Audiologists’ Role in Assessing Risk of Falls

2013 ◽  
Vol 14 (1) ◽  
pp. 22-34 ◽  
Author(s):  
Robin E. Criter ◽  
Jessie N. Patterson ◽  
Julie A. Honaker
Keyword(s):  
Risk Factors ◽  
Fall Prevention ◽  
Fall Risk ◽  
Well Being ◽  
Screening Tools ◽  
Older Individuals ◽  
Risk Of Falls ◽  
Falling Risk ◽  
Risk Factors For Falls ◽  
Fall Risk Screening

Falls are a significant problem for older individuals and a growing medical concern with the projected increase in individuals over the age of 65. Falls can result in serious consequences such injury or death; however, residual psychological effects include reduction in independence and emotional well-being. Audiologists may be at a unique position given the relatively high number of falls reported in the audiology clinic and must be alert to possible risk factors for falls and aware of the resources available to help our patients on a path to prevention. Audiological risk factors and fall risk screening tools are discussed. Falls are multi-faceted and require a multi-disciplinary approach to assessment, management, and prevention; audiologists can provide unique clinical recommendations and expertise to reduce falling risk. A movement of our profession towards better understanding of falling risk factors, and initiating research aimed at identifying sensitive and specific time efficient measures to incorporate into any audiology practice, are necessary steps to putting our patients on the path to fall prevention.

scholarly journals 127 Older Adults' Knowledge and Perceptions of Falls: A Mixed Methods Study

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv28-iv33
Author(s):  
Cheah Ping Ng ◽  
Devinder Kaur Ajit Singh ◽  
Maw Pin Tan ◽  
Saravana Kumar
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Fall Prevention ◽  
Fall Risk ◽  
Community Dwelling ◽  
Limited Information ◽  
Older Individuals ◽  
Fall Risk Factors ◽  
Global Issue ◽  
Risk Of Falls

Abstract Introduction Falls is a global issue due to its devastating consequences and costs associated with fall injuries in older adults. There is limited information regarding knowledge and perceptions about falls among older individuals in Malaysia. The aim of this study was to assess knowledge and perceptions of falls among older adults. Methods A total of twenty-five (n=25) community dwelling older adults were invited to participate in this study (age range 61-83, median=73). Focus group discussions were conducted to explore older adults’ perceptions on falls, while the Fall Risk Assessment Questionnaire (FRAQ) was used to assess their knowledge on falls. Results Three themes emerged from the qualitative data, which were ‘Ageing and its association with falls’, ‘Reactions to a fall’ and ‘Knowledge of fall interventions’. The quantitative results showed that more than half of the participants considered themselves at the risk of falls (n=15, 60%). Older adults had better knowledge on behavioral and environmental (percentage of errors: 19.4%; 35.2%) compared to medical and medication related fall risk factors (percentage of errors: 55.2%; 57.33%). Discussion Older adults had both positive and negative views on ageing and falls. Some of the fall prevention strategies highlighted were in line with evidence-based recommendations. However, majority exhibit fall prevention behaviors that were largely based on their personal experiences. Older adults lacked the knowledge on medical related fall risk factors as these require understanding of various medical conditions and the related medications. Conclusion Education intervention emphasizing on ageing, medical and medication related fall risk factors should now be evaluated.

scholarly journals 42 Fall Brain: Cognitive and Biological Perspectives

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv9-iv12
Author(s):  
Joe Verghese
Keyword(s):  
Risk Factors ◽  
Fall Prevention ◽  
Neural Mechanisms ◽  
Prevention Strategies ◽  
Clinical Predictors ◽  
Risk Of Falls ◽  
Falls In Older Adults ◽  
Reduce Risk ◽  
Risk Factors For Falls ◽  
The Relationship

Abstract While many fall prevention strategies targeted against clinical risk factors have been tested, their success in reducing falls has been modest. Current falls research in aging is mostly focused on clinical predictors of falls. Hence, there is a knowledge gap regarding the underlying biological and neural mechanisms of falls. Emerging evidence from our and other studies implicates biological derangements in inflammation, oxidative stress, and vascular pathways in the occurrence of disorders of gait, balance, and cognition, which in turn are major risk factors for falls in older adults. A growing understanding of the relationship between cognitive and mobility processes in aging opens up the possibility of novel interventions to improve mobility and reduce risk of falls.

scholarly journals Dynamic Performance-exposure Algorithm for Falling Risk Assessment and Fall Prevention in Community-dwelling Older Adults

2021 ◽  
Author(s):  
Catarina Pereira ◽  
Hugo Rosado ◽  
Gabriela Almeida ◽  
Jorge Bravo
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
High Risk ◽  
Fall Prevention ◽  
Dynamic Performance ◽  
Community Dwelling ◽  
Low Risk ◽  
Falling Risk ◽  
Risk Factors For Falls ◽  
Community Dwelling Older Adults

Abstract Background: Several models and algorithms were designed to identify older adults at risk of falling supported on an intrinsically and extrinsically traditional approach. However, the dynamic interaction between multiple risk factors for falls must be considered. The present study aimed to design a dynamic performance-exposure algorithm for falling risk assessment and fall prevention in community-dwelling older adults.Methods: The study involved 1) a cross-sectional survey assessing retrospective falls, performance-related risk factors for falls (sociodemographic such as gender and age, cognitive, health conditions, body composition, physical fitness, and dual-task outcomes), exposure risk factors (environmental hazards and (in)physical activity), and performance-exposure risk factors (affordance perception), and 2) follow-up survey assessing prospective falls. Participants were Portuguese community dwellings (≥ 65 years). Data were reported based upon descriptive statistics, curve estimation regression, binary logistic regression, and ROC curve.Results: The selected and ordered outcomes included in the algorithm and respective cutoffs were: (1) falls in previous year (high risk: n>1, moderated: n=1, low risk: n=0); (2) health conditions (high risk: n >3, moderated: n=3, low risk: n<3); (3) multidimensional balance (high risk: score <32 points, moderated risk: 32 points ≤ score ≤33 points, low risk: score>33); (4) lower body strength (high risk: rep/30s< 11, moderated risk: 11≤ rep/30s ≤14, low risk: rep/30s >4); (5) perceiving action boundaries (high risk: overestimation bias, moderated risk: not applied, low risk: underestimation bias); (6) fat body mass (high risk: % fat >38, moderated risk: 37≤ % fat ≤38, low risk: % fat <7); (7) environmental hazards (high risk: n>5, moderated risk: n=5, low risk: n<5); (8) rest period (high risk: hours/day >4.5, moderated risk: 4≤ hours/day ≤4.5, low risk: hours/day <4); (9) physical activity metabolic expenditure (high risk: MET-min/week <2300 or >5200, moderated risk: 2300≤ MET-min/week <2800, low risk: 2800≤ MET-min/week ≤5200).Conclusions: Results demonstrated a dynamic relationship between older adults’ performance capacity and the exposure to falls opportunity, supporting the build algorithm’s conceptual framework. Fall prevention measures should consider the above factors that most contribute to the individual risk of falling, relative weights, and their distance from low-risk value, as proposed in the dynamic algorithm.

FALL PREVENTION PRIMER FOR THE PRIMARY CARE PRACTIONER:

2016 ◽  
Vol 2 (8) ◽  
Author(s):  
Mindy Oxman Renfro, PhD, DPT, CPH, PT ◽  
Joyce Maring, EdD, DPT, PT ◽  
Donna Bainbridge, EdD, PT, AT-Ret
Keyword(s):  
Primary Care ◽  
Fall Prevention ◽  
Fall Risk ◽  
Hospital Readmissions ◽  
Screening Tools ◽  
Evidence Based ◽  
Risk Screening ◽  
Quality Reporting ◽  
The Impact ◽  
Fall Risk Screening

<p><strong>ABSTRACT:</strong></p><p>One of three older adults age 65+ fall each year, and every 20 minutes an older adult dies due to injuries sustained during a fall.  Yet, most patients do not report falls to their physician.  Primary care practitioners (PCPs) are well positioned to screen for fall risk and add proactive referral patterns to both well-selected practitioners and evidence-based fall prevention (EBFP) programs designed to help older patients stay healthy, active, and independent.</p><p>The purposes of this review are to summarize the data related to the impact of falls; review efficient and reliable screening tools that identify individuals at high fall risk; describe appropriate referrals that facilitate a match between individual specific risk factors and interventions; and, highlight evidence-based fall prevention (EBFP) programs available to significantly decrease fall risk with outstanding return on investment.</p><p>Simple administrative changes in a PCP’s practice accompanied by appropriate referrals will result in proactive fall prevention including lower rates of falls and fall injuries and fewer hospitalizations and/or hospital readmissions. Fall risk screening can be built into practice to seamlessly add services without impacting practitioner productivity. Additionally, reporting fall risk screening and prevention activities in the Physician Quality Reporting System will positively impact practice Medicare reimbursement rates.</p>

scholarly journals Multifactorial interventions to prevent falls in older adults

2021 ◽  
Vol 25 (3) ◽  
pp. 27-34
Author(s):  
Tatiana A. Богданова
Keyword(s):  
Risk Factors ◽  
Hearing Impairment ◽  
Fall Prevention ◽  
Sleep Disturbances ◽  
Multifactorial Intervention ◽  
Risk Of Falls ◽  
History Of ◽  
Risk Factors For Falls ◽  
Fear Of Falls

BACKGROUND: Falls are one of the most common syndromes in old age. An estimated 646,000 deaths from falls occur each year worldwide. Moreover, most fatal falls occur in people over 65 years of age. Most falls are the result of the interaction of several factors. AIMS: To examine the long-term effectiveness of multifactorial interventions in preventing falls in elderly and senile patients. MATERIALS AND METHODS: A sample of patients territorially attached to the Family Medicine Center of the North-Western State Medical University named after I.I. Mechnikov was established four years ago. Individual fall prevention programs were developed for all study participants (n = 260) because they had different falls risk factors. Patient follow-up was continued for 12 months. The results of the multifactorial intervention were evaluated after 12 months and after 3 years, 2 times in total, the last study in a random subsample of patients (n = 84). Aging asthenia screening, questionnaires, assessment of emotional status, and presence of sleep disturbances were performed to assess the risk of falls. The effectiveness of multifactorial interventions was assessed based on repeated assessment of risk factors for falls. RESULTS: Participants with a history of falls were significantly more likely to have symptoms of depression, anxiety, symptoms of frailty, visual and hearing impairment (p 0.05). On average, each participant in the group with falls had 6.1 2.1 risk factors for falls and 3.8 2.3 in the group without falls (p = 0.000). During the follow-up period after the interventions, the incidence of falls decreased 9-fold after one year (from 28.5% to 3.1%) and then increased to 23.8%. All patients who fell after the multifactorial intervention had a history of cognitive impairment and falls. In addition, in the group of patients with falls, fall risk factors such as low levels of physical activity, hearing impairment, and the presence of a traumatic environment at home were not eliminated. As a result of the interventions, fear of falls disappeared in 9 patients, 95% CI (2.35-65.89), p = 0.039. CONCLUSIONS: The study demonstrated a decrease in the effectiveness of multifactorial interventions to prevent falls at three years. A less persistent effect was seen in patients with a history of falls. A history of falls, symptoms of frailty, complaints of fear of falls, sleep disturbances, and anxiety symptoms were factors that increased the risk of falls. Individualized fall prevention programs resulted in decreased fear of falls.

scholarly journals Nursing care related to fall prevention among hospitalized elderly people: an integrative review

2021 ◽  
Vol 74 (suppl 2) ◽  
Author(s):  
Adnairdes Cabral de Sena ◽  
Angela Maria Alvarez ◽  
Simony Fabíola Lopes Nunes ◽  
Nadia Pinheiro da Costa
Keyword(s):  
Risk Factors ◽  
Elderly People ◽  
Nursing Care ◽  
Fall Prevention ◽  
Fall Risk ◽  
Risk Prevention ◽  
Hospitalized Elderly ◽  
Clinical Nursing ◽  
Fall Risk Factors ◽  
Care Behavior

ABSTRACT Objective: to identify scientific productions on nursing care related to fall risk prevention among hospitalized elderly people. Methods: an integrative literature review from 2015 to 2019 in the PubMed/MEDLINE, Scopus, Web of Science, LILACS, BDENF, SciELO and CINAHL databases, in Portuguese, English and Spanish. The keywords were elderly, hospitalization, accidents due to falls, nursing care. Results: thirty-three publications were analyzed. The synthesis of the studies resulted in the categories: Clinical nursing assessments to prevent falls among hospitalized elderly people; Fall risk factors for elderly people; Fall risk prevention strategies for elderly people. Final considerations: it was found that the scientific knowledge produced on nursing care related to fall risk prevention for hospitalized elderly people evidences the clinical assessment, risk factors and strategies such as nursing care, contributing to foster self-care behavior and promotion security for elderly people.

scholarly journals Assessment of risk of falls and internal risk factors in elderly patients who need heart pacemarkers

2021 ◽  
Vol 2 (9 (297)) ◽  
pp. 1-8
Author(s):  
Guoda Burneikaitė ◽  
Lina Spirgienė
Keyword(s):  
Risk Factors ◽  
Elderly Patients ◽  
Fall Risk ◽  
Pacemaker Implantation ◽  
Leg Pain ◽  
Old Patients ◽  
Fall Risk Factor ◽  
Fall Risk Factors ◽  
Experienced Fatigue ◽  
Risk Of Falls

Abstract. The aim is to assess the frequency of falls and intrinsic fall risk factors in patients requiring pacemakers. Methodology. The research was conducted from November 2020 to February 2021. Participated patients were hospitalized at the LUHS hospital Kauno Klinikos Department of Cardiology and required heart pacemaker implantation. Total 82 patients participated in the study. The questionnaire was composed by the authors of the research. The study was obtained by the Bioethics Permit of the Medical Academy of LUHS (No. BEC-SL (B) -42). Results. Almost half of the patients fell (45.1%) at least once a year. Elderly patients (65 years and older) are more likely to experience falls than patients under 65 years of age p=0,006. Elderly patients are more often exposed to various internal risk factors of falls: urination at night (82,9 %), weakness (82,9 %), dizziness (76,8 %). Perceived decreased leg muscle strength was found in both women and men (69.6% and 52.8%, respectively, p = 0.002). Patients older than 65 years and therefore <65 years experienced leg pain (54,9% and 7,2%, respectively, p = 0.002), urination at night (68,4% and 14,6%, respectively, p = 0.009), and experienced fatigue (63,0% and 13,6%, p = 0.028). Conclusions. Almost half of the patients who were in need of heart pacemaker implantation experienced falls. ≥ 65 years old patients experienced falls more than once a year. It has been found that these patients often experience weakness, fatigue, and dizziness. A common intrinsic fall risk factor is urination at night. ≥ 65 years old patients have more internal falls risk factors than patients under 65 years old.

scholarly journals Comparison of The Risk Factors For Falls Among Older Adults Between Urban and Rural Areas of Shantou City, China

2020 ◽  
Author(s):  
Xiaodong Chen ◽  
Zeting Lin ◽  
Ran Gao ◽  
Yijian Yang ◽  
Liping Li
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Fall Prevention ◽  
Rural Areas ◽  
Urban Areas ◽  
Multivariable Analysis ◽  
Living Environment ◽  
Balance Function ◽  
Urban And Rural Areas ◽  
Risk Factors For Falls

Abstract Background: To investigate the prevalence of falls and risk factors among older adults in urban and rural areas and to facilitate the design of fall prevention interventions.Methods: We used cluster random sampling to investigate the sociodemographic information, living habits, medical history, and falls among 649 older adult participants. Univariable and multivariable logistic regression was used to examine fall risk factors in urban and rural areas.Results: The fall rate and rate of injury from falls among older adults in urban areas were 27.3% and 18.6%, respectively, which were higher than those in rural areas (17.0% and 12.2%; P<0.05). Multivariable analysis showed that the risk factors for falls among urban older adults included a high school or below education level (OR=3.737, 95% CI: 1.503~9.291); diabetes medicine use (OR=4.518, 95% CI: 1.228~16.626); incontinence (OR=8.792, 95% CI: 1.894~40.824); lack of fall prevention education (OR = 11.907, 95% CI: 1.321～107.354); and reduced balance function (OR = 3.901, 95% CI: 1.894~7.815). The risk factors among rural older adults included a previous nonfarming occupation (OR=2.496, 95% CI: 1.416~4.398); incontinence (OR =11.396, 95% CI: 1.901~68.327); poor living environment (OR=3.457, 95% CI: 1.488~8.033); and reduced balance function (OR =4.260, 95% CI: 2.361~7.688).Discussion: The rate of falls among older adults in urban areas is higher than that in rural areas of Shantou City. Fall prevention in urban areas should target older adults with low education and modify the diabetes medication use. Interventions should focus on improving the home environment of older adults in rural areas.

Abstract WP375: Fall Risk in Acute Ischemic Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Robynn S Cox ◽  
Cheryl Bradas ◽  
Victoria Bowden ◽  
Beth Buckholz ◽  
Kathleen Kerber ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Fall Risk ◽  
Safety Net ◽  
Public Healthcare ◽  
Inpatient Setting ◽  
Stroke Patients ◽  
Safety Net Hospital ◽  
Risk Factors For Falls

Fall Risk Factors among Hospitalized Acute Post-Ischemic Stroke Patients in an Urban Public Healthcare System Background: Falls remain an important benchmarking indicator for hospitals. The incidence of falls is a nursing-sensitive indicator, amenable to preventable measures. Research indicates factors associated with falls, but few studies specifically identify factors among hospitalized patients with acute ischemic stroke (AIS). Purpose: Identify prevalence and risk factors for falls among acute, hospitalized AIS patients within an urban safety net hospital. Methods: Retrospective cohort study. Data abstracted from stroke and fall registries, and medical records from 2013-2015 among all adult patients admitted for AIS. Variables included traditional risk factors for falls, as well as stroke-specific factors (NIHSS score, functional status, stroke location and vessel, administration of tPA). Results: N=683 AIS stroke patients, with 1.6% fall rate. Falls among AIS patients accounted for 6% of all hospital falls. AIS patients who experienced an inpatient fall had a mean age of 67 (range 46-86), were mostly male (82%), and ambulating independently prior to arrival (91%). Mean NIHSS scores upon admission were higher among those who experienced a fall, when compared to AIS patients who did not fall (mean=8.73, 7.01, respectively). Most patients who experienced a fall demonstrated weakness and/or paresis upon initial exam (90%), with 64% experiencing small vessel ischemic changes, and 36% MCA strokes. Administration of tPA was not associated with increased falls. LOS was significantly increased among AIS patients who experienced a fall (7.7 vs. 4.8, respectively, p <0.01). Conclusions: Fall rates among hospitalized AIS patients may be lower than earlier reports, reflecting increased vigilance among providers and widespread integration of fall prevention strategies. Elevated NIHSS scores and weakness/paresis upon initial exam may be important predictors of falls among newly diagnosed AIS patients who had previously been able to ambulate independently. Consistent with fall literature among other populations, the occurrence of a fall in the inpatient setting can substantially increase length of stay.

137 Fall-Risk Increasing Drugs

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv34-iv39
Author(s):  
Nathalie Van Der Velde
Keyword(s):  
Risk Factors ◽  
Clinical Practice ◽  
Clinical Relevance ◽  
Fall Risk ◽  
Drug Withdrawal ◽  
Complex Interactions ◽  
Optimal Drug ◽  
Lowering Drug ◽  
Risk Factors For Falls

Abstract Use of certain drugs (psychotropic and cardiovascular) has been indicated as one of the major risk factors for falls. However, in clinical practice, physicians struggle with withdrawal of fall-risk-increasing drugs. At the heart of this struggle lies the inadequacy of our knowledge pertaining to the effectiveness of drug withdrawal for individual patients. Complex interactions between risk factors for falls can be expected, especially for drug-related fall incidents, as both drug-drug interactions as well as drug-disease interactions are known to be of clinical relevance. Also, specific biomarkers may be of importance, such as genetic variations as was recently shown by our group. By lowering drug-related fall risk, loss of quality of life, institutionalization and death can be prevented. For optimal drug withdrawal in clinical practice, better understanding and prediction of drug-related fall risk is essential. The presentation will address identification of fall-risk increasing drugs and specifically predictive factors that may be of clinical relevance such as the effect of genetic variation on medication-related falls.

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