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Honda H, Ashizawa R, Take K, Hirase T, Arizono S, Yoshimoto Y. Effect of chronic pain on the occurrence of falls in older adults with disabilities: a prospective cohort study. Physiother Theory Pract 2024; 40:1206-1214. [PMID: 36335438 DOI: 10.1080/09593985.2022.2141597] [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: 07/31/2021] [Revised: 10/11/2022] [Accepted: 10/13/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND The relationship between chronic pain and the occurrence of falls in healthy older adults has been clarified in previous studies, but its relationship in older adults with disabilities has not. OBJECTIVE This study aimed to determine whether chronic pain is related to the occurrence of falls in older adults with disabilities. METHODS The participants were 101 older adults above 65 years old who used long-term care insurance services in Japan. Of these, 30 were fallers and 71 were non-fallers. Chronic pain, defined as pain lasting more than three months, was assessed using questionnaires, and the falls' occurrence was followed up for six months using a fall calendar. Logistic regression analysis was used to analyze the data, with falls as the dependent variable, chronic pain as the independent variable, and age, sex, body mass index, number of drugs, sleep disorders, and depression as covariates. RESULTS After adjusting for covariates, chronic pain significantly influenced the occurrence of falls (odds ratio: 3.168, 95% confidence interval: 1.057-9.495, p = .04). CONCLUSION Chronic pain was related to the occurrence of falls in older adults with disabilities. There is a need to focus on chronic pain presence in falls' prevention among older adults with disabilities.
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Affiliation(s)
- Hiroya Honda
- Division of Rehabilitation Science, Seirei Christopher University Graduate School, Shizuoka, Japan
| | - Ryota Ashizawa
- Division of Rehabilitation Science, Seirei Christopher University Graduate School, Shizuoka, Japan
| | - Koki Take
- Visiting Nurse Station Sumiyoshi-daini, Shizuoka, Japan
| | - Tatsuya Hirase
- Division of Physical Therapy Science, Graduate Course of Health and Social Work, Kanagawa University of Human Services, Yokosuka-shi, Japan
| | - Shinichi Arizono
- School of Rehabilitation Science, Seirei Christopher University, Shizuoka, Japan
| | - Yoshinobu Yoshimoto
- School of Rehabilitation Science, Seirei Christopher University, Shizuoka, Japan
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van Scherpenseel MC, van Veenendaal LJ, te Velde SJ, Volk E, Barten DJJA, Veenhof C, Emmelot-Vonk MH, Ronteltap A. Reframing Communication about Fall Prevention Programs to Increase Older Adults' Intentions to Participate. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:704. [PMID: 38928950 PMCID: PMC11203759 DOI: 10.3390/ijerph21060704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/16/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024]
Abstract
INTRODUCTION Falls and fall-related injuries in community-dwelling older adults are a growing global health concern. Despite effective exercise-based fall prevention programs (FPPs), low enrollment rates persist due to negative connotations associated with falls and aging. This study aimed to investigate whether positive framing in communication leads to a higher intention to participate in an FPP among community-dwelling older adults. METHODS We conducted a two-sequence randomized crossover study. We designed two flyers, a standard flyer containing standard terminology regarding FPPs for older adults, and a reframed flyer highlighting fitness and activity by reframing 'fall prevention' as an 'exercise program' and 'old' as 'over 65 years'. With a Mann-Whitney U test, we investigated group differences regarding the intention to participate between the flyers. A sensitivity analysis and subgroup analyses were performed. We conducted qualitative thematic analysis on open-ended answers to gain a deeper understanding of participants' intention to participate. RESULTS In total, we included 133 participants. Findings indicated a significantly higher intention to participate in the reframed flyer (median = 4; interquartile range = 1-6) compared to the standard flyer (median = 2; interquartile range = 1-4) (p = 0.038). Participants favored more general terms such as 'over 65 years' over 'older adults'. Older adults who were female, not at high fall risk, perceived themselves as not at fall risk, and maintained a positive attitude to aging showed greater receptivity to positively-framed communications in the reframed flyer. Additionally, already being engaged in physical activities and a lack of practical information about the FPP appeared to discourage participation intentions. DISCUSSION The results in favor of the reframed flyer provide practical insights for designing and implementing effective (mass-)media campaigns on both (inter)national and local levels, as well as for interacting with this population on an individual basis. Aging-related terminology in promotional materials hinders engagement, underscoring the need for more positive messaging and leaving out terms such as 'older'. Tailored positively framed messages and involving diverse older adults in message development are essential for promoting participation in FPPs across various population subgroups to promote participation in FPPs among community-dwelling older adults.
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Affiliation(s)
- Meike C. van Scherpenseel
- Research Group Innovation of Human Movement Care, Research Center for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, 35011AA Utrecht, The Netherlands; (S.J.t.V.); (D.-J.J.A.B.); (C.V.); (A.R.)
| | - Lidia J. van Veenendaal
- Research Group Proactive Care for Older Adult People Living at Home, Research Center for Healthy an Sustainable Living, HU University of Applied Sciences Utrecht, 3501AA Utrecht, The Netherlands;
- Bachelor of Nursing, Institute for Nursing Studies, HU University of Applied Sciences Utrecht, 35011AA Utrecht, The Netherlands
| | - Saskia J. te Velde
- Research Group Innovation of Human Movement Care, Research Center for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, 35011AA Utrecht, The Netherlands; (S.J.t.V.); (D.-J.J.A.B.); (C.V.); (A.R.)
| | - Elise Volk
- Research Group Innovation of Human Movement Care, Research Center for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, 35011AA Utrecht, The Netherlands; (S.J.t.V.); (D.-J.J.A.B.); (C.V.); (A.R.)
| | - Di-Janne J. A. Barten
- Research Group Innovation of Human Movement Care, Research Center for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, 35011AA Utrecht, The Netherlands; (S.J.t.V.); (D.-J.J.A.B.); (C.V.); (A.R.)
| | - Cindy Veenhof
- Research Group Innovation of Human Movement Care, Research Center for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, 35011AA Utrecht, The Netherlands; (S.J.t.V.); (D.-J.J.A.B.); (C.V.); (A.R.)
- Department of Rehabilitation, Physiotherapy Science and Sport, University Medical Center Utrecht, Utrecht University, 3508GA Utrecht, The Netherlands
- Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, 3454 PV De Meern, The Netherlands
| | | | - Amber Ronteltap
- Research Group Innovation of Human Movement Care, Research Center for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, 35011AA Utrecht, The Netherlands; (S.J.t.V.); (D.-J.J.A.B.); (C.V.); (A.R.)
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Liang H, Zhang Z, Lai H, Tian T. Prevalence and risk factors for falls among older Chinese adults in the community: findings from the CLHLS study. Braz J Med Biol Res 2024; 57:e13469. [PMID: 38775548 PMCID: PMC11101163 DOI: 10.1590/1414-431x2024e13469] [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: 01/23/2024] [Accepted: 03/24/2024] [Indexed: 05/25/2024] Open
Abstract
Older adults have a high prevalence of falls due to a decline in physiological functions and various chronic diseases. This study aimed to investigate the prevalence of and risk factors for falls among older individuals in the Chinese Longitudinal Healthy Longevity Survey (CLHLS). We collected information from 9737 older individuals (average age=84.26 years) from the CLHLS and used binary logistic regression analysis to explore the independent risk factors and protective factors for falls. The logistic regression analysis results are reported as adjusted odds ratios (aORs) and 95% confidence intervals (95%CIs). The prevalence of falls among older adults in China was 21.6%, with women (24.6%) having a higher prevalence than men (18.1%). Logistic regression analysis revealed that never (or rarely) eating fresh fruit, difficulty with hearing, cataracts, and arthritis were the common independent risk factors for falls in older Chinese men and women. Among men, age ≥80 years (aOR=1.86), never doing housework (aOR=1.36), and dyslipidemia (aOR=1.47) were risk factors, while eating milk products once a week was a protective factor. Alcohol consumption (aOR=1.40), physical labor (aOR=1.28), and heart disease (aOR=1.21) were risk factors for falls in women, while a daily sleep duration of 6-12 h and garlic consumption once a week were protective factors. The prevalence of falls among older adults in China is 21.6% and is greater in women than in men. These risk and protective factors can be used to formulate reasonable recommendations for living habits, diet, and chronic disease control strategies.
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Affiliation(s)
- Haodong Liang
- The Affiliated TCM Hospital of Guangzhou Medical University,
Guangzhou, China
| | - Zijie Zhang
- The Second Clinical Medical College of Guangzhou University of
Chinese Medicine, Guangzhou, China
| | - Haitian Lai
- The Eighth Clinical Medical College of Guangzhou University of
Chinese Medicine, Guangzhou, China
| | - Tianzhao Tian
- The Affiliated TCM Hospital of Guangzhou Medical University,
Guangzhou, China
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Bai X, Han B, Zhang M, Liu J, Cui Y, Jiang H. The association between diuretics and falls in older adults: A systematic review and meta-analysis. Geriatr Nurs 2023; 52:106-114. [PMID: 37290215 DOI: 10.1016/j.gerinurse.2023.05.009] [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: 03/10/2023] [Revised: 05/18/2023] [Accepted: 05/18/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Diuretic intake increases the risk of falling. However, previous studies have shown inconsistent correlations between diuretics and falls. This meta-analysis aimed to provide a comprehensive overview of the relationship between diuretic use and risk of falls in older adult individuals. METHODS Six databases (Cochrane Library, PubMed, Medline, CINAHL, Web of Science, and EMBASE) were searched from their inception to November 9, 2022. The risk of bias was independently evaluated using the Newcastle-Ottawa Quality Assessment Scale. A comprehensive meta-analysis was used to analyze the eligible studies. RESULTS Fifteen articles were analyzed. Studies have shown that diuretics can increase the risk of falls in older adult individuals. The probability of falls in older adult individuals who used diuretics was 1.185 times higher than in those who did not take diuretics. CONCLUSION Diuretics were significantly associated with an increased risk of falls.
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Affiliation(s)
- Xue Bai
- School of Nursing, Fudan University, Shanghai, China; Huashan Hospital affiliated to Fudan University, Shanghai, China
| | - Bing Han
- Department of Nursing, Beijing Ji Shui Tan Hospital, Beijing, China
| | - Man Zhang
- School of Medical, Yan'an University, Yan'an City, Shaanxi Province, China
| | - Jinfeng Liu
- Mianyang Central Hospital, Mianyang City, Sichuan Province, China
| | - Yi Cui
- Department of Nursing, Air Force Medical University, Xi'an City, Shaanxi Province, China
| | - Hong Jiang
- Huashan Hospital affiliated to Fudan University, Shanghai, China.
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Gallibois M, Handrigan G, Caissie L, Cooling K, Hébert J, Jarrett P, McGibbon C, Read E, Sénéchal M, Bouchard DR. The Effect of a Standing Intervention on Falls in Long Term Care: a Secondary Analysis of a Randomized Controlled Trial. Can Geriatr J 2023; 26:247-252. [PMID: 37265979 PMCID: PMC10198682 DOI: 10.5770/cgj.26.656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
Background Older adults in long term care (LTC) spend over 90% of their day engaging in sedentary behaviour. Sedentary behaviour may exacerbate functional decline and frailty, increasing the risk for falls. The purpose of this study is to explore the impact of a 22-week standing intervention on falls among LTC residents at 12-month follow-up. Methods This was a planned secondary analysis of the Stand if You Can randomized controlled trial. The original trial randomized 95 participants (n = 47 control; n = 48 intervention) to either a sitting control or a supervised standing intervention group (100 minutes/week) for 22 weeks. Falls data were available to be collected over 12 months post-intervention for 89 participants. The primary outcome was a hazard of fall (Yes/No) during the 12-month follow-up period. Results A total of 89 participants (average age 86 years ± 8.05; 71.9% female) were followed for 12-months post-intervention. Participants in the intervention group (n=44) had a significantly greater hazard ratio of falls (2.01; 95% CI = 1.11 to 3.63) than the control group (n=45) when accounting for the history of falls, frailty status, cognition level, and sex. Conclusion Participants who received a standing intervention over 22 weeks were twice as likely to fall 12 months after the intervention compared with the control group. However, the prevalence of falls did not surpass what would be typically observed in LTC facilities. It is imperative that future studies describe in detail the context in which falls happen and collect more characteristics of participants in the follow-up period to truly understand the association between standing more and the risk of falls.
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Affiliation(s)
- Molly Gallibois
- Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
- Cardiometabolic Exercise & Lifestyles Laboratory (CELLAB), University of New Brunswick, Fredericton, NB
| | - Grant Handrigan
- Faculté des Sciences de la Santé et des Services Communautaires, Université de Moncton, Moncton, NB
| | - Linda Caissie
- Faculty of Social Science, Saint-Thomas University, Fredericton, NB
| | - Kendra Cooling
- Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
- Faculté des Sciences de la Santé et des Services Communautaires, Université de Moncton, Moncton, NB
| | - Jeffrey Hébert
- Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
- School of Psychology and Exercise Science, Murdoch University, Murdoch, Australia
| | - Pamala Jarrett
- Horizon Health Network, Department of Geriatric Medicine, Saint John, NB
- Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Chris McGibbon
- Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
- Institute of Biomedical Engineering, University of New Brunswick, Fredericton, NB
| | - Emily Read
- Faculty of Nursing, University of New Brunswick, Moncton, NB
| | - Martin Sénéchal
- Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
- Cardiometabolic Exercise & Lifestyles Laboratory (CELLAB), University of New Brunswick, Fredericton, NB
| | - Danielle R Bouchard
- Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
- Cardiometabolic Exercise & Lifestyles Laboratory (CELLAB), University of New Brunswick, Fredericton, NB
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Chen H, Huang L, Xiang W, Liu Y, Xu JW. Association between cognitive frailty and falls among older community dwellers in China: A Chinese longitudinal healthy longevity survey-based study. Front Aging Neurosci 2023; 14:1048961. [PMID: 36711208 PMCID: PMC9880264 DOI: 10.3389/fnagi.2022.1048961] [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: 09/20/2022] [Accepted: 12/28/2022] [Indexed: 01/14/2023] Open
Abstract
Background The combined effect of cognitive impairment (CoI) and frailty on falls is controversial. This study aimed to explore whether older adults with cognitive frailty (CF) were at a higher risk of falls than those with only CoI or frailty and to present a fall prediction model based on CF. Methods A total of 4,067 adults aged ≥ 60 years were included from the Chinese Longitudinal Healthy Longevity Survey through face-to-face interviews. Cognitive function and frailty were assessed using the mini-mental state examination scale and frailty index, respectively. Logistic regression was used to determine fall-associated risk factors and develop a fall prediction model. A nomogram was then plotted. The model performance was evaluated using the area under the curve (AUC), concordance index (C-index), and calibration curve. All analyses were performed using SPSS and R statistical packages. Results The prevalence of CF and falls were 1.4 and 19.4%, respectively. After adjusting for covariates, the odds ratio of CF, frailty only, and CoI only for falls were 2.27 (95% CI: 1.29-3.97), 1.41 (95% CI: 1.16-1.73), and 0.99 (95% CI: 0.43-2.29), respectively. CF, sex, age, hearing difficulty, depression, anxiety, disability in instrumental activities of daily living, and serious illness in the past 2 years were independently associated with falls. A prediction model based on these factors yielded an AUC of 0.646 and a C-index of 0.641. Conclusion Cognitive frailty (CF) exerted a cumulative effect on falls than did CoI or frailty alone. Joint assessments of cognitive function and frailty status may be beneficial for fall risk screening in community. A prediction model using CF as a factor could be helpful for this process.
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Affiliation(s)
- Huihe Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China,*Correspondence: Huihe Chen,
| | - Lanhui Huang
- Department of Geriatric Endocrinology and Metabolism, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Wei Xiang
- Department of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Yu Liu
- Department of Cardiology, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Jian-Wen Xu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China,Jian-Wen Xu,
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Luo Y, Ran H, Deng Y, Li H, Zhang M, Zhao L. Paid caregivers' experiences of falls prevention and care in China's senior care facilities: A phenomenological study. Front Public Health 2023; 11:973827. [PMID: 36875422 PMCID: PMC9978790 DOI: 10.3389/fpubh.2023.973827] [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: 06/20/2022] [Accepted: 01/25/2023] [Indexed: 02/18/2023] Open
Abstract
Background In China, as population aging accelerates, senior care facilities have gradually become a mainstream option. According to the World Health Organization (WHO), the annual rate of falls has increased from 30 to 50% in senior care facilities. A study found that older adults who live in senior care facilities are three times more likely to fall than those who live in the community. The quality of care is highly related to the occurrence of falls. Therefore, exploring paid caregivers' experiences is very important to prevent falls in senior care facilities. Objective The aim of this study was to explore paid caregivers' experiences of fall prevention and care in China's senior care facilities. Furthermore, we discussed the situation and provided suggestions. Design This is a phenomenological study using face-to-face, in-depth, semi-structured interviews. Setting The study was conducted at four senior care facilities in Changsha, Hunan, China. Participants Fourteen paid caregivers in four senior care facilities, including nursing assistants and senior nurses, participated in this study. Methods A purposive sample method was used to select 14 nursing assistants and senior nurses from four different senior care facilities in Changsha from March to April 2022. Every participant individually completed a face-to-face, in-depth, semi-structured interview. Based on the phenomenological research methodology, the thematic analysis method and the Colaizzi analysis method were used for data analysis and theme extraction. Results Based on interview data, a total of seven themes were distilled: (1) paid caregivers' professional requirements; (2) paid caregivers' attitude toward falls; (3) paid caregivers' fall training and education; (4) paid caregivers' knowledge about falls; (5) paid caregivers' fall risk assessment; (6) paid caregivers' fall prevention; and (7) paid caregivers' fall treatment. Conclusion In China's senior care facilities, paid caregivers to need to be responsible and pay appropriate attention to older adults. First, senior nurses and nursing assistants need to enhance communication and cooperation. Second, they must learn about deficiencies in fall risk assessment and try their best to improve their capability. Third, they must adopt appropriate education methods to improve fall prevention capability. Finally, the protection of privacy should be taken seriously.
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Affiliation(s)
- Yuan Luo
- Xiang Ya Nursing School, Central South University, Changsha, Hunan, China
| | - Haiye Ran
- Xiang Ya Nursing School, Central South University, Changsha, Hunan, China
| | - Yuqian Deng
- Xiang Ya Nursing School, Central South University, Changsha, Hunan, China
| | - Huan Li
- Xiang Ya Second Hospital of Central South University, Changsha, Hunan, China
| | - Mengxi Zhang
- Xiang Ya Second Hospital of Central South University, Changsha, Hunan, China
| | - Liping Zhao
- Xiang Ya Second Hospital of Central South University, Changsha, Hunan, China
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Leung T, Dean J, Fernandes JB, Godinho C. An Online Dual-Task Cognitive and Motor Exercise Program for Individuals With Parkinson Disease (PD3 Move Program): Acceptability Study. JMIR Aging 2022; 5:e40325. [PMID: 36548037 PMCID: PMC9816951 DOI: 10.2196/40325] [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: 06/15/2022] [Revised: 10/16/2022] [Accepted: 10/25/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Dual-task training is an emerging field used for people with Parkinson disease (PD) to improve their physical and cognitive well-being, but the patients' acceptability, safety, and adherence to such training in online settings are unknown. OBJECTIVE This study aims to evaluate the acceptability of a dual-task cognitive and motor online training program for people with PD as a group online community program. METHODS People with PD were invited to participate in an online program (PD3 Move) consisting of physical and vocal exercises in response to different cognitive challenges displayed as dynamic backgrounds on Zoom. The program ran twice per week for 16 weeks. Patient acceptability was assessed at 4 months by monitoring attendance rates and feedback from an exit questionnaire emailed to all participants assessing satisfaction, perceived benefit, safety, and willingness to continue and recommend to others. RESULTS The online program was delivered to 15 participants (n=9, 60%, females) with a diagnosis of PD, a mean age of 69.4 (SD 9.3) years, and Hoehn and Yahr (H&Y) stages I-IV. The attendance rate was high, with participants coming to more than 13 (81%) of the sessions. Participants were very satisfied (n=8, 53%) or satisfied (n=7, 47%) with the program. Participants reported that what they most liked were the new cognitive physical challenges. The 3 main facilitators to participating were perceiving the benefits, instructor's flexibility and engagement, and the social interaction moments with others. The 3 main difficulties were dealing with motor fluctuations (n=3, 20%), difficulties in using technology (n=2, 13%), and difficulty hearing instructions due to hearing loss (n=2, 13%). Patients had favorable perceived benefits of the program, with 14 (93%) considering it very useful for the current management of health and 1 (7%) moderately useful. No adverse events were reported, and all participants said that they were willing to continue the program and recommend it to others. CONCLUSIONS Our findings suggest that the online cognitive and motor program was well received, safe, and perceived to be of benefit to this group of medically stable people with PD in H&Y stages I-IV. Access to specialized care and enhancement of long-term adherence to regular exercise can be achieved with online community group programs.
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Affiliation(s)
| | - John Dean
- Triad Health AI, Aurora, CO, United States
| | - Júlio Belo Fernandes
- Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC), Centro de Investigação Interdisciplinar Egas Moniz, Almada, Portugal
| | - Catarina Godinho
- Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC), Centro de Investigação Interdisciplinar Egas Moniz, Almada, Portugal
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Xu Q, Ou X, Li J. The risk of falls among the aging population: A systematic review and meta-analysis. Front Public Health 2022; 10:902599. [PMID: 36324472 PMCID: PMC9618649 DOI: 10.3389/fpubh.2022.902599] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 09/20/2022] [Indexed: 01/22/2023] Open
Abstract
Aim This study aims to clarify the risk factors for falls to prevent severe consequences in older adults. Methods We searched the PubMed, Web of Science, Embase, and Google Scholar databases using the terms "risk factors" OR "predicting factors" OR "predictor" AND "fall" OR "drop" to identify all relevant studies and compare their results. The study participants were divided into two groups, the "fall group" and the "control group", and differences in demographic characteristics, lifestyles, and comorbidities were compared. Results We included 34 articles in the analysis and analyzed 22 factors. Older age, lower education level, polypharmacy, malnutrition, living alone, living in an urban area, smoking, and alcohol consumption increased the risk of falls in the aging population. Additionally, comorbidities such as cardiac disease, hypertension, diabetes, stroke, frailty, previous history of falls, depression, Parkinson's disease, and pain increased the risk of falls. Conclusion Demographic characteristics, comorbidities, and lifestyle factors can influence the risk of falls and should be taken into consideration.
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Affiliation(s)
| | | | - Jinfeng Li
- Department of Geriatrics, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China
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10
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Felton N, Deave T. The Lived Experience of Healthcare Workers in Preventing Falls in Community Dwelling Individuals with Dementia. Geriatrics (Basel) 2022; 7:113. [PMID: 36286216 PMCID: PMC9601408 DOI: 10.3390/geriatrics7050113] [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: 08/29/2022] [Revised: 10/02/2022] [Accepted: 10/05/2022] [Indexed: 11/06/2022] Open
Abstract
Older adults living with dementia have at least twice the risk of falling compared to their peers living without cognitive impairment. There is evidence for the effectiveness of standard interventions in falls prevention in community dwellings, but they may not translate to individuals with Mild Cognitive Impairment (MCI) or dementia. A qualitative enquiry, adopting an interpretive research design underpinned by a phenomenological approach using semi-structured interviews with four healthcare workers from the field was adopted. Data were analysed using Interpretive Phenomenological Analysis to identify themes. Four major themes were developed: on-going assessment is important in guiding interventions and influencing change, knowledge and experience informs practice, individuals living with dementia have complex physical and cognitive needs, and teamwork is essential in falls prevention strategies, which highlighted falls prevention in this context being multifactorial and complex. The findings found that combining physical and cognitive strategies as part of falls prevention has potential benefits for this population, including reducing falls risks and maintaining function. Targeted training and awareness raising within a supportive multi-disciplinary team structure is required, underpinned by on-going, person-centred assessments.
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Affiliation(s)
- Nansi Felton
- Avon and Wiltshire Mental Health Partnership NHS Trust, Bath NHS House, Newbridge Hill, Bath BA1 3QE, UK
- School for Health and Social Well-Being, University of the West of England, Bristol BS16 1DD, UK
| | - Toity Deave
- School for Health and Social Well-Being, University of the West of England, Bristol BS16 1DD, UK
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Ferreira CR, Mascarenhas-Melo F, Rodrigues AR, Lima MJR, Pinheiro JP, Chaves C, Teixeira-Lemos E, Bell V. Characterisation of institutionalised Portuguese older adult fallers: is there a place for pharmacist intervention? A preliminary study. Pharm Pract (Granada) 2022; 20:2717. [PMID: 36793917 PMCID: PMC9891778 DOI: 10.18549/pharmpract.2022.4.2717] [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: 07/28/2022] [Accepted: 08/17/2022] [Indexed: 12/14/2022] Open
Abstract
Background Falls are a major public health issue, given their prevalence and social impact. Older adults living in long-term care facilities (LTCF) are at greater risk of injury resulting from a fall due to multiple factors, such as nutritional, functional/cognitive impairment, postural instability, polypharmacy, and the presence of potentially inappropriate medications (PIMs). Medication management in LTCF is complex and often sub-optimal and might be crucial for falls. Pharmacist intervention is important, since they have a unique knowledge of medication. However, studies mapping the impact of pharmaceutical activities in Portuguese LTC settings are scarce. Objective This study aims to assess the characteristics of older adult fallers living in LTFCs and examine the relationship between falling and several factors in this population. We also intend to explore the prevalence of PIMs and their relationship with the occurrence of falls. Methods The study was conducted in two long-term care facilities for elderly people, in the central region of Portugal. We included patients aged 65 and older with no reduced mobility or physical weakness and with the ability to understand spoken and written Portuguese. The following information was assessed: sociodemographic characteristics, comorbidities, polypharmacy, fear of falling, functional, nutritional and cognitive status. PIMs were evaluated according to the Beers criteria (2019). Results A total of 69 institutionalised older adults, 45 women and 24 men, with a mean age of 83.14 ± 8.87 years were included. The prevalence of falls was 21.74% Out of these, 46.67% (n=7) fell once, 13.33% (n=2) fell twice, and 40% (n=6) fell 3 or more times. Fallers were mainly women, had lower levels of education, were well nourished, had moderate to severe levels of dependence, and displayed moderate cognitive impairment. All adult fallers had a fear of falling. The main comorbidities of this population were related to the cardiovascular system. Polypharmacy was present in every patient, and at least one PIM was identified in 88.41% of the subjects. Fear of falling (FOF) and cognitive impairment (in subjects with 1 to 11 years of education) showed statistically significant associations with the occurrence of falls (p=0.005 and p=0.05, respectively). No significant differences were found between fallers and non-fallers for any other factors. Conclusions This present study is a preliminary contribution to characterise a group of older adult fallers living in Portuguese LTCFs and demonstrated that fear of falling and cognitive impairment are associated with the occurrence of falls in this population. The high prevalence of polypharmacy and PIMs emphasises the need for tailored interventions featuring the collaboration of a pharmacist to optimise medication management in this population.
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Affiliation(s)
- Carina Ramos Ferreira
- Pharmacist, Laboratory of Social Pharmacy and Public Health, Faculty of Pharmacy of the University of Coimbra, University of Coimbra, Coimbra, Portugal.
| | - Filipa Mascarenhas-Melo
- Pharmacist, PhD, Drug Development and Technology Laboratory, Faculty of Pharmacy of the University of Coimbra, University of Coimbra, Coimbra, Portugal; REQUIMTE/LAQV, Group of Pharmaceutical Technology, Faculty of Pharmacy of the University of Coimbra, University of Coimbra, Coimbra, Portugal.
| | - Ana Rita Rodrigues
- Pharmacist, PhD student, Laboratory of Social Pharmacy and Public Health, Faculty of Pharmacy of the University of Coimbra, University of Coimbra, Coimbra, Portugal.
| | - Maria João Reis Lima
- Pharmacist, PhD, ESAV, CERNAS-IPV Research Centre, Polytechnic Institute of Viseu, Portugal.
| | - João Páscoa Pinheiro
- MD, PhD, Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal.
| | - Claúdia Chaves
- ND, MSN, PhD, Nursing Department, ESSV, Centre for Studies in Education and Innovation (CI&DEI), Polytechnic Institute of Viseu, Portugal.
| | - Edite Teixeira-Lemos
- Pharmacist, MSc, PhD, CERNAS-IPV Research Centre, Polytechnic Institute of Viseu, Portugal.
| | - Victoria Bell
- Pharmacist, MSc, PhD, Laboratory of Social Pharmacy and Public Health, Faculty of Pharmacy of the University of Coimbra, University of Coimbra, Coimbra, Portugal.
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Relationship between Anemia and Falls among Postmenopausal Women in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148242. [PMID: 35886093 PMCID: PMC9316311 DOI: 10.3390/ijerph19148242] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 06/28/2022] [Accepted: 07/04/2022] [Indexed: 12/10/2022]
Abstract
This study was conducted to explore the relationship between anemia and falls in postmenopausal women. The relationships between energy, protein, iron, and vitamin C intake were also checked. The data of this study are a combination of data from the Korea National Health and Nutrition Examination Survey (KNHANES) collected from the KNHANES VI-2,3 (2014–2015) and VII-1,2,3 (2016–2018). Falls and anemia were compared according to the subjects’ characteristics. Phi and Cramer’s V coefficient were applied to find the strength of association. Energy, protein, iron, and vitamin C intake and anemia were investigated. The relationship between the status as anemic and the occurrence of falls was analyzed using binary logistic regression. Of the 6665 subjects, 274 had a fall, and 596 had anemia. If the energy intake did not meet the estimated energy requirements, the state of anemia was significantly higher with a weak association. When protein, iron, and vitamin C did not meet the recommended nutrient intake, the anemia state was considerably higher with a weak to moderate association. Postmenopausal women with anemia were more likely to fall than subjects without anemia (OR = 1.88, p = 0.003). Additionally, anemia was confirmed to be related to insufficient energy, protein, iron, and vitamin C intake.
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Zhang XM, Wu XJ, Cao J, Jiao J, Chen W. Association between Cognitive Frailty and Adverse Outcomes among Older Adults: A Meta-Analysis. J Nutr Health Aging 2022; 26:817-825. [PMID: 36156673 DOI: 10.1007/s12603-022-1833-5] [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: 11/30/2022]
Abstract
OBJECTIVES This systematic review and meta-analysis aimed to pool the effect size of the association between cognitive frailty and adverse outcomes (e.g., falls, disability, and hospitalization) among older adults. DESIGN Systematic review and meta-analysis. METHODS PubMed, ScienceDirect, and Embase were searched from their respective inceptions to June 1, 2022. We extracted prospective cohort studies that reported the association between cognitive frailty and adverse outcomes. Random or fixed-effects models based on heterogeneity were used to pool the effect sizes of independent associations of cognitive frailty, frailty only, and cognitive impairment only with each adverse outcome. RESULTS Fifteen studies involving 49,122 older adults were included in the meta-analysis. Older adults with cognitive frailty had higher odds ratios (OR) for falls (1.82, 95% confidence interval [CI]: 1.29-2.58), disability (3.17, 95%CI: 2.24-4.48), and hospitalization (1.78, 95%CI: 1.48-2.14) compared with those without frailty and cognitive impairment. Older adults with frailty only demonstrated a high risk for falls (pooled OR 1.76, 95%CI: 1.25-2.48), disability (pooled OR 1.82, 95%CI: 1.43-2.33), and hospitalization (pooled OR 1.64, 95% CI: 1.45-1.85). The influence of cognitive impairment only on adverse outcomes was lower compared with cognitive frailty or frailty. Subgroup analyses showed that those with cognitive frailty (defined by the frailty phenotype plus Mini-Mental State Examination) were at greater risk for developing adverse outcomes. CONCLUSION Our findings indicate that cognitive frailty is an independent risk factor for adverse outcomes (e.g., falls, disability, and hospitalization). Early screening and comprehensive intervention may improve cognitive frailty and reduce the risk for adverse outcomes among older adults.
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Affiliation(s)
- X M Zhang
- Xiao-Ming Zhang, Xin-Juan Wu, Department of Nursing, Chinese Academy of Medical Sciences-Peking Union Medical College, Peking Union Medical College Hospital (Dongdan campus), No.1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing 100730, China, ,
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