scholarly journals 217 Investigating the Delivery of Falls Prevention Interventions to Older People Following Multi-Factorial Risk Assessment: A Cross-sectional Study

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Rebecca Dennehy ◽  
Patrick J Barry ◽  
Kieran A O'Connor ◽  
Finola Cronin ◽  
Spencer Turvey ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Older People ◽  
Waiting Times ◽  
Cross Sectional Study ◽  
Service Planning ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Cross Sectional ◽  
Falls Risk ◽  
Prevention Interventions

Abstract Background Falls are one of the most common threats to older peoples’ independence. In Ireland, approximately one in three adults aged ≥65 years fall each year. Multifactorial interventions, which include an assessment of an individual's risk of falling followed by customised interventions or referral have been shown to reduce the rate of falls among community-dwelling older people. As part of an Integrated Falls Prevention Pathway initiated in 2016, six multidisciplinary risk assessment clinics were established in Cork city and county. The aim of this study is to examine whether recommended follow-on interventions were received following a falls risk assessment in the community. Methods Routinely collected administrative data for clients who attended a falls risk assessment clinic are being collated. Data include client demographics, onward referrals, waiting times and receipt of intervention. A process map of the patient pathway following a falls risk assessment is under development and will be refined based on the study findings. Results Preliminary analysis of a two-year implementation period (April 2016-2018) indicates that following assessment, clients received an average of 2.4 onward referrals. Most referrals were made to general practice (29%, n=315), community physiotherapy (25%, n=272), and community occupational therapy (15%, n=165). Other referrals were to public health nurses (n=104, 10%) and falls prevention classes (n=60, 6%). Further analysis will identify the percentage of individuals who receive interventions, the type of interventions received, the percentage of patients who do not attend and the waiting lists. Conclusion The Integrated Falls Prevention Service is the sole example of an operational integrated falls pathway in Ireland. This research will identify potential roadblocks for providers and clients along the pathway and will identify opportunities to. The results will also be used to inform service planning and resource allocation to ensure that this model of care is sustainable.

Falls prevention interventions for community-dwelling older persons with cognitive impairment: a systematic review

2012 ◽  
Vol 25 (2) ◽  
pp. 215-227 ◽  
Author(s):  
Heidi Winter ◽  
Kerrianne Watt ◽  
Nancye May Peel
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Older People ◽  
Large Body ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Original Research ◽  
Cognitively Impaired ◽  
Falls Risk ◽  
Prevention Interventions

ABSTRACTBackground:Globally, falls in older people are a leading cause of injury-related mortality and morbidity. Cognitive impairment is a well-known risk factor for falls in this population group. While there is now a large body of evidence to support effective interventions for falls reduction across care settings, very little is known about interventions in the vulnerable, but increasing population of cognitively impaired community-dwelling older people. Therefore, the purpose of this systematic review is to investigate interventions designed to reduce falls in community-dwelling, cognitively impaired older adults.Methods:A literature search of databases was conducted to identify original research published in English, which met predefined inclusion and exclusion criteria for effective (non-pharmacological) falls prevention interventions in cognitively impaired community-dwelling people over 65 years of age. Data from the selected papers were extracted into data extraction tables and analyzed according to study characteristics, measures, results, and quality.Results:The review identified 11 studies providing data from 1,928 participants. Interventions included exercise, health assessment and management of risk, multi-component and cognitive behavioral programs, and hip protectors as falls risk reduction strategies. Seven of the selected studies showed an intervention effect in decreasing falls risk; however, only two of these showed a significant improvement in physical performance measures specifically in a cognitively impaired group.Conclusions:The diversity of interventions, study designs, populations, and quality of the studies, which met inclusion criteria, resulted in conflicting evidence and inconclusive results for falls prevention interventions in this highly complex population.

Drug Burden Index associated with function in community-dwelling older people in Finland: A cross-sectional study

2011 ◽  
Vol 44 (5) ◽  
pp. 458-467 ◽  
Author(s):  
Danijela Gnjidic ◽  
J. Simon Bell ◽  
Sarah N. Hilmer ◽  
Eija Lönnroos ◽  
Raimo Sulkava ◽  
...  
Keyword(s):  
Older People ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Sectional Study ◽  
Cross Sectional ◽  
Drug Burden Index ◽  
Community Dwelling Older People

scholarly journals Nutritional Status and Risk Factors for Frailty in Community-Dwelling Older People: A Cross-Sectional Study

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 1041 ◽  
Author(s):  
Pilar Pérez-Ros ◽  
Rafael Vila-Candel ◽  
Lourdes López-Hernández ◽  
Francisco Miguel Martínez-Arnau
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Nutritional Status ◽  
Older People ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Sectional Study ◽  
Cross Sectional ◽  
Community Dwelling Older People ◽  
The Relationship

Objective: This study aims to assess the relationship that frailty has with nutritional status and functional risk factors in community-dwelling older adults. Methods: Cross-sectional study in community-dwelling older people, independent for walking and without impaired cognition. Frailty was assessed by Fried criteria. Nutritional status was analyzed by the Mini Nutritional Assessment Short Form (MNA-SF), biochemical markers (albumin, total proteins, cholesterol, lymphocytes, and hemoglobin); and anthropometric parameters (body mass index [BMI], body fat percentage, handgrip, and perimeters). A comprehensive geriatric assessment analyzed other risk factors: functionality, cognition, falls, comorbidity, polypharmacy, physical activity, and quality of life (QoL). Results: We included 564 elderly people with a mean age of 76.05 (standard deviation 3.97) years; 63.1% (n = 356) were women, and 83.9% (n = 473) were prefrail, and frail. The sample presented high functionality and a nutritional status with a predominance of overweight and obesity. Factors associated with frailty (R2 = 0.43) were age over 75 years (odds ratio [OR] 3.31, 95% confidence interval [CI] 1.76, 6.21; p < 0.001), female gender (OR 2.37, 95% CI 1.24, 4.52; p = 0.009), anemia (OR 2.45, 95% CI 1.19, 5.02; p = 0.015), falls (OR 1.94, 95% CI 1.12, 3.25; p = 0.016) and the fear of falling (OR 4.01: 95% CI 1.76, 9.16; p = 0.001). Performing more than 3 weekly hours of physical activity was found to be a protective factor (OR 0.23, 95% CI 0.15, 0.35; p < 0.001). Conclusions: The relationship between frailty and malnutrition in functionally independent community-dwelling older people is unclear. More studies are needed to know what nutritional markers are related to frailty, cognition, and functionality in order to discriminate the risk factors for community-dwelling older people at risk of malnutrition and dependency.

scholarly journals Factors associated with screening positive for high falls risk in fragility fracture patients: a cross-sectional study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Nooshin K. Rotondi ◽  
Dorcas E. Beaton ◽  
Rebeka Sujic ◽  
Earl Bogoch ◽  
Taucha Inrig ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Fragility Fracture ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Falls Risk ◽  
Ongoing Work ◽  
Health Related ◽  
Risk Of Falls ◽  
Fracture Population

Abstract Background We sought to report the prevalence of fragility fracture patients who were screened at high falls risk using a large provincial database, and to determine the characteristics associated with being screened at high falls risk. Methods The study population included fragility fracture patients 50+ years of age who were screened at 35 hospital fracture clinics in Ontario over a 3.5 year period. The outcome was based on two screening questions measuring the risk of falling, both adapted from the STEADI (Stopping Elderly Accidents, Deaths & Injuries) tool. Multivariable associations of sociodemographic, fracture-related, and health-related characteristics were evaluated using logistic regression. Results Of the sample, 9735 (44.5%) patients were classified as being at high falls risk, and 12,089 (55.3%) were not. In the multivariable logistic regression, being 80+ years of age (vs. 50–64 years of age), non-community dwelling (vs. living with spouse, family member, roommate), having a mental/physical impairment (vs. none), and taking multiple medications, were all strongly associated with being screened at high falls risk. Conclusions Living in a non-community dwelling and taking 4+ medications were the variables most strongly associated with being screened at high falls risk. These are potentially modifiable characteristics that should be considered when assessing falls risk in fragility fracture patients, and particularly when designing interventions for preventing subsequent falls. Ongoing work to address the higher risk of falls in the fragility fracture population is warranted.

scholarly journals Prevalence and factors associated with frailty among community-dwelling older people in rural Thanjavur district of South India: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e032904 ◽  
Author(s):  
Kirubakaran Kesavan Kendhapedi ◽  
Niveditha Devasenapathy
Keyword(s):  
Older People ◽  
Fear Of Falling ◽  
Frailty Index ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Domain Definition ◽  
Tilburg Frailty Indicator ◽  
Community Dwelling Older People ◽  
Frailty Indicator

ObjectiveThere is sparse data on the prevalence of frailty from rural parts of India. Our aim was to estimate prevalence of frailty among community-dwelling older people in rural South Indian population and explore socio-demographic factors associated with frailty. We further explored the associations between frailty with fear of falling and falls.DesignCommunity based cross-sectional study.SettingFour villages in Thanjavur district of Southern India.ParticipantsRandom sample of adults aged 60 years and above from four villages.MethodsWe sampled community-dwelling older adults from the electoral list of four villages using stratified random sampling. We report prevalence of frailty as defined by physical definition (Fried’s Phenotype), accumulation of deficits (Frailty Index) and multi-domain definition (Tilburg Frailty Indicator). We report proportion of agreement of frailty status between the frailty tools. We used logistic regressions with robust SEs to examine the associations between socio-demographic determinants with frailty and the association between frailty with fear of falling and falls.ResultsAmong the 408 participants, the weighted (non-response and poststratification for sex) prevalence and 95% CI of frailty was 28% (18.9 to 28.1) for physical definition, 59% (53.9 to 64.3) for accumulation of deficits and 63% (57.4 to 67.6) for multi-domain definition. Frailty Index and Tilburg Frailty Indicator had good agreement (80%). Age, female, lower education, lower socioeconomic status, minimum physical activity in routine work were independently associated with frailty irrespective of the frailty definitions. Frail elderly had higher odds of falls as well as fear of falling compared with non-frail, irrespective of the definitions.ConclusionPrevalence of frailty among older people in rural Thanjavur district of South India was high compared with low-income and middle-income countries. Understanding the modifiable determinants of frailty can provide a valuable reference for future prevention and intervention.

scholarly journals Relationship between Perceived Indoor Temperature and Self-Reported Risk for Frailty among Community-Dwelling Older People

2019 ◽  
Vol 16 (4) ◽  
pp. 613 ◽  
Author(s):  
Yukie Nakajima ◽  
Steven Schmidt ◽  
Agneta Malmgren Fänge ◽  
Mari Ono ◽  
Toshiharu Ikaga
Keyword(s):  
Older People ◽  
Economic Status ◽  
Frailty Index ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Indoor Temperature ◽  
Cross Sectional ◽  
Economic Satisfaction ◽  
Increased Risk ◽  
Community Dwelling Older People

This study investigated the relationship between perceived indoor temperature in winter and frailty among community-dwelling older people. This cross-sectional study included 342 people 65 years and older in Japan. Participants answered questions about demographics, frailty, housing, and perceived indoor temperature in winter. Participants were grouped based on perceived indoor temperature (Cold or Warm) and economic satisfaction (Unsatisfied or Satisfied). Differences in the frailty index between perceived indoor temperature groups and economic satisfaction groups were tested by using ANCOVA and MANCOVA. An interaction effect showed that people in the Cold Group and unsatisfied with their economic status had significantly higher frailty index scores (F(1, 336) = 5.95, p = 0.015). Furthermore, the frailty index subscale of fall risk was the specific indicator of frailty that accounted for this significant relationship. While previous research has shown the risks related to cold indoor temperature in homes, interestingly among those who reported cold homes, only those who were not satisfied with their economic situation reported being at increased risk for frailty. This highlights the potential importance of preventing fuel poverty to prevent frailty.

scholarly journals Symptom burden in community-dwelling older people with multimorbidity: a cross-sectional study

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Jeanette Eckerblad ◽  
Kersti Theander ◽  
Anne Ekdahl ◽  
Mitra Unosson ◽  
Ann-Britt Wirehn ◽  
...  
Keyword(s):  
Older People ◽  
Symptom Burden ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Sectional Study ◽  
Cross Sectional ◽  
Community Dwelling Older People

Falls Risks and Prevention Behaviors Among Community-Dwelling Homebound and Non-Homebound Older Adults

2016 ◽  
Vol 37 (9) ◽  
pp. 1085-1106 ◽  
Author(s):  
Carri Casteel ◽  
Jennifer Jones ◽  
Paula Gildner ◽  
James M. Bowling ◽  
Susan J. Blalock
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Negative Binomial ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Falls Risk ◽  
Homebound Older Adults ◽  
Risk Factors For Falls

The objectives were to examine falls risk factors to determine how the magnitude of risk may differ between homebound and non-homebound older adults, and to describe falls prevention behaviors and participation in falls prevention education. A cross-sectional survey was conducted with convenience samples of community-dwelling older adults recruited through Meals on Wheels programs (homebound, n = 80) and senior centers (non-homebound, n = 84) in North Carolina. Data were collected during home visits and included an interview and medication inventory. Multivariate negative binomial regression with robust variance estimation modeled risk factors for falls. Risk factors for falls observed in both the homebound and non-homebound populations are consistent with what is known in the literature. However, the magnitude of the risk was higher in the homebound than in the non-homebound population with respect to vision impairments, number of high-risk and over-the-counter medications, and use of walking aids .Few participants reported participating in a falls prevention program.

scholarly journals Challenges of Singapore’s First Acute Geriatric Isolation Facility During the COVID-19 Pandemic

2021 ◽  
pp. 201010582110476
Author(s):  
Bernard Kok Chong Yap ◽  
Wrenzie Del Valle Espeleta ◽  
Savithri Sinnatamby ◽  
Fuyin Li ◽  
Bantilan Anna Liza ◽  
...  
Keyword(s):  
Older People ◽  
Psychological Symptoms ◽  
Care Delivery ◽  
Cross Sectional Study ◽  
Adverse Outcomes ◽  
Falls Prevention ◽  
P Value ◽  
Cross Sectional ◽  
Presenting Symptoms ◽  
Isolation Facility

Aim The COVID-19 pandemic has seen hospitals isolating suspect cases. Geriatric populations are at a risk of severe COVID-19 disease and often present with concomitant geriatric syndromes requiring holistic interdisciplinary care. However, isolation of older people poses challenges to care delivery. This study shares the experience of Singapore’s first acute geriatric isolation facility geriatric PARI (Pneumonia-Acute Respiratory Infection) ward and describes the geriatric-related outcomes and pitfalls in care delivery. Methods This is a retrospective cross-sectional study performed in 7 negative pressure isolation rooms in an acute care public hospital in Singapore. 100 patients admitted consecutively to the geriatric PARI ward were included. Patient demographics, presenting symptoms and geriatric-related adverse outcomes associated with hospitalisation were collected and analysed. Results Patients’ mean age was 86.4 years (standard deviation [SD]: 6.8) with significant comorbidities being hypertension (81%), hyperlipidaemia (74%) and renal disease (70%). 51% of patients had dementia and 24% had behaviour and psychological symptoms of dementia (BPSD). 27% of patients presented atypically with delirium and 15% presented with a fall. Delirium was associated with restraint use (OR: 3.88; p-value 0.01). Falls rate was 1.64 per 1000 occupied bed. 1 patient screened positive for COVID-19. Conclusions The geriatric PARI ward is essential for curbing nosocomial transmission of COVID-19. This is important in the older people with comorbidities who are more likely to develop morbidity and mortality. Our study reveals challenges in delivering person-centred care to the older patients in isolation rooms, especially in the management of delirium and falls prevention. Innovative strategies should be developed to minimise isolation-related adverse outcome.

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