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Nguyen T, Thiamwong L, Lou Q, Xie R. Unveiling Fall Triggers in Older Adults: A Machine Learning Graphical Model Analysis. MATHEMATICS (BASEL, SWITZERLAND) 2024; 12:1271. [PMID: 38784721 PMCID: PMC11113328 DOI: 10.3390/math12091271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
While existing research has identified diverse fall risk factors in adults aged 60 and older across various areas, comprehensively examining the interrelationships between all factors can enhance our knowledge of complex mechanisms and ultimately prevent falls. This study employs a novel approach-a mixed undirected graphical model (MUGM)-to unravel the interplay between sociodemographics, mental well-being, body composition, self-assessed and performance-based fall risk assessments, and physical activity patterns. Using a parameterized joint probability density, MUGMs specify the higher-order dependence structure and reveals the underlying graphical structure of heterogeneous variables. The MUGM consisting of mixed types of variables (continuous and categorical) has versatile applications that provide innovative and practical insights, as it is equipped to transcend the limitations of traditional correlation analysis and uncover sophisticated interactions within a high-dimensional data set. Our study included 120 elders from central Florida whose 37 fall risk factors were analyzed using an MUGM. Among the identified features, 34 exhibited pairwise relationships, while COVID-19-related factors and housing composition remained conditionally independent from all others. The results from our study serve as a foundational exploration, and future research investigating the longitudinal aspects of these features plays a pivotal role in enhancing our knowledge of the dynamics contributing to fall prevention in this population.
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Affiliation(s)
- Tho Nguyen
- Department of Statistics and Data Science, University of Central Florida, Orlando, FL 32816, USA
| | - Ladda Thiamwong
- College of Nursing, University of Central Florida, Orlando, FL 32816, USA
| | - Qian Lou
- Department of Computer Science, University of Central Florida, Orlando, FL 32816, USA
| | - Rui Xie
- Department of Statistics and Data Science, University of Central Florida, Orlando, FL 32816, USA
- College of Nursing, University of Central Florida, Orlando, FL 32816, USA
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Piotrkowska R, Mędrzycka-Dąbrowska WA, Tomaszek L. Timed Up and Go test score and factors associated with a moderate-to-high risk of future falls in patients scheduled for vascular surgeries-a cross-sectional study. Front Public Health 2024; 12:1363828. [PMID: 38577292 PMCID: PMC10991680 DOI: 10.3389/fpubh.2024.1363828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 03/12/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction Peripheral artery and aorta diseases contribute to complex consequences in various areas, as well as increasing physical and mental discomfort resulting from the progressive limitation or loss of functional capacities, in particular in relation to walking, decreased endurance during physical exercise, a drop in effort tolerance, and pain suffered by patients. Limitations in functional capacities also increase the risk of falls. Most falls take place during the performance of simple activities. The aim of this study was to investigate factors associated with moderate-to-high risk of future falls in patients scheduled for vascular surgeries. Methods This cross-sectional study included patients aged 33-87, scheduled for vascular surgeries. Based on the Timed Up and Go test, patients were categorized as having a moderate-to-high (≥ 10 s) or low risk of falls. Multiple logistic regression was carried out to assess the relationship between fall-risk levels and independent sociodemographic and clinical variables. Results Forty-eight percent of patients were categorized as having a moderate-to-high risk of future falls. Females (OR = 1.67; Cl95%: 1.07-2.60) and patients who suffered from hypertension (OR = 2.54; Cl95%: 1.19-5.40) were associated with a moderate-to-high risk of future falls. The Barthel Index correlated negatively (OR = 0.69; Cl95%: 0.59-0.80), while age correlated positively with fall-risk levels (OR = 1.07; Cl95%: 1.02-1.12). Conclusion Factors that may be associated with a moderate-to-high risk of future falls in patients scheduled for vascular surgeries include age, female gender, hypertension, and the Barthel Index.
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Affiliation(s)
- Renata Piotrkowska
- Department of Surgical Nursing, Medical University of Gdansk, Gdańsk, Poland
- Clinic of Cardiac and Vascular Surgery, University Clinical Center, Gdańsk, Poland
| | | | - Lucyna Tomaszek
- Department of Specialist Nursing, Faculty of Medicine and Health Sciences, Kraków Academy of Andrzej Frycz Modrzewski, Kraków, Poland
- Institute of Tuberculosis and Lung Diseases, Rabka-Zdrój Branch, Rabka-Zdrój, Poland
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Adandom HC, Nwankwo HC, Adandom II, Akinrolie O, Odole AC, Scott DR, Awosoga OA. Exploring the relationship between falls, fall-related psychological concerns, and personality traits in adults: A scoping review protocol. Health Sci Rep 2024; 7:e1848. [PMID: 38299208 PMCID: PMC10826239 DOI: 10.1002/hsr2.1848] [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: 06/28/2023] [Revised: 10/08/2023] [Accepted: 12/19/2023] [Indexed: 02/02/2024] Open
Abstract
Background and Aims Personality traits, such as neuroticism and extraversion, are emerging as important predictors of falls. Despite their significance, existing fall prevention programs often overlook these traits, creating a notable research gap. This study aims to conduct a comprehensive scoping review to explore the existing literature on the relationships among personality traits, falls, and fall-related psychological concerns (FrPCs). Methods This scoping review will adhere to the framework established by Arksey and O'Malley, incorporating extensions recommended by the Joanna Briggs Institute and using the PRISMA-ScR checklist. A thorough search strategy will be employed, aligning with the population, concept, and context (PCC) selection criteria. Electronic databases, including MEDLINE, APA PsycINFO, Web of Science, CINAHL, and SPORTDiscus, will be searched from their inception to the present. Additionally, a manual search of the reference lists of identified and relevant full-text articles will be conducted. Two independent reviewers will screen titles and abstracts, perform full-text reviews, and extract data from pertinent articles. Discussion Personality traits are increasingly recognized as influential predictors of falls and related psychological concerns. This review aims to make a substantial contribution to the existing literature by being the first to comprehensively explore and provide a descriptive synthesis of the relationship between personality traits and falls, as well as FrPCs in adults. It is hoped that the outcomes of this review will enhance our comprehension of the role of personality traits in falls, potentially informing future research and strategies for this critical area of study. Scoping Review Registration This scoping review protocol was registered with Open Science Framework (https://doi.org/10.17605/OSF.IO/KR74X).
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Affiliation(s)
| | - Henry C. Nwankwo
- Warwick Medical SchoolUniversity of WarwickCoventryUnited Kingdom
| | | | - Olayinka Akinrolie
- Applied Health Science, Faculty of Graduate StudiesUniversity of ManitobaWinnipegManitobaCanada
| | - Adesola C. Odole
- Department of Physiotherapy, College of MedicineUniversity of IbadanIbadanNigeria
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Pitluk Barash M, Elboim-Gabyzon M, Shuper Engelhard E. Investigating the emotional content of older adults engaging in a fall prevention exercise program integrated with dance movement therapy: a preliminary study. Front Psychol 2023; 14:1260299. [PMID: 37790228 PMCID: PMC10543662 DOI: 10.3389/fpsyg.2023.1260299] [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: 07/17/2023] [Accepted: 09/04/2023] [Indexed: 10/05/2023] Open
Abstract
Fall prevention interventions for older adults have primarily focused on the physical aspects, overlooking the emotional aspects inherent in falls. This qualitative study presents a novel fall prevention intervention that integrates physical therapy exercise (PTE) based on the Otago Exercise Program with Dance Movement Therapy (DMT) to address the emotional experience during PTE. The aim of this study is to explore the emotional content expressed by older adults during balance-focused exercises and the unique emotional content expressions following the PTE + DMT intervention compared to the PTE intervention. Eleven older adults (aged 81-91 years) from a day center were randomly assigned to either the PTE + DMT group (n = 6) or the PTE group (n = 5). Interpretative phenomenological analysis of the instructors' observations and process diary identified three themes that emerged during the sessions: (1) self-image and self-worth, (2) the individual in relation to others, and (3) past memories. These themes highlight both similarities and differences between the groups. These findings provide valuable insights into the emotional experiences encountered by older adults, particularly in the context of falls prevention practices. Recognizing, understanding, and facilitating the expression of these experiences can enhance the effectiveness of fall prevention interventions and contribute to the overall health of older adults.
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Affiliation(s)
- Michal Pitluk Barash
- The Graduate School of Creative Art Therapies, Faculty of Humanities & Social Sciences, Kibbutzim College of Education, Tel Aviv, Israel
- The Graduate School of Creative Art Therapies, Faculty of Social Welfare & Health Sciences, Emili Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa, Israel
| | - Michal Elboim-Gabyzon
- Physical Therapy Department, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
| | - Einat Shuper Engelhard
- The Graduate School of Creative Art Therapies, Faculty of Humanities & Social Sciences, Kibbutzim College of Education, Tel Aviv, Israel
- The Graduate School of Creative Art Therapies, Faculty of Social Welfare & Health Sciences, Emili Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa, Israel
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Pitluk Barash M, Shuper Engelhard E, Elboim-Gabyzon M. Feasibility and Effectiveness of a Novel Intervention Integrating Physical Therapy Exercise and Dance Movement Therapy on Fall Risk in Community-Dwelling Older Women: A Randomized Pilot Study. Healthcare (Basel) 2023; 11:healthcare11081104. [PMID: 37107938 PMCID: PMC10137670 DOI: 10.3390/healthcare11081104] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/15/2023] [Accepted: 04/02/2023] [Indexed: 04/29/2023] Open
Abstract
This pilot study presents a novel fall prevention intervention that integrates physical therapy exercise (PTE) and dance movement therapy (DMT) to address both physical and emotional fall risk factors, as well as factors influencing adherence to treatment. The aim of this study was to examine the feasibility and effectiveness of the intervention in a sample of eight older women (median = 86 [81.25-90.75] years) from a day center for senior citizens. The intervention, based on the Otago Exercise Program and DMT techniques, aimed to address the emotional experience during physical exercise. Participants were randomly assigned to either a PTE+DMT intervention group (n = 5) or a PTE control group (n = 3). A pre-post intervention battery of physical and emotional fall risk assessments, therapist-patient bond, and home exercise adherence was conducted. Non-parametric tests results showed significant improvement in the PTE+DMT group in measures of balance and fear of falling compared to the PTE group. However, no other significant differences were found between the groups in terms of falls-related psychological concerns, self-perceived health status, therapist-patient bond, and home exercise adherence. These findings demonstrate the feasibility and potential benefits of an intervention that integrates both physical and emotional aspects to reduce fall risk in older adults, and provide a basis for further studies and modifications in the research protocol.
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Affiliation(s)
- Michal Pitluk Barash
- The Graduate School of Creative Art Therapies, Faculty of Social Welfare & Health Sciences, Emili Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa 3498838, Israel
| | - Einat Shuper Engelhard
- The Graduate School of Creative Art Therapies, Faculty of Social Welfare & Health Sciences, Emili Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa 3498838, Israel
- The Graduate School of Creative Art Therapies, Faculty of Humanities & Social Sciences, Kibbutzim College of Education, Tel Aviv 6250769, Israel
| | - Michal Elboim-Gabyzon
- Physical Therapy Department, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa 3498838, Israel
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Lathouwers E, Dillen A, Díaz MA, Tassignon B, Verschueren J, Verté D, De Witte N, De Pauw K. Characterizing fall risk factors in Belgian older adults through machine learning: a data-driven approach. BMC Public Health 2022; 22:2210. [PMID: 36443808 PMCID: PMC9707258 DOI: 10.1186/s12889-022-14694-5] [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: 05/25/2022] [Accepted: 11/22/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Falls are a major problem associated with ageing. Yet, fall-risk classification models identifying older adults at risk are lacking. Current screening tools show limited predictive validity to differentiate between a low- and high-risk of falling. OBJECTIVE This study aims at identifying risk factors associated with higher risk of falling by means of a quality-of-life questionnaire incorporating biological, behavioural, environmental and socio-economic factors. These insights can aid the development of a fall-risk classification algorithm identifying community-dwelling older adults at risk of falling. METHODS The questionnaire was developed by the Belgian Ageing Studies research group of the Vrije Universiteit Brussel and administered to 82,580 older adults for a detailed analysis of risk factors linked to the fall incidence data. Based on previously known risk factors, 139 questions were selected from the questionnaire to include in this study. Included questions were encoded, missing values were dropped, and multicollinearity was assessed. A random forest classifier that learns to predict falls was trained to investigate the importance of each individual feature. RESULTS Twenty-four questions were included in the classification-model. Based on the output of the model all factors were associated with the risk of falling of which two were biological risk factors, eight behavioural, 11 socioeconomic and three environmental risk factors. Each of these variables contributed between 4.5 and 6.5% to explaining the risk of falling. CONCLUSION The present study identified 24 fall risk factors using machine learning techniques to identify older adults at high risk of falling. Maintaining a mental, physical and socially active lifestyle, reducing vulnerability and feeling satisfied with the living situation contributes to reducing the risk of falling. Further research is warranted to establish an easy-to-use screening tool to be applied in daily practice.
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Affiliation(s)
- Elke Lathouwers
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium.,Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Arnau Dillen
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium.,Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - María Alejandra Díaz
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium.,Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Bruno Tassignon
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Jo Verschueren
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Dominique Verté
- Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, 1050, Brussels, Belgium.,Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium
| | - Nico De Witte
- Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, 1050, Brussels, Belgium.,Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium.,Gerontology and Frailty in Ageing (FRIA) research department, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
| | - Kevin De Pauw
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium. .,Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, 1050, Brussels, Belgium.
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Relationship between handgrip strength and self-reported functional difficulties among older Indian adults: The role of self-rated health. Exp Gerontol 2022; 165:111833. [DOI: 10.1016/j.exger.2022.111833] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/05/2022] [Accepted: 05/09/2022] [Indexed: 11/20/2022]
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Yue Z, Liang H, Gao X, Qin X, Li H, Xiang N, Liu E. The association between falls and anxiety among elderly Chinese individuals: The mediating roles of functional ability and social participation. J Affect Disord 2022; 301:300-306. [PMID: 35051441 DOI: 10.1016/j.jad.2022.01.070] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/20/2021] [Accepted: 01/11/2022] [Indexed: 12/19/2022]
Abstract
BACKGROUND Elderly individuals who experience falls suffer from higher levels of anxiety because of physical or mental injury. This study examined the association between falls and anxiety among elderly Chinese individuals. It also explored the mediating roles of functional ability and social participation in the link between falls and anxiety. METHODS The analytical sample included 8233 elderly people aged 60 and above, and prospective data were obtained from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Anxiety was evaluated by a 7-item Generalized Anxiety Disorder (GAD-7) scale, and falls were determined by self-report. The association between falls and anxiety was assessed by linear regression. Mediation analysis was used to explore the potential mediating roles of functional ability and social participation on the association between falls and anxiety. RESULTS Suffering falls predicted higher anxiety levels among elderly individuals (B = 0.608, 95% CI: 0.471, 0.746). Functional ability and social participation play partial mediating roles in the association between falls and anxiety, and the mediating effects were 0.036 (95% CI: 0.020, 0.058) and 0.005 (95% CI: 0.003, 0.014), respectively. The serial mediating effect of functional ability and social participation on the association between falls and anxiety was 0.003 (95% CI: 0.002, 0.005). LIMITATIONS This study is based upon cross-sectional data, which limit inferring causality. CONCLUSIONS This study suggests that policy-makers should explore how to encourage elderly individuals who experience falls to restore functional ability and participate in appropriate social activities to alleviate anxiety.
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Affiliation(s)
- Zhang Yue
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Hang Liang
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Xuyao Gao
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Xigang Qin
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Huwei Li
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Nan Xiang
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, China
| | - Erpeng Liu
- Institute of Income Distribution and Public Finance, Zhongnan University of Economics and Law, Wuhan, China.
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