scholarly journals Interrelated Neuromuscular and Clinical Risk Factors That Contribute to Falls

2019 ◽  
Vol 74 (9) ◽  
pp. 1526-1532 ◽  
Author(s):  
Rachel E Ward ◽  
Lien Quach ◽  
Sarah A Welch ◽  
Suzanne G Leveille ◽  
Elizabeth Leritz ◽  
...  
Keyword(s):  
Older Adults ◽  
Risk Assessment ◽  
Executive Function ◽  
Self Efficacy ◽  
Fall Risk ◽  
Fall Rate ◽  
Psychiatric Medication ◽  
Clinical Factors ◽  
The Relationship ◽  
Neuromuscular Impairment

Abstract Background Neuromuscular and clinical factors contribute to falls among older adults, yet the interrelated nature of these factors is not well understood. We investigated the relationships between these factors and how they contribute to falls, which may help optimize fall risk assessment and prevention. Methods A total of 365 primary care patients (age = 77 ± 7, 67% female) were included from the Boston Rehabilitative Impairment Study of the Elderly. Neuromuscular measures included leg strength and leg velocity, trunk extensor endurance, and knee range of motion. Clinical measures included memory, executive function, depressive symptoms, pain, sensory loss, vision, comorbidity, physical activity, mobility self-efficacy, and psychiatric medication. Factor analysis was used to evaluate clustering of factors. Negative binomial regression assessed the relationship of factors with three-year fall rate. Interactions were tested to examine whether clinical factors modified the relationship between neuromuscular factors and falls. Results Three factors emerged: (i) neuromuscular factors, pain, and self-efficacy; (ii) memory; and (iii) executive function. Having three neuromuscular impairments predicted higher fall rate (incidence rate ratio [95% confidence interval]: 3.39 [1.82–6.32]) but was attenuated by memory (1.69 [1.10–2.61]), mobility self-efficacy (0.99 [0.98–0.99]), psychiatric medication use (1.54 [1.10–2.14]), and pain (1.13 [1.04–1.23]). Pain modified the relationship between neuromuscular impairment burden (number of neuromuscular impairments) and falls. Having three neuromuscular impairments was associated with a higher fall rate in patients with high levels of pain (5.73 [2.46–13.34]) but not among those with low pain. Conclusions Neuromuscular impairment burden was strongly associated with fall rate in older adults with pain. These factors should be considered together during fall risk assessment, post fall assessment, and prevention.

scholarly journals The Relationship Between Storey of Buildings and Fall Risk

2021 ◽  
Vol 9 ◽  
Author(s):  
Ching-Yao Tsai ◽  
En-Sheng Lin ◽  
Yang-Tzu Li ◽  
Tao-Hsin Tung ◽  
Wei-Cheng Chen
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Risk Factor ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Longitudinal Survey ◽  
Clinical Factors ◽  
The Relationship ◽  
Unadjusted Analysis

Purpose: This study examined the association between storey of building and fall risk in older adults' residences and residents' level of fear of falling.Methods: The National Health and Ageing Trends Study (NHATS) collected information that would provide an understanding of basic trends people aged 65 years and older. Using a longitudinal survey, the present study employed the first round of NHATS data that was collected in 2011. In the first round, 12,411 participants were enrolled, and 8,077 interviews were completed. The study sample sizes for falling and worry about falling are 6,153 and 6,142, respectively.Results: Unadjusted analysis revealed that storey of building was a risk factor for fall and worry about falling. There was a higher prevalence for fall and worry about falling when subjects lived in single storey of building compared with the subjects live in multi-storey. Logistic regression analysis showed no highly significant between storey of building and the fall/fear of falling.Conclusion: Several clinical factors independently were indicated pertaining to the fall and worry about falling in older adult's residences.

scholarly journals Fall predictors beyond fall risk assessment tool items for acute hospitalized older adults: a matched case–control study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hye-Mi Noh ◽  
Hong Ji Song ◽  
Yong Soon Park ◽  
Junhee Han ◽  
Yong Kyun Roh
Keyword(s):  
Older Adults ◽  
Risk Assessment ◽  
Fall Risk ◽  
Case Control Study ◽  
Case Control ◽  
Clinical Factors ◽  
Fall Risk Assessment ◽  
Laboratory Results ◽  
Hospitalized Older Adults ◽  
Control Study

AbstractWe investigated whether clinical factors including comorbidities, medications, and laboratory results predict inpatient fall risk in older adults. The participants in this case–control study included hospitalized older adults with acute conditions who had falls during their hospital stay (case group) and 410 hospitalized older adults who did not experience falls (control group). Data on medical history, fall risk assessment (Morse Fall Scale; MFS), medications, and laboratory results were obtained. Conditional logistic regression analysis was performed to estimate the association between clinical factors and falls. Receiver operating characteristic curves and area under the curve (AUC) were used to determine whether clinical factors could discriminate between fallers and controls. We evaluated three models: (M1) MFS, (M2) M1 plus age, sex, ward, and polypharmacy, and (M3) M2 plus clinical factors. Patients with diabetes mellitus or MFS scores ≥ 45 had the highest risk of falls. Calcium channel blockers, diuretics, anticonvulsants, and benzodiazepines were associated with high fall risk. The AUC of the three models was 0.615, 0.646, and 0.725, respectively (M1 vs. M2, P = 0.042 and M2 vs. M3, P < .001). Examining clinical factors led to significant improvements in fall prediction beyond that of the MFS in hospitalized older adults.

The relationship between executive function and fine motor control in young and older adults

2017 ◽  
Vol 51 ◽  
pp. 41-50 ◽  
Author(s):  
Emily J. Corti ◽  
Andrew R. Johnson ◽  
Hayley Riddle ◽  
Natalie Gasson ◽  
Robert Kane ◽  
...  
Keyword(s):  
Older Adults ◽  
Motor Control ◽  
Executive Function ◽  
Fine Motor ◽  
Fine Motor Control ◽  
The Relationship

scholarly journals Development of a New Fall Risk Assessment Index for Older Adults

2012 ◽  
Vol 6 (3) ◽  
pp. 160-162 ◽  
Author(s):  
Minoru Yamada ◽  
Hidenori Arai ◽  
Koutatsu Nagai ◽  
Buichi Tanaka ◽  
Toshiaki Uehara ◽  
...  
Keyword(s):  
Older Adults ◽  
Risk Assessment ◽  
Fall Risk ◽  
Fall Risk Assessment ◽  
Assessment Index

Audiologist's Role Within the Changing Climate of Fall Prevention: Are We Ready?

2016 ◽  
Vol 1 (8) ◽  
pp. 4-13
Author(s):  
Alaina M. Bassett ◽  
Julie A. Honaker
Keyword(s):  
Older Adults ◽  
Risk Assessment ◽  
Fall Prevention ◽  
Fall Risk ◽  
Reporting System ◽  
Risk Assessments ◽  
Mandated Reporting ◽  
Medicare Beneficiaries ◽  
Medical Settings ◽  
Quality Reporting

This article is aimed to address the vestibular audiologist's role in assessing patient fall risk as tasked by Medicare. With implementation of the Physician's Quality Reporting System (PQRS), audiologists performing standard measures of the vestibular battery must report on measures #154: Falls: Risk assessment and #155: Falls: Plan of care for Medicare beneficiaries. Mandated reporting of this measure includes vestibular audiologists in the multidisciplinary medical management of fall prevention in older adults. In order for audiologists to provide the most relevant care, it is important to evaluate the current fall risk assessments in medical settings, how the implementation of these measures can be structured within the audiology clinic, and challenges audiologist may face with implementation.

Usability of self-guided mixed reality fall risk assessment for older adults

2020 ◽  
Vol 19 (4) ◽  
pp. 1-7
Author(s):  
Katherine L. Hsieh ◽  
Ruopeng Sun ◽  
Jacob J. Sosnoff
Keyword(s):  
Older Adults ◽  
Risk Assessment ◽  
Fall Risk ◽  
Mixed Reality ◽  
Fall Risk Assessment

scholarly journals Subjective wellbeing as a determinant of glycated hemoglobin in older adults: longitudinal findings from the English Longitudinal Study of Ageing

2019 ◽  
Vol 50 (11) ◽  
pp. 1820-1828 ◽  
Author(s):  
Lydia Poole ◽  
Ruth A. Hackett ◽  
Laura Panagi ◽  
Andrew Steptoe
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Subjective Wellbeing ◽  
Glycated Hemoglobin ◽  
Linear Regression Models ◽  
Clinical Factors ◽  
Subclinical Disease ◽  
The Relationship ◽  
English Longitudinal Study

AbstractBackgroundPrevious research has shown an association between subjective wellbeing and incident diabetes. Less is known about the role of wellbeing for subclinical disease trajectories as captured via glycated hemoglobin (HbA1c). We aimed to explore the association between subjective wellbeing and future HbA1c levels, and the role of sociodemographic, behavioral and clinical factors in this association.MethodsWe used data from the English Longitudinal Study of Ageing for this study (N = 2161). Subjective wellbeing (CASP-19) was measured at wave 2 and HbA1c was measured 8 years later at wave 6. Participants were free from diabetes at baseline. We conducted a series of analyses to examine the extent to which the association was accounted for by a range of sociodemographic, behavioral and clinical factors in linear regression models.ResultsModels showed that subjective wellbeing (CASP-19 total score) was inversely associated with HbA1c 8 years later after controlling for depressive symptoms, age, sex, and baseline HbA1c (B = −0.035, 95% CI −0.060 to –0.011, p = 0.005). Inclusion of sociodemographic variables and behavioral factors in models accounted for a large proportion (17.0% and 24.5%, respectively) of the relationship between wellbeing and later HbA1c; clinical risk factors explained a smaller proportion of the relationship (3.4%).ConclusionsPoorer subjective wellbeing is associated with greater HbA1c over 8 years of follow-up and this relationship can in part be explained by sociodemographic, behavioral and clinical factors among older adults.

scholarly journals A STUDY OF EXECUTIVE FUNCTION (EF) AND PROSPECTIVE FALL RISK IN COMMUNITY-DWELLING OLDER ADULTS

2017 ◽  
Vol 1 (suppl_1) ◽  
pp. 1051-1051
Author(s):  
C. Smith ◽  
C. Bula ◽  
H. Krief ◽  
L. Seematter-Bagnoud ◽  
B. Santos-Eggimann
Keyword(s):  
Older Adults ◽  
Executive Function ◽  
Fall Risk ◽  
Community Dwelling ◽  
Community Dwelling Older Adults

Sleep quality mediates the relationship between frailty and cognitive dysfunction in non-demented middle aged to older adults

2019 ◽  
Vol 31 (06) ◽  
pp. 779-788 ◽  
Author(s):  
Sonya Kaur ◽  
Nikhil Banerjee ◽  
Michelle Miranda ◽  
Mitchell Slugh ◽  
Ni Sun-Suslow ◽  
...  
Keyword(s):  
Older Adults ◽  
Executive Function ◽  
Sleep Quality ◽  
Cognitive Decline ◽  
Processing Speed ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Subjective Sleep Quality ◽  
Delayed Recall ◽  
The Relationship

ABSTRACTObjectives:Frailty is associated with cognitive decline in older adults. However, the mechanisms explaining this relationship are poorly understood. We hypothesized that sleep quality may mediate the relationship between frailty and cognition.Participants:154 participants aged between 50-90 years (mean = 69.1 years, SD = 9.2 years) from the McKnight Brain Registry were included.Measurements:Participants underwent a full neuropsychological evaluation, frailty and subjective sleep quality assessments. Direct relationships between frailty and cognitive function were assessed using linear regression models. Statistical mediation of these relationships by sleep quality was assessed using nonparametric bootstrapping procedures.Results:Frailty severity predicted weaker executive function (B = −2.77, β = −0.30, 95% CI = −4.05 – −1.29) and processing speed (B = −1.57, β = −0.17, 95% CI = −3.10 – −0.16). Poor sleep quality predicted poorer executive function (B = −0.47, β = −0.21, 95% CI = −0.79 – −0.08), processing speed (B = −0.64, β = −0.28, 95% CI = −0.98 – −0.31), learning (B = −0.42, β = −0.19, 95% CI = −0.76 – −0.05) and delayed recall (B = −0.41, β = −0.16, 95% CI = −0.80 – −0.31). Poor sleep quality mediated the relationships between frailty severity and executive function (B = −0.66, β = −0.07, 95% CI = −1.48 – −0.39), learning (B = −0.85, β = −0.07, 95% CI = −1.85 – −0.12), delayed recall (B = −0.47, β = −0.08, 95% CI = −2.12 – −0.39) and processing speed (B = −0.90, β = −0.09, 95% CI = −1.85 – −0.20).Conclusions:Relationships between frailty severity and several cognitive outcomes were significantly mediated by poor sleep quality. Interventions to improve sleep quality may be promising avenues to prevent cognitive decline in frail older adults.

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