Association between a history of falls and the ability to multi-task in community-dwelling older people

2010 ◽  
Vol 22 (5-6) ◽  
pp. 427-432 ◽  
Author(s):  
Hyuma Makizako ◽  
Taketo Furuna ◽  
Hiroyuki Shimada ◽  
Hikaru Ihira ◽  
Mika Kimura ◽  
...  
Keyword(s):  
Older People ◽  
Community Dwelling ◽  
History Of ◽  
Community Dwelling Older People

scholarly journals Development and internal validation of a risk prediction model for falls among older people using primary care electronic health records

2021 ◽  
Author(s):  
Noman Dormosh ◽  
Martijn C Schut ◽  
Martijn W Heymans ◽  
Nathalie van der Velde ◽  
Ameen Abu-Hanna
Keyword(s):  
Primary Care ◽  
High Risk ◽  
Older People ◽  
Prediction Model ◽  
Community Dwelling ◽  
Receiver Operating Curve ◽  
Free Text ◽  
Medical Conditions ◽  
History Of ◽  
Community Dwelling Older People

Abstract Background Currently used prediction tools have limited ability to identify community-dwelling older people at high risk for falls. Prediction models utilizing Electronic Heath Records (EHR) provide opportunities but up to now showed limited clinical value as risk stratification tool; because of among others the underestimation of falls prevalence. The aim of this study was to develop a fall prediction model for community-dwelling older people using a combination of structured data and free text of primary care EHR and to internally validate its predictive performance. Methods EHR data of individuals aged 65 or over. Age, sex, history of falls, medications and medical conditions were included as potential predictors. Falls were ascertained from the free text. We employed the Bootstrap-enhanced penalized logistic regression with the least absolute shrinkage and selection operator to develop the prediction model. We used 10-fold cross-validation to internally validate the prediction strategy. Model performance was assessed in terms of discrimination and calibration. Results Data of 36,470 eligible participants were extracted from the dataset. The number of participants who fell at least once was 4,778 (13.1%). The final prediction model included age, sex, history of falls, two medications and five medical conditions. The model had a median area under the receiver operating curve of 0.705 (IQR 0.700-0.714) . Conclusions Our prediction model to identify older people at high risk for falls achieved fair discrimination, and had reasonable calibration. It can be applied in clinical practice as it relies on routinely collected variables and does not require mobility assessment tests.

scholarly journals 01 Prediction of Falls in Community-Dwelling Older People using an Accelerometer: The Results of a 1-Year Prospective Study

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv1-iv2
Author(s):  
Hiroshi Osaka ◽  
Daisuke Fujita ◽  
Kenichi Kobara ◽  
Yosuke Yoshimura ◽  
Hiromi Matsumoto ◽  
...  
Keyword(s):  
Older People ◽  
Fall Risk ◽  
Walking Speed ◽  
Exercise Duration ◽  
Community Dwelling ◽  
Gait Parameters ◽  
Weight Shift ◽  
Trunk Acceleration ◽  
History Of ◽  
Community Dwelling Older People

Abstract Background Fall preventive exercise for community-dwelling older people in Japan has a certain effect. The purpose of this study was to examine the predictors of fall risk in older people engaging in preventive exercise. Methods In this prospective study, we recruited 162 community-dwelling older people. We had them complete a self-report questionnaire containing items on weekly exercise frequency, exercise duration, exercise efficacy, amount of pain, number of diagnosis chronic diseases, health anxiety level, vision impairment, difficulty using the stairs, insomnia, fear of falling, history of falls, and forgetfulness, as well as the Falls Efficacy Scale. Walking speed and trunk acceleration during walking were also measured in all participants. From trunk acceleration, we calculated five gait parameters: fluctuation, weight shift, lateral balance, anteroposterior balance, and rhythm. Participants were classified as fallers or non-fallers according to the incidence of falls over a 1-year period from baseline assessment. Results Of all participants, 19 (11.7%) were classified as fallers and 143 (88.3%) as non-fallers. In comparing the fallers and non-fallers, we found significant differences in their exercise duration, exercise efficacy, amount of pain, history of falls, walking speed, and the gait parameters of weight shift and anteroposterior balance. A logistic regression analysis revealed that walking speed (odds ratio: 0.049, 95% confidence interval [CI]: 0.005-0.265, p=0.008) and weight shift (odds ratio: 0.021, 95%CI: 0.000-0.877, p=0.043) were predictors of falls. Conclusion The gait parameter of weight shift is the amplitude ratio of the auto-correlation function from vertical acceleration. This gait parameter is an original metrics and might show the temporal structure around the terminal stance. Measurement of gait parameters, in addition to physical performance, using an accelerometer seems beneficial for fall risk identification among community-dwelling older people engaged in fall preventive exercise.

Prioritization and management of calls from older people to GP out-of-hours services

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Suzanne Smith ◽  
Lucia Carragher
Keyword(s):  
Older People ◽  
Service Provision ◽  
Emergency Services ◽  
Oldest Old ◽  
Community Dwelling ◽  
Third Party ◽  
Older Person ◽  
Out Of Hours ◽  
Accident And Emergency ◽  
Community Dwelling Older People

Abstract Background Urgent out-of-hours medical care is necessary to ensure people can remain living at home into older age. However, older people experience multiple barriers to using out-of-hours services including poor awareness about the general practitioner (GP) out-of-hours (GPOOH) service and how to access it. In particular, older people are reluctant users of GPOOH services because they expect either their symptoms will not be taken seriously or they will simply be referred to hospital accident and emergency services. The aim of this study was to examine if this expectation was borne out in the manner of GPOOH service provision. Objective The objective was to establish the urgency categorization and management of calls to GPOOH , for community dwelling older people in Ireland. Methods An 8-week sample of 770 calls, for people over 65 years, to a GPOOH service in Ireland, was analysed using Excel and Nvivo software. Results Urgency categorization of older people shows 40% of calls categorized as urgent. Recognition of the severity of symptoms, prompting calls to the GPOOH service, is also reflected in a quarter of callers receiving a home visit by the GP and referral of a third of calls to emergency services. The findings also show widespread reliance on another person to negotiate the GPOOH system, with a third party making 70% of calls on behalf of the older person seeking care. Conclusion Older people are in urgent need of medical services when they contact GPOOH service, which plays an effective and patient-centred gatekeeping role, particularly directing the oldest old to the appropriate level of care outside GP office hours. The promotion of GPOOH services should be enhanced to ensure older people understand their role in supporting community living.

Ten‐year trends in lifestyle habits among community‐dwelling older people in Taiwan

2021 ◽  
Author(s):  
Hsiao‐Ting Tsou ◽  
Tai‐Yin Wu ◽  
Kuan‐Liang Kuo ◽  
Sheng‐Huang Hsiao ◽  
Sheng‐Jean Huang ◽  
...  
Keyword(s):  
Older People ◽  
Community Dwelling ◽  
Lifestyle Habits ◽  
Community Dwelling Older People

scholarly journals Frailty Status and All-Cause Mortality in the Community-Dwelling Older People: An Umbrella Review

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 488-489
Author(s):  
A R M Saifuddin Ekram ◽  
Joanne Ryan ◽  
Carlene Britt ◽  
Sara Espinoza ◽  
Robyn Woods
Keyword(s):  
Older People ◽  
Systematic Reviews ◽  
Community Dwelling ◽  
Umbrella Review ◽  
Frailty Phenotype ◽  
Frailty Status ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Community Dwelling Older People ◽  
Meta Analyses

Abstract Frailty is increasingly recognised for its association with adverse health outcomes including mortality. However, various measures are used to assess frailty, and the strength of association could vary depending on the specific definition used. This umbrella review aimed to map which frailty scale could best predict the relationship between frailty and all-cause mortality among community-dwelling older people. According to the PRISMA guidelines, Medline, Embase, EBSCOhost and Web of Science databases were searched to identify eligible systematic reviews and meta-analyses which examined the association between frailty and all-cause mortality in the community-dwelling older people. Relevant data were extracted and summarised qualitatively. Methodological quality was assessed by AMSTAR-2 checklist. Five moderate-quality systematic reviews with a total of 374,529 participants were identified. Of these, two examined the frailty phenotype and its derivatives, two examined the cumulative deficit models and the other predominantly included studies assessing frailty with the FRAIL scale. All of the reviews found a significant association between frailty status and all-cause mortality. The magnitude of association varied between individual studies, with no consistent pattern related to the frailty measures that were used. In conclusion, regardless of the measure used to assess frailty status, it is associated with an increased risk of all-cause mortality.

scholarly journals The composition of the gut microbiome differs among community dwelling older people with good and poor appetite

2021 ◽  
Author(s):  
Natalie J. Cox ◽  
Ruth C.E. Bowyer ◽  
Mary Ni Lochlainn ◽  
Philippa M. Wells ◽  
Helen C. Roberts ◽  
...  
Keyword(s):  
Older People ◽  
Gut Microbiome ◽  
Community Dwelling ◽  
Poor Appetite ◽  
Community Dwelling Older People
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