scholarly journals Dizziness and its association with walking speed and falls efficacy among older men and women in an urban population

2019 ◽  
Vol 32 (6) ◽  
pp. 1049-1056 ◽  
Author(s):  
Ellen Lindell ◽  
Lena Kollén ◽  
Mia Johansson ◽  
Therese Karlsson ◽  
Lina Rydén ◽  
...  
Keyword(s):  
Walking Speed ◽  
Fear Of Falling ◽  
Risk Groups ◽  
Functional Tests ◽  
Swedish Version ◽  
The Past ◽  
Increased Risk ◽  
Risk Of Falls ◽  
The Relationship ◽  
Older Men And Women

Abstract Background Dizziness is common among older people and falling is a feared complication. Aim The purpose of this study was to investigate the presence of dizziness and its association with falls, walking speed and fear of falling, including sex differences, among 79-year-olds. Secondary purposes were to describe the relationship between dizziness and falls to number of medications and diseases. Method The study consisted of the fifth cohort of Gothenburg’s H70 birth cohort studies. A sample of 662 79-year-olds (404 women, 258 men) were investigated with questions regarding dizziness, previous falls and falls efficacy [estimated according to the falls efficacy scale Swedish version (FES (S))]. Functional tests included self-selected and maximal walking speed over 20 m. Results Dizziness was reported among 51% of the women and by 58% of the men (p = 0.12). Approximately, 40% had fallen during the past 12 months (41% women, 38% of the men, p = 0.48). Dizziness was related to a higher risk of falls among women (OR 2.63 (95% CI 1.67−4.14, p < 0.0001), but not among men (OR 1.07, 95% CI 0.63−1.82, p = 0.8). Dizzy individuals had lower scores on FES (S) (p < 0.01), more medications (p < 0.001) and diseases (p < 0.001) than those without dizziness. Participants who reported dizziness walked 10% slower than participants without dizziness (p < 0.001). Conclusion Women with dizziness more often reported falls compared to women without dizziness—a trend that was not seen among men. Persons with dizziness walked slower. Many medications increased risk of falling; hence, number of medications alone might help pinpoint risk groups for falling.

scholarly journals Obesity and Bone: A Complex Relationship

2021 ◽  
Vol 22 (24) ◽  
pp. 13662
Author(s):  
Giuseppe Rinonapoli ◽  
Valerio Pace ◽  
Carmelinda Ruggiero ◽  
Paolo Ceccarini ◽  
Michele Bisaccia ◽  
...  
Keyword(s):  
High Fat Diet ◽  
Obese Subject ◽  
Osteoporotic Fractures ◽  
Mechanical Effect ◽  
Normal Weight ◽  
Obese Children ◽  
Risk Of Fracture ◽  
Increased Risk ◽  
Risk Of Falls ◽  
The Relationship

There is a large literature on the relationship between obesity and bone. What we can conclude from this review is that the increase in body weight causes an increase in BMD, both for a mechanical effect and for the greater amount of estrogens present in the adipose tissue. Nevertheless, despite an apparent strengthening of the bone witnessed by the increased BMD, the risk of fracture is higher. The greater risk of fracture in the obese subject is due to various factors, which are carefully analyzed by the Authors. These factors can be divided into metabolic factors and increased risk of falls. Fractures have an atypical distribution in the obese, with a lower incidence of typical osteoporotic fractures, such as those of hip, spine and wrist, and an increase in fractures of the ankle, upper leg, and humerus. In children, the distribution is different, but it is not the same in obese and normal-weight children. Specifically, the fractures of the lower limb are much more frequent in obese children. Sarcopenic obesity plays an important role. The authors also review the available literature regarding the effects of high-fat diet, weight loss and bariatric surgery.

The impact of family members on the self-reported health of older men and women in a rural area of Bangladesh

2004 ◽  
Vol 24 (6) ◽  
pp. 903-920 ◽  
Author(s):  
OMAR RAHMAN ◽  
JANE MENKEN ◽  
RANDALL KUHN
Keyword(s):  
Rural Area ◽  
Binary Logistic Regression ◽  
Older Men ◽  
Older Woman ◽  
Men And Women ◽  
Increased Risk ◽  
Reported Health ◽  
The Impact ◽  
The Relationship ◽  
Older Men And Women

The purpose of this study is to examine whether the co-residence of spouses and children affects self-reported general health among older men and women in a rural area of Bangladesh. Binary logistic regression has been used to explore the impact of spouses and children on self-reported health, with particular attention to the gender of children and interactions with chronic disease. The data are from the Matlab Health and Socio-Economic Survey. A sample of 765 women and 979 men aged 60 or more years with at least one surviving child was available. The principal result is that for an older woman, optimum self-reported health is most likely when a spouse and at least one son and one daughter are present. Any deviation from this family pattern (either no spouse or children of only one sex) leads to a significantly increased risk of poor self-reported health. On the other hand, among older men there were no differences in self-reported health among the various spouse-child combinations. The relationship between a balanced gender distribution of children and optimum self-reported health among older women may explain the levelling out of fertility at roughly three children per women despite intensive family planning promotion in the area. Further reductions in fertility (an important policy concern) may depend on improving the substitutability of sons and daughters in the support of their elderly mothers.

Somatosensory Impairments, Falls History and Fear of Falling in Glaucoma - A Survey Study Approach

2021 ◽  
Vol 65 (1) ◽  
pp. 11-15
Author(s):  
Caitlin O’Connell ◽  
Gadi Wollstein ◽  
Ian P. Conner ◽  
Mark S. Redfern ◽  
Kevin C. Chan ◽  
...  
Keyword(s):  
Visual Field ◽  
Older Workers ◽  
Daily Living ◽  
Fear Of Falling ◽  
Survey Study ◽  
Risk Of Falling ◽  
Study Approach ◽  
Increased Risk ◽  
Visual Field Deficits ◽  
The Relationship

The primary aim was to determine if somatosensory impairments alter the association between falls history and glaucoma severity. A secondary aim was to identify the activities of daily living that cause increased concern related to falling in glaucoma and their association with glaucoma severity. Established questionnaires about falls and fear of falling (FoF) were mailed to participants diagnosed with glaucoma. Ninety-eight participants responded. Self-reported feet numbness and tingling symptoms were used to determine the presence of somatosensory impairments. Self-reported falls in glaucoma are associated with visual field deficits in both eyes, particularly in the presence of somatosensory impairments. In addition, increased FoF levels are linked with worse visual field deficits in both eyes, especially when performing challenging walking tasks. Somatosensory impairments alter the relationship between falls risk and visual field deficits in glaucoma. This information may be helpful in identifying older workers at an increased risk of falling.

Changes in the Dynamic Stability of Walking in Active Healthy Older Adults Independent of Changes in Walking Speed

2008 ◽  
Author(s):  
Hyun Gu Kang ◽  
Jonathan B. Dingwell
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Dynamic Stability ◽  
Walking Speed ◽  
Age Groups ◽  
Leg Strength ◽  
Age Related ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Walking Speeds

Older adults commonly walk slower, which many believe helps improve their walking stability. However, they remain at increased risk of falls. We investigated how differences in age and walking speed independently affect dynamic stability during walking, and how age-related changes in leg strength and ROM affected this relationship. Eighteen active healthy older and 17 younger adults walked on a treadmill for 5 minutes each at each of 5 speeds (80–120% of preferred). Local divergence exponents and maximum Floquet multipliers (FM) were calculated to quantify each subject’s responses to small inherent perturbations during walking. These older adults exhibited the same preferred walking speeds as the younger subjects (p = 0.860). However, these older adults still exhibited greater local divergence exponents (p&lt;0.0001) and higher maximum FM (p&lt;0.007) than young adults at all walking speeds. These older adults remained more unstable (p&lt;0.04) even after adjusting for declines in both strength and ROM. In both age groups, local divergence exponents decreased at slower speeds and increased at faster speeds (p&lt;0.0001). Maximum FM showed similar changes with speed (p&lt;0.02). The older adults in this study were healthy enough to walk at normal speeds. However, these adults were still more unstable than the young adults, independent of walking speed. This greater instability was not explained by loss of leg strength and ROM. Slower speeds led to decreased instability in both groups.

Falls Among Older Adults: A Public Health Concern

2011 ◽  
Vol 12 (1) ◽  
pp. 13-18 ◽  
Author(s):  
Jaynee Handelsman
Keyword(s):  
Older Adults ◽  
Fear Of Falling ◽  
Head Injuries ◽  
Assessment Tools ◽  
Health Concern ◽  
Falls Risk ◽  
Number Of Factors ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Comprehensive Evaluations

The risk of falling increases with advancing age, and falls in older adults are associated with immediate serious consequences, such as fractures and head injuries, as well as longer-term problems, such as disability, fear of falling, and loss of independence. The determination of fall risk among older adults and the prevention of falls have been a major focus of research for more than a decade. A number of factors have been identified that increase the likelihood that an individual will fall, and various strategies for assessing falls risk have been reported. Some have proposed clinically based assessment tools that can be easily included as part of an annual exam, whereas others have proposed laboratory based comprehensive evaluations. Regardless of the type of falls assessment strategy, the desired outcome is to provide interventions that may result in a reduction in falls risk. The purpose of this paper is to provide a brief review of the magnitude of the problem, factors that are known to be associated with an increased risk of falls, components that may be included in a fall prevention program, and evidence of factors that contribute to improved outcomes.

THE USE OF POSTUROGRAPHY IN INVESTIGATING THE RISK OF FALLING IN FRAIL OR PREFRAIL OLDER PEOPLE WITH DIABETES

2019 ◽  
pp. 1-7
Author(s):  
H. Domergue ◽  
L. Rodríguez-Mañas ◽  
O. Laosa Zafra ◽  
K. Hood ◽  
D. Gasq ◽  
...  
Keyword(s):  
Older People ◽  
Walking Speed ◽  
Analysis Data ◽  
Diabetic Patients ◽  
Clinical Test ◽  
Risk Of Falling ◽  
Timed Up And Go ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Risk Patients

Background: In older people, diabetes is associated with an increased risk of falls and frailty. The value of using posturography for evaluating the risk of falling is unclear. In theory, a time-scale analysis should increase the metrological properties of the posturography assessment. Objectives: This study aimed to determine which posturographic parameters can be used to identify fall-risk patients in a frail diabetic older population and to assess their interest in comparison to usual clinical trials for gait and balance. Design: This is a prospective observational cohort. Settings: frail or pre-frail diabetic patients, in Bordeaux, France. Participants: 84 patients were included in the study (mean age 80.09 years, 64.5% of men).Criteria for inclusion were: age over 70 years, diabetes mellitus for over 2 years, and at least one of the Fried’s frailty criteria. Measurements: Gait and balance assessments were undertaken at baseline: Static posturography, the timed up and go test, short physical performance battery, and (gait) walking speed. Raw data from posturography were used for wavelet analysis. Data on self reported new falls were collected prospectively during 6 months. Results: The posturography parameter most useful was area of 90% confidence ellipse of statokinesigram (COP90area): area under the ROC curve AUC = 0.617 (95% CI, 0.445-0.789) and OR=1.003 (95%CI 1.000-1.005) p =0.05. The optimum clinical test was the time to walk over 4m AUC=0.735 (95%CI, 0.587-0.882) and OR=1.42 (95%CI 1.08-1.87) p= 0.013. Conclusion: Posturography has limited utility for assessment of falls risk in frail older people with diabetes. Gait and balance clinical assessments such as walking speed continue to retain their value.

scholarly journals Immunotherapy to treat malignancy in patients with pre-existing autoimmunity

2020 ◽  
Vol 8 (1) ◽  
pp. e000356 ◽  
Author(s):  
Patrick Boland ◽  
Anna C Pavlick ◽  
Jeffrey Weber ◽  
Sabina Sandigursky
Keyword(s):  
Autoimmune Disease ◽  
Autoimmune Diseases ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Retrospective Data ◽  
Prospective Data ◽  
The Past ◽  
Increased Risk ◽  
Autoimmune Conditions ◽  
The Relationship

In the past 10 years, immune checkpoint inhibitors (ICIs) have become an additional pillar of cancer therapy by activating the immune system to treat a number of different malignancies. Many patients receiving ICIs develop immune-related adverse events (irAEs) that mimic some features of classical autoimmune diseases. Unfortunately, patients with underlying autoimmune conditions, many of whom have an increased risk for malignancy, have been excluded from clinical trials of ICIs due to a concern that they will have an increased risk of irAEs. Retrospective data from patients with autoimmune diseases and concomitant malignancy treated with ICIs are encouraging and suggest that ICIs may be tolerated safely in patients with specific autoimmune diseases, but there are no prospective data to guide management. In this manuscript, we review the relationship between pre-existing autoimmune disease and irAEs from checkpoint inhibitors. In addition, we assess the likelihood of autoimmune disease exacerbations in patients with pre-existing autoimmunity receiving ICI.

scholarly journals Association between Trunk Muscle Strength and Fall Risk in Older Men and Women with Lumbar Spondylosis

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 521
Author(s):  
Tadashi Ito ◽  
Yoshihito Sakai ◽  
Hideshi Sugiura ◽  
Keitaro Kawai ◽  
Yoshifumi Morita ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Older Men ◽  
Abdominal Muscle ◽  
Back Muscle ◽  
Lumbar Spondylosis ◽  
Back Muscle Strength ◽  
Risk Of Falls ◽  
Abdominal Muscle Strength ◽  
The Relationship ◽  
Older Men And Women

Various factors significantly affect the risk of falls among older adults with lumbar spondylosis. However, the relationship between falls and trunk muscle strength in older men is poorly explored. Thus, we aimed to investigate the relationship between back muscle strength and fall risk in older men and women with lumbar spondylosis. Based on self-reported fall scores, 39 outpatients were classified into two groups. Back and abdominal muscle strength, among other data, were compared between the two groups. Spearman’s rank correlation analysis was used to assess the relationship between fall scores and selected variables. Back (r = −0.491, p = 0.002) and abdominal muscle strength (r = −0.415, p = 0.009) were related to the fall score. Furthermore, back and abdominal muscle strength were related to the fall score in women with a high risk of falls, whereas back muscle strength, erector spinae, and lumbar multifidus cross-sectional areas, and visual analog scale were related to the fall score in men with a high risk of falling. Back muscle strength and fall scores may be useful to assess the risk of falls in older patients with lumbar spondylosis. However, evaluating this relationship may require separate sex-specific analyses.

scholarly journals The relationship between the risk of falling and fear of falling among aged hospitalized patients

2020 ◽  
Author(s):  
Ali Dadgari ◽  
Hadi Hojati ◽  
Seyed Mohammad Mirrezaie
Keyword(s):  
Assessment Tool ◽  
Fear Of Falling ◽  
Hospitalized Patients ◽  
Aged Patients ◽  
Significance Level ◽  
Exact Test ◽  
Aged People ◽  
Risk Of Falls ◽  
The Relationship ◽  
Fear Of Falls

  Background & Aim: Identifying aged people at risk of falls in hospitals is particularly important for the prevention of falls. A review of the literature revealed that the association of falls and fear of falls had not been investigated extensively in previous studies in Iran. This study aimed to determine the relationship between falling and fear of falling among aged hospitalized patients. Methods & Materials: In this descriptive-correlational study, 1123 subjects were recruited. Of all subjects, 385 aged hospitalized patients, 60 years old and above, were conveniently selected based on inclusion criteria in Shahroud Imam Hossein hospital from March to December 2016. Johns Hopkins fall risk assessment tool (JHFRAT) was used to evaluate the risk of falls among older adults and the Falling Efficiency Scale (FES) was applied to assess fear of falling. SPSS software version 19with the significance level of p<0.05. Chi-Square test and exact test of Fisher and logistic regression has been used for data analysis. Results: All aged patients (n=1123) admitted in the emergency room were assessed for eligibility to inclusion in the study.  Of all subjects, 385 patients were included in this study. The subjects' mean of age was 71.68±4.32 years, age range: 60-84. Of all samples (n=385) of study 90 (23.4%), 151(39.2%) and 144 (37.4%) had a low, middle, and high risk of falls, respectively. Of all participants of the study, 193(51%) subjects were male and 192(49%) were female. One-third (36.4%) of the subjects had a fear of falls and (33.8%) experienced fall in the last six months before admission.  A statistically significant relationship was found between the incidence of falls and fear of falling (P<0.001). Conclusion: This study found JHFRAT and FES as two applicable instruments for assessment of aged people. The result of this study concluded that evaluation of fear of falling and the risk of falls among aged hospitalized patients is recommended as a routine procedure to predict the risk of falls. Nurses are in the best position to evaluate the fear of falls and risk of falls, so it is recommended considering the fear of falls as a potential risk factor for falls in the hospital.

Depressive Disorders Are Associated With Risk of Falls in People With Chronic Kidney Disease

2020 ◽  
pp. 107839032097064
Author(s):  
Brandon M. Kistler ◽  
Jagdish Khubchandani ◽  
Paul Bennett ◽  
Kenneth R. Wilund ◽  
Jacob Sosnoff
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Depressive Disorders ◽  
Behavioral Risk ◽  
Behavioral Risk Factor Surveillance ◽  
Risk Factor Surveillance ◽  
Increased Risk ◽  
Risk Of Falls ◽  
History Of ◽  
The Relationship

OBJECTIVES People with chronic kidney disease (CKD) are at increased risk for falls and fall-related injuries. Depressive disorders (DEP) are common in individuals with CKD and may increase the risk of falls and fall-related injuries. However, not much is known about the relationship between DEP and falls in people with CKD. The purpose of this study was to determine the influence of DEP on the relationship between CKD, falls, and fall-related injuries. METHOD Using the Behavioral Risk Factor Surveillance System, we identified 16,574 adults with CKD. Patients with CKD were stratified by history of self-reported DEP (SRDEP), and multivariate logistic regression was conducted to determine the odds for falls and fall-related injuries among those with and without SRDEP. RESULTS In unadjusted regression analysis, falls (OR = 2.40, 95% CI = 2.08-2.76) and fall-related injuries (OR = 2.12, 95% CI = 1.72-2.59) were higher in individuals with CKD and history of SRDEP compared to those with CKD and no history of SRDEP. Adjustment for confounders had little effect on the relationship between a history of SRDEP and either falls (AOR = 1.87, 95% CI = 1.60-2.19) or fall-related injuries (AOR = 1.58, 95% CI = 1.26-1.97). CONCLUSIONS People with CKD and DEP are at increased odds for falls and fall-related injuries even after adjustment for sociodemographic, lifestyle factors, and comorbidities. Prospective studies are warranted to further understand this relationship, but it may be prudent for clinicians, in particular nurses, to consider fall risk when treating DEP in patients with CKD.

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