/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Studies on rehabilitation for falls after a stroke remain limited despite its impact being profound. This scenario justifies a deeper understanding of why falls in stroke rehabilitation received less attention. Current investigations on the perception of falls and stroke also proved inadequate. Therefore, this study aims to explore the perceptions and experiences of older Malaysian stroke survivors, spousal caregivers, and healthcare practitioners on falls in stroke rehabilitation. Method: A qualitative study of three focus groups with 18 individuals from one community-based stroke rehabilitation center was conducted. The discussions were audio-recorded, video-recorded, transcribed, summarized, and analyzed using thematic analysis. Results: Three themes emerged from the analysis: (i) perceived factors and consequences of falls after stroke, (ii) physical-based interventions predominate in rehabilitation for falls after stroke, and (iii) the role of home hazards in fall prevention is taken for granted. Although, awareness of falls is high, they are regarded as a peripheral issue in stroke. Rehabilitation interventions such as improved functionality are believed to be adequate and can indirectly prevent falls. Other interventions for fall prevention such as home hazards management are relatively less known. Conclusion: There is a need for more attention regarding home environment risk assessment and intervention among healthcare professionals, and more education for clients and caregivers is required. Although, other stroke interventions may also benefit stroke survivors, falls prevention should be a central component in stroke rehabilitation. As this study focused on a specific population, the findings should be validated with larger populations, and in diverse settings.
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Affiliation(s)
- Husna Ahmad Ainuddin
- Department of Rehabilitation Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
- Centre of Occupational Therapy Studies, Faculty of Health Sciences, Universiti Teknologi MARA, Selangor, Malaysia
| | - Muhammad Hibatullah Romli
- Department of Rehabilitation Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Selangor, Malaysia
| | - Tengku Aizan Hamid
- Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Selangor, Malaysia
| | - Mazatulfazura SF Salim
- Department of Rehabilitation Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Lynette Mackenzie
- Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
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20
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Trevisan C, Ripamonti E, Grande G, Triolo F, Ek S, Maggi S, Sergi G, Fratiglioni L, Welmer AK. The association between injurious falls and older adults' cognitive function: the role of depressive mood and physical performance. J Gerontol A Biol Sci Med Sci 2021; 76:1699-1706. [PMID: 33649763 PMCID: PMC8361354 DOI: 10.1093/gerona/glab061] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Indexed: 12/12/2022] Open
Abstract
Background The impact of falls on cognitive function is unclear. We explored whether injurious falls are associated with cognitive decline in older adults, and evaluated the role of changes in psychological and physical health as mediators of such association. Methods This prospective study involved 2267 community-dwelling participants in the Swedish National study on Aging and Care in Kungsholmen (≥60 years). Data on injurious falls (ie, falls requiring medical attention) during each 3-year time interval of follow-up were obtained from national registers. Assessment of cognitive function (Mini-Mental State Examination), depressive mood (Montgomery-Åsberg Depression Rating Scale), and physical performance (walking speed) were carried out every 3 or 6 years over a 12-year follow-up. The association between falls and cognition was estimated through linear mixed-effects models, and the mediating role of changes in depressive mood and physical performance was tested using mediation analysis. Results After adjusting for potential confounders, individuals who experienced injurious falls had a greater annual decline in Mini-Mental State Examination in the subsequent time interval (β = −1.49, 95% CI: −1.84; −1.13), than those who did not. The association increased with the occurrence of ≥2 falls (β = −2.13, 95% CI: −2.70; −1.56). Worsening of walking speed and depressive mood explained around 26% and 8%, respectively, of the association between falls and cognitive decline. Conclusions Injurious falls are associated with greater cognitive decline, and this association is partly mediated by worsening of physical performance and, in a lesser extent, of depressive mood. These findings suggest that physical deficits and low mood are potential therapeutic targets for mitigating the association between falls and cognitive decline.
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Affiliation(s)
- Caterina Trevisan
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Department of Medicine (DIMED), Geriatrics Division, University of Padova, Italy
| | - Enrico Ripamonti
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Giulia Grande
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Federico Triolo
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Stina Ek
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Stefania Maggi
- National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy
| | - Giuseppe Sergi
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Italy
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Anna-Karin Welmer
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Stockholm Gerontology Research Center, Stockholm, Sweden.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Allied Health Professionals, Function Area Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
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Pillay J, Riva JJ, Tessier LA, Colquhoun H, Lang E, Moore AE, Thombs BD, Wilson BJ, Tzenov A, Donnelly C, Émond M, Holroyd-Leduc J, Milligan J, Keto-Lambert D, Rahman S, Vandermeer B, Tricco AC, Straus SE, Thomas SM, Mitchelmore BR, Rolland-Harris E, Hartling L. Fall prevention interventions for older community-dwelling adults: systematic reviews on benefits, harms, and patient values and preferences. Syst Rev 2021; 10:18. [PMID: 33422103 PMCID: PMC7797084 DOI: 10.1186/s13643-020-01572-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 12/23/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND An estimated 20-30% of community-dwelling Canadian adults aged 65 years or older experience one or more falls each year. Fall-related injuries are a leading cause of hospitalization and can lead to functional independence. Many fall prevention interventions, often based on modifiable risk factors, have been studied. Apart from the magnitude of the benefits and harms from different interventions, the preferences of older adults for different interventions as well as the relative importance they place on the different potential outcomes may influence recommendations by guideline panels. These reviews on benefits and harms of interventions, and on patient values and preferences, will inform the Canadian Task Force on Preventive Health Care to develop recommendations on fall prevention for primary care providers. METHODS To review the benefits and harms of fall prevention interventions, we will update a previous systematic review of randomized controlled trials with adaptations to modify the classification of interventions and narrow the scope to community-dwelling older adults and primary-care relevant interventions. Four databases (MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Ageline), reference lists, trial registries, and relevant websites will be searched, using limits for randomized trials and date (2016 onwards). We will classify interventions according to the Prevention of Falls Network Europe (ProFANE) Group's taxonomy. Outcomes include fallers, falls, injurious falls, fractures, hip fractures, institutionalization, health-related quality of life, functional status, and intervention-related adverse effects. For studies not included in the previous review, screening, study selection, data extraction on outcomes, and risk of bias assessments will be independently undertaken by two reviewers with consensus used for final decisions. Where quantitative analysis is suitable, network or pairwise meta-analysis will be conducted using a frequentist approach in Stata. Assessment of the transitivity and coherence of the network meta-analyses will be undertaken. For the reviews on patient preferences and outcome valuation (relative importance of outcomes), we will perform de novo reviews with searches in three databases (MEDLINE, PsycInfo, and CINAHL) and reference lists for cross-sectional, longitudinal quantitative, or qualitative studies published from 2000. Selection, data extraction, and risk of bias assessments suitable for each study design will be performed in duplicate. The analysis will be guided by a narrative synthesis approach, which may include meta-analysis for health-state utilities. We will use the CINeMa approach to a rate the certainty of the evidence for outcomes on intervention effects analyzed using network meta-analysis and the GRADE approach for all other outcomes. DISCUSSION We will describe the flow of literature and characteristics of all studies and present results of all analyses and summary of finding tables. We will compare our findings to others and discuss the limitations of the reviews and the available literature. SYSTEMATIC REVIEW REGISTRATION This protocol has not been registered.
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Affiliation(s)
- Jennifer Pillay
- Alberta Research Centre for Health Evidence, University of Alberta, 11405 87 Avenue, Edmonton, AB T6G 1C9 Canada
| | - John J. Riva
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Laure A. Tessier
- Global Health and Guidelines Division, Public Health Agency of Canada, Ottawa, Canada
| | - Heather Colquhoun
- Occupational Science and Occupational Therapy Department, University of Toronto, Toronto, Canada
| | - Eddy Lang
- Cumming School of Medicine, University of Calgary and Alberta Health Services, Calgary, Canada
| | - Ainsley E. Moore
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | | | - Brenda J. Wilson
- Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John’s, Canada
| | - Amanda Tzenov
- Memorial University of Newfoundland, St. John’s, Canada
| | | | - Marcel Émond
- Department of Family Medicine and Emergency Medicine, Université Laval, Quebec City, Canada
| | | | - Jamie Milligan
- Schlegel Specialist in Mobility and Falls, Schlegel-UW Research Institute for Aging, Department of Family Medicine, McMaster University, Hamilton, Canada
| | - Diana Keto-Lambert
- Alberta Research Centre for Health Evidence, University of Alberta, 11405 87 Avenue, Edmonton, AB T6G 1C9 Canada
| | - Sholeh Rahman
- Alberta Research Centre for Health Evidence, University of Alberta, 11405 87 Avenue, Edmonton, AB T6G 1C9 Canada
| | - Ben Vandermeer
- Alberta Research Centre for Health Evidence, University of Alberta, 11405 87 Avenue, Edmonton, AB T6G 1C9 Canada
| | - Andrea C. Tricco
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael’s Hospital, Unity Health Toronto, Toronto, Canada
| | - Sharon E. Straus
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael’s Hospital, Unity Health Toronto, Toronto, Canada
| | - Sonia M. Thomas
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael’s Hospital, Unity Health Toronto, Toronto, Canada
| | | | | | - Lisa Hartling
- Alberta Research Centre for Health Evidence, University of Alberta, 11405 87 Avenue, Edmonton, AB T6G 1C9 Canada
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Di Lorito C, Long A, Byrne A, Harwood RH, Gladman JRF, Schneider S, Logan P, Bosco A, van der Wardt V. Exercise interventions for older adults: A systematic review of meta-analyses. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:29-47. [PMID: 32525097 PMCID: PMC7858023 DOI: 10.1016/j.jshs.2020.06.003] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 03/24/2020] [Accepted: 04/26/2020] [Indexed: 05/26/2023]
Abstract
BACKGROUND The evidence concerning which physical exercise characteristics are most effective for older adults is fragmented. We aimed to characterize the extent of this diversity and inconsistency and identify future directions for research by undertaking a systematic review of meta-analyses of exercise interventions in older adults. METHODS We searched the Cochrane Database of Systematic Reviews, PsycInfo, MEDLINE, Embase, CINAHL, AMED, SPORTDiscus, and Web of Science for articles that met the following criteria: (1) meta-analyses that synthesized measures of improvement (e.g., effect sizes) on any outcome identified in studies of exercise interventions; (2) participants in the studies meta-analyzed were adults aged 65+ or had a mean age of 70+; (3) meta-analyses that included studies of any type of exercise, including its duration, frequency, intensity, and mode of delivery; (4) interventions that included multiple components (e.g., exercise and cognitive stimulation), with effect sizes that were computed separately for the exercise component; and (5) meta-analyses that were published in any year or language. The characteristics of the reviews, of the interventions, and of the parameters improved through exercise were reported through narrative synthesis. Identification of the interventions linked to the largest improvements was carried out by identifying the highest values for improvement recorded across the reviews. The study included 56 meta-analyses that were heterogeneous in relation to population, sample size, settings, outcomes, and intervention characteristics. RESULTS The largest effect sizes for improvement were found for resistance training, meditative movement interventions, and exercise-based active videogames. CONCLUSION The review identified important gaps in research, including a lack of studies investigating the benefits of group interventions, the characteristics of professionals delivering the interventions associated with better outcomes, and the impact of motivational strategies and of significant others (e.g., carers) on intervention delivery and outcomes.
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Affiliation(s)
- Claudio Di Lorito
- Division of Rehabilitation, Ageing, and Wellbeing, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK.
| | - Annabelle Long
- Division of Rehabilitation, Ageing, and Wellbeing, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
| | - Adrian Byrne
- Division of Rehabilitation, Ageing, and Wellbeing, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
| | - Rowan H Harwood
- Division of Health Sciences, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
| | - John R F Gladman
- Division of Rehabilitation, Ageing, and Wellbeing, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
| | - Stefan Schneider
- Institute of Movement and Neurosciences, German Sport University, Cologne 50933, Germany
| | - Pip Logan
- Division of Rehabilitation, Ageing, and Wellbeing, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
| | - Alessandro Bosco
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK
| | - Veronika van der Wardt
- Center for Methodology and Health Research, Department of General Medicine, Preventive and Rehabilitative Medicine, Philipps-Universität Marburg, Marburg 35032, Germany
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Bogolepova A, Vasenina E, Gomzyakova N, Gusev E, Dudchenko N, Emelin A, Zalutskaya N, Isaev R, Kotovskaya Y, Levin O, Litvinenko I, Lobzin V, Martynov M, Mkhitaryan E, Nikolay G, Palchikova E, Tkacheva O, Cherdak M, Chimagomedova A, Yakhno N. Clinical Guidelines for Cognitive Disorders in Elderly and Older Patients. Zh Nevrol Psikhiatr Im S S Korsakova 2021. [DOI: 10.17116/jnevro20211211036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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24
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Guerra FVG, Moreira RP, de Oliveira Ferreira G, Felício JF, Cavalcante TF, de Araujo TL, de Araujo MFM. Effectiveness of the fall prevention intervention in older adults with arterial hypertension: randomized clinical trial. Geriatr Nurs 2020; 42:27-32. [PMID: 33212355 DOI: 10.1016/j.gerinurse.2020.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 10/29/2020] [Accepted: 11/02/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of the nursing intervention Fall Prevention in reducing falls in older adults with arterial hypertension. METHODS Pilot clinical trial, with 118 participants with arterial hypertension from a city in the Northeast of Brazil. Participants were allocated by simple randomization into two groups: intervention (n = 58) and control (n = 60). The intervention was carried out at the participants' homes and consisted of guidelines for modifying environmental and behavioral risk factors for falls. A protocol with nursing activities associated with the Fall Prevention intervention proposed in the Nursing Interventions Classification (NIC) taxonomy was used. The outcome was the self-reported occurrence of falls. RESULTS There was a significant difference between the groups in the frequency of self-reported falls (p=0.38) with fewer falls occurring in the intervention group. Sixteen participants fell, of which 5.1% attributed the fall to difficulty walking, 6.8% fell in the living room, 3.4% had a sprain, and 6.8% reported to be afraid to fall again. CONCLUSION The nursing intervention Fall Prevention was effective in reducing the occurrence of falls in older adults with arterial hypertension. These findings contribute to the advancement of clinical protocols for the prevention of falls in older adults, as the educational intervention investigated is applicable to different sociodemographic and cultural scenarios.
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Affiliation(s)
- Francisca Valuzia Guedes Guerra
- Health Sciences Institute, University for International Integration of the Afro-Brazilian Lusophony, s/n José Franco de Oliveira St., 62.790-970, Redenção, CE, Brazil.
| | - Rafaella Pessoa Moreira
- Health Sciences Institute, University for International Integration of the Afro-Brazilian Lusophony, s/n José Franco de Oliveira St., 62.790-970, Redenção, CE, Brazil.
| | - Glauciano de Oliveira Ferreira
- Health Sciences Institute, University for International Integration of the Afro-Brazilian Lusophony, s/n José Franco de Oliveira St., 62.790-970, Redenção, CE, Brazil.
| | - Janiel Ferreira Felício
- Health Sciences Institute, University for International Integration of the Afro-Brazilian Lusophony, s/n José Franco de Oliveira St., 62.790-970, Redenção, CE, Brazil.
| | - Tahissa Frota Cavalcante
- Health Sciences Institute, University for International Integration of the Afro-Brazilian Lusophony, s/n José Franco de Oliveira St., 62.790-970, Redenção, CE, Brazil.
| | - Thelma Leite de Araujo
- Nursing Departament, Federal University of Ceará, 1115 Alexandre Baraúna St., 60430-160, Fortaleza, CE, Brazil.
| | - Marcio Flavio Moura de Araujo
- Health Sciences Institute, University for International Integration of the Afro-Brazilian Lusophony, s/n José Franco de Oliveira St., 62.790-970, Redenção, CE, Brazil.
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25
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Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020; 396:1204-1222. [PMID: 33069326 PMCID: PMC7567026 DOI: 10.1016/s0140-6736(20)30925-9] [Citation(s) in RCA: 6661] [Impact Index Per Article: 1665.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 02/27/2020] [Accepted: 04/14/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. METHODS GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. FINDINGS Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990-2010 time period, with the greatest annualised rate of decline occurring in the 0-9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10-24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10-24 years were also in the top ten in the 25-49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50-74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. INTERPRETATION As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and development investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. FUNDING Bill & Melinda Gates Foundation.
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26
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Senderovich H, Tsai PM. Do Exercises Prevent Falls Among Older Adults: Where Are We Now? A Systematic Review. J Am Med Dir Assoc 2020; 21:1197-1206.e2. [DOI: 10.1016/j.jamda.2020.05.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 04/25/2020] [Accepted: 05/05/2020] [Indexed: 12/27/2022]
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Ye P, Liu Y, Zhang J, Peng K, Pan X, Shen Y, Xiao S, Armstrong E, Er Y, Duan L, Ivers R, Keay L, Tian M. Falls prevention interventions for community-dwelling older people living in mainland China: a narrative systematic review. BMC Health Serv Res 2020; 20:808. [PMID: 32859186 PMCID: PMC7456050 DOI: 10.1186/s12913-020-05645-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 08/12/2020] [Indexed: 11/24/2022] Open
Abstract
Background Falls in community-dwelling older people have been recognised as a significant public health issue in China given the rapidly growing aged population. Although there are several reviews documenting falls prevention programs for community-dwelling older adults, no systematic reviews of the scope and quality of falls prevention interventions in Mainland China exist. Therefore, the aim of this study was to systematically review falls prevention interventions for community-dwelling older people living in Mainland China. Methods We systematically reviewed literature from Chinese and English databases. All types of randomised controlled trials (RCTs) and quasi-experimental studies published from 1st January 1990 to 30th September 2019 were included. Observational studies and studies in care facilities and hospitals were excluded. Narrative synthesis was performed to summarise the key features of all included studies. Quality assessment was conducted using the Cochrane Risk of Bias Tool and ROBINS-I tool for randomised and non-randomised studies respectively. Results A total of 1020 studies were found, and 101 studies were included in the analysis. Overall, very few high quality studies were identified, and there was insufficient rigor to generate reliable evidence on the effectiveness of interventions or their scalability. Most interventions were multiple component interventions, and most studies focused on outcomes such as self-reported falls incidence or awareness of falls prevention. Conclusion There is an opportunity to undertake an evaluation of a rigorously-designed, large-scale falls prevention program for community-dwelling older people in Mainland China. To help mitigate the rising burden of falls in Mainland China, recommendations for future falls prevention interventions have been made. These include: (1) target disadvantaged populations; (2) incorporate personalised interventions; and (3) investigate the effectiveness of those under-explored interventions, such as psychological, social environment, management of urinary incontinence, fluid or nutrition therapy and surgery. The study results will also potentially provide a useful evidence base for other low-and-middle income countries in a similar situation.
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Affiliation(s)
- Pengpeng Ye
- The George Institute for Global Health, University of New South Wales, PO Box M201, Missenden Road, Sydney, NSW, 2050, Australia. .,National Centre for Non-Communicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China.
| | - Yishu Liu
- The George Institute for Global Health, University of New South Wales, PO Box M201, Missenden Road, Sydney, NSW, 2050, Australia.,The George Institute for Global Health at Peking University Health Science Centre, Beijing, China
| | - Jing Zhang
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Ke Peng
- The George Institute for Global Health, University of New South Wales, PO Box M201, Missenden Road, Sydney, NSW, 2050, Australia.,School of Public Health, The University of Sydney, Sydney, Australia
| | - Xuru Pan
- School of Public Health, Peking University Health Science Centre, Beijing, China
| | - Yang Shen
- The George Institute for Global Health at Peking University Health Science Centre, Beijing, China
| | - Shaoming Xiao
- School of Public Health, Peking University Health Science Centre, Beijing, China
| | - Elizabeth Armstrong
- School of Population Health, University of New South Wales, Sydney, Australia.,Falls Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, Australia
| | - Yuliang Er
- National Centre for Non-Communicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Leilei Duan
- National Centre for Non-Communicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Rebecca Ivers
- The George Institute for Global Health, University of New South Wales, PO Box M201, Missenden Road, Sydney, NSW, 2050, Australia.,School of Population Health, University of New South Wales, Sydney, Australia
| | - Lisa Keay
- The George Institute for Global Health, University of New South Wales, PO Box M201, Missenden Road, Sydney, NSW, 2050, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Maoyi Tian
- The George Institute for Global Health, University of New South Wales, PO Box M201, Missenden Road, Sydney, NSW, 2050, Australia.,The George Institute for Global Health at Peking University Health Science Centre, Beijing, China
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Ichikawa M, Kuriyama A, Shirakura Y, Ikegami T. Health and Economic Burden of Injurious Falls Into Irrigation Canals in Japan: A Retrospective Cohort Study. J Emerg Med 2020; 59:424-431. [PMID: 32771319 DOI: 10.1016/j.jemermed.2020.06.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 06/20/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Falls into small water bodies can cause drowning and trauma. Such falls, especially into irrigation canals, and the subsequent trauma are common in Japan. However, few studies have investigated their characteristics, costs, and prognosis. OBJECTIVE Our aim was to clarify the characteristics, prognosis, and economic burden of trauma due to falls into irrigation canals in Kurashiki City, Japan. METHODS This 4-year, single-center, retrospective cohort study was conducted at a Japanese tertiary care hospital between January 1, 2013 and December 31, 2016. We enrolled patients who had fallen into irrigation canals constructed more than 300 years ago, and transported to our hospital by ambulance. The study outcomes included the characteristics, prognosis, and health care costs of such trauma. RESULTS We enrolled 266 patients with a median age of 66 years (range 19-64 years). Most patients fell into irrigation canals while walking (49.3%), riding a bicycle (35.0%), or driving or riding in a car (7.1%). Extremities were the most frequently affected body parts, and the head and chest were less frequently affected. Four patients (1.5%) died in the emergency department (ED), and 121 (45.5%) were hospitalized (109 in our hospital and 12 transferred to other hospitals). The total costs of ED and hospital stays were 777,625 US dollars (266 patients) and 712,059 US dollars (109 patients hospitalized in our hospital), respectively. CONCLUSIONS Trauma due to falls into irrigation canals can be severe and even fatal, and the related costs are high. Our study highlights the importance of implementing appropriate measures to prevent falls into irrigation canals and of promoting awareness among citizens.
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Affiliation(s)
- Motohiro Ichikawa
- Emergency and Critical Care Center, Kurashiki Central Hospital, Okayama, Japan
| | - Akira Kuriyama
- Emergency and Critical Care Center, Kurashiki Central Hospital, Okayama, Japan
| | - Yuki Shirakura
- Emergency and Critical Care Center, Kurashiki Central Hospital, Okayama, Japan
| | - Tetsunori Ikegami
- Emergency and Critical Care Center, Kurashiki Central Hospital, Okayama, Japan
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Building Nutrition into a Falls Risk Screening Program for Older Adults in Family Health Teams in North Eastern Ontario. Can J Aging 2020; 40:97-113. [PMID: 32248865 DOI: 10.1017/s0714980819000850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Approximately 30 per cent of those over the age of 65 living in the community fall at least once each year, and a similar proportion are at nutrition risk. Screening is an important component of prevention. The objective of this study was to understand how to add nutrition risk screening to a falls risk screening program in family health teams (FHTs). Interview participants (n = 31) were staff/management, regional representatives, and clients from six FHTs that had started integrating screening. Thematic analysis was conducted. Themes identified how to develop screening programs: setting up for successful screening, making it work, and following up with risk. An overarching theme recognized "it's about building relationships". Adding nutrition risk to a falls risk screening program takes effort, and is different for each FHT based on their work flow and client population. Determining how to integrate screening into the work flow and planning to address identified risk are necessary components.
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Racine E, Soye A, Barry P, Cronin F, Hosford O, Moriarty E, O'Connor KA, Turvey S, Timmons S, Kearney PM, McHugh SM. 'I've always done what I was told by the medical people': a qualitative study of the reasons why older adults attend multifactorial falls risk assessments mapped to the Theoretical Domains Framework. BMJ Open 2020; 10:e033069. [PMID: 32075829 PMCID: PMC7044899 DOI: 10.1136/bmjopen-2019-033069] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES Multifactorial falls risk assessments reduce the rate of falls in older people and are recommended by international guidelines. Despite their effectiveness, their potential impact is often constrained by barriers to implementation. Attendance is an issue. The aim of this study was to explore why older people attend community-based multifactorial falls risk assessment clinics, and to map these reasons to a theoretical framework. DESIGN This is a qualitative study. Semi-structured interviews were conducted and analysed thematically. Each theme and subtheme were then mapped onto the Theoretical Domains Framework (TDF) to identify the determinants of behaviour. PARTICIPANTS Older adults (aged 60 and over) who attended community-based multifactorial falls risk assessments. RESULTS Sixteen interviews were conducted. Three main themes explained participants' reasons for attending the multifactorial risk assessment; being that 'type of person', being 'linked in' with health and community services and having 'strong social support'. Six other themes were identified, but these themes were not as prominent during interviews. These were knowing what to expect, being physically able, having confidence in and being positive towards health services, imagining the benefits given previous positive experiences, determination to maintain or regain independence, and being 'crippled' by the fear of falling. These themes mapped on to nine TDF domains: 'knowledge', 'skills', 'social role and identity', 'optimism', 'beliefs about consequences', 'goals', 'environmental context and resources', 'social influences' and 'emotion'. There were five TDF domains that were not relevant to the reasons for attending. CONCLUSIONS These findings provide theoretically based factors that influence attendance which can be used to inform the development of interventions to improve attendance to falls prevention programmes.
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Affiliation(s)
- Emmy Racine
- School of Public Health, University College Cork, Cork, Ireland
| | - Anna Soye
- School of Public Health, University College Cork, Cork, Ireland
| | | | | | - Orla Hosford
- Health Service Executive, Naas, Leinster, Ireland
| | | | | | | | - Suzanne Timmons
- Centre for Gerontology and Rehabilitation, University College Cork, Cork, Ireland
| | | | - Sheena M McHugh
- School of Public Health, University College Cork, Cork, Ireland
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Worum H, Lillekroken D, Ahlsen B, Roaldsen KS, Bergland A. Bridging the gap between research-based knowledge and clinical practice: a qualitative examination of patients and physiotherapists' views on the Otago exercise Programme. BMC Geriatr 2019; 19:278. [PMID: 31638912 PMCID: PMC6805671 DOI: 10.1186/s12877-019-1309-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 10/10/2019] [Indexed: 12/21/2022] Open
Abstract
Background Falls and fall-related injuries exacerbate the health problems of older adults, and they are a public health concern. Despite an abundance of research, the implementation of evidence-based fall prevention programs has been slow and limited, additionally and these programs have not reduced the incidence of falling. Therefore, the primary objective of the present study was to examine patients and physiotherapists’ views on the factors that influence the implementation of the community- and evidence-based Otago Exercise Programme for fall prevention. Methods We conducted eight in-depth interviews with physiotherapists and patients, and a focus group interview with 12 physiotherapists and authority figures who represented local hospitals and municipalities. The resultant qualitative data were subjected to thematic analysis. Results The analysis yielded two main themes: the researcher’s role and position in the implementation process and the tension between research-based knowledge and clinical practice. The participants believed that research-based knowledge can address the challenges of clinical practice. Further, the patients reported that the fall prevention program made them feel safe and enhanced their ability to cope with daily life. The physiotherapists also observed that research findings do not readily translate into clinical practice. Further, they contended that research-based knowledge is not universal and that it cannot be generalized across different contexts; instead, it must be adapted and translated into a user-friendly language. The findings suggest that the application of research-based knowledge does equate to filling up empty jars and that research-based knowledge does not flow from the expert to the non-expert as water through a tube. Indeed, physiotherapists and patients are not tabula rasa. Additionally, the participants believed that researchers and stakeholders must think critically about who has the power and voice to create a common understanding. Conclusions Our findings delineate the means by which the gap between research and practice regarding the Otago fall prevention program can bridged. The program can guide clinical work and provide important information that can be used to improve the quality of other fall prevention programs. However, the research-based knowledge that it confers must be adapted for use in clinical contexts.
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Affiliation(s)
- Hilde Worum
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
| | - Daniela Lillekroken
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Birgitte Ahlsen
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Kirsti Skavberg Roaldsen
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.,Department of Neurobiology, Health Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Research, Sunnaas Rehabilitation Hospital, Oslo, Norway
| | - Astrid Bergland
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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Twiss M, Hilfiker R, Hinrichs T, de Bruin ED, Rogan S. Effectiveness of non-pharmaceutical interventions to prevent falls and fall-related fractures in older people living in residential aged care facilities – a systematic review and network meta-analysis protocol. PHYSICAL THERAPY REVIEWS 2019. [DOI: 10.1080/10833196.2019.1664082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Michiel Twiss
- Department of Health, Division of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland
| | - Roger Hilfiker
- School of Health Sciences, Physiotherapy, HES-SO Valais-Wallis, Leukerbad, Switzerland
| | - Timo Hinrichs
- Department of Sport, Exercise, and Health, Division of Sports and Exercise Medicine, University of Basel, Basel, Switzerland
| | - Eling D. de Bruin
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Slavko Rogan
- Department of Health, Division of Physiotherapy, Bern University of Applied Sciences, Bern, Switzerland
- Akademie für Trainingslehre und Physiotherapie, Grenzach-Wyhlen, Germany
- Faculty of Physical Education and Physiotherapy, Vrije Universeit Brussel, Brussels, Belgium
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33
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Secondary fracture prevention: Drug treatment, fall prevention and nutrition requirements. Best Pract Res Clin Rheumatol 2019; 33:290-300. [PMID: 31547984 DOI: 10.1016/j.berh.2019.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
In view of the high imminent risk for subsequent fractures, evaluation as early as possible after the fracture will result in early decisions about drug treatment, fall prevention and nutritional supplements. Drug treatment includes anti-resorptive and bone forming agents. Anti-resorptive therapy with broad spectrum fracture prevention and early anti-fracture effects are the first choice. In patients with multiple or severe VFs, the bone forming agent teriparatide should be considered. Adequate calcium and vitamin D are needed in all patients, together with appropriate nutrition, including adequate protein intake.
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Cheng P, Wang L, Ning P, Yin P, Schwebel DC, Liu J, Qi J, Hu G, Zhou M. Unintentional falls mortality in China, 2006-2016. J Glob Health 2019; 9:010603. [PMID: 30992985 PMCID: PMC6445498 DOI: 10.7189/jogh.09.010603] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background To examine trends in unintentional falls mortality from 2006 to 2016 in China by location (urban/rural), sex, age group and mechanism. Methods Mortality data were retrieved from the National Disease Surveillance Points system (DSPs) of China, a nationally representative data source. Percent change in mortality between 2006 and 2016 was calculated as “mortality rate ratio - 1” based on a negative binomial regression model. Results The crude unintentional falls mortality was 9.55 per 100 000 population in 2016. From 2006 to 2016, the age-adjusted unintentional falls mortality increased by 5% (95% confidence interval (CI) = 1%-9%), rising from 7.65 to 8.03 per 100 000 population. Males, rural residents and older age groups consistently had higher falls mortality rates than females, urban residents and younger age groups. Falls on the same level from slipping, tripping and stumbling (W01) was the most common mechanisms of falls mortality, accounting for 29% of total mortality. Conclusions Unintentional falls continued to be a major cause of death in China from 2006 to 2016. Empirically-supported interventions should be implemented to reduce unintentional falls mortality.
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Affiliation(s)
- Peixia Cheng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University. Changsha, China.,Joint first authors
| | - Lijun Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention. Beijing, China.,Joint first authors
| | - Peishan Ning
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University. Changsha, China
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention. Beijing, China
| | - David C Schwebel
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jiangmei Liu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention. Beijing, China
| | - Jinlei Qi
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention. Beijing, China
| | - Guoqing Hu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University. Changsha, China.,Joint senior authors
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention. Beijing, China.,Joint senior authors
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Suzuki M, Matsui Y, Ootaka E, Ichikawa C, Abe K, Furuta Y, Naito T, Kato M, Taniguchi Y, Hiramatsu T, Maruoka N, Kobayashi S, Rokkaku R, Seki Y, Izumi K, Kanamori M. [Effects of a fall intervention program for elderly patients with dementia based on person-centered care on care staff]. Nihon Ronen Igakkai Zasshi 2019; 56:487-497. [PMID: 31761855 DOI: 10.3143/geriatrics.56.487] [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] [Indexed: 06/10/2023]
Abstract
AIM This study aimed to clarify the effects of a fall prevention intervention that focused on the characteristics of falls among elderly patients with dementia and was based on person-centered care in geriatric facilities on care staff. METHODS This study was conducted between May 2016 and January 2017, and the subjects were classified into two groups: the intervention group, consisting of members who had participated in a three-month education training program, and the control group, consisting of members who provided the usual care. The study period was nine months divided as follows: training period (three months), fall prevention practice (three months), and follow-up period (three months). The quality of care was measured using the Nursing Quality Indicator for Preventing Falls (NQIPFD), and the assessment scale of health care professionals' recognition of the successful Interdisciplinary Team Approach in Health Care Facilities for the Elderly was also used. In total, the care staff members were evaluated four times: once to obtain baseline values before training, and again after the training period, after the fall prevention practice, and after the follow-up period. The results were analyzed using an analysis of variance (fixed factors = group and time, random factor = subjects, and covariance = years of experience working at the geriatric facility and type of job). RESULTS There were 50 care staff subjects in the intervention group and 69 people in the control group. The results of the analysis of variance indicated that there was a significant difference in the NQIPFD between baseline 68.60 (±9.09) and follow-up 70.02 (±9.88) in the intervention group. With regard to the differences by intervention, the effect size of the dementia knowledge scale scores was 0.243 higher than the others, which was significant (p<0.01). CONCLUSIONS The results showed that the participation of care staff in a fall intervention program to support elderly patients with dementia based on person-centered care significantly improved the NQIPFD and other measured factors. These findings suggest that the program fostered positive effects among the care staff.
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Affiliation(s)
- Mizue Suzuki
- Faculty of Nursing, Hamamastu University School of Medicine
| | | | | | | | | | - Yoshie Furuta
- Faculty of Nursing, Hamamastu University School of Medicine
| | | | - Mayumi Kato
- National University Corporation, Kanazawa University
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Silva VMD, Arruda ASFD, Silva LDSVE, Pontes Junior FL, Cachioni M, Melo RCD. Effectiveness of a multiple intervention programme for the prevention of falls in older adults persons from a University of the Third Age. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2019. [DOI: 10.1590/1981-22562019022.190032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective: To evaluate the effectiveness of a multiple intervention programme for the prevention of falls in older adults from a University of the Third Age (U3A). Method: A quasi-experimental, non-controlled, longitudinal and quantitative study was performed. 69 older adults were allocated into three groups: Control (CG), Physical Exercise (PEG) and Multiple Intervention (MIG). The instruments/tests used were: sociodemographic questionnaire, Geriatric Depression Scale (15-items), Mini-Mental State Examination, Timed-Up and Go (TUG), Sit-to-Stand and Hand-Grip Strength, Falls Efficacy Scale-International and Falls Risk Awareness Questionnaire (FRAQ).The PEG and MIG groups underwent physical training (walking, muscular resistance, and balance) for 16 weeks (2x/week, 60 min/session). In the same period, the MIG also participated in educational sessions (1x/week, 60min/session). Covariance analysis was used for group comparisons. The effect size of the interventions was also calculated. The level of significance was set at p<0.05. Results: 51 older adults (67±6.2 years and 76.3% women), of whom 15 were in the CG, 20 in the PEG and 16 in the MIG, concluded the study. TUG time in both intervention groups was reduced, but FRAQ score improved in the MIG only. Both interventions had a small effect on TUG time, while multiple intervention had a large effect on FRAQ. Conclusion: Multiple intervention brought additional benefits to the older adults from this U3A. In addition to improving balance, the older adults who underwent the multiple intervention increased their knowledge about risk factors for falls.
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Affiliation(s)
| | | | | | | | - Meire Cachioni
- Universidade de São Paulo, Brazil; Universidade Estadual de Campinas, Brazil
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Jansen CP, Nerz C, Kramer F, Labudek S, Klenk J, Dams J, König HH, Clemson L, Becker C, Schwenk M. Comparison of a group-delivered and individually delivered lifestyle-integrated functional exercise (LiFE) program in older persons: a randomized noninferiority trial. BMC Geriatr 2018; 18:267. [PMID: 30400832 PMCID: PMC6219201 DOI: 10.1186/s12877-018-0953-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 10/17/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The Lifestyle-Integrated Functional Exercise (LiFE) program is effective in improving strength, balance, and physical activity (PA) while simultaneously reducing falls in older people by incorporating exercise activities in recurring daily tasks. However, implementing the original LiFE program includes substantial resource requirements. Therefore, as part of the LiFE-is-LiFE project, a group format (gLiFE) of the LiFE program has been developed, which will be tested regarding its noninferiority to the individually delivered LiFE in terms of PA-adjusted fall incidence and overall cost-effectiveness. METHODS In a multi-centre, single-blinded noninferiority trial, an envisaged sample of N = 300 participants (> 70 years; faller and/or confirmed falls risk; community-dwelling) will be randomized in either LiFE or gLiFE. Both groups will undergo the same strength and balance activities as well as PA promotion activities and habitualization strategies as described in the LiFE programme, however, based on different approaches of delivery: During the 6-month intervention phase, LiFE participants will receive seven home visits and two telephone calls; in gLiFE, the program will be delivered in seven group sessions and also two telephone calls. Main outcomes are a) fall incidence per PA and b) incremental cost-effectiveness ratio comparing costs and quality-adjusted life years between the two interventions. Secondary outcomes include PA behaviour, motor performance, health status, psychosocial status, program evaluation, and adherence. Measurements will be conducted at baseline, 6-month and 12-month follow-up; evaluation of intervention sessions and assessment of psychosocial variables related to execution and habitualization of LiFE activities will be made during the intervention period as well. DISCUSSION Compared to LiFE, we expect gLiFE to (a) reduce falls per PA by a similar rate; (b) be more cost-effective; (c) comparably enhance physical performance in terms of strength and balance as well as PA. By investigating the economic and societal benefit, this study will be of high practical relevance as noninferiority of gLiFE would facilitate large-scale implementation due to lower resource usage. This would result in better reach and increased accessibility, which is important for subjects with a history of falls and/or being at risk of falls. TRIAL REGISTRATION ClinicalTrials.gov NCT03462654 . Registered on March 12, 2018.
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Affiliation(s)
| | - Corinna Nerz
- Department of Clinical Gerontology and Geriatric Rehabilitation, Robert Bosch Hospital, Stuttgart, Germany
| | - Franziska Kramer
- Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Sarah Labudek
- Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Jochen Klenk
- Department of Clinical Gerontology and Geriatric Rehabilitation, Robert Bosch Hospital, Stuttgart, Germany
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
- IB Hochschule Berlin, Studienzentrum Stuttgart, Stuttgart, Germany
| | - Judith Dams
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lindy Clemson
- Faculty of Health Sciences, University of Sydney, Sydney, Australia
| | - Clemens Becker
- Department of Clinical Gerontology and Geriatric Rehabilitation, Robert Bosch Hospital, Stuttgart, Germany
| | - Michael Schwenk
- Network Aging Research, Heidelberg University, Heidelberg, Germany
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Quatman CE, Anderson JP, Mondor M, Halweg J, Quatman-Yates C, Switzer JA. Frequent 911 Fall Calls in Older Adults: Opportunity for Injury Prevention Strategies. J Am Geriatr Soc 2018; 66:1737-1743. [DOI: 10.1111/jgs.15457] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 04/23/2018] [Accepted: 04/25/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Carmen E. Quatman
- Department of Orthopedics; Ohio State University; Columbus Ohio
- Center for Surgical Health Assessment, Research and Policy, Wexner Medical Center; Ohio State University; Columbus Ohio
| | | | - Michael Mondor
- University of Minnesota Medical Center; Minneapolis Minnesota
| | - Jodi Halweg
- University of Minnesota Medical Center; Minneapolis Minnesota
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