scholarly journals USING MODELING TO COMPARE THE ABILITY OF FALLS SCREENING TOOLS TO PREDICT FUTURE FALLS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S566-S567
Author(s):  
Elizabeth R Burns ◽  
Vicki J Pineau ◽  
Rosalind Koff ◽  
Sarah Hodge ◽  
Bess Welch
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Fall Risk ◽  
Screening Tools ◽  
Risk Of Falling ◽  
History Of ◽  
Nationally Representative ◽  
Key Questions

Abstract The STEADI initiative recommends screening older adults for falls annually using either the 12-item “Stay Independent” or the “three-key questions” screening tools. Both tools ask about falling in the preceding year. However, the comparative predictability of each tool has not been assessed. In response, CDC and NORC, assessed both tools’ ability to predict falls at six and twelve months. Adults 65+ (n=1900), were recruited from a nationally representative panel and were screened for fall risk at baseline using both tools and then followed for a year to determine if they fell. At baseline, 38% of older adults were categorized at-risk of falling based on the 12-item “Stay Independent” and 56% were considered at-risk based on the three-key questions. The history of falling question was excluded for the six month analyses. The “Stay Independent” identified 60% of fallers and the remaining two questions of the three-key questions identified 57% of fallers.

The Relationship Between Fear of Falling and Functional Fitness among Older Adults Living in Rest Home

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
H Tuna ◽  
Ö Bozan ◽  
B Gürpınar ◽  
N İlçin
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Dynamic Balance ◽  
Upper Body ◽  
Functional Fitness ◽  
Fall Risk Factors ◽  
Rest Home ◽  
History Of

Objective: This study aimed to report the fear of falling and assess its associations with several fall-related characteristics and functional fitness parameters among older adults living in the rest home. Methods: Seventy-eight older adults aged between 65-94 years were included in the study. History of falling and the number of risk factors for falling were recorded. Fear of falling was evaluated with The Falls Efficacy ScaleInternational. Functional fitness was assessed with Senior Fitness Test, including tests for the functional measurement of strength, flexibility, aerobic endurance and dynamic balance. Result: The mean age of participants was 78.46±7.16 years. There were correlations exist between fear of falling and number of fall risk factors, dynamic balance, upper body flexibility and aerobic endurance (p<0.05). Multiple linear regression analysis showed that the parameters with the highest determinants of fear of falling were the dynamic balance and history of falling (p<0.05). Conclusions: In our study, history of falling, number of fall risk factors, flexibility for the upper body, aerobic endurance and dynamic balance were parameters related to fear of falling among older adults, but the most influential factors in fear of falling were dynamic balance and history of falling.

scholarly journals Multisensory integration involved in the body perception of community-dwelling older adults

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
M. Hide ◽  
Y. Ito ◽  
N. Kuroda ◽  
M. Kanda ◽  
W. Teramoto
Keyword(s):  
Older Adults ◽  
Multisensory Integration ◽  
Fall Risk ◽  
Community Dwelling ◽  
The Body ◽  
Risk Of Falling ◽  
Body Perception ◽  
Rubber Hand ◽  
Timed Up And Go ◽  
Community Dwelling Older Adults

AbstractThis study investigates how the multisensory integration in body perception changes with increasing age, and whether it is associated with older adults’ risk of falling. For this, the rubber hand illusion (RHI) and rubber foot illusion (RFI) were used. Twenty-eight community-dwelling older adults and 25 university students were recruited. They viewed a rubber hand or foot that was stimulated in synchrony or asynchrony with their own hidden hand or foot. The illusion was assessed by using a questionnaire, and measuring the proprioceptive drift and latency. The Timed Up and Go Test was used to classify the older adults into lower and higher fall-risk groups. No difference was observed in the RHI between the younger and older adults. However, several differences were observed in the RFI. Specifically, the older adults with a lower fall-risk hardly experienced the illusion, whereas those with a higher fall-risk experienced it with a shorter latency and no weaker than the younger adults. These results suggest that in older adults, the mechanism of multisensory integration for constructing body perception can change depending on the stimulated body parts, and that the risk of falling is associated with multisensory integration.

Diabetes Risk Scores in 2011

2010 ◽  
Vol 7 (1) ◽  
pp. 19
Author(s):  
Beverley Balkau ◽  
Lei Chen ◽  
◽  
Keyword(s):  
At Risk ◽  
Prediction Interval ◽  
Routine Care ◽  
Diabetes Risk ◽  
Intensive Treatment ◽  
Screening Tools ◽  
Risk Scores ◽  
Family History Of Diabetes ◽  
Dutch Study ◽  
History Of

Diabetes risk scores can be used as pre-screening tools to detect those likely to have diabetes. Scores usually include clinical characteristics such as age, sex, family history of diabetes and hypertension. However, it is disputed whether screening for diabetes is cost-effective. The recently reported Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen Detected Diabetes in Primary Care (ADDITION) study, in which diabetes was diagnosed following screening by a risk score, did not show that intensive treatment in such individuals was different from routine care in terms of cardiovascular outcomes. Risk scores are also used to identify those at risk of diabetes in the future, and at-risk individuals may then be encouraged to participate in diabetes prevention programmes. Risk scores from routine biology, in particular fasting glucose, have also been developed to improve prediction over clinical risk factors. Now more sophisticated approaches are being used to predict diabetes – multiple biomarkers, genetics, proteomics, lipidomics and metabolomics – with the idea that if individuals are identified a long time in advance of the onset of the disease, prevention can start much earlier when it may be more successful. Diabetes risk scores follow on from a long history of cardiovascular risk scores. Scores should be given with an uncertainly or prediction interval within which the score lies with 95% confidence.

scholarly journals Risk-of-falling related outcomes improved in community-dwelling older adults after a 6-week sideways walking intervention: a feasibility and pilot study

2020 ◽  
Author(s):  
Andreas Skiadopoulos ◽  
Nick Stergiou
Keyword(s):  
Older Adults ◽  
Pilot Study ◽  
Fall Risk ◽  
Exercise Intervention ◽  
Community Dwelling ◽  
Recruitment Strategy ◽  
Large Trial ◽  
Risk Of Falling ◽  
Walking Intervention ◽  
Community Dwelling Older Adults

Abstract BackgroundAging increases fall risk and alters gait mechanics and control. Our previous work has identified sideways walking as a potential training regimen to decrease fall risk by improving frontal plane control in older adults’ gait. The purposes of this pilot study were to test the feasibility of sideways walking as an exercise intervention and to explore its preliminary effects on risk-of-falling related outcomes.MethodsWe conducted a 6-week single-arm intervention pilot study. Participants were community-dwelling older adults ≥ 65 years old with walking ability. Key exclusion criteria were neuromusculoskeletal and cardiovascular disorders that affect gait. Individualized sideways walking intervention carried out under close supervision in a 200 m indoor walking track (3 days∙week− 1). Recruitment and retention capability, safety, and fidelity of intervention delivery were recorded. We also collected (open-label) walking speed, gait variability, self-reported and performance-based functional measures to assess participants’ risk-of-falling at baseline and post-intervention: immediate, and 6 weeks after the completion of the intervention.ResultsOver a 7-month period, 42 individuals expressed interest, 21 assessed for eligibility (21/42), and 15 consented to participate (15/21). Most of the potential participants were reluctant to commit to a 6-week intervention. Desired recruitment rate was achieved after revising the recruitment strategy. One participant dropped out (1/15). Remaining participants demonstrated excellent adherence to the protocol. Participants improved on most outcomes and the effects remained at follow-up. No serious adverse events were recorded during the intervention.ConclusionOur 6-week sideways walking training was feasible to deliver and demonstrated strong potential as an exercise intervention to improve risk-of-falling outcomes in community-dwelling older adults. In a future trial, alternative clinical tools should be considered to minimize the presence of ceiling/floor effects. A future large trial is needed to confirm sideways walking as a fall prevention intervention.Trial registrationClinicalTrials.gov identifier: NCT04505527. Retrospectively registered 10 August 2020.Trial fundingCenter for Research in Human Movement Variability, National Institutes for Health, University of Nebraska Collaboration Initiative.

scholarly journals Relationship between falls and Fall Risk Increasing Drugs. A retrospective case control study

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
N Tiwana ◽  
A Pietronigro ◽  
M Mosillo ◽  
N Principi ◽  
D Carnevali ◽  
...  
Keyword(s):  
Risk Factors ◽  
Fall Risk ◽  
Case Control Study ◽  
Holistic Approach ◽  
Case Control ◽  
Assessment Tools ◽  
Screening Tools ◽  
Risk Of Falling ◽  
Retrospective Case ◽  
Control Study

Abstract Background Falls and fall-related injuries are a major public health issue which needs global attention due to its clinical and socioeconomic impact. Inpatient falls are the most common adverse event in hospital. Important risk factors for falls are polypharmacy and the assumption of so-called Fall Risk Increasing Drugs (FRIDs). Aims of our study were to investigate the associations between falls and the use of medications among inpatients by conducting a retrospective case-control study in a rehabilitation hospital in Northern Italy in 2018. Methods Three unique control for each faller, matched by age, sex and hospitalization ward, were selected. A Conditional Logistic Regression was performed to analyze the impact that 13 types of FRIDs individually and the number of administrated FRIDs had on the risk of falling. A second regression model was obtained adjusting the case-control matching for CIRS, Morse and Barthel scores. Results We identified 148 cases and 444 controls. 3 types of FRIDs were significantly correlated (p &lt; 0,05) with an increased risk of falling: Antipsychotics [OR:1,98;CI 95%:1,01-3,89], Antidepressants [OR:2,18;CI 95%:1,32-3,59], Diuretics [OR:1,71;CI 95%:1,09-2,68]. Antidepressants were the only type of FRID significantly correlated (p = 0,008) even in the model adjusted for CIRS, Morse and Barthel scores [OR:2,00;CI 95%:1,20-3,34]. The unadjusted model showed that the addition of one type of FRID to therapy was significantly associated with the fall event (p &lt; 0.05) [OR:1.21;CI 95%: 1.05 - 1.40]. Conclusions Assumption of drugs and polypharmacy could play a role in hospital falling. Recently developed fall risk assessment tools suffer from low specificity and sensitivity and do not assess these risk factors. A holistic approach with a multidimensional evaluation of the patient through screening tools, functional assessment tools and a full medical evaluation should be improved. Key messages Drugs may represent an important variable in determining the risk of falls in hospitalized patients, but they should not be considered alone. Screening tools for fall risk should take into account polypharmacy such as other intrinsic and extrinsic risk factors within an holistic approach.

scholarly journals Screening Tool Identifies Older Adults With Cancer at Risk for Poor Outcomes

2020 ◽  
Vol 18 (3) ◽  
pp. 305-313 ◽  
Author(s):  
Ryan D. Nipp ◽  
Leah L. Thompson ◽  
Brandon Temel ◽  
Charn-Xin Fuh ◽  
Christine Server ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
At Risk ◽  
Overall Survival ◽  
Symptom Burden ◽  
Hazard Ratio ◽  
Screening Tools ◽  
Vulnerable Patients ◽  
Poor Outcomes

Background: Oncologists often struggle with managing the complex issues unique to older adults with cancer, and research is needed to identify patients at risk for poor outcomes. Methods: This study enrolled patients aged ≥70 years within 8 weeks of a diagnosis of incurable gastrointestinal cancer. Patient-reported surveys were used to assess vulnerability (Vulnerable Elders Survey [scores ≥3 indicate a positive screen for vulnerability]), quality of life (QoL; EORTC Quality of Life of Cancer Patients questionnaire [higher scores indicate better QoL]), and symptoms (Edmonton Symptom Assessment System [ESAS; higher scores indicate greater symptom burden] and Geriatric Depression Scale [higher scores indicate greater depression symptoms]). Unplanned hospital visits within 90 days of enrollment and overall survival were evaluated. We used regression models to examine associations among vulnerability, QoL, symptom burden, hospitalizations, and overall survival. Results: Of 132 patients approached, 102 (77.3%) were enrolled (mean [M] ± SD age, 77.25 ± 5.75 years). Nearly half (45.1%) screened positive for vulnerability, and these patients were older (M, 79.45 vs 75.44 years; P=.001) and had more comorbid conditions (M, 2.13 vs 1.34; P=.017) compared with nonvulnerable patients. Vulnerable patients reported worse QoL across all domains (global QoL: M, 53.26 vs 66.82; P=.041; physical QoL: M, 58.95 vs 88.24; P<.001; role QoL: M, 53.99 vs 82.12; P=.001; emotional QoL: M, 73.19 vs 85.76; P=.007; cognitive QoL: M, 79.35 vs 92.73; P=.011; social QoL: M, 59.42 vs 82.42; P<.001), higher symptom burden (ESAS total: M, 31.05 vs 15.00; P<.001), and worse depression score (M, 4.74 vs 2.25; P<.001). Vulnerable patients had a higher risk of unplanned hospitalizations (hazard ratio, 2.38; 95% CI, 1.08–5.27; P=.032) and worse overall survival (hazard ratio, 2.26; 95% CI, 1.14–4.48; P=.020). Conclusions: Older adults with cancer who screen positive as vulnerable experience a higher symptom burden, greater healthcare use, and worse survival. Screening tools to identify vulnerable patients should be integrated into practice to guide clinical care.

scholarly journals Differentiating fallers from nonfallers using nonlinear variability analyses of data from a low-cost portable footswitch device: a feasibility study

2021 ◽  
Vol 23 (2) ◽  
Author(s):  
Srikumar Krishnamoorthy ◽  
Heqi Xu ◽  
Zhengyi Zhang ◽  
Changxue Xu
Keyword(s):  
Older Adults ◽  
Feasibility Study ◽  
Fall Risk ◽  
Detrended Fluctuation Analysis ◽  
Low Cost ◽  
Reaction Force ◽  
Fluctuation Analysis ◽  
Temporal Variables ◽  
History Of ◽  
Detrended Fluctuation

Purpose: Falls are one of the main causes of injuries in older adults. This study evaluated a low-cost footswitch device that was designed to measure gait variability and investigates whether there are any relationships between variability metrics and clinical balance tests for individuals with a history of previous falls. Methods: Sixteen older adults completed a history of falls questionnaire, three functional tests related to fall risk, and walked on a treadmill with the footswitch device. We extracted the stride times from the device and applied two nonlinear variability analyses: coefficient of variation and detrended fluctuation analysis. Results: The temporal variables and variability metrics from the footswitch device correlated with gold-standard measurements based on ground reaction force data. One variability metric (detrended fluctuation analysis) showed a significant relationship with the presence of past falls with a sensitivity of 43%. Conclusion: This feasibility study demonstrates the basis for using low-cost footswitch devices to predict fall risk.

scholarly journals Proposals for continued research to determine older adults’ falls risk

2020 ◽  
Vol 05 (04) ◽  
pp. 89-91
Author(s):  
Beatrice Pettersson ◽  
Ellinor Nordin ◽  
Anna Ramnemark ◽  
Lillemor Lundin-Olsson
Keyword(s):  
Older Adults ◽  
Risk Assessment ◽  
Fall Risk ◽  
Assessment Tools ◽  
Risk Of Falling ◽  
Self Assessment ◽  
Preventative Measures ◽  
Increased Risk ◽  
Risk Assessment Tools ◽  
Falls Prediction

Early detection of older adults with an increased risk of falling could enable early onset of preventative measures. Currently used fall risk assessment tools have not proven sufficiently effective in differentiating between high and low fall risk in community-living older adults. There are a number of tests and measures available, but many timed and observation-based tools are performed on a flat floor without interaction with the surrounding. To improve falls prediction, measurements in other areas that challenge mobility in dynamic conditions and that take a persons’ own perception of steadiness into account should be further developed and evaluated as single or combined measures. The tools should be easy to apply in clinical practice or used as a self-assessment by the older adults themselves.

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