scholarly journals Chronic Pain and Risk of Injurious Falls in Community-Dwelling Older Adults

2020 ◽  
Author(s):  
Yurun Cai ◽  
Suzanne G Leveille ◽  
Ling Shi ◽  
Ping Chen ◽  
Tongjian You
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Community Dwelling ◽  
Pain Interference ◽  
Fall Injuries ◽  
Injurious Falls ◽  
Increased Risk ◽  
Falls In Older Adults ◽  
Pain Characteristics

Abstract Background Fall injuries are a leading cause of death in older adults. The potential impact of chronic pain characteristics on risk for injurious falls is not well understood. This prospective cohort study examined the relationship between chronic pain and risk for injurious falls in older adults. Method The MOBILIZE Boston Study enrolled 765 community-dwelling adults aged 70 years and older living in and around Boston, Massachusetts. Chronic pain characteristics, including pain severity, pain interference, and pain distribution, were measured at baseline using the Brief Pain Inventory subscales and a joint pain questionnaire. Occurrence of falls and fall-related injuries were recorded using monthly fall calendar postcards and fall follow-up interviews during the 4-year follow-up period. Results Negative binomial regression models showed that pain interference and pain distribution, but not pain severity, independently predicted injurious falls adjusting for potential confounders. Participants in the highest third of pain interference scores had a 61% greater risk of injurious falls compared to those reporting little or no pain interference. Compared to no pain, multisite pain was associated with a 57% greater risk of injurious falls. Stratified by gender, the association was only significant in women. In the short term, moderate-to-severe pain in a given month was associated with increased risk of injurious falls in the subsequent month. Conclusions Global pain measures are associated with increased risk of injurious falls in older adults. Pain assessment should be incorporated into fall risk assessments. Interventions are needed to prevent fall injuries among elders with chronic pain.

scholarly journals CHRONIC PAIN CONTRIBUTES TO INJURIOUS FALLS IN COMMUNITY-DWELLING OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S622-S622
Author(s):  
Yurun Cai ◽  
Suzanne Leveille ◽  
Ling Shi ◽  
Tongjian You ◽  
Ping Chen
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Community Dwelling ◽  
Pain Severity ◽  
Pain Interference ◽  
Fall Injuries ◽  
Injurious Falls ◽  
Multisite Pain ◽  
Community Dwelling Older Adults ◽  
Pain Distribution

Abstract Fall injuries are a leading cause of death among older adults, and chronic pain has been identified as a fall risk factor. However, the potential impact of chronic pain on injurious falls is unknown. This prospective study examined the relation between chronic pain and injurious falls in a 4-year follow-up of community-dwelling older adults. The MOBILIZE Boston study recruited 765 older adults aged ≥70y living in the Boston area. Pain characteristics, including pain severity, pain interference, and pain location, were measured at baseline using the Brief Pain Inventory subscales and a joint pain questionnaire. Musculoskeletal pain distribution was categorized as “no pain”, “single site pain”, or “multisite pain”. Injurious falls were ascertained in telephone interviews following reports of falls on the monthly fall calendar postcards. The overall rate of injurious falls was 35/100 person-years. Negative binomial models, adjusting for sociodemographics, BMI, chronic conditions, mobility difficulty, analgesic and psychiatric medications, and depression, showed that pain interference and pain distribution, but not pain severity, independently predicted injurious falls. Participants in the highest third of pain interference scores had a 53% greater risk of injurious falls compared to those in the lowest pain interference group (adj.IRR=1.53, 95% CI: 1.15, 2.05). Older adults with multisite pain had a 50% higher risk of injurious falls than those without pain (adj.IRR=1.50, 95% CI: 1.16, 1.93). Risk of injurious falls related to pain was stronger among women than men. Research is needed to determine effective strategies to prevent fall injuries among older adults with chronic pain.

scholarly journals Sensory loss and suicide ideation in older adults: findings from the Three-City cohort study

2018 ◽  
Vol 31 (1) ◽  
pp. 139-145 ◽  
Author(s):  
S. Cosh ◽  
I. Carrière ◽  
V. Daien ◽  
C. Tzourio ◽  
C. Delcourt ◽  
...  
Keyword(s):  
Older Adults ◽  
Major Depressive Disorder ◽  
Suicidal Ideation ◽  
Suicide Ideation ◽  
Vision Loss ◽  
Community Dwelling ◽  
Sensory Loss ◽  
Major Depressive ◽  
Increased Risk

ABSTRACTObjectives:To examine the longitudinal risk of vision loss (VL) or hearing loss (HL) for experiencing suicidal ideation in older adults.Design:The Three-City study, examining data from three waves of follow-up (2006–2008, 2008–2010, and 2010–2012).Setting:Community-dwelling older French adults.Participants:N = 5,438 adults aged 73 years and over.Measurements:Suicidality was assessed by the Mini-International Neuropsychiatric Interview, Major Depressive Disorder module. Mild VL was defined as Parinaud of 3 or 4 and severe VL as Parinaud >4. Mild HL was self-reported as difficulty understanding a conversation and severe HL as inability to understand a conversation.Results:Severe VL was associated with an increased risk of suicidal ideation at baseline (OR = 1.59, 95% CIs = 1.06–2.38) and over five years (OR = 1.65, 95% CIs = 1.05–2.59). Mild and severe HL were associated with an increased risk of suicidal ideation, both at baseline (OR = 1.29, 95% CIs = 1.03–1.63; OR = 1.78, 95% CIs = 1.32–2.40) and over five years (OR = 1.47, 95% CIs = 1.17–1.85; OR = 1.97, 95% CIs = 1.44–2.70).Conclusion:Sensory losses in late life pose a risk for suicidal ideation. Suicidality requires better assessment and intervention in this population.

scholarly journals MECHANISM OF ACTION: AGE DIFFERENCES IN RESPONSE TO ACCEPTANCE AND COMMITMENT THERAPY FOR CHRONIC PAIN

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S809-S809
Author(s):  
Julie L Wetherell ◽  
Matthew Herbert ◽  
Niloofar Afari
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Acceptance And Commitment Therapy ◽  
Behavioral Therapy ◽  
Pain Interference ◽  
Younger Adults ◽  
Pain Acceptance ◽  
Commitment Therapy ◽  
Acceptance And Commitment

Abstract A recent randomized comparison of Acceptance and Commitment Therapy (ACT) vs. Cognitive-Behavioral Therapy for chronic pain found a clear age interaction effect, such that older adults benefitted more from ACT. In a subsequent study comparing ACT delivered in person to ACT delivered via telehealth to a sample of veterans (N=128, mean age 51.9, SD 13.3, range 25-89), we found no significant age by modality interactions, suggesting that older veterans responded as well as younger people did to telehealth delivery. Consistent with our previous findings, we found a trend for older adults to experience greater reduction in pain interference (p = .051) and significantly greater reduction in pain severity (p = .001) than younger adults following ACT. In younger veterans, change in pain acceptance from baseline to posttreatment was related to change in pain interference from baseline to 6-month follow-up (r = -.38), but change in pain interference from baseline to posttreatment was not related to change in pain acceptance from baseline to follow-up (r = .14), suggesting that, consistent with the ACT model, increased pain acceptance at posttreatment was related to reduced pain interference at follow-up. By contrast, in older veterans, both correlations were significant and of comparable magnitude (rs = -.43 and -.46, respectively), providing no support for the idea that change in pain acceptance drove change in pain interference. Overall, our findings suggest that ACT may work better in older adults with chronic pain than in younger adults, but via a different mechanism.

scholarly journals 88 Prospective Association of Obesity and Falls among Malaysian Community-Dwelling Older Adults

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv18-iv27
Author(s):  
Sheng Hui Kioh ◽  
Sumaiyah Mat ◽  
Phyo Myint ◽  
Shahrul B Kamaruzzaman ◽  
Maw Pin Tan
Keyword(s):  
Older Adults ◽  
Physical Performance ◽  
Body Fat ◽  
Community Dwelling ◽  
Percentage Body Fat ◽  
Waist Hip Ratio ◽  
Increased Risk ◽  
Prospective Association ◽  
Community Dwelling Older Adults

Abstract Background Cross-sectional studies linking the association between obesity and falls are limited and their results are somewhat conflicting. The inconsistent evidence between obesity and falls could be explained by the utilization of different measures of obesity including BMI, WC, waist hip ratio (WHR) and percentage body fat (%BF) in different studies. Aims To examine the prospective association between various measures of obesity and falls among community-dwelling older adults. Methods We utilized data from the wave 1 and wave 2 of the Malaysian Elder’s Longitudinal Research Study (MELoR). Basic demographic characteristics, medical history, lifestyle factors and falls history in preceding 12 months was recorded by computer assisted questionnaire in participant’s home while anthropometric measurements, body composition assessments and physical performance were collected at the hospital during a hospital check-up at baseline. The main exposure variables were increased body mass index (BMI), waist circumference (WC), waist hip ratio (WHR) and percentage body fat (%BF) and the main outcome was self-report falls in the preceding 12 months at time of follow-up. Results Among 746 participants at baseline and follow-up (mean age 68.9 ± 7.3 years, old, 56.7% women), 150(20.1%) individuals had ≥1 time of fall at follow-up. No differences in mean age and proportion of men and women among fallers and non-fallers. However, fallers were found to have higher WHR, lower percentage muscle mass and performed poorer in physical performance (p-value<0.01). Of the four obesity indicators, higher WHR at baseline was associated with increased risk of fall 12 months later even after adjustment for all potential confounders (aOR= 2.01; 95%CI= 1.26-3.18). Conclusions In conclusion, our findings suggest that WHR is the measure of adiposity most likely to differentiate fallers from non-fallers prospectively. Future studies should evaluate the mechanisms underlying the increased risk of falls associated with increased WHR.

scholarly journals Digestive Symptoms in Older Adults: Prevalence and Associations with Institutionalization and Mortality

2012 ◽  
Vol 26 (12) ◽  
pp. 881-884 ◽  
Author(s):  
Turki AlAmeel ◽  
Mohammed Basheikh ◽  
Melissa K Andrew
Keyword(s):  
Older Adults ◽  
Secondary Analysis ◽  
Community Dwelling ◽  
Increased Risk ◽  
Reported Health ◽  
And Function ◽  
Self Assessed Health ◽  
Cognition Impairment ◽  
Community Dwelling Older Adults

BACKGROUND: Digestive symptoms are common in adults. However, little is known about their prevalence in older adults and the association of digestive symptoms with institutionalization and mortality in community-dwelling older adults.OBJECTIVE: To determine the prevalence of digestive symptoms among older adults in Canada and whether they are associated with increased risk of institutionalization and mortality, independent of the effect of potential confounders.METHODS: The present study was a secondary analysis of data collected from community-dwelling participants 65 years of age and older in the Canadian Study of Health and Aging. Measures incuded age, sex, presence of digestive symptoms, cognition, impairment in activities of daily living (ADL) and self-reported health. Outcome measures included death or institutionalization over the 10 years of follow-up.RESULTS: Digestive symptoms were found in 2288 (25.6%) of the 8949 subjects. Those with digestive symptoms were older, with a mean difference in age of six months (P=0.007). Digestive symptoms were more common among women (28.4%) than men (20.3%), among individuals with poor self-reported health and those with an increased number of impairments in their ADLs (P<0.001). The presence of digestive symptoms was associated with higher mortality (HR 1.15 [95% CI 1.05 to 1.25] adjusted for age, sex, cognitive function and ADL impairment); however, this association was not statistically significant after adjusting for self-reported health.CONCLUSION: Although digestive symptoms were associated with increased mortality independent of age and sex, cognition and function, this association was largely explained by poor self-assessed health. Digestive symptoms were not associated with institutionalization

scholarly journals 400Overactive bladder with/without urinary incontinence and falls in the community-dwelling elderly

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Kenji Omae ◽  
Noriaki Kurita ◽  
Taro Takeshima ◽  
Toru Naganuma ◽  
Sei Takahashi ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Fall Risk ◽  
Community Dwelling ◽  
Important Predictor ◽  
Multivariable Logistic Regression Analysis ◽  
Logistic Regression Models ◽  
Falls In Older Adults ◽  
Tree Approach

Abstract Background Little is known about the fall risk of older adults with overactive bladder (OAB), especially in the absence of urgency incontinence (UI). Methods This prospective cohort study included 630 community-dwelling, independent older adults 75 years old or older who attended a health check-up in 2017 with a 1-year follow-up. The associations of OAB with and without UI (OAB-wet and OAB-dry) with a fall history, and future fall risk compared to no OAB were assessed using logistic regression models. The contribution of OAB as a predictor of falls was examined using a random forest and decision tree approach. Results Of the 577 analyzed participants (median age 79 years), 273 were men. The prevalence of OAB-dry and OAB-wet at baseline was 15% and 14%, respectively. Multivariable logistic regression analysis revealed that both OAB-dry and OAB-wet were associated with a higher likelihood of prior falls (adjusted ORs vs no OAB 2.03 and 2.21, respectively; 95% CI 1.23–3.37 and 1.29–3.78, respectively). Among the 363 participants without a fall history, the adjusted ORs (95% CIs) of OAB-dry and OAB-wet for the occurrence of falls during the 1-year follow-up were 2.74 (1.19–6.29) and 1.35 (0.47–3.87), respectively. The tree-based approach used for all participants showed that OAB was an important predictor of falls in adults without a fall history. Conclusions OAB, even in the absence of UI, is an important predictor of falls in older adults with a low absolute fall risk. Key messages Our findings suggest that OAB is a risk factor for falls in the community-dwelling elderly irrespective of the presence of UI.

scholarly journals Postural changes versus balance control and falls in community-living older adults: a systematic review

2018 ◽  
Vol 31 (0) ◽  
Author(s):  
Viviane Lemos Silva Fernandes ◽  
Darlan Martins Ribeiro ◽  
Luciana Caetano Fernandes ◽  
Ruth Losada de Menezes
Keyword(s):  
Older Adults ◽  
Observational Studies ◽  
Lumbar Lordosis ◽  
Community Dwelling ◽  
Spinal Curvature ◽  
Community Living ◽  
Postural Changes ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Falls In Older Adults

Abstract Introduction: Since falls are considered to be a public health problem, it is important to identify whether postural changes over time contribute to the risk of falls in older adults. Objective: To investigate whether postural changes increase fall risk and/or postural imbalance in healthy, community-dwelling older adults. Methods: In April 2016, two reviewers independently searched the PubMed, Web of Science, SPORTDiscus, and CINAHL databases for studies in English published in the previous 10 years, using the following combined keywords: “posture” or (“kyphosis”,“lumbar lordosis”,“flexed posture”,“spinal curvature”,“spinal sagittal contour”) AND “elderly” AND “fall”. Study quality was assessed according to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines for observational studies. Results: The search retrieved 1,734 articles. Only observational studies that assessed posture, balance, and/or falls in older adults were considered eligible for review. The final sample included 17 articles: reliability and reproducibility of the instruments were not reported in five studies, while two studies offered a questionable description of the instruments used. Fourteen articles analyzed postural changes at the trunk level and three articles assessed them at the ankles and feet. Most studies found a positive association between postural changes and an increased risk for loss of balance and falls. Conclusion: Thoracic hyperkyphosis, loss of lumbar lordosis, and decreased plantar arch seem to contribute to greater postural instability, and thus to a higher risk of falls in community-living older adults.

Predictive Validity of Health-Related Fitness Tests on Back Pain and Related Disability: A 6-Year Follow-Up Study Among High-Functioning Older Adults

2012 ◽  
Vol 9 (2) ◽  
pp. 249-258 ◽  
Author(s):  
Pauliina Husu ◽  
Jaana Suni
Keyword(s):  
Older Adults ◽  
Back Pain ◽  
Community Dwelling ◽  
Screening Tools ◽  
Increased Risk ◽  
Fitness Tests ◽  
Health Related ◽  
Side Bending ◽  
Health Related Fitness

Background:Back pain and related disability seem to be increasing among older adults. Health-related fitness tests have been developed to identify individuals at risk for mobility difficulties. However, poor fitness as a risk factor for back problems has seldom been studied. The purpose of the current study was to investigate whether performance in fitness tests predicts back pain and related disability during 6 years of follow-up.Methods:Study population consisted of community-dwelling men and women, born 1927 to 1941, who participated in assessment of health-related fitness and reported no long-term back pain or related disability at baseline (n = 517). The assessment included measurements of body mass index (BMI), one-leg stand, backward tandem walk, trunk side-bending, dynamic back extension, forward squat, 6.1-m walking speed and 1-km walk time.Results:Prospective analyses indicated that poor fitness (poorest-third) in one-leg stand and trunk side-bending tests were the most powerful predictors of back pain. Regarding disability, poor fitness in dynamic back extension and overweight in terms of BMI ≥ 27 increased the risk.Conclusions:Tests of balance, trunk flexibility and trunk muscle endurance, as well as BMI can be implemented as screening tools for identifying persons with increased risk of back pain and related disability.

scholarly journals Ultra-Processed Food Consumption is Associated with Renal Function Decline in Older Adults: A Prospective Cohort Study

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 428
Author(s):  
Jimena Rey-García ◽  
Carolina Donat-Vargas ◽  
Helena Sandoval-Insausti ◽  
Ana Bayan-Bravo ◽  
Belén Moreno-Franco ◽  
...  
Keyword(s):  
Older Adults ◽  
Renal Function ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Community Dwelling ◽  
Processed Food ◽  
Renal Function Decline ◽  
Increased Risk

Ultra-processed food (UPF) consumption has been associated with increased risk of cardiovascular risk factors and mortality. However, little is known on the UPF effect on renal function. The aim of this study is to assess prospectively the association between consumption of UPF and renal function decline. This is a prospective cohort study of 1312 community-dwelling individuals aged 60 and older recruited during 2008–2010 and followed up to December 2015. At baseline, a validated dietary history was obtained. UPF was identified according to NOVA classification. At baseline and at follow-up, serum creatinine (SCr) and estimated glomerular filtration rate (eGFR) levels were ascertained and changes were calculated. A combined end-point of renal decline was considered: SCr increase or eGFR decreased beyond that expected for age. Logistic regression with adjustment for potential confounders was performed. During follow-up, 183 cases of renal function decline occurred. The fully adjusted odds ratios (95% CI) of renal function decline across terciles of percentage of total energy intake from UPF were 1.56 (1.02–2.38) for the second tercile, and 1.74 (1.14–2.66) for the highest tercile; p-trend was 0.026. High UPF consumption is independently associated with an increase higher than 50% in the risk of renal function decline in Spanish older adults.

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