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Montalvão-Sousa TM, Ferreira PDA, Colombelli NL, de Carvalho KMB, Blazevich AJ, Lima RM. Sarcopenic obesity defined by the ESPEN and EASO consensus statement in older women: Risk of falls and bone mineral density implications. Arch Gerontol Geriatr 2024; 124:105444. [PMID: 38643667 DOI: 10.1016/j.archger.2024.105444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/08/2024] [Accepted: 04/11/2024] [Indexed: 04/23/2024]
Abstract
PURPOSE To apply the ESPEN-EASO diagnostic criteria for Sarcopenic Obesity (SO) in older women and to assess its association with the risk of falls, fear of falls (FOF), and bone mineral density (BMD). METHODS After exclusion criteria, 232 women aged ≥60 years (68.2 ± 6.1) were enrolled in the study. Volunteers had handgrip strength (HGS; dynamometer) and body composition assessed by DXA before risk of falls was evaluated using the QuickScreen and FOF evaluated by the Falls Efficiency Scale. SO was defined according to the ESPEN-EASO algorithm, which includes reduced HGS and fat-free mass, and elevated fat mass. RESULTS The prevalence of SO was 6.5 %, which was associated with a higher proportion of fallers in the previous year (X2 6.2, P = 0.04), reduced reaction time (X2 6.2, P = 0.04), reduced sit-to-stand performance (X2 6.2, P = 0.04), and a higher probability of falls [ꭓ2(6) = 17.689, p = 0.004]. FOF was lower in the eutrophic group (ꭓ2(2) = 15,662, p < 0,001) than both the obesity (p = 0.001) and SO (p = 0.05) groups. For total and femoral neck BMD, the eutrophic group presented significantly lower values (1.05 and 0.79 g/cm2) than the obesity group (1.10 and 0.87 g/cm2), but similar to the SO group (1.02 and 0.83 g/cm2). These results remained significant after adjustments for potential confounders. CONCLUSIONS SO specified by the ESPEN-EASO framework was associated with a higher risk of falls but not with increased FOF than obesity alone. The favorable influence of overweight and obesity on BMD seems to be attenuated in individuals with SO. Our findings support the clinical significance of the ESPEN-EASO definition.
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Affiliation(s)
| | | | | | | | - Anthony J Blazevich
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Ricardo M Lima
- Faculty of Physical Education, University of Brasília, Brasília, Distrito Federal, Brazil
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Mawarikado Y, Inagaki Y, Fujii T, Kubo T, Kido A, Tanaka Y. Association between postoperative fall history and toe grip strength in patients after total knee arthroplasty: A prospective observational study. J Foot Ankle Res 2024; 17:e12007. [PMID: 38632697 PMCID: PMC11080902 DOI: 10.1002/jfa2.12007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 03/25/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Factors associated with falls after total knee arthroplasty (TKA) have been rarely reported. The aim of this study was to identify factors that influence the incidence of falls after TKA, focusing on toe grip strength (TGS) in particular, which has been associated with falls in older adults. METHODS 217 patients who underwent TKA were included and followed up for 1 year. Main study outcome measures were the presence or absence of falls within 1 year after TKA. Multiple logistic regression analysis was used with postoperative falls as the dependent variable and preoperative falls and postoperative TGS on the affected sides as independent variables. RESULTS 170 (43 and 127 in the fall and non-fall groups) patients were included in the analysis. The presence of a preoperative falls history before TKA and a weak postoperative affected TGS indicated an increased susceptibility of the patient to fall postoperatively. CONCLUSIONS Results of the current study revealed the association between postoperative TGS and postoperative falls. We highlight the importance of preoperative fall monitoring and postoperative TGS evaluation to prevent falls after TKA.
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Affiliation(s)
- Yuya Mawarikado
- Graduate School of MedicineMusculoskeletal Reconstructive SurgeryNara Medical UniversityKashiharaNaraJapan
| | - Yusuke Inagaki
- Department of Rehabilitation MedicineNara Medical UniversityKashiharaNaraJapan
| | - Tadashi Fujii
- Department of Orthopeadic SurgeryKashiba Asahigaoka HospitalKashibaNaraJapan
| | - Takanari Kubo
- Department of RehabilitationOsaka Kawasaki Rehabilitation UniversityKaizukaOsakaJapan
| | - Akira Kido
- Department of Rehabilitation MedicineNara Medical UniversityKashiharaNaraJapan
| | - Yasuhito Tanaka
- Graduate School of MedicineMusculoskeletal Reconstructive SurgeryNara Medical UniversityKashiharaNaraJapan
- Department of Orthopaedic SurgeryNara Medical UniversityKashiharaNaraJapan
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Olokunlade T, Benden ME, Han G, Sherman LD, Smith ML. Factors Associated With Incident and Recurrent Falls Among Men Enrolled in Evidence-Based Fall Prevention Programs: An Examination of Race and Ethnicity. J Appl Gerontol 2024:7334648241251735. [PMID: 38741336 DOI: 10.1177/07334648241251735] [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: 05/16/2024] Open
Abstract
We examined factors associated with incident (one) and recurrent (2+) falls among 7207 non-Hispanic White (NHW) (89.7%), non-Hispanic Black (NHB) (5.0%), and Hispanic (5.3%) men ages ≥60 years with ≥1 chronic conditions, enrolled in an evidence-based fall program. Multinomial and binary regression analyses were used to assess factors associated with incident and recurrent falls. Relative to zero falls, NHB and Hispanic men were less likely to report incident (OR = 0.55, p < .001 and OR = 0.70, p = .015, respectively) and recurrent (OR = 0.41, p < .001 and OR = 0.58, p < .001, respectively) falls. Men who reported fear of falling and restricting activities were more likely to report incident (OR = 1.16, p < .001 and OR = 1.32, p < .001, respectively) recurrent and (OR = 1.46, p < .001 and OR = 1.71, p < .001, respectively) falls. Men with more comorbidities were more likely to report recurrent falls (OR = 1.10, p < .001). Compared to those who experienced one fall, men who reported fear of falling (OR = 1.28, p < .001) and restricting activities (OR = 1.31, p < .001) were more likely to report recurrent falls. Findings highlight the importance of multi-component interventions to prevent falls.
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Affiliation(s)
- Temitope Olokunlade
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Mark E Benden
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Gang Han
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Ledric D Sherman
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
- Center for Health Equity and Evaluation Research, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Matthew Lee Smith
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
- Center for Health Equity and Evaluation Research, School of Public Health, Texas A&M University, College Station, TX, USA
- Center for Community Health and Aging, School of Public Health, Texas A&M University, College Station, TX, USA
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Thies SB, Bevan S, Wassall M, Shajan BK, Chowalloor L, Kenney L, Howard D. Evaluation of a novel biomechanics-informed walking frame, developed through a Knowledge Transfer Partnership between biomechanists and design engineers. BMC Geriatr 2023; 23:734. [PMID: 37957568 PMCID: PMC10642022 DOI: 10.1186/s12877-023-04443-7] [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: 02/12/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Walking aids such as walking frames offer support during walking, yet paradoxically, people who self-report using them remain more likely to fall than people who do not. Lifting of walking frames when crossing door thresholds or when turning has shown to reduce stability, and certain design features drive the need to lift (e.g. small, non-swivelling wheels at the front). To overcome shortfalls in design and provide better stability, biomechanists and industrial engineers engaged in a Knowledge Transfer Partnership to develop a novel walking frame that reduces the need for lifting during everyday tasks. This paper presents the results for the final prototype regarding stability, safety and other aspects of usability. METHODS Four studies were conducted that explored the prototype in relation to the current standard frame: a detailed gait lab study of 9 healthy older adults performing repeated trials for a range of everyday tasks provided mechanical measures of stability, a real-world study that involved 9 users of walking frames provided measures of body weight transfer and lifting events, two interview studies (5 healthcare professionals and 7 users of walking frames) elicited stakeholder perceptions regarding stability, safety and usability. RESULTS Analysis of healthy older adults using a standard walking frame and the prototype frame demonstrated that the prototype increases stability during performance of complex everyday tasks (p < 0.05). Similarly, gait assessments of walking frame users in their home environment showed that the prototype facilitated safer usage patterns and provided greater and more continuous body weight support. Interviews with healthcare professionals and users showed that the prototype was perceived to be safe and effective and hence more usable. CONCLUSIONS The outcomes of the separate studies all support the same conclusion: the prototype is an improvement on the status quo, the typical front-wheeled Zimmer frame for indoor use which has not changed in design for decades. The significance of this work lies in the success of the Knowledge Transfer Partnership and in biomechanics-informed design leading to improvements, which in future may be applied to other walking aids, to benefit walking aid users by promoting safer, more stable use of their aid.
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Affiliation(s)
- Sibylle Brunhilde Thies
- Centre for Health Sciences Research, School of Health & Society, University of Salford, Brian Blatchford Building Room PO28, Salford, Greater Manchester, UK.
| | - Susan Bevan
- NRS Healthcare, Coalville, LE67 1UB, Leicestershire, UK
| | - Matthew Wassall
- Centre for Health Sciences Research, School of Health & Society, University of Salford, Brian Blatchford Building Room PO28, Salford, Greater Manchester, UK
| | - Blessy Kurissinkal Shajan
- Centre for Health Sciences Research, School of Health & Society, University of Salford, Brian Blatchford Building Room PO28, Salford, Greater Manchester, UK
| | - Lydia Chowalloor
- Centre for Health Sciences Research, School of Health & Society, University of Salford, Brian Blatchford Building Room PO28, Salford, Greater Manchester, UK
| | - Laurence Kenney
- Centre for Health Sciences Research, School of Health & Society, University of Salford, Brian Blatchford Building Room PO28, Salford, Greater Manchester, UK
| | - Dave Howard
- Centre for Health Sciences Research, School of Health & Society, University of Salford, Brian Blatchford Building Room PO28, Salford, Greater Manchester, UK
- School of Science, Engineering and Environment, University of Salford, Salford, Greater Manchester, UK
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Xiao X, Li L, Yang H, Peng L, Guo C, Cui W, Liu S, Yu R, Zhang X, Zhang M. Analysis of the incidence of falls and related factors in elderly patients based on comprehensive geriatric assessment. Aging Med (Milton) 2023; 6:245-253. [PMID: 37711258 PMCID: PMC10498826 DOI: 10.1002/agm2.12265] [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: 03/29/2023] [Revised: 08/10/2023] [Accepted: 08/10/2023] [Indexed: 09/16/2023] Open
Abstract
Objective To investigate the incidence of falls in elderly aged 65 years and above among outpatients and inpatients, and to analyze its related factors and identify prevention strategies. Methods A retrospective analysis was conducted on 451 patients aged 65 years and above who received comprehensive geriatric assessment in outpatients and inpatients from the Department of Geriatrics in the Second Xiangya Hospital from March 2021 to March 2022. According to whether there had been at least one fall in the past year, the patients were divided into a fall group and a non-fall group. Data were collected from the We-Chat applet of comprehensive geriatric assessment. A t test and chi-square test were performed to compare the difference between the two groups. Logistic regression analysis was then conducted to identify factors associated with falls. Results (1) The incidence of falls among the outpatient and inpatient was 28.8%. (2) The rate of light, moderate, and heavy dependence on daily living ability and decreased mobile balance ability were higher in the fall group than those in the non-fall group. The average calf circumference in the fall group was significantly lower than that in the non-fall group. (3) The prevalence of diabetes and eye diseases in the fall group was significantly higher than that in the non-fall group. (4) The percentage of insomnia and suspicious insomnia cases in the fall group was higher than that in the non-fall group. The mean scores for dysphagia, frailty, and incontinence were higher and the mean malnutrition score was lower in the fall group than in the non-fall group. (5) Multiple logistic regression analysis showed that frailty, insomnia, and malnutrition were independent influencing factors of fall (OR = 1.955, 1.652, 10.719, P = 0.044, 0.041, 0.025, respectively). Conclusions The incidence of falls among outpatients and inpatients aged 65 years and above is high. Frailty, insomnia, and malnutrition are the main factors influencing falls in these patients.
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Affiliation(s)
- Xun Xiao
- Department of Geriatrics, The Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Ling Li
- Department of Geriatrics, The Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Huijuan Yang
- Department of Geriatrics, The Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Lei Peng
- Department of Geriatrics, The Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Chunbo Guo
- Department of Geriatrics, The Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Wei Cui
- Department of Geriatrics, The Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Shunying Liu
- Department of Geriatrics, The Second Xiangya HospitalCentral South UniversityChangshaChina
| | - Renhe Yu
- College of Public HealthCentral South UniversityChangshaChina
| | - Xiangyu Zhang
- Department of Geriatrics, The Second Xiangya HospitalCentral South UniversityChangshaChina
- Hunan Clinical Medical Research Center for Geriatric SyndromeChangshaChina
| | - Mengxi Zhang
- Department of Geriatrics, The Second Xiangya HospitalCentral South UniversityChangshaChina
- Hunan Clinical Medical Research Center for Geriatric SyndromeChangshaChina
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Xu S, Qian L, Hao J, Wang J, Qiu Y. Balance-Associated Tests Contribute to Predicting the Need for Ambulatory Assistive Devices (AAD) among Community-Dwelling Older Adults. Healthcare (Basel) 2023; 11:2405. [PMID: 37685439 PMCID: PMC10487081 DOI: 10.3390/healthcare11172405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/20/2023] [Accepted: 08/26/2023] [Indexed: 09/10/2023] Open
Abstract
This study aims to analyze the use of ambulatory assistive devices (AAD) in relation to balance-associated tests and assist medical staff in providing professional objective reference values for older adults on whether to use AAD. Older adults (n = 228) were recruited from the local community to participate in this study. Participants were divided into the AAD-use group and the non-AAD-use group. Four balance-associated tests and scales were applied to predict the relationship between balance function and the use of AAD in older adults. They were used to assess the participant's balance function and confidence in maintaining balance and were considered the most reliable measures of balance. There were significant differences in the Berg Balance Scale (BBS) score and Timed Up and Go Test (TUGT) among the subjects in the AAD-use group and non-AAD-use group (p < 0.001). The ROC curve analysis presented the following cut-off values for balance tests and scales: 23.62 s for the TUGT test and 41.5 points for the BBS score. For example, if the TUGT score is greater than 23.62 s and the BBS score is below 41.5 points, AAD is recommended for older adults to maintain balance and prevent falls. These objective reference standards may be useful in guiding medical personnel to determine whether older adults need to use AAD. In future studies, we hope to include more participants for subgroup analysis, investigating different types of AAD and their effects on older adults.
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Affiliation(s)
- Shiqi Xu
- Wuxi School of Medicine, Jiangnan University, Wuxi 214126, China; (S.X.); (J.H.)
| | - Lei Qian
- Department of Rehabilitation, Wuxi 9th Affiliated Hospital of Soochow University, Wuxi 214023, China;
| | - Jianru Hao
- Wuxi School of Medicine, Jiangnan University, Wuxi 214126, China; (S.X.); (J.H.)
| | - Jun Wang
- Department of Rehabilitation, Wuxi 9th Affiliated Hospital of Soochow University, Wuxi 214023, China;
| | - Yuyu Qiu
- Wuxi School of Medicine, Jiangnan University, Wuxi 214126, China; (S.X.); (J.H.)
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Li Y, Hou L, Zhao H, Xie R, Yi Y, Ding X. Risk factors for falls among community-dwelling older adults: A systematic review and meta-analysis. Front Med (Lausanne) 2023; 9:1019094. [PMID: 36687461 PMCID: PMC9853191 DOI: 10.3389/fmed.2022.1019094] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 12/02/2022] [Indexed: 01/09/2023] Open
Abstract
Background and objective The prevalence of falls among older adults living in the community is ~30% each year. The impacts of falls are not only confined to the individual but also affect families and the community. Injury from a fall also imposes a heavy financial burden on patients and their families. Currently, there are different reports on the risk factors for falls among older adults in the community. A retrospective analysis was used in this study to identify risk factors for falls in community-dwelling older adults. This research aimed to collect published studies to find risk factors for falls in community-dwelling older adults. Methods We searched for literature from the founding of PubMed, EMBASE, the Cochrane Library, the Web of Science, the China National Knowledge Infrastructure (CNKI), the China Science and Technology Periodicals Database (VIP), and the Wanfang database until September 2022. The studies were selected using inclusion and exclusion criteria. We collected information from relevant studies to compare the impact of potential risk factors such as age, female gender, fear of falling, history of falls, unclear vision, depression, and balance disorder on falls among community-dwelling older adults. Results A total of 31 studies were included with 70,868 community seniors. A significant risk factor for falls in the community of older adults was dementia (2.01, 95% CI: 1.41-2.86), age (1.15, 95% CI: 1.09-1.22), female gender (1.52, 95% CI: 1.27-1.81), fear of falling (2.82, 95% CI: 1.68-4.74), history of falls (3.22, 95% CI: 1.98-5.23), vision unclear (1.56, 95% CI: 1.29-1.89), depression (1.23, 95% CI: 1.10-1.37), and balance disorder (3.00, 95% CI: 2.05-4.39). Conclusion This study provides preliminary evidence that falls among community-dwelling older adults are associated with factors such as age, female gender, fear of falling, history of falls, unclear vision, depression, and balance disorders. The results of this research may help improve clinician awareness, risk stratification, and fall prevention among community-dwelling older adults. Systematic review registration identifier INPLASY2022120080.
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Affiliation(s)
- Ying Li
- School of Nursing, Weifang University of Science and Technology, Weifang, Shandong, China
| | - Lingyu Hou
- Nursing Department, Peking University Shenzhen Hospital, Shenzhen, China
| | - Hanping Zhao
- School of Nursing, Weifang University of Science and Technology, Weifang, Shandong, China
| | | | - Yue Yi
- Department of Neurology, Shandong Guoxin Senior Care Group Laiwu Central Hospital, Jinan, China
| | - Xiaorong Ding
- Nursing Department, Peking University Shenzhen Hospital, Shenzhen, China
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Liu M, Mo C, Luo Y, Peng W, Tang S. Longitudinal Relationship between Mobility Device Use, Falls and Fear of Falling (FOF) Differed by Frailty Status among Community-Dwelling Older Adults. J Nutr Health Aging 2023; 27:673-679. [PMID: 37702341 DOI: 10.1007/s12603-023-1952-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/16/2023] [Indexed: 09/14/2023]
Abstract
OBJECTIVES This study examined the longitudinal relationship between mobility device use, falls and fear of falling (FOF) among community-dwelling older adults by frailty status over a one-year follow-up. DESIGN A longitudinal cohort study. SETTING Communities in the United States. PARTICIPANTS Community-dwelling older adults from the National Health and Aging Trends Study, a nationally representative survey of Medicare Beneficiaries in the United States (N=5,896). MEASUREMENTS Based on yes or no response to the corresponding items for the variables, fall-related outcomes were determined separately including falls and FOF. Falls were assessed by asking participants whether they had a fall and if they had fallen down more than one time. FOF was measured by asking participants whether they worried about falling and if this worry ever limited activities. Mobility device use was determined by asking whether participants used any type of mobility devices and the number of devices used, including cane, walker, wheelchair and scooter. Frailty was assessed using the frailty phenotype. Multinomial logistic regression models were conducted to examine the association between mobility device use and fall-related outcomes among older adults by frailty status. RESULTS At Year 1, 28.6% of participants reported using mobility devices. Among robust participants, using one mobility device had 3.58 times higher risks of FOF with fear-related activity restriction (FAR) than non-device users (95% CI: 1.10-11.65). Cane-only robust users had 5.94 and 2.18 times higher risks of FOF with and without FAR (95% CI: 1.80-19.57; 95% CI: 1.12-4.22) than non-device users. Among pre-frail participants, using one mobility device was associated with recurrent falls and FOF with FAR (RRR=2.02, 95% CI: 1.30-3.14; RRR=2.13, 95% CI: 1.25-3.63). Using ≥2 devices was associated with one fall (RRR=2.08, 95% CI: 1.30-3.33), recurrent falls (RRR=2.92, 95% CI: 1.62-5.25) and FOF with FAR (RRR=2.84, 95% CI: 1.34-6.02). Pre-frail cane-only users were more likely to have one fall (RRR=1.57, 95% CI: 1.06-2.32), recurrent falls (RRR=2.36, 95% CI: 1.48-3.77) and FOF with FAR (RRR=2.08, 95% CI: 1.12-3.87) than non-device users. The number of mobility device used and the use of canes failed to be significantly associated with fall-related outcomes among frail participants. CONCLUSION The number of mobility devices used and the only use of canes were associated with fall-related outcomes among robust and pre-frail individuals. Further research is needed to develop targeted strategies for preventing falls and FOF among older adults with mobility device use, particularly for those in the early stages of frailty.
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Affiliation(s)
- M Liu
- Minhui Liu, Central South University Xiangya School of Nursing, China,
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Blanco‐Blanco J, Albornos‐Muñoz L, Costa‐Menen MÀ, García‐Martínez E, Rubinat‐Arnaldo E, Martínez‐Soldevila J, Moreno‐Casbas MT, Bays‐Moneo AB, Gea‐Sánchez M. Prevalence of falls in noninstitutionalized people aged 65−80 and associations with sex and functional tests: A multicenter observational study. Res Nurs Health 2022; 45:433-445. [PMID: 35735212 PMCID: PMC9543892 DOI: 10.1002/nur.22249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 05/14/2022] [Accepted: 05/30/2022] [Indexed: 11/09/2022]
Abstract
Falls have a considerable impact on the functional prognosis of older adults. The main focus of this multicenter, retrospective, observational study was to examine the prevalence of falls in Spanish people aged 65−80 years still living at home. The secondary aims included examining the overall sociodemographic and clinical variables associated with a history of falls and then stratifying these findings by sex. We also aimed to determine the differences between sexes with regard to the history and consequences of falls and to evaluate associations between fall history and functional performance tests. The 747 older adults had all participated in the otago exercise program, which is a progressive home program of strength, balance, and endurance exercises. They were recruited by nurses in 21 primary care centers in 10 Spanish provinces between September 2017 to December 2018. The participants' mean age was 72.2 (SD: 4.3) years, and 67% were women. We recorded sociodemographic and clinical variables, functional performance test results, and any falls and/or injuries in the last 12 months. We found that 32% had fallen, 36% of those had fallen more than once, and 48% had sustained injuries when they fell. The bivariate analysis showed that women had more than twice the odds of falling than men and that living alone and being obese or overweight increased the odds of a fall, although living alone was not associated with falls in the multivariable analysis. Our results could guide the development of risk‐specific fall prevention programs to prevent disabilities in older people.
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Affiliation(s)
- Joan Blanco‐Blanco
- Department of Nursing and Physiotherapy University of Lleida Lleida Spain
- Group for the Study of Society Health Education and Culture, GESEC University of Lleida Lleida Spain
- Health Care Research Group GRECS, Biomedical Research Institute of Lleida IRB‐Lleida Lleida Spain
| | - Laura Albornos‐Muñoz
- Unidad de Investigación en Cuidados y Servicios de Salud (Investén‐isciii), REDISSEC, Instituto de Salud Carlos III Madrid Spain
| | - Maria Àngels Costa‐Menen
- Department of Nursing and Physiotherapy University of Lleida Lleida Spain
- Health Care Research Group GRECS, Biomedical Research Institute of Lleida IRB‐Lleida Lleida Spain
- CAP Onze de Setembre, ICS Lleida Spain
| | - Ester García‐Martínez
- Department of Nursing and Physiotherapy University of Lleida Lleida Spain
- Group for the Study of Society Health Education and Culture, GESEC University of Lleida Lleida Spain
- Health Care Research Group GRECS, Biomedical Research Institute of Lleida IRB‐Lleida Lleida Spain
| | - Esther Rubinat‐Arnaldo
- Department of Nursing and Physiotherapy University of Lleida Lleida Spain
- Group for the Study of Society Health Education and Culture, GESEC University of Lleida Lleida Spain
- Health Care Research Group GRECS, Biomedical Research Institute of Lleida IRB‐Lleida Lleida Spain
| | - Jordi Martínez‐Soldevila
- Department of Nursing and Physiotherapy University of Lleida Lleida Spain
- Group for the Study of Society Health Education and Culture, GESEC University of Lleida Lleida Spain
- Health Care Research Group GRECS, Biomedical Research Institute of Lleida IRB‐Lleida Lleida Spain
| | - María Teresa Moreno‐Casbas
- Unidad de Investigación en Cuidados y Servicios de Salud (Investén‐isciii), CIBERFES, Instituto de Salud Carlos III Madrid Spain
| | | | - Montserrat Gea‐Sánchez
- Department of Nursing and Physiotherapy University of Lleida Lleida Spain
- Group for the Study of Society Health Education and Culture, GESEC University of Lleida Lleida Spain
- Health Care Research Group GRECS, Biomedical Research Institute of Lleida IRB‐Lleida Lleida Spain
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Combined Use of Transcutaneous Electrical Nerve Stimulation and Short Foot Exercise Improves Navicular Height, Muscle Size, Function Mobility, and Risk of Falls in Healthy Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127196. [PMID: 35742445 PMCID: PMC9223504 DOI: 10.3390/ijerph19127196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/07/2022] [Accepted: 06/10/2022] [Indexed: 02/05/2023]
Abstract
Electrical stimulation is an established method that is used to improve muscle strength. The present study compared changes in the navicular drop test (NDT), muscle size, the five times sit to stand (5TSTS) test, the timed up and go (TUG) test, and the risk of falls in response to transcutaneous electrical nerve stimulation (TENS) plus short foot exercise (SFE) and SFE alone in 68 healthy elderly participants aged 65−75 years. Participants were randomly assigned to two groups: TENS plus SFE and SFE alone (with sham TENS). Measurements of NDT, muscle size, 5TSTS, TUG, and risk of falls were made before and after 4 weeks of training. The NDT was significantly improved by a median of 0.31 mm in the TENS plus SFE group and 0.64 mm in the SFE alone group (p < 0.001). Similarly, there was a significant improvement in Falls Efficacy Scale International (FES-I), 5TSTS, and TUG for both groups (p < 0.001). The abductor hallucis muscle size increased by 0.23 cm2 in the TENS plus SFE group and 0.26 cm2 in the SFE alone group (p < 0.001). There were no significant differences between the two groups for any variables (p > 0.05) except TUG, which showed a greater improvement in the TENS plus SFE group (p = 0.008). Our findings demonstrated that TENS plus SFE and SFE alone improved intrinsic foot muscle size. However, TENS plus SFE tended to improve NDT more than SFE alone, particularly in cases of severe muscle weakness. Thus, the combined use of TENS plus SFE could be recommended for muscle strengthening and balance programs for fall prevention in older adults.
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Luebbert S, Christensen W, Finkel C, Worsowicz G. Falls in Senior Adults: Demographics, Cost, Risk Stratification, and Evaluation. MISSOURI MEDICINE 2022; 119:158-163. [PMID: 36036034 PMCID: PMC9339401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Falls occur at staggering rates across the country, with 25% of Americans over 65 reporting annual falls. The fall rate in Missourian older adults is 27.3%. Eighty-six percent of fall-related deaths happen over the age of 65. There are many intrinsic and extrinsic factors that contribute to falls, with some factors that can be targeted and optimized by physicians. There are nuances to the history and physical that can help physicians identify these risk factors.
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Affiliation(s)
- Stephen Luebbert
- Resident Physician at the University of Missouri - Columbia School of Medicine Department of Physical Medicine and Rehabilitation, Columbia, Missouri (UMC SOM DPMR COMO)
| | | | - Claire Finkel
- Associate Residency Program Director UMC SOM DPMR COMO
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Taguchi CK, Araújo BCL, Santana LSD, Santos RVDS, Teixeira JP, Silva ARD. Speech therapy´s intervention for falling prevention in aging. Codas 2021; 33:e20200312. [PMID: 34586329 DOI: 10.1590/2317-1782/20202020312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 11/30/2020] [Indexed: 11/22/2022] Open
Abstract
PURPOSE to verify the effectiveness of a Speech Therapy intervention program to decrease the risk of falls in elderly people. METHODS Exploratory and intervention study where upon 148 volunteers from community, both genders, with an average of 68.6(± 6.5) years were submitted to the Dynamic Gait Index (DGI)- Brazilian brief and the Timed Up and Go (TUG). Volunteers with or without potential risk for falling were invited to participate in a 50-minutes long intervention program carried out for five consecutive weeks, based on Cawthorne and Cooksey exercises. Seventy-two volunteers 68.1(±6.5) years presented in at least three meeting, were reassessed. The results were analyzed by Wilcoxon, Chi-square, Spearman and Correlation Matrix tests, with p≤5.0%. RESULTS Thirty-seven (25.0%) and 106 (71.6%) participants presented, respectively, risks for falls in the DGI-Brazilian brief and TUG. There was negative correlation between the DGI-Brazilian brief (p=0.034) and positive with the TUG (p=0.0071) with age and both instruments (p=0.00000016). Through the comparison the initial and final data a positive correlation was found for the DGI-Brazilian brief and for TUG in the Chi-square test and by Wilcoxon's. Better performance was observed in both tests after the intervention. CONCLUSION The intervention was effective in decreasing the risk for falls and improving gait performance, and functional and dynamic balance.
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Song CY, Tsauo JY, Fang PH, Fang IY, Chang SH. Physical Fitness among Community-Dwelling Older Women with and without Risk of Falling-The Taipei Study, Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147243. [PMID: 34299691 PMCID: PMC8306518 DOI: 10.3390/ijerph18147243] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 07/01/2021] [Indexed: 12/30/2022]
Abstract
The purposes of this study were to compare the differences in physical fitness between community-dwelling older women fallers and non-fallers, with and without a risk of falling, and to investigate the relation between physical fitness and falling risk factors. This study was a secondary data analysis from a community- and exercise-based fall-prevention program. Baseline assessments pertaining to body weight and height, self-reported chronic diseases, the 12-item fall risk questionnaire (FRQ), senior fitness test, single-leg stand test, and handgrip strength test were extracted. Participants (n = 264) were classified into fallers and non-fallers, and sub-classified according to the risk of falling (FRQ ≥4 and <4). While controlling for the effect of age, body mass index (BMI), and multimorbidity, one-way analysis of covariance indicated that older women with a risk of falling showed poorer performances of the 8-foot up-and-go, 2-min step and 30-s chair stand compared with those without a risk of falling, regardless of the history of falls. Additionally, weaker grip strength was found in non-fallers with falling risk. Some significant, but low-to-moderate, correlations were found between physical fitness tests and fall risk factors in the FRQ, particularly in gait/balance problem and leg muscle weakness. Proactive efforts are encouraged to screen and manage deterioration in the identified physical fitness.
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Affiliation(s)
- Chen-Yi Song
- Department of Long-Term Care, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan
- Correspondence: (C.-Y.S.); (S.-H.C.)
| | - Jau-Yih Tsauo
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei 100, Taiwan;
| | - Pei-Hsin Fang
- Physical Education Center, Southern Taiwan University of Science and Technology, Tainan 710, Taiwan; (P.-H.F.); (I.-Y.F.)
| | - I-Yao Fang
- Physical Education Center, Southern Taiwan University of Science and Technology, Tainan 710, Taiwan; (P.-H.F.); (I.-Y.F.)
| | - Shao-Hsi Chang
- Department of Physical Education, National Taiwan Normal University, Taipei 106, Taiwan
- Correspondence: (C.-Y.S.); (S.-H.C.)
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