Effectiveness ofTai Ji Quanvs Multimodal and Stretching Exercise Interventions for Reducing Injurious Falls in Older Adults at High Risk of Falling

Abstract Background Falls and fall-related injuries are common in community-dwelling older persons. Longitudinal data on effective fall prevention programs are rare. Objective Therefore, we evaluated a 4-months multi-component exercise fall prevention program in a primary care setting on long-term effects over 24 months on falls and concomitant injuries in older community-dwelling persons with high risk of falling. Design and Setting In the Prevention of Falls (PreFalls) study, forty general practitioners in Germany were cluster-randomized (1:1) into an intervention group (IG) or control group (CG). Three hundred seventy-eight independently living people with high risk of falling (78.1 ± 5.9 years, 75% women) were assigned to IG (n = 222) or CG (n = 156). Intervention and Measurements Patients in IG took part in a 4-months multi-component exercise program comprising strength and balance exercises (28 sessions); patients in CG received no intervention. Primary outcome measure was number of falls over 24 months, analyzed by a patient-level, linear mixed Poisson model. Secondary endpoints were number of fall-related injuries, changes in physical function, fear of falling, and mortality. Results After 24 months, the IG demonstrated significantly fewer falls (IRR = 0.63, p = 0.021), injurious falls (IRR = 0.69, p = 0.034), and less fear of falling (p = 0.005). The mortality rate was 5.0% in IG and 10.3% in CG (HR = 0.51, 95% CI: 0.24 to 1.12; p = 0.094). Conclusions In older community-dwelling persons with high risk of falling, a short-term multi-component exercise intervention reduced falls and injurious falls, as well as fear of falling over 24 months.

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Balance Differences between North and South American Older Adults: A Cross-Sectional, Age and Sex Matched Study

10.20944/preprints202111.0387.v1 ◽

2021 ◽

Author(s):

Matheus Almeida Souza ◽

Daniel Goble ◽

Paige Arney ◽

Edgar Ramos Vieira ◽

Gabriela Silveira-Nunes ◽

...

Keyword(s):

Older Adults ◽

High Risk ◽

North American ◽

Force Plate ◽

South American ◽

Risk Of Falling ◽

Men And Women ◽

Falls Risk ◽

South Americans ◽

North And South

This study aimed to characterize the risk of falling in low, moderate and high risk participants from two different geographical locations using a portable force-plate. A sample of 390 older adults from South and North America were matched for age, sex, height and weight. All participants performed a standardized balance assessment using a force plate. Participants were classified in low, moderate and high risk of falling. No differences were observed between South and North American men, nor comparing North American men and women. South American women showed the significantly shorter center of pressure path length compared to other groups. The majority of the sample was categorized as having low risk of falling (male: 65.69 % and female: 61.87 %), with no differences between men and women. Also, no differences were found between North vs. South Americans, nor for falls risk levels when male and female groups were compared separately. In conclusion, South American women had better balance compatible with the status of the 50-59 years’ normative age-range. The prevalence of low falls risk was ~ 61-65 % and the prevalence of moderate to high risk was ~ 16-19 %. The frequency of fall risk did not differ significantly between North and South Americans, nor between males and females.

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Exercise interventions reduce the risk of injurious falls among older adults

Evidence-Based Nursing ◽

10.1136/eb-2018-102917 ◽

2018 ◽

Vol 21 (3) ◽

pp. 75-75

Author(s):

Anne-Marie Hill

Keyword(s):

Older Adults ◽

Exercise Interventions ◽

Injurious Falls

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Falls in older adults with cancer: an updated systematic review of prevalence, injurious falls, and impact on cancer treatment

Supportive Care in Cancer ◽

10.1007/s00520-020-05619-2 ◽

2020 ◽

Vol 29 (1) ◽

pp. 21-33

Author(s):

S. Sattar ◽

K. Haase ◽

S. Kuster ◽

M. Puts ◽

S. Spoelstra ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Cancer Treatment ◽

Injurious Falls ◽

Falls In Older Adults

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Cognitive and Physical Function in Relation to the Risk of Injurious Falls in Older Adults: A Population-Based Study

The Journals of Gerontology Series A ◽

10.1093/gerona/glw141 ◽

2016 ◽

pp. glw141 ◽

Cited By ~ 12

Author(s):

Anna-Karin Welmer ◽

Debora Rizzuto ◽

Erika J. Laukka ◽

Kristina Johnell ◽

Laura Fratiglioni

Keyword(s):

Older Adults ◽

Physical Function ◽

Population Based ◽

Population Based Study ◽

Injurious Falls ◽

Falls In Older Adults

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Evidence Supports Action to Prevent Injurious Falls in Older Adults

JAMA ◽

10.1001/jama.2017.15098 ◽

2017 ◽

Vol 318 (17) ◽

pp. 1659 ◽

Cited By ~ 2

Author(s):

Eric B. Larson

Keyword(s):

Older Adults ◽

Injurious Falls ◽

Falls In Older Adults

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The Association between Gait Speed and Falls in Community Dwelling Older Adults with and without Mild Cognitive Impairment

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18073712 ◽

2021 ◽

Vol 18 (7) ◽

pp. 3712

Author(s):

Claire E. Adam ◽

Annette L. Fitzpatrick ◽

Cindy S. Leary ◽

Anjum Hajat ◽

Elizabeth A. Phelan ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Gait Speed ◽

Community Dwelling ◽

Self Report ◽

P Value ◽

Risk Of Falling ◽

Falls In Older Adults ◽

Status Interaction

(1) Background: Falls are common in older adults and result in injuries, loss of independence, and death. Slow gait is associated with falls in older adults, but few studies have assessed the association between gait speed and falls among those with mild cognitive impairment (MCI). (2) Methods: The association between gait speed and falls was assessed in 2705 older adults with and without MCI participating in the Ginkgo Evaluation of Memory Study. Gait speed was measured via a 15-foot walk test and fall history through self-report. We used data collected at the 12-month (2001–2003) and 18-month visits (2002–2004). (3) Results: Participant average age was 78.5 years (sd = 3.2); 45% were female, and 14% had MCI at baseline. The average gait speed was 0.93 m/s (sd = 0.20). Sixteen percent (n = 433) and 18% (n = 498) reported at least one fall at the 12-month and 18-month visits, respectively. Faster gait speed was associated with decreased risk of falling (RR: 0.95, 95% CI: 0.91, 0.99) for every 10 cm/s increase in gait speed adjusted for age, gender, study arm, site, and MCI status. (4) Conclusions: The relationship between gait speed and risk of falling did not vary by MCI status (interaction p-value = 0.78).

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Associations between Daily Movement Distribution, Bone Structure, Falls, and Fractures in Older Adults: A Compositional Data Analysis Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18073757 ◽

2021 ◽

Vol 18 (7) ◽

pp. 3757

Author(s):

Ana Moradell ◽

Irene Rodríguez-Gómez ◽

Ángel Iván Fernández-García ◽

David Navarrete-Villanueva ◽

Jorge Marín-Puyalto ◽

...

Keyword(s):

Older Adults ◽

Bone Mass ◽

Cortical Thickness ◽

Compositional Data ◽

Fear Of Falling ◽

Movement Behavior ◽

Risk Of Falling ◽

Mineral Density ◽

Exercise Interventions ◽

History Of

With aging, bone density is reduced, increasing the risk of suffering osteoporosis and fractures. Increasing physical activity (PA) may have preventive effects. However, until now, no studies have considered movement behaviors with compositional data or its association to bone mass and structure measured by peripheral computed tomography (pQCT). Thus, the aim of our study was to investigate these associations and to describe movement behavior distribution in older adults with previous falls and fractures and other related risk parameters, taking into account many nutritional and metabolic confounders. In the current study, 70 participants above 65 years old (51 females) from the city of Zaragoza were evaluated for the EXERNET-Elder 3.0 project. Bone mass and structure were assessed with pQCT, and PA patterns were objectively measured by accelerometry. Prevalence of fear of falling, risk of falling, and history of falls and fractures were asked through the questionnaire. Analyses were performed using a compositional data approach. Whole-movement distribution patterns were associated with cortical thickness. In regard to other movement behaviors, moderate-to-vigorous PA (MVPA) showed positive association with cortical thickness and total true bone mineral density (BMD) at 38% (all p < 0.05). In addition, less light PA (LPA) and MVPA were observed in those participants with previous fractures and fear of falling, whereas those at risk of falling and those with previous falls showed higher levels of PA. Our results showed positive associations between higher levels of MVPA and volumetric bone. The different movement patterns observed in the groups with a history of having suffered falls or fractures and other risk outcomes suggest that different exercise interventions should be designed in these populations in order to improve bone and prevent the risk of osteoporosis and subsequent fractures.

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Strength Training to Prevent Falls in Older Adults: A Systematic Review with Meta-Analysis of Randomized Controlled Trials

Journal of Clinical Medicine ◽

10.3390/jcm10143184 ◽

2021 ◽

Vol 10 (14) ◽

pp. 3184

Author(s):

João Gustavo Claudino ◽

José Afonso ◽

Javad Sarvestan ◽

Marcel Bahia Lanza ◽

Juliana Pennone ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Strength Training ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Cochrane Library ◽

Controlled Trials ◽

Exercise Interventions ◽

Randomized Controlled ◽

Falls In Older Adults

We performed a systematic review with meta-analysis of randomized controlled trials (RCTs) to assess the effects of strength training (ST), as compared to alternative multimodal or unimodal exercise programs, on the number of falls in older adults (≥60 years). Ten databases were consulted (CINAHL, Cochrane Library, EBSCO, EMBASE, PEDro, PubMed, Scielo, Scopus, SPORTDiscus and Web of Science), without limitations on language or publication date. Eligibility criteria were as follows: RCTs with humans ≥60 years of age of any gender with one group performing supervised ST and a group performing another type of exercise training, reporting data pertaining falls. Certainty of evidence was assessed with Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Meta-analysis used a random effects model to calculate the risk ratio (RR) for number of falls. Five RCTs with six trials were included (n = 543, 76% women). There was no difference between ST and alternative exercise interventions for falls (RR = 1.00, 95% CI 0.77–1.30, p = 0.99). The certainty of evidence was very low. No dose–response relationship could be established. In sum, ST showed comparable RR based on number of falls in older adults when compared to other multimodal or unimodal exercise modalities, but evidence is scarce and heterogeneous, and additional research is required for more robust conclusions. Registration: PROSPERO CRD42020222908.

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