Changes in self-estimated step-over ability among older adults: A 3-year follow-up study

2020 ◽  
Author(s):  
Ryota Sakurai ◽  
Yoshinori Fujiwara ◽  
Hiroyuki Suzuki ◽  
Susumu Ogawa ◽  
Takahiro Higuchi ◽  
...  
Keyword(s):  
Older Adults ◽  
Estimation Error ◽  
Low Frequency ◽  
Community Dwelling ◽  
Physical Ability ◽  
Age Related ◽  
Risk Of Falls ◽  
Falls In Older Adults ◽  
Step Over

Abstract Objectives There is a growing body of literature examining age-related overestimation of one’s own physical ability, which is a potential risk of falls in older adults, but it is unclear what leads them to overestimate. This study aimed to examine 3-year longitudinal changes in self-estimated step-over ability, along with one key risk factor: low frequency of going outdoors (FG), which is a measure of poor daily physical activity. Method This cohort study included 116 community-dwelling older adults who participated in baseline and 3-year follow-up assessments. The step-over test was used to measure both the self-estimated step-over bar height (EH) and the actual bar height (AH). Low FG was defined as going outdoors either every few days or less at baseline. Results The number of participants who overestimated their step-over ability (EH>AH) significantly increased from 10.3% to 22.4% over the study period. AH was significantly lower at follow-up than at baseline in both participants with low and high FGs. Conversely, among participants with low FG, EH was significantly higher at follow-up than at baseline, resulting in increased self-estimation error toward overestimation. Regression model showed that low FG was independently associated with increased error in estimation (i.e., tendency to overestimate) at follow-up. Discussion The present study indicated that self-overestimated physical ability in older adults is not only due to decreased physical ability but also due to increased self-estimation of one’s ability as a function of low FG. Active lifestyle may be critical for maintaining accurate estimations of one’s own physical ability.

scholarly journals Lower-Limb Factors Associated with Balance and Falls in Older Adults: A Systematic Review and Clinical Synthesis

2019 ◽  
Vol 110 (5) ◽  
Author(s):  
Christopher Neville ◽  
Hung Nguyen ◽  
Kim Ross ◽  
Mariana Wingood ◽  
Elizabeth Walker Peterson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Lower Limb ◽  
Fall Risk ◽  
Community Dwelling ◽  
Sufficient Evidence ◽  
Cochrane Library ◽  
Direct Link ◽  
Age Related ◽  
Falls In Older Adults

Background Despite sufficient evidence to suggest that lower-limb–related factors may contribute to fall risk in older adults, lower-limb and footwear influences on fall risk have not been systematically summarized for readers and clinicians. The purpose of this study was to systematically review and synethesize the literature related to lower-limb, foot, and footwear factors that may increase the risk of falling among community-dwelling older adults. Methods We searched PubMed, Embase, PsycINFO, CINAHL, Web of Science, Cochrane Library, and AgeLine. To describe the trajectory toward increasing risk of falls, we examined those articles that linked age-related changes in the lower limb or footwear to prospective falls or linked them to evidenced-based fall risk factors, such as gait and balance impairment. Results This systematic review consisted of 81 articles that met the review criteria, and the results reflect a narrative review of the appraised literature for eight pathways of lower-limb–related influences on fall risk in older adults. Six of the eight pathways support a direct link to fall risk. Two other pathways link to the intermediate factors but lack studies that provide evidence of a direct link. Conclusions This review provides strong guidance to advance understanding and assist with managing the link between lower-limb factors and falls in older adults. Due to the lack of literature in specific areas, some recommendations were based on observational studies and should be applied with caution until further research can be completed.

Exploring trajectories in dietary adequacy of the B vitamins folate, riboflavin, vitamins B6 and B12, with advancing older age: a systematic review

2020 ◽  
pp. 1-11 ◽  
Author(s):  
N. Gillies ◽  
D. Cameron-Smith ◽  
S. Pundir ◽  
C. R. Wall ◽  
A. M. Milan
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Community Dwelling ◽  
B Vitamins ◽  
Cross Sectional ◽  
Longitudinal Changes ◽  
Dietary Adequacy ◽  
Metabolism Regulation ◽  
Age Related

Abstract Maintaining nutritional adequacy contributes to successful ageing. B vitamins involved in one-carbon metabolism regulation (folate, riboflavin, vitamins B6 and B12) are critical nutrients contributing to homocysteine and epigenetic regulation. Although cross-sectional B vitamin intake in ageing populations is characterised, longitudinal changes are infrequently reported. This systematic review explores age-related changes in dietary adequacy of folate, riboflavin, vitamins B6 and B12 in community-dwelling older adults (≥65 years at follow-up). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, databases (MEDLINE, Embase, BIOSIS, CINAHL) were systematically screened, yielding 1579 records; eight studies were included (n 3119 participants, 2–25 years of follow-up). Quality assessment (modified Newcastle–Ottawa quality scale) rated all of moderate–high quality. The estimated average requirement cut-point method estimated the baseline and follow-up population prevalence of dietary inadequacy. Riboflavin (seven studies, n 1953) inadequacy progressively increased with age; the prevalence of inadequacy increased from baseline by up to 22·6 and 9·3 % in males and females, respectively. Dietary folate adequacy (three studies, n 2321) improved in two studies (by up to 22·4 %), but the third showed increasing (8·1 %) inadequacy. Evidence was similarly limited (two studies, respectively) and inconsistent for vitamins B6 (n 559; −9·9 to 47·9 %) and B12 (n 1410; −4·6 to 7·2 %). This review emphasises the scarcity of evidence regarding micronutrient intake changes with age, highlighting the demand for improved reporting of longitudinal changes in nutrient intake that can better direct micronutrient recommendations for older adults. This review was registered with PROSPERO (CRD42018104364).

scholarly journals Falls Among High- and Low- Frequency Sleep Medication Users With and Without Dementia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 197-197
Author(s):  
Alexandra Wennberg ◽  
Loretta Anderson
Keyword(s):  
Older Adults ◽  
National Health ◽  
High Frequency ◽  
Medication Use ◽  
Low Frequency ◽  
Sleep Medication ◽  
Risk Of Falls ◽  
Falls In Older Adults ◽  
Adjusted Model

Abstract Difficulty with sleep and falls are prevalent among older adults. Sleep medication use is associated with falls in older adults, but little is known about its impact in older adults with dementia. We used data from the 2011 National Health and Aging Trends Study to assess the association of low- versus high- frequency sleep medication use with falls in older adults with self-reported dementia. In our fully adjusted model, among those with dementia, high-frequency sleep medication users were more likely to fall than low-frequency sleep medication users (OR=3.86, 95% CI: 1.31, 11.37). Among those without dementia, high-frequency sleep medication users were more likely to fall than low-frequency sleep medication users (OR=1.40, 95% CI: 1.11, 1.77). Reducing sleep medication use in older adults with and without dementia may help reduce the risk of falls and fall-related outcomes in older adults.

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.

Poor Sleep and Risk of Falls in Community-Dwelling Older Adults: A Systematic Review

2016 ◽  
Vol 37 (9) ◽  
pp. 1059-1084 ◽  
Author(s):  
Yaena Min ◽  
Patricia W. Slattum
Keyword(s):  
Older Adults ◽  
Sleep Problems ◽  
Community Dwelling ◽  
Poor Sleep ◽  
Short Sleep Duration ◽  
Exclusion Criteria ◽  
Future Studies ◽  
Risk Of Falls ◽  
Falls In Older Adults ◽  
Community Dwelling Older Adults

Concerns about sleep problems and falls in older adults are significant. This article reviews the association between sleep problems and falls in community-dwelling adults aged 65 years or older. Multiple databases were searched from inception until 2015 using sleep, sleep disorders, and falls as keywords, limiting to studies published in English in peer-reviewed journals. After screening and assessing for eligibility, 18 articles were selected based on the inclusion and exclusion criteria. Findings of an association between sleep problems and risk of falls are conflicting, but some specific sleep problems such as extremely short sleep duration, daytime sleepiness and naps appear to be significantly related to falls in older adults. Methodological limitations including variability in covariates included in the analyses and measurement of the exposure and outcome variables were identified. The results of this review identified the need to have comparable definitions, validated tools, and rigorous design of future studies.

FRAILTY AND RISK OF FALLS IN COMMUNITY-DWELLING OLDER ADULTS LIVING IN A RURAL SETTING. THE ATAHUALPA PROJECT

2019 ◽  
pp. 1-5
Author(s):  
O.H. Del Brutto ◽  
R.M. Mera ◽  
C.D. Peinado ◽  
M. Zambrano ◽  
M.J. Sedler
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Univariate Analysis ◽  
Correlation Coefficients ◽  
Community Dwelling ◽  
Rural Setting ◽  
Risk Of Falls ◽  
History Of ◽  
Falls In Older Adults ◽  
The Impact

Background: Data supporting a link between frailty and risk of falls is mostly confined to individuals living in urban centers, where risk factors and lifestyles are different from that of rural settings. Objective: To assess the association between frailty and risk of falls in older adults living in rural Ecuador. Design: Population-based cross-sectional study. Participants: Community-dwellers aged ≥60 years living in a rural Ecuadorian village, in whom frail status and risk of falls were assessed. Measurements: Frailty was evaluated by the Edmonton Frailty Scale (EFS) and risk of falls by the Downton Fall Risk Index (DFRI). Multivariate models were fitted to evaluate whether frailty was associated with risk of falls (dependent variable), after adjusting for demographics, alcohol intake, cardiovascular risk factors, sleep quality, symptoms of depression, and history of an overt stroke. Correlation coefficients were constructed to assess confounders modifying this association. Results: A total of 324 participants (mean age: 70.5±8 years) were included. The mean EFS score was 4.4±2.5 points, with 180 (56%) participants classified as robust, 76 (23%) as pre-frail and 68 (21%) as frail. The DFRI was positive in 87 (27%) participants. In univariate analysis, the EFS score was higher among participants with a positive DFRI (p<0.001). The number of frail individuals was higher (p<0.001), while that of robust individuals was lower (p<0.001) among those with a positive DFRI. Adjusted logistic regression models showed no association between frailty and the DFRI. Correlation coefficients showed that age, high glucose levels, and history of an overt stroke tempered the association between frailty and the risk of falls found in univariate analyses. Conclusions: Frailty is not independently associated with risk of falls in older adults living in a remote rural setting. Further studies are needed to assess the impact of frailty on the risk of falls in these populations.

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