scholarly journals Predictors for functional decline after an injurious fall: a population-based cohort study

2020 ◽  
Author(s):  
Stina Ek ◽  
Debora Rizzuto ◽  
Weili Xu ◽  
Amaia Calderón-Larrañaga ◽  
Anna-Karin Welmer
Keyword(s):  
Cohort Study ◽  
Functional Status ◽  
Negative Impact ◽  
Community Dwelling ◽  
Living Alone ◽  
Related Factors ◽  
Self Rated Health ◽  
Injurious Falls ◽  
Injurious Fall ◽  
Physically Inactive

Abstract Background The functional consequences of injurious falls are well known. However, studies of the factors that can modify trajectories of disability after an injury from a fall are scarce. Aims We aimed to investigate whether sociodemographic and health-related factors may impact this association. Methods The study population consisted of 1426 community-dwelling older adults (≥ 60 years) from the SNAC-K cohort study in Stockholm, Sweden. Functional status over 12 years of follow-up was assessed using the number of limitations in basic and instrumental activities of daily living. Sex, cohabitation status, physical activity, and self-rated health were assessed at baseline. Injurious falls were defined as falls requiring healthcare and were assessed over 3 years starting at baseline. Data were analyzed using linear-mixed effects models. Results The fastest increase in the number of disabilities was observed in those who had endured an injurious fall and were living alone (β coefficient = 0.408; p < 0.001), been physically inactive (β coefficient = 0.587; p < 0.001), and had poor self-rated health (β coefficient = 0.514; p < 0.001). The negative impact of these factors was more pronounced among fallers compared to non-fallers. Discussion Living alone, being physically inactive, and having poor self-rated health magnifies the negative effect of an injurious fall on functional status. Among individuals who endure an injurious fall, the heterogeneity in long-term functional status is substantial, depending on the individuals’ characteristics and behaviors. Conclusions These findings emphasize the need for a person-centered approach in care provision and can guide secondary prevention within health care.

scholarly journals What influences diet quality in older people? A qualitative study among community-dwelling older adults from the Hertfordshire Cohort Study, UK

2017 ◽  
Vol 20 (15) ◽  
pp. 2685-2693 ◽  
Author(s):  
Ilse Bloom ◽  
Wendy Lawrence ◽  
Mary Barker ◽  
Janis Baird ◽  
Elaine Dennison ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Older People ◽  
Social Engagement ◽  
Community Dwelling ◽  
Related Factors ◽  
Age Related ◽  
Hertfordshire Cohort Study ◽  
The Uk ◽  
Community Dwelling Older Adults

AbstractObjectiveTo explore influences on diet in a group of community-dwelling older adults in the UK.DesignData were collected through focus group discussions with older people; discussions were audio-recorded, transcribed verbatim and transcripts analysed thematically.SettingHertfordshire, UK.SubjectsParticipants were sampled purposively from the Hertfordshire Cohort Study, focusing on those whose diets had been assessed at two time points: 1998–2001 and 2011.ResultsNinety-two adults participated (47 % women; 74–83 years) and eleven focus groups were held. A number of age-related factors were identified that were linked to food choices, including lifelong food experiences, retirement, bereavement and medical conditions, as well as environmental factors (such as transport). There appeared to be variability in how individuals responded to these influences, indicating that other underlying factors may mediate the effects of age-related factors on diet. Discussions about ‘keeping going’, being motivated to ‘not give up’, not wanting to be perceived as ‘old’, as well as examples of resilience and coping strategies, suggest the importance of mediating psychological factors. In addition, discussion about social activities and isolation, community spirit and loneliness, indicated the importance of social engagement as an influence on diet.ConclusionsInterventions to promote healthier diets in older age should take account of underlying psychological and social factors that influence diet, which may mediate the effects of age-related factors.

scholarly journals Trajectories of self-rated health in an older general population and their determinants: the Lifelines Cohort Study

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e035012
Author(s):  
Marlies Feenstra ◽  
Barbara C van Munster ◽  
Janet L MacNeil Vroomen ◽  
Sophia E de Rooij ◽  
Nynke Smidt
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
General Population ◽  
Health Risk ◽  
Chronic Diseases ◽  
Community Dwelling ◽  
Endocrine Function ◽  
Self Rated Health ◽  
Physiological Markers ◽  
Community Dwelling Older Adults

ObjectivesPoor self-rated health (SRH) is a strong predictor of premature mortality in older adults. Trajectories of poor SRH are associated with multimorbidity and unhealthy behaviours. Whether trajectories of SRH are associated with deviating physiological markers is unclear. This study identified trajectories of SRH and investigated the associations of trajectory membership with chronic diseases, health risk behaviours and physiological markers in community-dwelling older adults.Study design and settingProspective general population cohort.ParticipantsTrajectories of SRH over 5 years were identified using data of 11 600 participants aged 65 years and older of the Lifelines Cohort Study.Outcome measuresTrajectories of SRH were the main outcome. Covariates included demographics (age, gender, education), chronic diseases, health-risk behaviour (physical activity, smoking, drinking) and physiological markers (body mass index, cardiovascular function, lung function, glucose metabolism, haematological condition, endocrine function, renal function, liver function and cognitive function).ResultsFour stable trajectories were identified, including excellent (n=607, 6%), good (n=2111, 19%), moderate (n=7677, 65%) and poor SRH (n=1205, 10%). Being women (OR: 1.4; 95% CI: 1.0 to 1.9), low education (OR: 2.1; 95% CI: 1.5 to 3.0), one (OR: 10.4; 95% CI: 7.4 to 14.7) or multiple chronic diseases (OR: 37.8; 95% CI: 22.4 to 71.8), smoking (OR: 1.8; 95% CI: 1.0 to 3.2), physical inactivity (OR: 3.1; 95% CI: 1.8 to 5.2), alcohol abstinence (OR: 2.2; 95% CI: 1.4 to 3.2) and deviating physiological markers (OR: 1.5; 95% CI: 1.1 to 2.0) increase the odds for a higher probability of poor SRH trajectory membership compared with excellent SRH trajectory membership.ConclusionSRH of community-dwelling older adults is stable over time with the majority (65%) having moderate SRH. Older adults with higher probabilities of poor SRH often have unfavourable health status.

scholarly journals Loneliness, isolation and living alone associate with psychological well-being among the older adults in Taipei

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 926-926
Author(s):  
Hui-chuan Hsu
Keyword(s):  
Older Adults ◽  
Psychological Health ◽  
Multinomial Logistic Regression ◽  
Living Arrangement ◽  
Senior Citizen ◽  
Well Being ◽  
Living Alone ◽  
Related Factors ◽  
Self Rated Health ◽  
Economic Satisfaction

Abstract Purpose: The purpose of this study was to examine the clustering of loneliness, isolation, and living alone, the risk factors and the associations with psychological wellbeing. Methods: The data were from the 2019 Taipei City Senior Citizen Condition Survey collected by face-to-face interviews, which included aged 60 and above community-based and institution-based samples. The completed sample was 3,853 persons. Loneliness, isolation, and living arrangement were analysed by cluster analysis to define the Loneliness-Isolation-Living Alone clusters. Multinomial logistic regression was used to examine the related factors to LIL clusters. Results: Four clusters of the older adults were identified and named as following: Connected (44.1%), Alone /Institutionalized (9.2%); Lonely (10.7%); and Isolated (22.0%). Compared with the Connected cluster, the Alone/Institutionalized cluster was more likely to have higher education, more IADL difficulties, more diseases , lower economic satisfaction, more likely to be males, having no spouse, and no children; the Lonely cluster was more likely to poor self-rated health, lower financial satisfaction, feeling less age-friendliness, more likely to be older, female, and no spouse; the Isolated cluster was more likely to have lower education, reported poorer self-rated health, lower economic satisfaction, and being older. The Alone/Institutionalized cluster and the Lonely cluster had higher depressive symptoms; the Alone/Institutionalized, Lonely, and Isolated clusters reported lower life satisfaction and had higher risks of cognitive impairment. Discussion: Loneliness, isolation, and living alone jointly associate with psychological health and well-being. High risk older populations may need social care and encourage social participation to promote health and wellbeing.

scholarly journals Incidence and risk factors for falls among community-dwelling elderly subjects on a 1-year follow-up: a prospective cohort study from Ernakulam, Kerala, India

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e033691
Author(s):  
Divyamol K Sasidharan ◽  
Priya Vijayakumar ◽  
Manu Raj ◽  
Sumi Soman ◽  
Libin Antony ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Activities Of Daily Living ◽  
Movement Disorders ◽  
Prospective Cohort ◽  
Daily Living ◽  
The Elderly ◽  
Community Dwelling ◽  
Living Alone

ObjectivesThere is limited knowledge regarding epidemiology and risk of falls among the elderly living in low-income and middle-income countries. In this situation, the current study aims to report the incidence of falls and associated risk factors among free living elderly population from Kerala, India.DesignProspective cohort study with stratified random cluster sampling.SettingThe study location was Ernakulam, Kerala, India, and we collected information via house visits using a questionnaire. During the research, the subjects were followed up prospectively for 1 year by phone at intervals of 3 months and missing subjects were contacted by house visits.ParticipantsCommunity-dwelling elderly above 65 years of age.ResultsWe recruited a total of 1000 participants out of which a total of 201 (20.1%) subjects reported a fall during the follow-up. The incidence rate of falls was 31 (95% CI 27.7 to 34.6) per 100 person-years. Female sex (OR 1.48, 95% CI 1.05 to 2.10, p=0.027), movement disorders including Parkinsonism (OR 2.26, 95% CI 1.00 to 5.05, p=0.048), arthritis (OR 1.48, 95% CI 1.05 to 2.09, p=0.026), dependence in basic activities of daily living (OR, 3.49, 95% CI 2.00 to 6.09, p<0.001), not using antihypertensive medications (OR, 1.53, 95% CI 1.10 to 2.13, p=0.012), living alone during daytime (OR 3.27, 95% CI 1.59 to 6.71, p=0.001) and a history of falls in the previous year (OR, 2.25, 95% CI 1.60 to 3.15, p<0.001) predicted a fall in the following year.ConclusionsOne in five community-dwelling senior citizen fall annually and one in four who fall are prone to fall again in the following year. Interventions targeting falls among the elderly need to focus on modifiable risk factors such as living alone during daytime, movement disorders, arthritis and dependence on basic activities of daily living.

scholarly journals The Association of Early-Morning Eating Habits With High Nutrient Intake by Older Japanese Adults Living Alone

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 241-242
Author(s):  
Yoko Matsuoka ◽  
Junhua Zhang ◽  
Weida Lyu ◽  
Kei Aoyagi ◽  
Mai Takase ◽  
...  
Keyword(s):  
Older Adults ◽  
Eating Habits ◽  
Early Morning ◽  
Community Dwelling ◽  
Living Alone ◽  
Dietary Behaviors ◽  
Food Groups ◽  
Cross Sectional ◽  
Self Rated Health ◽  
Nutrition Intake

Abstract The consumption of essential nutrition is fundamental to maintain the health of older adults. Conventional studies report that community dwelling older adults who live alone have the tendency to skip meals and result in low nutrition intake. However, the details regarding the dietary behavior and its association with the status of nutrition intake remain unclear. In this study, a cross-sectional analysis was conducted to explore the association between the time of meals and nutrition balance. In October 2019, questionnaire surveys were distributed to 184 participants of a lunch event dedicated to older adults living alone (Kashiwa, Japan). The time of meals, number of meals per day, consumption status of 10 food groups, and self-rated health were used for the analysis (N=165). As a result, older adults who usually ate their first meal between 5 to 8 A.M. ate three meals/day, while those who ate their first meal after 8 A.M. ate two meals/day. Those who ate their meal between 5 to 8 A.M., frequently consumed meat, fish and seafood, milk, and green and yellow vegetables compared to those who ate after 8 A.M. Self-rated health score was also high. The consumption of early-morning meals was associated with good dietary behaviors. The importance of eating breakfast has been emphasized, however, the time of the breakfast could vary among individuals. This study proposed the importance of considering the time of the meal. Development of intervention programs which encourage early-morning meal consumption might be helpful to form healthy dietary behaviors of older adults.

scholarly journals Social Disconnection and Living Arrangements among Older Adults: The Singapore Chinese Health Study

Gerontology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Jon Barrenetxea ◽  
Yi Yang ◽  
An Pan ◽  
Qiushi Feng ◽  
Woon-Puay Koh
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Living Arrangement ◽  
Community Dwelling ◽  
Living Alone ◽  
Health Study ◽  
Factors Associated ◽  
Self Rated Health ◽  
Singapore Chinese ◽  
Social Disconnection

<b><i>Introduction:</i></b> Although living alone is associated with social disconnection, older adults could be socially disconnected despite living with others. Understanding the factors associated with social disconnection by living arrangement could help identify vulnerable older adults in the community. We examined the sociodemographic and health factors associated with social disconnection among two groups of older adults: those living alone and those living with others. <b><i>Methods:</i></b> We used data from 16,943 community-dwelling older adults from the third follow-up of the Singapore Chinese Health Study (mean age: 73 years, range: 61–96 years). We defined social disconnection as having no social participation and scoring in the lowest decile on the Duke Social Support Scale of perceived social support. We ran logistic regression models to study the sociodemographic (age, gender, and education) and health (self-rated health, instrumental limitations, cognitive function, and depression) factors associated with social disconnection, stratified by living arrangement. <b><i>Results:</i></b> About 6% of our participants were socially disconnected. Although living alone was significantly associated with social disconnection (OR 1.93, 95% CI: 1.58–2.35), 85.6% of socially disconnected older adults lived with others, most of them (92%) with family. Lower education level, cognitive impairment, fair/poor self-rated health, instrumental limitations, and depression were independently associated with social disconnection. Among those living alone, men were more likely to experience social disconnection than women (OR 2.18, 95% CI: 1.43–3.32). <b><i>Discussion/Conclusion:</i></b> Though living alone is associated with social disconnection, most socially disconnected individuals lived with family. Community interventions could focus on those in poor health despite living with family and older men living alone.

Associations of blood pressure with risk of injurious falls in old age vary by functional status: A cohort study

2020 ◽  
Vol 140 ◽  
pp. 111038
Author(s):  
Anna-Karin Welmer ◽  
Rui Wang ◽  
Debora Rizzuto ◽  
Stina Ek ◽  
Davide L. Vetrano ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cohort Study ◽  
Functional Status ◽  
Old Age ◽  
Injurious Falls

scholarly journals Association between gaps in antihypertensive medication adherence and injurious falls in older community-dwelling adults: a prospective cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e022927 ◽  
Author(s):  
Paul Dillon ◽  
Susan M Smith ◽  
Paul John Gallagher ◽  
Gráinne Cousins
Keyword(s):  
Medication Adherence ◽  
Antihypertensive Medication ◽  
Community Dwelling ◽  
Risk Of Falling ◽  
Medication Refill ◽  
Injurious Falls ◽  
Increased Risk ◽  
Injurious Fall

ObjectiveGrowing evidence suggests that older adults are at an increased risk of injurious falls when initiating antihypertensive medication, while the evidence regarding long-term use of antihypertensive medication and the risk of falling is mixed. However, long-term users who stop and start these medications may have a similar risk of falling to initial users of antihypertensive medication. Our aim was to evaluate the association between gaps in antihypertensive medication adherence and injurious falls in older (≥65 years) community-dwelling, long-term (≥≥1 year) antihypertensive users.DesignProspective cohort study.SettingIrish Community Pharmacy.ParticipantsConsecutive participants presenting a prescription for antihypertensive medication to 106 community pharmacies nationwide, community-dwelling, ≥65 years, with no evidence of cognitive impairment, taking antihypertensive medication for ≥1 year (n=938).MeasuresGaps in antihypertensive medication adherence were evaluated from linked dispensing records as the number of 5-day gaps between sequential supplies over the 12-month period prior to baseline. Injurious falls during follow-up were recorded via questionnaire during structured telephone interviews at 12 months.ResultsAt 12 months, 8.1% (n=76) of participants reported an injurious fall requiring medical attention. The mean number of 5-day gaps in medication refill behaviour was 1.47 (SD 1.58). In adjusted, modified Poisson models, 5-day medication refill gaps at baseline were associated with a higher risk of an injurious fall during follow-up (aRR 1.18, 95% CI 1.02 to 1.37, p=0.024).ConclusionEach 5-day gap in antihypertensive refill adherence increased the risk of self-reported injurious falls by 18%. Gaps in antihypertensive adherence may be a marker for increased risk of injurious falls. It is unknown whether adherence-interventions will reduce subsequent risk. This finding is hypothesis generating and should be replicated in similar populations.

scholarly journals Potentially serious alcohol–medication interactions and falls in community-dwelling older adults: a prospective cohort study

2019 ◽  
Vol 48 (6) ◽  
pp. 824-831 ◽  
Author(s):  
Alice Holton ◽  
Fiona Boland ◽  
Paul Gallagher ◽  
Tom Fahey ◽  
Frank Moriarty ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Community Dwelling ◽  
Adjusted Relative Risk ◽  
Injurious Falls ◽  
Risk Of Falls ◽  
Community Dwelling Older Adults

Abstract Objective To investigate the association between potentially serious alcohol–medication interactions (POSAMINO criteria), hypothesised to increase the risk of falls in older adults, and falls in community-dwelling older adults at two and 4 years follow-up. Design A prospective cohort study. Setting The Irish Longitudinal Study on Ageing. Subjects A total of 1,457 community-dwelling older adults aged ≥65 years, with a complete alcohol and regular medication data to allow for the application of the POSAMINO criteria. Outcomes Self-reported falls at 2 and 4 years follow-up, any falls (yes/no), injurious falls (yes/no) and number of falls (count variable). Results The number of participants who reported falling since their baseline interview at 2 and 4 years were 357 (24%) and 608 (41.8%), respectively; 145 (10%) reported an injurious fall at 2 years and 268 (18%) at 4 years. Median (IQR) number of falls was 1 (1–2) at 2 years and 2 (1–3) at 4 years. Exposure to CNS POSAMINO criteria, hypothesised to increase the risk of falls due primarily to increased sedation, was associated with a significantly increased risk for falling (adjusted relative risk (RR) 1.50, 95% confidence interval (CI) 1.21–1.88) and for injurious falls (adjusted RR 1.62, 95% CI: 1.03–2.55) at 4 years. These equate to an absolute risk of 19% for falling (95% CI: 5–33%) and 8% for injurious falls (95% CI, 4–20%) at 4 years. Conclusions Assessment and management strategies to prevent falls in community-dwelling older adults should consider patients’ alcohol consumption alongside their assessment of patient medications, particularly among those receiving CNS agents.

Is the Drug Burden Index Related to Declining Functional Status at Follow-up in Community-Dwelling Seniors Consulting for Minor Injuries? Results from the Canadian Emergency Team Initiative Cohort Study

Drugs & Aging ◽  
2018 ◽  
Vol 36 (1) ◽  
pp. 73-83 ◽  
Author(s):  
Edeltraut Kröger ◽  
Marilyn Simard ◽  
Marie-Josée Sirois ◽  
Marianne Giroux ◽  
Caroline Sirois ◽  
...  
Keyword(s):  
Cohort Study ◽  
Functional Status ◽  
Community Dwelling ◽  
Drug Burden Index ◽  
Emergency Team ◽  
Minor Injuries
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