Anxiety symptoms during hospitalization of elderly are associated with increased risk of post-discharge falls

2016 ◽  
Vol 28 (6) ◽  
pp. 951-958 ◽  
Author(s):  
Maayan Agmon ◽  
Anna Zisberg ◽  
Orly Tonkikh ◽  
Gary Sinoff ◽  
Efrat Shadmi
Keyword(s):  
Older Adults ◽  
Fall Prevention ◽  
Functional Decline ◽  
Anxiety Symptoms ◽  
Prevention Strategies ◽  
Post Discharge ◽  
Medical Centers ◽  
Increased Risk ◽  
The Relationship

ABSTRACTBackground:The aim of this study was to test the association between anxiety at the time of hospitalization and falls occurring within one month of discharge, and to offer potential mechanisms for this association.Methods:One-month, prospective cohort study of 556 older adults in two medical centers in Israel. Anxiety and functional decline were assessed during hospitalization and falls were assessed one month post-discharge.Results:A total of 72 (12.9%) participants reported at least one fall during the 30-day post-discharge period. Controlling for demographics, functional decline and pre-morbid functional status, the odds of falls between discharge, and 1-month follow-up were almost twice as high among patients with anxiety symptoms (OR = 1.89, 95% CI: 1.04-3.48) compared with those who screened negative for anxiety. After accounting for in-hospital functional decline, the relationship between anxiety symptoms and falls decreased by 11% (from OR = 2.13 to 1.89), indicating that the relationship between anxiety and falls was partially mediated by functional decline during hospitalization.Conclusions:Anxiety at time of hospitalization is associated with falls 30-days post-discharge, controlling for several well-known confounders. This relationship is partially mediated by functional decline. Identifying patients with anxiety for inclusion in targeted rehabilitation interventions may be an important component of fall prevention strategies.

scholarly journals Elevated plasma growth and differentiation factor 15 predicts incident anemia in older adults aged 60 years and older

2020 ◽  
Author(s):  
Yuko Yamaguchi ◽  
Marta Zampino ◽  
Toshiko Tanaka ◽  
Stefania Bandinelli ◽  
Yusuke Osawa ◽  
...  
Keyword(s):  
Older Adults ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Differentiation Factor ◽  
Hazards Model ◽  
Increased Risk ◽  
The Relationship

Abstract Background Anemia is common in older adults and associated with greater morbidity and mortality. The causes of anemia in older adults have not been completely characterized. Although elevated circulating growth and differentiation factor 15 (GDF-15) has been associated with anemia in older adults, it is not known whether elevated GDF-15 predicts the development of anemia. Methods We examined the relationship between plasma GDF-15 concentrations at baseline in 708 non-anemic adults, aged 60 years and older, with incident anemia during 15 years of follow-up among participants in the Invecchiare in Chianti (InCHIANTI) Study. Results During follow-up, 179 (25.3%) participants developed anemia. The proportion of participants who developed anemia from the lowest to highest quartile of plasma GDF-15 was 12.9%, 20.1%, 21.2%, and 45.8%, respectively. Adults in the highest quartile of plasma GDF-15 had an increased risk of developing anemia (Hazards Ratio 1.15, 95% Confidence Interval 1.09, 1.21, P<.0001) compared to those in the lower three quartiles in a multivariable Cox proportional hazards model adjusting for age, sex, serum iron, soluble transferrin receptor, ferritin, vitamin B12, congestive heart failure, diabetes mellitus, and cancer. Conclusions Circulating GDF-15 is an independent predictor for the development of anemia in older adults.

scholarly journals 60 Obesity in Older Adults in the Epic Norfolk Study is Associated with Reduced 20-Year Falls Hospitalization

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv13-iv17
Author(s):  
Sheng Hui Kioh ◽  
Mat Sumaiyah ◽  
Phyo Myint ◽  
Maw Pin Tan
Keyword(s):  
Older Adults ◽  
Body Height ◽  
Age Groups ◽  
Age Group ◽  
Future Studies ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Using Data ◽  
The Relationship

Abstract Background One in three older adults fall each year leading to increased disability, hospitalizations and mortality. Recent studies suggested an increased risk of falls among obese individuals which may correlate with increased rates of falls hospitalizations. However, there is not much information supporting the hypothesis that obesity may influence the risk of falls related hospitalizations. Aims To prospectively investigate whether body mass index (BMI) is a predictor for falls hospitalization by age group in the population of the EPIC-Norfolk Study. Methods Body height and weight were measured at baseline and BMI calculated. Falls hospitalization status over 20 years’ follow-up was ascertained using data linkage with centralized NHS records. Participants were categorized into the four BMI groups: underweight (BMI <18.5kg/m2 ), normal (18.5 ≤ BMI < 25.0 kg/m2), overweight ( 25.0 ≤ BMI < 30.0 kg/m2 ) and obese ( BMI ≥ 30.0kg/m2 ), and according to three age groups ( < 55 years, 55-64 years, ≥ 65 years). Results Data from 25636 individuals, (54.7%) women and (45.3%) men, mean age 59.2 ± 9.3 years, were included. For individuals within the under 55-year age group at baseline, individuals who were overweight (HR = 1.25; 95% CI= 1.01-1.56) and obese (HR = 1.54; 95% CI= 1.17-1.81) were at higher risk of falls hospitalization compared with those with normal BMI. As for individuals aged ≥ 65 years at recruitment, individuals who were obese were less likely to be hospitalized after a fall (HR = 0.85; 95% CI= 0.74 – 0.97) compared to those with normal BMI. Conclusions The relationship between obesity and falls hospitalization over 20 years differed between those aged <55years and 65years, with an increased risk observed for those <55years and reduced risk in those 65years. The underlying rationale for this finding will need to be evaluated in future studies.

scholarly journals Acute Dental Periapical Abscess and New-Onset Atrial Fibrillation: A Nationwide, Population-Based Cohort Study

2021 ◽  
Vol 10 (13) ◽  
pp. 2927
Author(s):  
Amaar Obaid Hassan ◽  
Gregory Y. H. Lip ◽  
Arnaud Bisson ◽  
Julien Herbert ◽  
Alexandre Bodin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cohort Study ◽  
Multivariable Analysis ◽  
National Database ◽  
Increased Risk ◽  
Periapical Abscess ◽  
The Relationship ◽  
Onset Atrial Fibrillation ◽  
New Onset

There are limited data on the relationship of acute dental infections with hospitalisation and new-onset atrial fibrillation (AF). This study aimed to assess the relationship between acute periapical abscess and incident AF. This was a retrospective cohort study from a French national database of patients hospitalized in 2013 (3.4 million patients) with at least five years of follow up. In total, 3,056,291 adults (55.1% female) required hospital admission in French hospitals in 2013 while not having a history of AF. Of 4693 patients classified as having dental periapical abscess, 435 (9.27%) developed AF, compared to 326,241 (10.69%) without dental periapical abscess that developed AF over a mean follow-up of 4.8 ± 1.7 years. Multivariable analysis indicated that dental periapical abscess acted as an independent predictor for new onset AF (p < 0.01). The CHA2DS2VASc score in patients with acute dental periapical abscess had moderate predictive value for development of AF, with Area Under the Curve (AUC) 0.73 (95% CI, 0.71–0.76). An increased risk of new onset AF was identified for individuals hospitalized with dental periapical abscess. Careful follow up of patients with severe, acute dental periapical infections is needed for incident AF, as well as investigations of possible mechanisms linking these conditions.

scholarly journals The Relationship Between the Home Environment and Falls for Older Adults With Visual Impairments

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 770-770
Author(s):  
Bonnielin Swenor ◽  
Aleksandra Mihailovic ◽  
Pradeep Ramulu
Keyword(s):  
Older Adults ◽  
Home Environment ◽  
Visually Impaired ◽  
Visual Impairments ◽  
Fold Increase ◽  
Engineering Society ◽  
Environment Assessment ◽  
Risk Factors For Falls ◽  
The Relationship

Abstract The home environment and features of the home have been identified as important risk factors for falls, and may pose particular risk for older adults with visual impairments given difficulty with hazard perception. We used data from 245 participants in the Falls in Glaucoma Study [mean age: 71 years, mean follow-up: 31 months] with homes graded using our previously validated Home Environment Assessment for the Visually Impaired (HEAVI), which quantifies the number of in-home fall-related hazards and found that neither the number of hazards nor the percentage of hazardous items were associated falls/year. However, each 10-fold increase in lighting was associated with a 35% lower rate of falls/year (RR=0.65, 95%CI=0.46 to 0.92) and there was a 50% reduction in falls/year when lighting was at or above 30 footcandles (minimum lighting level recommended by the Engineering Society of North America) compared to lighting &lt;30 footcandles (RR=0.50, 95%CI=0.26 to 0.96).

scholarly journals The Impact of Weather and Seasons on Falls and Physical Activity among Older Adults with Glaucoma: A Longitudinal Prospective Cohort Study

Sensors ◽  
2021 ◽  
Vol 21 (10) ◽  
pp. 3415
Author(s):  
Hursuong Vongsachang ◽  
Aleksandra Mihailovic ◽  
Jian-Yu E ◽  
David S. Friedman ◽  
Sheila K. West ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Fall Prevention ◽  
Regression Models ◽  
Activity Promotion ◽  
Injurious Fall ◽  
Multivariable Regression ◽  
Multivariable Regression Models ◽  
The Impact ◽  
The Relationship

Understanding periods of the year associated with higher risk for falling and less physical activity may guide fall prevention and activity promotion for older adults. We examined the relationship between weather and seasons on falls and physical activity in a three-year cohort of older adults with glaucoma. Participants recorded falls information via monthly calendars and participated in four one-week accelerometer trials (baseline and per study year). Across 240 participants, there were 406 falls recorded over 7569 person-months, of which 163 were injurious (40%). In separate multivariable regression models incorporating generalized estimating equations, temperature, precipitation, and seasons were not significantly associated with the odds of falling, average daily steps, or average daily active minutes. However, every 10 °C increase in average daily temperature was associated with 24% higher odds of a fall being injurious, as opposed to non-injurious (p = 0.04). The odds of an injurious fall occurring outdoors, as opposed to indoors, were greater with higher average temperatures (OR per 10 °C = 1.46, p = 0.03) and with the summer season (OR = 2.69 vs. winter, p = 0.03). Falls and physical activity should be understood as year-round issues for older adults, although the likelihood of injury and the location of fall-related injuries may change with warmer season and temperatures.

scholarly journals Virtual reality intervention to improve apathy in residential aged care: protocol for a multisite non-randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e046030
Author(s):  
Dimitrios Saredakis ◽  
Hannah A D Keage ◽  
Megan Corlis ◽  
Tobias Loetscher
Keyword(s):  
Older Adults ◽  
Virtual Reality ◽  
Passive Control ◽  
Aged Care ◽  
Residential Aged Care ◽  
Laptop Computer ◽  
Reminiscence Therapy ◽  
Increased Risk ◽  
Secondary Outcomes

IntroductionApathy is a prevalent neuropsychiatric symptom for older adults residing in aged care. Left untreated, apathy has been associated with accelerated cognitive decline and increased risk of mortality. Reminiscence therapy is commonly used in aged care and has demonstrated to reduce apathy. Traditional methods of reminiscence use physical objects and more recently technology including tablets and laptop computers have demonstrated potential. Virtual reality (VR) has successfully been used to treat psychological disorders; however, there is little evidence on using VR for behavioural symptoms such as apathy in older adults. Using VR to deliver reminiscence therapy provides an immersive experience, and readily available applications provide access to a large range of content allowing easier delivery of therapy over traditional forms of therapy. This study aims to identify changes in apathy after a reminiscence therapy intervention using head-mounted displays (HMDs).Methods and analysisParticipants will be allocated to one of three groups; reminiscence therapy using VR; an active control using a laptop computer or physical items and a passive control. A total of 45 participants will be recruited from residential aged care (15 in each group). The three groups will be compared at baseline and follow-up. The primary outcome is apathy, and secondary outcomes include cognition and depression. Side effects from using HMDs will also be examined in the VR group. Primary and secondary outcomes at baseline and follow-up will be analysed using linear mixed modelling.Ethics and disseminationEthics approval was obtained from the University of South Australia Human Research Ethics Committee. The results from this study will be disseminated through manuscript publications and national/international conferences.Trial registration numberACTRN12619001510134.

scholarly journals The Association of Sensory Impairment With Incident Disability-Related Cessation of Employment in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 216-216
Author(s):  
Ahmed Shakarchi ◽  
Emmanuel Garcia Morales ◽  
Nicholas Reed ◽  
Bonnielin Swenor
Keyword(s):  
Older Adults ◽  
Hearing Aids ◽  
Population Based ◽  
Sensory Impairment ◽  
Loss To Follow Up ◽  
Increased Risk ◽  
Cox Proportional Hazard Regression ◽  
Study Participants ◽  
Adjusted Model

Abstract Sensory impairment (SI) is common among older adults, and it is an increasingly important public health challenge as the population ages. We evaluated the association between SI and incident disability-related cessation of employment in older adults using the population-based Health and Retirement Study. Participants employed in 2006 completed biennial interviews until self-reported incident disability-related cessation of employment. Participants were censored at loss to follow-up, retirement, or 2018. Participants rated their vision and hearing, using eyeglasses or hearing aids if applicable, on a Likert scale (poor, fair, good, very good, excellent). SI was defined as poor or fair ability, and SI was categorized as neither SI (NSI), vision impairment alone (VI), hearing impairment alone (HI), and dual SI (DSI). Cox proportional hazard regression assessed the association between SI and incident disability-related cessation of employment, adjusting for demographic and health covariates. Overall, 4726 participants were included: 421 (8.9%) were with VI, 487 (10.3) with HI, and 203 (4.3%) with DSI. Mean age was 61.0 ± 6.8 years, 2488 (52.6%) were women, and 918 (19.4) were non-White. In the fully adjusted model, incident disability-related cessation of employment over the 12-year follow-up period was higher in VI (Hazard Ratio (HR)=1.30, 95% confidence interval (CI)=0.92, 1.85), HI (HR=1.60, CI=1.16, 2.22), and DSI (HR=2.02, CI=1.38, 2.96). These findings indicate that employed older adults with SI are at increased risk of incident disability-related cessation of employment, and that older adults with DSI are particularly vulnerable. Addressing SI in older adults may lengthen their contribution to the workforce.

Prospective Associations of Physical Frailty With Future Falls and Fear of Falling: A 48-Month Cohort Study

2021 ◽  
Author(s):  
K Makino ◽  
S Lee ◽  
S Bae ◽  
I Chiba ◽  
K Harada ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Fear Of Falling ◽  
Community Dwelling ◽  
Cardiovascular Health Study ◽  
Physical Frailty ◽  
Frailty Status ◽  
Community Dwelling Older Adults ◽  
The Relationship

Abstract Objective The present study aimed to examine the prospective associations of physical frailty with future falls and fear of falling (FOF) among community-dwelling older adults. Methods A prospective cohort study with a 48-month follow-up was conducted in a Japanese community. Participants were 2469 community-dwelling older adults aged 65 years or older who completed baseline and follow-up assessments at intervals of 48±2 months. Primary outcomes were recent falls (defined as at least one fall within the past year) and FOF (determined by response to “Are you afraid of falling?”) at follow-up survey. Physical frailty, operationalized by the frailty phenotype (slowness, weakness, exhaustion, weight loss, and low activity) based on the criteria of the Japanese version of the Cardiovascular Health Study (J-CHS), was also assessed as a predictor of future falls and FOF. Results Multivariate logistic regression showed that pre-frailty or frailty increase the risk of not only future falls (OR: 1.57; 95%CI = 1.20-2.05) but also FOF (OR: 1.33; 95%CI = 1.05-1.69). In addition, the relationship between baseline frailty status and future falls remained significant after adjusting for baseline FOF (OR: 1.55; 95%CI = 1.19-2.02), and the relationship between baseline frailty status and future FOF also remained significant after adjusting for baseline falls (OR: 1.32; 95%CI = 1.04-1.68). Conclusions Frailty status may predict future falls and FOF among community-dwelling older adults. Strategies to prevent frailty may be beneficial to prevent not only future falls but also future FOF in a community setting. Impact Falls and FOF have a close relationship but a different clinical meaning. Older adults with physical frailty may require monitoring as high-risk not only for falls but also for FOF.

Walking for Better Outcomes and Recovery: The Effect of WALK-FOR in Preventing Hospital-Associated Functional Decline Among Older Adults

2019 ◽  
Vol 74 (10) ◽  
pp. 1664-1670 ◽  
Author(s):  
Yaniv Cohen ◽  
Anna Zisberg ◽  
Yehudit Chayat ◽  
Nurit Gur-Yaish ◽  
Efrat Gil ◽  
...  
Keyword(s):  
Older Adults ◽  
Group Intervention ◽  
Functional Decline ◽  
Intervention Group ◽  
Control Group ◽  
Community Mobility ◽  
Steps Per Day ◽  
Quasi Experimental ◽  
Activity Survey

Abstract Background In-hospital immobility of older adults is associated with hospital-associated functional decline (HAFD). This study examined the WALK-FOR program’s effects on HAFD prevention. Methods A quasi-experimental pre-post two-group (intervention group [IG] n = 188, control group [CG] n = 189) design was applied in two hospital internal medical units. On admission, patients reported pre-hospitalization functional status, which was assessed again at discharge and 1-month follow-up. Primary outcome was decline in basic activities of daily living (BADL), using the Modified Barthel Index. Secondary outcomes were decline in instrumental ADL (Lawton’s IADL scale) and community mobility (Yale Physical Activity Survey). All participants (75.1 ± 7 years old) were cognitively intact and ambulatory at admission. The WALK-FOR included a unit-tailored mobility program utilizing patient-and-staff education with a specific mobility goal (900 steps per day), measured by accelerometer. Results Decline in BADL occurred among 33% of the CG versus 23% of the IG (p = .02) at discharge, and among 43% of the CG versus 30% in the IG (p = .01) at 1-month follow-up. Similarly, 26% of the CG versus 15% of the IG declined in community mobility at 1-month follow-up (p = .01). Adjusted for major covariates, the intervention reduced the odds of decline in BADL by 41% (p = .05) at discharge and by 49% at 1-month follow-up (p = .01), and in community mobility by 63% (p = .02). There was no significant effect of the intervention on IADL decline (p = .19). Conclusions The WALK-FOR intervention is effective in reducing HAFD.

Relationship Between Mental Health, Resilience, and Physical Activity in Older Adults: A 2-Year Longitudinal Study

2021 ◽  
pp. 1-9
Author(s):  
Maria Priscila Wermelinger Ávila ◽  
Jimilly Caputo Corrêa ◽  
Alessandra Lamas Granero Lucchetti ◽  
Giancarlo Lucchetti
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Older Adults ◽  
Regression Models ◽  
Linear Regression Models ◽  
Physically Active ◽  
Effective Interventions ◽  
Self Sufficiency ◽  
The Relationship

The aim of this study was to longitudinally investigate the association between resilience and mental health in older adults and to determine the influence of physical activity on this relationship. A total of 291 older adults were included in a 2-year follow-up study. Adjusted linear regression models evaluated the association between resilience at baseline and mental health after 2 years in sufficiently and insufficiently physically active older adults. A negative correlation was found between resilience at baseline and depression, anxiety, and stress after 2 years for the overall sample. This association changed after stratifying the group. Sufficiently physically active individuals made greater use of the resilience components “Self-Sufficiency” and “Perseverance,” whereas insufficiently physically active individuals made greater use of “Meaning of Life” and “Existential Singularity.” Physical activity can influence the relationship between resilience and mental health. These results can help guide the devising of more effective interventions for this age group.

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