scholarly journals A Regression Tree for Identifying Risk Factors for Fear of Falling: The International Mobility in Aging Study (IMIAS)

2019 ◽  
Vol 75 (1) ◽  
pp. 181-188 ◽  
Author(s):  
Carmen-Lucia Curcio ◽  
Yan Yan Wu ◽  
Afshin Vafaei ◽  
Juliana Fernandez de Souza Barbosa ◽  
Ricardo Guerra ◽  
...  
Keyword(s):  
Risk Factors ◽  
Functional Impairment ◽  
Fear Of Falling ◽  
Classification Tree ◽  
Regression Tree ◽  
International Mobility ◽  
Mobility Disability ◽  
Self Rated Health ◽  
Aging Study

Abstract Background We determine the best combination of factors for predicting the risk of developing fear of falling (FOF) in older people via Classification Regression Tree (CaRT) analysis. Methods Community-dwelling older adults living in Canada, Albania, Brazil, and Colombia were from International Mobility in Aging Study (IMIAS). In 2014, 1,725 participants (aged 65–74) were assessed. With a retention rate of 81%, in 2016, 1,409 individuals were reassessed. Risk factors for FOF were entered into the CaRT: age, sex, education, self-rated health, comorbidity, medication, visual impairment, frailty, cognitive deficit, depression, fall history, Short Physical Performance Battery (SPPB), walking aid use, and mobility disability measured by the Nagi questionnaire. Results The classification tree included 12 end groups representing differential risks of FOF with a minimum of two and a maximum of five predictors. The first split in the tree involved impaired physical function (SPPB scores). Respondents with less than 8 in SPPB score and mobility disability had 82% risk of developing FOF at the end of 2-year follow-up. Between 23.2% and 82.3% of the risk of developing FOF in 2 years of follow-up were explained by only five variables: age, sex, self-rated health, functional impairment measured by SPPB, and mobility disability. In those with no functional impairment or mobility disability, levels of education, sex, and self-rated health were important predictors of FOF in the future. Conclusion This classification tree included different groups based on specific combinations of a maximum of five easily measurable predictors with emphasis on impaired physical functioning risk factors for developing FOF.

Abdominal Obesity and Mobility Disability in Older Adults: A 4-Year Follow-Up of the International Mobility in Aging Study

2018 ◽  
Vol 22 (10) ◽  
pp. 1228-1237 ◽  
Author(s):  
Juliana Fernandes de Souza Barbosa ◽  
C. dos Santos Gomes ◽  
J. Vilton Costa ◽  
T. Ahmed ◽  
M. V. Zunzunegui ◽  
...  
Keyword(s):  
Older Adults ◽  
Abdominal Obesity ◽  
International Mobility ◽  
Mobility Disability ◽  
Aging Study

Gait Disorder among Elderly People, Psychomotor Disadaptation Syndrome: Post-Fall Syndrome, Risk Factors and Follow-Up – A Cohort Study of 70 Patients

Gerontology ◽  
2020 ◽  
pp. 1-8
Author(s):  
Maxence Meyer ◽  
Florentin Constancias ◽  
Thomas Vogel ◽  
Georges Kaltenbach ◽  
Elise Schmitt
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Fear Of Falling ◽  
Functional Mobility ◽  
General Physician ◽  
Major Health ◽  
Mobility Assessment ◽  
Control Study ◽  
Major Health Issue

<b><i>Introduction:</i></b> Falls among older people are a major health issue and the first cause of accidental death after 75 years of age. Post-fall syndrome (PFS) is commonly known and yet poorly studied. <b><i>Objective:</i></b> Identify risk factors for PFS and do a follow-up 1 year later. <b><i>Methods:</i></b> We included all patients over 70 years of age hospitalized after suffering a fall in a case-control study, and then followed them in a cohort study. PFS was retained in case of functional mobility decline (transferring, walking) occurring following a fall in the absence of an acute neurological, orthopedic or rheumatic pathology directly responsible for the decline. The data initially collected were: clinical (anamnestic, emergency and departmental/ward evolution, medical history, lifestyle, treatments, clinical examination items); and imaging if the patient had been subjected to brain imaging in the last 3 years prior to inclusion. Regarding the follow-up at 1 year, we collected from the general physician the occurrence and the characteristics of new falls, functional mobility assessment, hospitalization and death. <b><i>Results:</i></b> Inclusion took place from March 29, 2016 to June 7, 2016 and follow-up until June 30, 2017. We included 70 patients. A total of 29 patients exhibited a PFS (41.4 %). Risk factors for PFS included age, walking disorder prior to the fall, the use of a walking aid prior to the fall, no unaccompanied outdoor walk in the week before the fall, visual impairment making close reading impossible, stiffness in ankle dorsiflexion, grip strength and the fear of falling. Among patients with PFS, 52.9% could still perform a transfer at 1 year and 64.7% could still walk against 80.7% and 85.2%, respectively, for patients without PFS. <b><i>Conclusion:</i></b> The study showed the existence of body functions/structure impairments and activity limitations prior to the fall among patients exhibiting a PFS. This suggests the existence of a pre-fall syndrome, i.e., a psychomotor disadaptation syndrome existing prior to the fall. Among the 8 risk factors, fear of falling, vision impairment and muscle strength could be targeted for improvement. The diagnosis of PFS could be a marker of loss of functional mobility at 1 year.

scholarly journals Prevalence of Poor Self-Rated Health and Associated Risk Factors among Older Adults in Cali, Colombia

2013 ◽  
pp. 224-231 ◽  
Author(s):  
Jose Mauricio Ocampo-Chaparro ◽  
Helmer de Jesus Zapata-Ossa ◽  
Angela M Cubides-Munévar ◽  
Carmen Lucia Curcio ◽  
Juan de Dios Villegas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Fear Of Falling ◽  
Population Based ◽  
Cross Sectional Study ◽  
Cluster Sampling ◽  
Frailty Syndrome ◽  
Cross Sectional ◽  
Self Rated Health ◽  
Modifiable Factors

Introduction: Self-rated health (SRH) has beeen considered an important marker of quality of life and an independent predictor of mortality in older adults. Objective: To determine the prevalence of poor SRH and identify risk factors associated with poor SRH among older adults residing in the Commune 18 of the city of Cali, Colombia, in 2009. Methods: A population-based cross-sectional study with a single-stage cluster sampling design. Sample included 314 persons aged 60 and older. The dependent variable, SRH was dichotomized into good (excellent, very good, good) and poor (fair, poor). Independent variables were sociodemographic, biological, mental, functional and geriatric syndromes. Logistic regression was used for multivariate statistical modeling. Results: Overall, 40.1% reported poor SRH (women 42.9%, men 35.0%). Factors independently associated with poor SRH were diabetes mellitus, depression, fear of falling and frailty syndrome (frail and pre-frail vs. non-frail). Widowed men reported poorer health than married men while other marital status (single/separated/divorced) was associated with better self rated health in women. Conclusion: Potential modifiable factors such as depression and frailty syndrome are important determinants for poor SRH in Colombian older adults.

scholarly journals P66 Risk factors for chronic widespread pain among older workers: findings from the Health and Employment After Fifty (HEAF) study

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Georgia Ntani ◽  
Stefania D'Angelo ◽  
Clare Harris ◽  
Cathy Linaker ◽  
Karen Walker-Bone
Keyword(s):  
Risk Factors ◽  
Older Workers ◽  
Chronic Widespread Pain ◽  
Psychosocial Aspects ◽  
Physical Workload ◽  
Widespread Pain ◽  
Self Rated Health ◽  
Personal Risk ◽  
Personal Risk Factors

Abstract Background Incident chronic widespread pain (CWP) is associated with demographic and personal risk factors such as low mood and somatisation. More recently, there has been increased focus on the role of workplace factors on CWP. However, evidence from studies exploring the interaction of demographic, personal risk factors, job activities and psychosocial aspects of work on pain in older workers is limited. We assessed several potential determinants of the onset of CWP among participants in the HEAF study, a prospective UK cohort. Methods A cohort of participants aged 50-64 years were recruited from 24 English general practices in 2013-14 and have been followed-up annually by postal questionnaire. At baseline, information was collected about demographic and employment circumstances, physical workload, psychosocial aspects of work and their general health, mood and well-being. At three years of follow-up, information about pain was also obtained by reporting painful sites on a body mannikin, and CWP was defined according to the ACR criteria. Associations between potential risk factors and the onset of new CWP were explored using logistic regression modelling. Effect estimates were summarised by odds ratios (OR) and 95% confidence intervals (CIs). Results HEAF recruited a total of 8,134 people aged 50-64 years at baseline. Among the N = 3,909 still at work at three years’ follow-up, N = 3,873 did not report CWP in the first two years of follow-up. The incidence of CWP at three years follow-up was 7.4% (males: 5.7%; females: 8.9%). Multivariate analyses showed that the strongest predictors of the onset of new CWP were: female sex (OR(95% CI): 1.7(1.2-2.3)), reporting that they have low expectations of coping with physical demands of the job (OR (95%CI): 2.1 (1.5-3.0)); somatisation (OR(95%CI): 2.1(1.3-3.2)) and poor self-rated health (OR(95%CI): 2.3(1.7-3.2)). Physical workload and other psychosocial aspects of work were also significantly associated with onset of CWP but with relatively smaller effect sizes (physical workload OR(95%CI): 1.2(1.1-1.3)); lack of appreciation OR (95% CI): 1.6(1.1-2.5)) Conclusion Our results complement previous findings that physical loading at work independently predicts the onset of CWP. However, personal risk factors like self-rated health and work-related expectations demonstrated stronger effects. These findings can inform future interventions for prevention of CWP. Disclosures G. Ntani None. S. D'Angelo None. C. Harris None. C. Linaker None. K. Walker-Bone None.

scholarly journals Are Leading Risk Factors for Cancer and Mental Disorders Multimorbidity Shared by These Two Individual Conditions in Community-Dwelling Middle-Aged Adults?

Cancers ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1700
Author(s):  
Xianwen Shang ◽  
Allison M. Hodge ◽  
Wei Peng ◽  
Mingguang He ◽  
Lei Zhang
Keyword(s):  
Risk Factors ◽  
Psychological Distress ◽  
Mental Disorders ◽  
Community Dwelling ◽  
Fruit Intake ◽  
Self Rated Health ◽  
Incidence Of Cancer ◽  
Modifiable Factors ◽  
Shared Risk

Data on the leading shared risk factors of cancer and mental disorders are limited. We included 98,958 participants (54.8% women) aged 45–64 years from the 45 and Up Study who were free of cancer, depression, and anxiety at baseline (2006–2009). The incidence of cancer, mental disorders, and multimorbidity (concurrent cancer and mental disorders) was identified using claim databases during follow-up until 31 December 2016. During a nine-year follow-up, the cumulative incidence of cancer, mental disorders, and multimorbidity was 8.8%, 17.4%, and 2.2%, respectively. Participants with cancer were 3.41 times more likely to develop mental disorders, while individuals with mental disorders were 3.06 times more likely to develop cancer than people without these conditions. The shared risk factors for cancer and mental disorders were older age, female gender, smoking, psychological distress, low fruit intake, poor/fair self-rated health, hypertension, arthritis, asthma, and diabetes. Low education, low income, overweight/obesity, and family history of depression were risk factors for mental disorders and multimorbidity but not cancer. In conclusion, smoking, low fruit intake, and obesity are key modifiable factors for the prevention of cancer and mental disorders. Individuals with poor/fair self-rated health, high psychological distress, asthma, hypertension, arthritis, or diabetes should be targeted for the prevention and screening of cancer and mental disorders.

scholarly journals Incidence, persistence and risk factors of fear of falling in older adults: cohort study (2008–2013) in Rio de Janeiro, Brazil

2020 ◽  
Vol 54 ◽  
pp. 56
Author(s):  
Flávia Moura Malini Drummond ◽  
Roberto Alves Lourenço ◽  
Claudia De Souza Lopes
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Rio De Janeiro ◽  
Walking Speed ◽  
Fear Of Falling ◽  
Activity Level ◽  
Self Rated Health ◽  
History Of

OBJECTIVE: To evaluate the incidence and persistence of fear of falling in older adults and the clinical/functional, psychosocial and lifestyle-related risk factors. METHODS: A longitudinal study with 393 community-dwelling older adults aged 65 years and over (110 men/ 283 women) resident in the North Zone of the city of Rio de Janeiro, Brazil. The fear of falling was assessed by the Falls Efficacy Scale-I-BR. The explanatory variables assessed were: number of comorbidities and medicines, history of falls, fracture from falling, use of walking aids, functional dependence in basic and instrumental activities of daily living, hearing and visual impairment, hand grip strength, walking speed, self-rated health, body mass index, depressive symptoms, cognitive impairment, living alone and activity level. Incidence, persistence and risk factors were estimated. Multivariate analysis was performed using Poisson Regression, obtaining relative risks (RR) and corresponding to 95% confidence intervals. RESULTS: Among the 393 participants, fear of falling occurred in 33.5% and was persistent in 71.3%. Incidence was found to associate with using seven or more medicines and reporting worse activity level than the prior year. Risk factors for persistent fear were: using seven or more medicines, a history of one or two falls, reduced walking speed, hearing impairment, cognitive impairment, depressive symptoms and poor or very poor self-rated health. CONCLUSION: Fear of falling is a frequent and persistent condition. Many factors related to persistent fear showed no association with the incidence of fear, emphasizing the need for focused strategies to reduce risk factors that may be associated with the chronification of fear of falling.

PS01.001: CARCINOMA IN ESOPHAGEAL ACHALASIA: WHO, WHEN AND HOW

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 49-49
Author(s):  
Vinicius ◽  
Guilherme Mazzini ◽  
José Felipe Juchem ◽  
Richard Gurski
Keyword(s):  
Risk Factors ◽  
Conflicts Of Interest ◽  
Classification Tree ◽  
Esophageal Achalasia ◽  
Conservative Surgery ◽  
Epidermoid Carcinoma ◽  
Barium Swallow ◽  
Risk Parameters ◽  
End Stage

Abstract Background Esophageal achalasia is a precancerous condition for epidermoid carcinoma; prevalence and risk factors for cancer development are not defined. Aim of the study was to determine these parameters. Methods Achalasia patients observed in the period 1955-2016, since 1973 were periodically submitted to clinical assessment, barium swallow (esophageal diameter and residual barium column were measured), endoscopy, according to a prospective protocol. In this study we included patients with a minimum 12 months follow-up, endoscopy or radiology at the last control. Follow up was discontinued for decision or death of patients. Results Five hundred and eighty-three of 681 cases were considered. The median follow-up was 147.13 months (IQR 70.42-257.82 months); 17 epidermoid, 1 carcinosarcoma were diagnosed (30.8/1000 cases). At multivariate analysis esophageal diameter (p < 0.001), residual barium column (p < 0.05) and duration of dysphagia (p < 0.001) were independent risk factors. Conversely, the risk of epidermoid carcinoma development decreased after residual barium swallow decrease (p < 0.05), consequent to efficacious therapy. According to classification tree (Figure), patients with severe dysphagia at the last clinical-radiological control and sigmoid esophagus experienced a risk of epidermoid carcinoma development equal to 48.6%. classification tree for squamous cell carcinoma. o outcome; se sigmoid esophagus.jpg Conclusion End-stage achalasia and dysphagia lasting longer than 22 years are risk factors for development of epidermoid cancer. Effective Heller myotomy can interrupt the carcinogenetic process in the presence of end-stage achalasia. Patients who overcome the risk parameters, should be offered esophagectomy or conservative surgery followed by strict endoscopic surveillance. Disclosure All authors have declared no conflicts of interest.

Predictive factors of nonfatal self-harm among community-dwelling older adults assessed for support services

2020 ◽  
pp. 1-14
Author(s):  
Gary Cheung ◽  
Yi Chai ◽  
M. Isabela Troya ◽  
Hao Luo
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
At Risk ◽  
Predictive Factors ◽  
Functional Impairment ◽  
Support Services ◽  
Community Dwelling ◽  
First Year ◽  
Self Harm

ABSTRACT Background: Older adults receiving support services are a population at risk for self-harm due to physical illness and functional impairment, which are known risk factors. This study aims to investigate the relative importance of predictive factors of nonfatal self-harm among older adults assessed for support services in New Zealand. Methods: interRAI-Home Care (HC) national data of older adults (aged ≥ 60) were linked to mortality and hospital discharge data between January 1, 2012 and December 31, 2016. We calculated the crude incidence of self-harm per 100,000 person-years, and gender and age-adjusted standardized incidence ratios (SIRs). The Fine and Gray competing risk regression model was fitted to estimate the hazard ratio (HR; 95% CIs) of self-harm associated with various demographic, psychosocial, clinical factors, and summary scales. Results: A total of 93,501 older adults were included. At the end of the follow-up period, 251 (0.27%) people had at least one episode of nonfatal self-harm and 36,333 (38.86%) people died. The overall incidence of nonfatal self-harm was 160.39 (95% CI, 141.36–181.06) per 100,000 person-years and SIR was 5.12 (95% CI, 4.51–5.78), with the highest incidence in the first year of follow-up. Depression diagnosis (HR, 3.02, 2.26–4.03), at-risk alcohol use (2.38, 1.30–4.35), and bipolar disorder (2.18, 1.25–3.80) were the most significant risk factors. Protective effects were found with cancer (0.57, 0.36–0.89) and severe level of functional impairment measured by Activities of Daily Living (ADL) Hierarchy Scale (0.56, 0.35–0.89). Conclusion: Psychiatric factors are the most significant predictors for nonfatal self-harm among older adults receiving support services. Our results can be used to inform healthcare professionals for timely identification of people at high risk of self-harm and the development of more efficient and targeted prevention strategies, with specific attention to individuals with depression or depressive symptoms, particularly in the first year of follow-up.

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