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Lee HC, Hsieh CJ, Jerng JS. Incidence and Factors Associated with Falls in Older People in a Long-Term Care Facility: A Prospective Study in Taiwan. Healthcare (Basel) 2024; 12:959. [PMID: 38786371 PMCID: PMC11121478 DOI: 10.3390/healthcare12100959] [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: 03/15/2024] [Revised: 04/23/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND The effectiveness of applying a fall-risk assessment to prevent falls in residents of long-term care facilities has not been investigated. METHODS This prospective study enrolled elderly residents in a long-term care facility in Taiwan. Caregivers were provided with a health-status assessment and fall-risk data to enhance their fall-prevention practices. A multivariate analysis was performed to identify the factors associated with falls. RESULTS A total of 123 subjects, including 68 and 55 for general and nursing-care models, respectively, were assessed. Their health status and risk of falls were provided to the care units to enhance their fall-prevention practices. Subjects in the nursing-care model had more dementia and more prescribed medications, worse physiologic conditions, and higher fall risk. Of them, 28 (23%) had subsequent falls. A univariate analysis showed that those with and without falls were similar in demographic characteristics, prescribed medications, physiologic function, and fall risk. There was a tendency for more falls in the nursing-care model residents (accounting for 61% of those who fell; p = 0.053). A regression analysis showed that gender (beta = 1.359; 95% confidence interval = 0.345-2.374; p = 0.010) and NPI score (beta = 0.101; 95% CI = 0.001-0.200; p = 0.047) were associated with the risk of falls. CONCLUSION Residents at the long-term care facility had a significant risk of falls despite knowledge of their fall risk and the implementation of preventive measures. In this context of being aware of the risk, gender, and psychiatric symptoms were significantly associated with falls. Caregivers at long-term care facilities should implement further measures to prevent falls based on behavioral and psychological symptoms.
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Affiliation(s)
- Hung-Chun Lee
- Department of Nursing, National Taiwan University Hospital, Taipei 100225, Taiwan
| | - Chia-Jung Hsieh
- School of Nursing, College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 112303, Taiwan
| | - Jih-Shuin Jerng
- Department of Internal Medicine, National Taiwan University Hospital, Taipei 100225, Taiwan
- Center for Quality Management, National Taiwan University Hospital, Taipei 100225, Taiwan
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Zhao Y, Xie D, Zhang C, Wang H, Zhang B, Liu S, Li M, Chen G, Ding H. Analysis of factors influencing fall risk among elderly people in rural of China. Sci Rep 2024; 14:9703. [PMID: 38678070 PMCID: PMC11055911 DOI: 10.1038/s41598-024-60430-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 04/23/2024] [Indexed: 04/29/2024] Open
Abstract
Falls can cause serious health problems in the elderly. China is gradually entering a moderately aging society. In rural areas of China, the elderly are at a higher risk of falling. This study aims to explore and analyze the factors affecting the fall risk of elderly people in rural areas of China, and provide theoretical basis for reducing the fall risk of elderly people. M County, Anhui Province, China was selected as the survey site by the typical field sampling method, and the elderly people in rural areas were selected as the research objects. A total of 1187 people were investigated. Mann-Whitney U test and Kruskal-Wallis H test were used for univariate analysis, and multiple linear regression was used for multivariate analysis. Chronic diseases, multimorbidity, daily living ability, mental health, working status and family doctors are the factors that influence falls among elderly people in rural areas of China (P < 0.05, Adjusted R2 = 0.395). The falls risk of the elderly in rural areas of China is influenced by multiple factors. Therefore, comprehensive measures should be taken to reduce the fall risk by comprehensively evaluating the influencing factors.
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Affiliation(s)
- Yaodong Zhao
- Department of Health Service Management, School of Health Management, Anhui Medical University, Anhui, China
| | - Dan Xie
- School of Health Management, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Chi Zhang
- School of Health Management, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Haibo Wang
- Department of Health Service Management, School of Health Management, Anhui Medical University, Anhui, China
| | - Beibei Zhang
- Department of Health Service Management, School of Health Management, Anhui Medical University, Anhui, China
| | - Song Liu
- Department of Health Service Management, School of Health Management, Anhui Medical University, Anhui, China
| | - Min Li
- School of Health Management, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Guimei Chen
- School of Health Management, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Hong Ding
- School of Health Management, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.
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Gao S, Sun S, Sun T, Lu T, Ma Y, Che H, Liu M, Xue W, He K, Wang Y, Cao F. Chronic diseases spectrum and multimorbidity in elderly inpatients based on a 12-year epidemiological survey in China. BMC Public Health 2024; 24:509. [PMID: 38368398 PMCID: PMC10874035 DOI: 10.1186/s12889-024-18006-x] [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: 08/01/2023] [Accepted: 02/06/2024] [Indexed: 02/19/2024] Open
Abstract
BACKGROUND The number and proportion of the elderly population have been continuously increasing in China, leading to the elevated prevalence of chronic diseases and multimorbidity, which ultimately brings heavy burden to society and families. Meanwhile, the status of multimorbidity tends to be more complex in elderly inpatients than community population. In view of the above concerns, this study was designed to investigate the health status of elderly inpatients by analyzing clinical data in Chinese People's Liberation Army (PLA) General Hospital from 2008 to 2019, including the constitution of common diseases, comorbidities, the status of multimorbidity, in-hospital death and polypharmacy among elderly inpatients, so as to better understand the diseases spectrum and multimorbidity of elderly inpatients and also to provide supporting evidence for targeted management of chronic diseases in the elderly. METHODS A clinical inpatients database was set up by collecting medical records of elderly inpatients from 2008 to 2019 in Chinese PLA General Hospital, focusing on diseases spectrum and characteristics of elderly inpatients. In this study, we collected data of inpatients aged ≥ 65 years old, and further analyzed the constitution of diseases, multimorbidity rates and mortality causes in the past decade. In addition, the prescriptions were also analyzed to investigate the status of polypharmacy in elderly inpatients. RESULTS A total of 210,169 elderly patients were hospitalized from January 1st, 2008 to December 31st, 2019. The corresponding number of hospitalizations was 290,833. The average age of the study population was 72.67 years old. Of the total population, 73,493 elderly patients were re-admitted within one year, with the re-hospitalization rate of 25.27%. Malignant tumor, hypertension, ischemic heart disease, diabetes mellitus and cerebrovascular disease were the top 5 diseases. Among the study population, the number of patients with two or more long-term health conditions was 267,259, accounting for 91.89%, with an average of 4.68 diseases. In addition, the average number of medications taken by the study population was 5.4, among which, the proportion of patients taking more than 5 types of medications accounted for 55.42%. CONCLUSIONS By analyzing the constitution of diseases and multimorbidity, we found that multimorbidity has turned out to be a prominent problem in elderly inpatients, greatly affecting the process of healthy aging and increasing the burden on families and society. Therefore, multidisciplinary treatment should be strengthened to make reasonable preventive and therapeutic strategies to improve the life quality of the elderly. Meanwhile, more attention should be paid to reasonable medications for elderly patients with multimorbidity to avoid preventable side effects caused by irrational medication therapy.
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Affiliation(s)
- Shan Gao
- Chinese PLA Medical School, Chinese PLA General Hospital, 28# Fuxing Road, Beijing, Haidian District, 100853, China
| | - Shasha Sun
- Department of Cardiology & National Clinical Research Center for Geriatric Diseases, The Second Medical Center of Chinese PLA General Hospital, 28# Fuxing Road, Beijing, Haidian District, 100853, China
| | - Ting Sun
- Department of Cardiology & National Clinical Research Center for Geriatric Diseases, The Second Medical Center of Chinese PLA General Hospital, 28# Fuxing Road, Beijing, Haidian District, 100853, China
| | - Tingting Lu
- Department of Cardiology & National Clinical Research Center for Geriatric Diseases, The Second Medical Center of Chinese PLA General Hospital, 28# Fuxing Road, Beijing, Haidian District, 100853, China
| | - Yan Ma
- Chinese PLA Medical School, Chinese PLA General Hospital, 28# Fuxing Road, Beijing, Haidian District, 100853, China
- Department of Cardiology & National Clinical Research Center for Geriatric Diseases, The Second Medical Center of Chinese PLA General Hospital, 28# Fuxing Road, Beijing, Haidian District, 100853, China
| | - Hebin Che
- Medical Big Data Research Center, Chinese PLA General Hospital, 28# Fuxing Road, Beijing, Haidian District, 100853, China
| | - Miao Liu
- Chinese PLA Medical School, Chinese PLA General Hospital, 28# Fuxing Road, Beijing, Haidian District, 100853, China
| | - Wanguo Xue
- Medical Big Data Research Center, Chinese PLA General Hospital, 28# Fuxing Road, Beijing, Haidian District, 100853, China
| | - Kunlun He
- Medical Big Data Research Center, Chinese PLA General Hospital, 28# Fuxing Road, Beijing, Haidian District, 100853, China
| | - Yabin Wang
- Department of Cardiology & National Clinical Research Center for Geriatric Diseases, The Second Medical Center of Chinese PLA General Hospital, 28# Fuxing Road, Beijing, Haidian District, 100853, China.
| | - Feng Cao
- Department of Cardiology & National Clinical Research Center for Geriatric Diseases, The Second Medical Center of Chinese PLA General Hospital, 28# Fuxing Road, Beijing, Haidian District, 100853, China.
- State Key Laboratory of Kidney Disease, Chinese PLA General Hospital, 28# Fuxing Road, Beijing, Haidian District, 100853, China.
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Li S, Cui G, Er Y, Ye P, Xue T, Zhang J(J, Liu X, Duan L, Lv F, Yao Y. Housing Environmental Factors Driving Falls Among Middle-Aged and Older Adults: A National Cohort Study. Innov Aging 2023; 7:igad121. [PMID: 38106373 PMCID: PMC10724174 DOI: 10.1093/geroni/igad121] [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: 07/01/2023] [Indexed: 12/19/2023] Open
Abstract
Background and Objectives Housing is one of the main places where falls occur; however, few studies have examined housing environmental factors driving fall risk. This study aimed to explore the associations between housing environmental factors and falls in China. Research Design and Methods The study included data of middle-aged and older adults aged ≥45 years from 4 waves of the China Health and Retirement Longitudinal Study. We assessed 7 housing environmental factors: building materials, toilet types, household tidiness, household cooking fuels, and access to electricity, running water, and bathing facilities. Based on these, we divided housing environments into 3 types: good (0-2 poor factors), moderate (3-5 poor factors), and poor (6-7 poor factors). Falls incidence (yes or no) was self-reported during the survey period. We applied the Cox proportional hazard model to estimate the associations, adjusting for a set of covariates such as sociodemographic characteristics, lifestyles, and disease status. Results A total of 12,382 participants were analyzed, and the incidence of falls was 31.7%. According to the fully adjusted model, having a squatting toilet (hazard ratio [HR] = 1.14, 95% confidence interval [CI] = 1.03-1.26), household untidiness (HR = 1.09, 95% CI = 1.01-1.18), and solid fuel use for cooking (HR = 1.10, 95% CI = 1.02-1.18) were associated with a higher risk of falls (ps < .05), compared to their counterparts. We found a linear relationship between housing environments and falls (p for trend = .001). Specifically, moderate (HR = 1.16, 95% CI = 1.06-1.27) and poor housing environments (HR = 1.21, 95% CI = 1.08-1.34) were associated with a higher risk of falls compared to a good housing environment. Discussion and Implications Among middle-aged and older Chinese adults, a better household environment, including sitting toilets, tidy living conditions, and clean fuel use for cooking, may reduce the risk of falls. The evidence from our study suggests the need to implement age-friendly housing environments to prevent falls and disability in an aging society.
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Affiliation(s)
- Shaojie Li
- School of Public Health, Peking University, Beijing, China
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Guanghui Cui
- Department of Integrated Traditional Chinese and Western Medicine, Peking University First Hospital, Beijing, China
| | - Yuliang Er
- Division of Injury Prevention and Mental Health, National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Pengpeng Ye
- Division of Injury Prevention and Mental Health, National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tao Xue
- School of Public Health, Peking University, Beijing, China
- Institute of Reproductive and Child Health, Ministry of Health Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Junfeng (Jim) Zhang
- Global Health Institute and the Nicholas School of Environment, Duke University, Durham, North Carolina, USA
| | - Xiaoyun Liu
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Leilei Duan
- Division of Injury Prevention and Mental Health, National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Faqin Lv
- Ultrasonic Department, The Third Medical Center of Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Yao Yao
- China Center for Health Development Studies, Peking University, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China
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Alanazi A, Salih S. Fall Prevalence and Associated Risk Factors Among the Elderly Population in Tabuk City, Saudi Arabia: A Cross-Sectional Study 2023. Cureus 2023; 15:e45317. [PMID: 37846272 PMCID: PMC10577021 DOI: 10.7759/cureus.45317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2023] [Indexed: 10/18/2023] Open
Abstract
Background Falls are common among older adults, and they constitute a major public health issue with high morbidity and mortality. Aim This study aimed to estimate the prevalence of falls and investigate the contributing risk factors among the elderly population in Tabuk City, Saudi Arabia. Methods This cross-sectional study recruited a random representative sample of the elderly aged ≥ 60 years. We collected data by interviewing the participants using a structured, Arabic-language questionnaire. It included personal information, a history of falls in the past three and 12 months, comorbidities, and environmental factors. The main outcome was a history of falls in the preceding year. Multivariable logistic regression was used to evaluate the association between potential risk factors and falls. Results The study included 296 participants. Most participants were female (66.9%), aged 60-69 years (68.2%), and married (68.9%). The self-reported prevalence of falls over the preceding 12 months was 25.3% (95% confidence interval (CI): 20.6-30.5). Older people with depressive symptoms had significantly increased vulnerability to falls (adjusted odds ratio (AOR): 0.452, 95% CI: 0.239-0.854). Environmental factors were associated with a 1.799 times (95% CI: 1.041-3.109) increased likelihood of fall, and gait impairment was the strongest risk factor (AOR: 2.775, 95% CI: 1.558-4.942). Conclusions Falls are common among the elderly population in Tabuk City, Saudi Arabia. Gait impairment, the presence of depressive symptoms, and environmental hazards were substantially associated with falls, suggesting that most falls are preventable.
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Affiliation(s)
- Abdallalh Alanazi
- Preventive Medicine Department, Public Health Administration, Tabuk, SAU
| | - Safa Salih
- Preventive Medicine Department, Public Health Administration, Tabuk, SAU
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