scholarly journals Risk Factors for Falls and Fragility Fractures in Community-Dwelling Seniors: A One-Year Prospective Study

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Sacha Song ◽  
Joy C. MacDermid ◽  
Ruby Grewal
Keyword(s):  
Risk Factors ◽  
Fracture Risk ◽  
Fear Of Falling ◽  
Fragility Fractures ◽  
Community Dwelling ◽  
Activity Level ◽  
Activity Levels ◽  
Mineral Density ◽  
One Year ◽  
Risk Factors For Falls

Objective. To evaluate risk factors for falls and fragility fractures in healthy seniors. Methods. Assessing 50 ambulatory community-dwelling volunteers ≥65 for demographics, BMI, bone mineral density (BMD) (DEXA), fracture risk (FRAX), balance (Biodex), fear of falling (Modified Falls Efficacy Scale (MFES)), and activity level (RAPA). One-year followup was done through phone interviews. Results. Most participants (17 males, 33 females; mean age 72.0±5.5 years) had normal BMD and were active with little to no fear of falling. Balance did not correlate with FRAX or fear of falling. Activity level did not correlate with FRAX, but the active group had less fear of falling. Most scored below age specific norms on balance testing. Fear of falling was not significantly different between genders but did correlate with FRAX, indicating that patients with higher fracture risk were also more afraid of falling. Individuals who fell after one year had increased fear of falling and decreased activity levels. Conclusions. Community-dwelling seniors with higher risk of future fractures were more afraid of falling. Although healthy and active, this cohort had poor balance compared to age matched norms. Further research on how to best assess fall risk and improve balance to prevent fractures is needed.

scholarly journals Effects of the falls and fractures clinic as an integrated multidisciplinary model of care in Australia: a pre–post study

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e027013 ◽  
Author(s):  
Fernando Gomez ◽  
Carmen Lucia Curcio ◽  
Sharon Lee Brennan-Olsen ◽  
Derek Boersma ◽  
Steven Phu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Fracture Prevention ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Care Plan ◽  
Secondary Outcome ◽  
Clinical Approach ◽  
Model Of Care ◽  
Mineral Density ◽  
Risk Factors For Falls

ObjectivesTraditionally, the approach to fracture prevention has focused on increasing bone mineral density while typically lacking a combined clinical approach to falls prevention and vice versa. To resolve this gap, we implemented and evaluated a novel combined model of care to the assessment and prevention of osteoporosis and falls in the outpatients setting.SettingFalls and Fractures Clinic (FFC) at Nepean Hospital (Penrith, NSW, Australia).ParticipantsPre-effects and posteffects assessment of 106 community-dwelling older patients referred from the community.Primary and secondary outcome measuresPrevious falls and fractures were recorded. Clinical, functional and paraclinical evaluations were performed. A comprehensive multidisciplinary care plan was then tailored based on the presence of risk factors. Six-month follow-ups were performed assessing the incidence of falls and fractures, change in risk factors for falls and level of risk, with the recommended plan.ResultsWe report that 97% of patients had a fall in the preceding 6 months, 47.6% of whom experienced a fracture from the fall. Furthermore, 64% of patients had a marked risk for falling by Physiological Profile Assessment (PPA), 90% had intermediate–high 10-year probability of fracture according to FRAX and 78% had sarcopenia. At 6-month follow-up, we observed more than an 80% reduction in falls and recurrent falls, and 50% reduction in fractures. In addition, 65% of patients had reduced PPA and a 57% reduction in 10-year fracture probability.ConclusionsIn conclusion, we suggest that a multidisciplinary FFC can provide substantial reductions in falls and fractures for high-risk older people, even over a relatively short 6-month time period. The current model of service provision via traditional falls clinics could be significantly improved by encompassing fracture prevention within the multifactorial approach to interventions.

scholarly journals Prevalence, Circumstances, and Risk Factors of Falls Among Community Dwelling Members of University of the Third Age

2021 ◽  
Vol 9 ◽  
Author(s):  
Asmidawati Ashari ◽  
Tengku Aizan Hamid ◽  
Mohd Rizal Hussain ◽  
Rahimah Ibrahim ◽  
Keith D. Hill
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Multiple Logistic Regression Analysis ◽  
Community Dwelling ◽  
Activity Level ◽  
Step Test ◽  
Cross Sectional ◽  
Falls Risk ◽  
Risk Factors For Falls ◽  
Community Dwelling Older Adults

Objective: Study aimed to identify the prevalence of falls and associated contributory factors among older Malaysians.Methods: A cross sectional study among community dwelling older adults aged 50 years and above. Self-administered questionnaires on history of falls in the previous 12 months, physical assessment and computerized and clinical measures of balance were assessed on a single occasion.Results: Forty nine (31.0%) participants fell, with 4.4% reported having multiple falls within the previous 12 months. Slips were the most prevalent cause of falls, accounting for 49% of falls. More than half (54.5%) of falls occurred in the afternoon while participants walked inside the home (32.7%), outside home (30.6%), and 36.7% were in community areas. More than half of respondents were identified as having turning instability. Step Test, turn sway, depression, physical activity level and edge contrast sensitivity were significantly worse for fallers (p < 0.05). Multiple logistic regression analysis showed that turning performance, visual acuity and back pain were significantly associated with falls risk, accounting for 72% of the variance of risk factors for falls among studied population.Conclusion: Falls are common among community dwelling older Malaysians. The findings provide information of falls and falls risk factors among community dwelling older adults in Malaysia. Future intervention studies should target locally identified falls risk factors. This study has highlighted the importance of instability during turning as an important fall risk factor.

scholarly journals Fear of Falling, Recurrence of Falls, and Quality of Life in Patients with a Low Energy Fracture—Part II of an Observational Study

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 584
Author(s):  
Puck C. R. van der Vet ◽  
Jip Q. Kusen ◽  
Manuela Rohner-Spengler ◽  
Björn-Christian Link ◽  
Roderick M. Houwert ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Low Energy ◽  
Activity Levels ◽  
Activity Restriction ◽  
One Year ◽  
Falls In Elderly

Background and objective: Falls in elderly cause injury, mortality, and loss of independence, making Fear of Falling (FoF) a common health problem. FoF relates to activity restriction and increased fall risk. A voluntary intervention including fall risk assessment and prevention strategies was implemented to reduce falls in elderly patients with low energy fractures (LEF). The primary purpose of this study was to evaluate FoF and the number of subsequent falls in trauma patients one year after a LEF. The secondary aim was to examine how FoF affects patients’ lives in terms of Quality of Life (QoL), mobility, and activity levels. Finally, participation in the voluntary fall prevention program (FPP) was evaluated. Materials and Methods: Observational cohort study in one Swiss trauma center. LEF patients, treated between 2012 and 2015, were analyzed one year after injury. Primary outcomes were Falls-Efficacy Score-International (FES-I) and number of subsequent falls. Secondary outcomes were EuroQoL-5-Dimensions-3-Levels (EQ5D-3L), mobility, activity levels, and participation in the FPP. Subgroup analysis was performed for different age categories. Results: 411 patients were included for analysis. Mean age was 72 ± 9.3, mean FES-I was 21.1 ± 7.7. Forty percent experienced FoF. A significant negative correlation between FoF and QoL (R = 0.64; p < 0.001) was found. High FoF correlated with lower activity levels (R= −0.288; p < 0.001). Six percent visited the FPP. Conclusions: At follow-up, 40% suffered from FoF which seems to negatively affect patients’ QoL. Nevertheless, participation in the FPP was low. Simply informing patients about their susceptibility to falls and recommending participation in FPPs seems insufficient to motivate and recruit patients into FPPs. We suggest implementing repeated fall risk- and FoF screenings as standard procedures in the follow-up of LEF, especially in patients aged over 75 years.

Risk Factors for the Development of Osteoporosis and Osteoporotic Fractures Among Older Men

2009 ◽  
Vol 36 (9) ◽  
pp. 1947-1952 ◽  
Author(s):  
MARIA THOMAS-JOHN ◽  
MARY B. CODD ◽  
SIALAJA MANNE ◽  
NELSON B. WATTS ◽  
ANNE-BARBARA MONGEY
Keyword(s):  
Risk Factors ◽  
African American ◽  
Dairy Products ◽  
African American Men ◽  
Osteoporotic Fractures ◽  
Fragility Fractures ◽  
Older Men ◽  
Current Treatment ◽  
Androgen Deprivation ◽  
Mineral Density

Objective.Osteoporotic fractures are associated with significant morbidity and mortality particularly among older men. However, there is little information regarding risk factors among this population. The aims of our study were to determine risk factors for osteoporosis and fragility fractures and the predictive value of bone mineral density (BMD) measurements for development of fragility fractures in a cohort of elderly Caucasian and African American men.Methods.We evaluated 257 men aged 70 years or older for risk factors for osteoporosis and fragility fractures using a detailed questionnaire and BMD assessment. Exclusion criteria included conditions known to cause osteoporosis such as hypogonadism and chronic steroid use, current treatment with bisphosphonates, bilateral hip arthroplasties, and inability to ambulate independently.Results.Age, weight, weight loss, androgen deprivation treatment, duration of use of dairy products, exercise, and fracture within 10 years prior to study entry were associated with osteoporosis (p ≤ 0.05). Fragility fractures were associated with duration of use of dairy products, androgen deprivation treatment, osteoporosis, and history of fracture within 10 years prior to BMD assessment (p ≤ 0.05). There were some differences in risk factors between the Caucasian and African American populations, suggesting that risk factors may vary between ethnic groups.Conclusion.Although men with osteoporosis had a higher rate of fractures, the majority of fractures occurred in men with T-scores > −2.5 standard deviations below the mean, suggesting that factors other than BMD are also important in determining risk.

Radiology of Osteoporosis

2016 ◽  
Vol 67 (1) ◽  
pp. 28-40 ◽  
Author(s):  
Thomas M. Link
Keyword(s):  
Computed Tomography ◽  
Fracture Risk ◽  
New Technologies ◽  
Assessment Tool ◽  
Quantitative Computed Tomography ◽  
Osteoporotic Fractures ◽  
Fragility Fractures ◽  
Bone Architecture ◽  
Mineral Density ◽  
Fracture Risk Assessment Tool

The radiologist has a number of roles not only in diagnosing but also in treating osteoporosis. Radiologists diagnose fragility fractures with all imaging modalities, which includes magnetic resonance imaging (MRI) demonstrating radiologically occult insufficiency fractures, but also lateral chest radiographs showing asymptomatic vertebral fractures. In particular MRI fragility fractures may have a nonspecific appearance and the radiologists needs to be familiar with the typical locations and findings, to differentiate these fractures from neoplastic lesions. It should be noted that radiologists do not simply need to diagnose fractures related to osteoporosis but also to diagnose those fractures which are complications of osteoporosis related pharmacotherapy. In addition to using standard radiological techniques radiologists also use dual-energy x-ray absorptiometry (DXA) and quantitative computed tomography (QCT) to quantitatively assess bone mineral density for diagnosing osteoporosis or osteopenia as well as to monitor therapy. DXA measurements of the femoral neck are also used to calculate osteoporotic fracture risk based on the Fracture Risk Assessment Tool (FRAX) score, which is universally available. Some of the new technologies such as high-resolution peripheral computed tomography (HR-pQCT) and MR spectroscopy allow assessment of bone architecture and bone marrow composition to characterize fracture risk. Finally radiologists are also involved in the therapy of osteoporotic fractures by using vertebroplasty, kyphoplasty, and sacroplasty. This review article will focus on standard techniques and new concepts in diagnosing and managing osteoporosis.

scholarly journals Physical activity types and risk of dementia in community-dwelling older people: the Three-City cohort.

2020 ◽  
Author(s):  
Caroline Dupré ◽  
Bienvenue Bongue ◽  
Catherine Helmer ◽  
Jean François Dartigues ◽  
David Hupin ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older People ◽  
Sport Activity ◽  
Apoe Genotype ◽  
Community Dwelling ◽  
Activity Level ◽  
Activity Levels ◽  
Dementia Risk ◽  
Sport Activities ◽  
Activity Types

Abstract Background Physical activity may decrease the risk of dementia; however, previous cohort studies seldom investigated the different types of physical activity and household activities. Our objective was to analyze the links between two physical activity types and dementia in older people. Methods The study used data from the prospective observational Three-city cohort and included 1550 community-dwelling individuals aged 72 to 87 without dementia at baseline. Physical activity was assessed with the Voorrips questionnaire. Two sub-scores were calculated to assess household/transportation activities and leisure/sport activities. Restricted cubic spline and proportional hazard Cox models were used to estimate the non-linear exposure-response curve for the dementia risk and the appropriate activity level thresholds. Models were adjusted for possible confounders, including socio-demographic variables, comorbidities, depressive symptoms and APOE genotype. Results The median age was 80 years, and 63.6% of participants were women. After a median follow-up of 4.6 years, dementia was diagnosed in 117 participants (7.6%). An inverse J-shaped association was found between household/transportation physical activity sub-score and dementia risk, which means that the risk is lowest for the moderately high values and then re-increases slightly for the highest values. The results remained significant when this sub-score was categorized in three classes (low, moderate, and high), with hazard ratios (95% confidence interval) of 0.55 (0.35-0.87) and 0.62 (0.38-1.01) for moderate and high activity levels, respectively. No significant effect was found for leisure/sport activities. Conclusions The 5-year risk of dementia was significantly and negatively associated with the household/transportation activity level, but not with the leisure and sport activity sub-score. This highlights the importance of considering all physical activity types in 72 years or older people.

Risk factors for future falls among community-dwelling older adults without a fall in the previous year: A prospective one-year longitudinal study

2020 ◽  
Vol 91 ◽  
pp. 104161 ◽  
Author(s):  
Jaqueline Mello Porto ◽  
Natália Camargo Rodrigues Iosimuta ◽  
Renato Campos Freire Júnior ◽  
Roberta de Matos Brunelli Braghin ◽  
Érika Leitner ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Longitudinal Study ◽  
Community Dwelling ◽  
One Year ◽  
Community Dwelling Older Adults

Predicting Activity Levels in Virtual Communities

2011 ◽  
pp. 387-389
Author(s):  
Ori B. Kushnir
Keyword(s):  
Virtual Communities ◽  
Interval Data ◽  
Activity Level ◽  
Data Series ◽  
Time Interval ◽  
Activity Levels ◽  
Data Set ◽  
Back Testing ◽  
One Year ◽  
Testing Standards

Data was collected from two communities: a smaller community with approximately 200 participants, but where the number of participants is precisely known; and a very large community, with thousands of participants, where the number of participants can only be estimated from the number of different nicknames used within a given time interval. Data from certain days when there were documented technical issues that may have affected activity has been removed from the sample. In both cases, we have taken one geographically centric data series and one global series, covering users in multiple areas and time zones. We use the number of messages sent in three-hour intervals as a proxy for the activity level in a community, as accurate figures regarding the number of messages viewed by unique persons are difficult to establish. This results in a data set of approximately 9,500 samples from each community, collected over a period of just less than four years. When fitting the models, we used accepted back-testing standards, relying on a fixed interval (one year) when fitting parameters and forecasting activity for any given point in time. One exception to this is seasonality adjustment, where we used the entire data set—this should not have a significant effect, as we made the same seasonal adjustment to the input for all models. Empirical results provided throughout the article are based on data from the larger community.

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