Somatosensory Impairments, Falls History and Fear of Falling in Glaucoma - A Survey Study Approach

2021 ◽  
Vol 65 (1) ◽  
pp. 11-15
Author(s):  
Caitlin O’Connell ◽  
Gadi Wollstein ◽  
Ian P. Conner ◽  
Mark S. Redfern ◽  
Kevin C. Chan ◽  
...  
Keyword(s):  
Visual Field ◽  
Older Workers ◽  
Daily Living ◽  
Fear Of Falling ◽  
Survey Study ◽  
Risk Of Falling ◽  
Study Approach ◽  
Increased Risk ◽  
Visual Field Deficits ◽  
The Relationship

The primary aim was to determine if somatosensory impairments alter the association between falls history and glaucoma severity. A secondary aim was to identify the activities of daily living that cause increased concern related to falling in glaucoma and their association with glaucoma severity. Established questionnaires about falls and fear of falling (FoF) were mailed to participants diagnosed with glaucoma. Ninety-eight participants responded. Self-reported feet numbness and tingling symptoms were used to determine the presence of somatosensory impairments. Self-reported falls in glaucoma are associated with visual field deficits in both eyes, particularly in the presence of somatosensory impairments. In addition, increased FoF levels are linked with worse visual field deficits in both eyes, especially when performing challenging walking tasks. Somatosensory impairments alter the relationship between falls risk and visual field deficits in glaucoma. This information may be helpful in identifying older workers at an increased risk of falling.

scholarly journals Paving the Way Toward Distinguishing Fallers From Non-fallers in Bilateral Vestibulopathy: A Wide Pilot Observation

2021 ◽  
Vol 12 ◽  
Author(s):  
Nolan Herssens ◽  
Bieke Dobbels ◽  
Julie Moyaert ◽  
Raymond Van de Berg ◽  
Wim Saeys ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Fear Of Falling ◽  
Daily Life ◽  
Contextual Information ◽  
Vestibular Function ◽  
Future Research ◽  
Risk Of Falling ◽  
Bilateral Vestibulopathy ◽  
Activities Of Daily Life ◽  
Increased Risk

Patients with bilateral vestibulopathy (BVP) present with unsteadiness during standing and walking, limiting their activities of daily life and, more importantly, resulting in an increased risk of falling. In BVP patients, falls are considered as one of the major complications, with patients having a 31-fold increased risk of falling compared to healthy subjects. Thus, highlighting objective measures that can easily and accurately assess the risk of falling in BVP patients is an important step in reducing the incidence of falls and the accompanying burdens. Therefore, this study investigated the interrelations between demographic characteristics, vestibular function, questionnaires on self-perceived handicap and balance confidence, clinical balance measures, gait variables, and fall status in 27 BVP patients. Based on the history of falls in the preceding 12 months, the patients were subdivided in a “faller” or “non-faller” group. Results on the different outcome measures were compared between the “faller” and “non-faller” subgroups using Pearson's chi-square test in the case of categorical data; for continuous data, Mann–Whitney U test was used. Performances on the clinical balance measures were comparable between fallers and non-fallers, indicating that, independent from fall status, the BVP patients present with an increased risk of falling. However, fallers tended to report a worse self-perceived handicap and confidence during performing activities of daily life. Spatiotemporal parameters of gait did not differ between fallers and non-fallers during walking at slow, preferred, or fast walking speed. These results may thus imply that, when aiming to distinguish fallers from non-fallers, the BVP patients' beliefs concerning their capabilities may be more important than the moderately or severely affected physical performance within a clinical setting. Outcome measures addressing the self-efficacy and fear of falling in BVP patients should therefore be incorporated in future research to investigate whether these are indeed able to distinguish fallers form non-fallers. Additionally, information regarding physical activity could provide valuable insights on the contextual information influencing behavior and falls in BVP.

The relationship between activities of daily living,falls and fear of falling in older adults : A crosssectional study

2021 ◽  
Vol 20 (2) ◽  
pp. 420-425
Author(s):  
Hamed Mortazavi ◽  
Mahbubeh Tabatabaeichehr ◽  
Masoumeh Taherpour ◽  
Mohadece Masoumi
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Social Life ◽  
Daily Living ◽  
Fear Of Falling ◽  
Medical Science ◽  
The Elderly ◽  
Cluster Sampling ◽  
Elderly Persons ◽  
The Relationship

Objective : Doingactivities of daily living can bring independence for the elderly. It can also maintain their health and social participation. However, experience of falls and fear of falling can affect the health and personal social life of the elderly. The aim of this study was to evaluate the relationship between falls and fear of falling with activities of daily living in older adults. Materials and methods : Four hundred and fifty elderly persons were enrolled in this cross-sectional study using cluster sampling. Demographic variables, Fall Efficacy Scale- International (FES-I) and questionnaires related to the study of activities of daily living were employed. To investigate advanced activities of daily living, open-ended questions were used. The history of falls within the last 12 months was investigated. Results : Mean score of basic activities of daily living in the elderly being studied was 15.49±1.74, and 95.4% of them were independent in doing these activities.Mean score of instrumental activities of daily living was 11.30±3.36, and 71.5% of them were independent in doing these activities. Participation of elderly persons in social activities was reported to be 77.9%. There was a significant relationship between activities of daily living (basic, instrumental, and advanced) and falls and fear of falling (p<0.05). Conclusion : Falls and fear of falling reduce the independence of elderly persons in doing activities of daily living. Bangladesh Journal of Medical Science Vol.20(2) 2021 p.420-425

scholarly journals 13 Effects of Benzodiazepines on Orthostatic Blood Pressure in Older People

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Giulia Rivasi ◽  
Rose Anne Kenny ◽  
Andrea Ungar ◽  
Roman Romero-Ortuno
Keyword(s):  
Blood Pressure ◽  
Older People ◽  
Fear Of Falling ◽  
Community Dwelling ◽  
University Hospital ◽  
Risk Of Falling ◽  
Non Invasive ◽  
Orthostatic Blood Pressure ◽  
History Of ◽  
The Relationship

Abstract Background Older people taking benzodiazepines (BDZs) have higher risk of falling, which is mainly attributed to unfavorable drug-related effects on cognition and psychomotor functioning. BDZs may also have hypotensive effects, but evidence concerning the relationship between BDZs and orthostatic blood pressure (BP) behaviour in older people is scarce. We investigated the effects of BDZs on BP response to an orthostatic active stand test. Methods We performed a retrospective analysis of data from an outpatient research clinic in an Irish university hospital, where people aged 60 or older underwent a comprehensive geriatric assessment between August 2007 and May 2009. Non-invasive beat-to-beat orthostatic BP was measured during active stand, with systolic BP assessed at each 10-second interval. Information on regular BDZs use was collected. Factors independently associated with orthostatic systolic BP were investigated using multiple linear regression. Results Of 624 community-dwelling people who underwent a clinic assessment, orthostatic active stand data was collected in 541. Information on regular BDZs use was available in 538 people. Of 538 participants, mean age was 72.7±7.2, 67.7% were female and 33 (6.1%) reported regular use of BDZs. History of falls (p=0.027) and fear of falling (p<0.001) were more prevalent in this subgroup. During active stand, participants on BDZs showed a significantly greater systolic BP drop 10 seconds after the posture change (“immediate” BP drop). No significant differences were detected in orthostatic systolic BP in the latter phases of the active stand. After adjusting for possible confounders, BDZs use was independently associated with a mean immediate systolic BP drop of 12 mmHg after standing. Conclusion BDZs may confer higher risk of an immediate systolic BP drop after standing in older people, which may contribute to their known falls risk. BDZ should be avoided in older people at risk of falling.

The Relationship Between Experiences With the Criminal Justice System and Mental Health Outcomes Among Survivors of Homicide

2018 ◽  
Vol 33 (2) ◽  
pp. 310-329 ◽  
Author(s):  
Evgenia Milman ◽  
Joah L. Williams ◽  
Kaitlin Bountress ◽  
Alyssa A. Rheingold
Keyword(s):  
Mental Health ◽  
Criminal Justice ◽  
Criminal Justice System ◽  
Justice System ◽  
Stress Disorder ◽  
Police Department ◽  
Survey Study ◽  
Homicide Survivors ◽  
Increased Risk ◽  
The Relationship

Homicide survivors are at increased risk for mental health disorders, including depression, posttraumatic stress disorder (PTSD), and complicated grief (CG). Accordingly, this survey study examined how satisfaction with the criminal justice system (CJS) was associated with depression, PTSD, and CG among 47 homicide survivors. It also examined how satisfaction with specific aspects of the CJS related to satisfaction with the overall CJS. Satisfaction with the overall CJS was uniquely associated with depression (odds ratio [OR] = 2.32; 95% confidence interval [CI] [1.16, 4.66]) while satisfaction with the police department was uniquely associated with CG (OR = 2.14; 95% CI [1.02, 4.47]). Satisfaction with having input into the CJS process and satisfaction with efforts devoted by the CJS to apprehend the perpetrator were uniquely related to satisfaction with the overall CJS (β = .49, p = .003 and β = .40, p = .007, respectively).

scholarly journals Patients’ thoughts on their falls in a rehabilitation hospital: a qualitative study of patients with stroke

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saika Aihara ◽  
Shin Kitamura ◽  
Masayuki Dogan ◽  
Sachiko Sakata ◽  
Kunitsugu Kondo ◽  
...  
Keyword(s):  
Fear Of Falling ◽  
Lessons Learned ◽  
Positive Thinking ◽  
Risk Of Falling ◽  
Comprehensive Information ◽  
Increased Risk ◽  
Before And After ◽  
Risky Behaviours ◽  
Past Experiences ◽  
Need For Rehabilitation

Abstract Background Patients with stroke in rehabilitation wards are at an increased risk of falling. Although patients’ participation in establishing medical safety is considered crucial, there is limited evidence on their perspectives of falls. This study aims to comprehensively elucidate the subjective falling experience of patients with stroke who have been admitted to rehabilitation wards. Methods Twenty-three consecutive patients with stroke (44 to 90 years) who experienced a fall during hospitalisation were interviewed within 1 week after the fall, and thematic analysis was used to analyse the data. Results Five themes surrounding fall events were extracted from the narratives: ‘Psychological background before the action’, ‘Support for the action’, ‘Direct causes of the fall’, ‘Patients’ awareness after the fall’, and ‘Changes in attitudes and behaviours after the fall’. ‘Psychological background before the action’ comprised hastiness or hesitation to call for help. Participants often took an action based on ‘Support for the action’ derived from their past experiences of moving safely, their confidence, and/or motivation to challenge themselves to move. ‘Direct causes of the fall’ consisted of unfamiliar actions, training fatigue, the surrounding environment, reduced physical function due to paralysis, lack of attention, overconfidence in their ability, and insufficient prediction of falls. ‘Patients’ awareness after the fall’ consisted of re-affirming difficult movements, the need for rehabilitation, a reduced ability to move, an increased risk of falling, the need for attention while moving, a fear of falling, and a lack of lessons learned from falling. Finally, patients demonstrated ‘Changes in attitudes and behaviours after the fall’ such as embodying a positive attitude to cope with the risk of falling or behavioural changes to reduce the risk of falling. Conclusions Comprehensive information on patients’ perspectives before and after the fall was elucidated, uncovering many aspects including the psychological background for why patients engaged in risky behaviours resulting in falls, presence of positive thinking, and behaviour after the fall. By incorporating the patients’ views on fall incidences and their assessment, we can develop appropriate prevention strategies against falls.

scholarly journals Fear of Falling and Cognitive Impairments in Elderly People with Hip Fractures

2017 ◽  
Vol 7 (3) ◽  
pp. 386-394 ◽  
Author(s):  
Mari Kasai ◽  
Kenichi Meguro ◽  
Hiroshi Ozawa ◽  
Keiichi Kumai ◽  
Hideki Imaizumi ◽  
...  
Keyword(s):  
Hip Fractures ◽  
Daily Living ◽  
Fear Of Falling ◽  
Cognitive Impairments ◽  
Functional Independence ◽  
Covariate Effects ◽  
Physical Functions ◽  
And Gender ◽  
The Relationship ◽  
Prevalence Of Dementia

Background/Aim: The purpose of this study was to investigate the estimated prevalence of dementia and the relationship between cognitive impairment and fear of falling in patients with hip fractures. Methods: Analysis 1 included 100 patients with hip fractures. Analysis 2 included a subgroup of subjects with ≥75 years of functional independence: 46 patients with hip fractures and 46 control subjects without hip fractures, and presence or absence of dementia. We used an informant-rated questionnaire including the AD8 for screening for dementia, the Barthel Index for assessing activities of daily living, and the Short Falls Efficacy Scale-International (FES-I) for assessing fear of falling. Results: The estimated prevalence of dementia was 66% in patients with hip fractures. There were significant fracture and dementia effects, with significant covariate effects of age and gender on the Short FES-I scores. Conclusion: Our results suggested that more than two-thirds of patients with hip fractures had dementia. Fear of falling may reflect not only physical functions but also cognitive impairments.

scholarly journals Dizziness and its association with walking speed and falls efficacy among older men and women in an urban population

2019 ◽  
Vol 32 (6) ◽  
pp. 1049-1056 ◽  
Author(s):  
Ellen Lindell ◽  
Lena Kollén ◽  
Mia Johansson ◽  
Therese Karlsson ◽  
Lina Rydén ◽  
...  
Keyword(s):  
Walking Speed ◽  
Fear Of Falling ◽  
Risk Groups ◽  
Functional Tests ◽  
Swedish Version ◽  
The Past ◽  
Increased Risk ◽  
Risk Of Falls ◽  
The Relationship ◽  
Older Men And Women

Abstract Background Dizziness is common among older people and falling is a feared complication. Aim The purpose of this study was to investigate the presence of dizziness and its association with falls, walking speed and fear of falling, including sex differences, among 79-year-olds. Secondary purposes were to describe the relationship between dizziness and falls to number of medications and diseases. Method The study consisted of the fifth cohort of Gothenburg’s H70 birth cohort studies. A sample of 662 79-year-olds (404 women, 258 men) were investigated with questions regarding dizziness, previous falls and falls efficacy [estimated according to the falls efficacy scale Swedish version (FES (S))]. Functional tests included self-selected and maximal walking speed over 20 m. Results Dizziness was reported among 51% of the women and by 58% of the men (p = 0.12). Approximately, 40% had fallen during the past 12 months (41% women, 38% of the men, p = 0.48). Dizziness was related to a higher risk of falls among women (OR 2.63 (95% CI 1.67−4.14, p < 0.0001), but not among men (OR 1.07, 95% CI 0.63−1.82, p = 0.8). Dizzy individuals had lower scores on FES (S) (p < 0.01), more medications (p < 0.001) and diseases (p < 0.001) than those without dizziness. Participants who reported dizziness walked 10% slower than participants without dizziness (p < 0.001). Conclusion Women with dizziness more often reported falls compared to women without dizziness—a trend that was not seen among men. Persons with dizziness walked slower. Many medications increased risk of falling; hence, number of medications alone might help pinpoint risk groups for falling.

scholarly journals How does driving license withdrawal affect subjective well-being? A Swedish comparative survey study of visual field loss

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Jonna Nyberg ◽  
Gunilla Björklund ◽  
Åsa Aretun ◽  
Hans-Yngve Berg ◽  
Thomas Strandberg
Keyword(s):  
Visual Field ◽  
Visual Field Loss ◽  
Well Being ◽  
Survey Study ◽  
Subjective Well Being ◽  
Driving License ◽  
Negative Effect ◽  
Private Car ◽  
The Relationship ◽  
Car Driving

AbstractResearch has found strong relationships between access to transport, accessibility of activities, and subjective well-being (SWB), and society is said to be car dependent. Accordingly, this study investigates, in a Swedish context, whether and how withdrawal of a driving license for a private car due to visual field loss (VFL) affects SWB. A web survey was used for statistical comparisons of three respondent groups (n = 436): people with a driving license, people with a driving license and VFL, and people whose driving license was withdrawn due to VFL. The inclusion criterion for all participants was that they should have a diagnosis that could cause VFL. The no-license group had lower overall SWB than did respondents with driving licenses. The no-license group also perceived less access to transport means in order to live a life to be satisfied with than did the other groups. The most used transport means in the no-license group was getting a lift in a car, though this group had a strong desire to drive a car. Few respondents in the license groups wanted to use specific transport means to a greater extent, car driving being the most used transport means. Some inter-group differences were seen regarding how access to activities (measured by frequency of actual trips) affected SWB. This study found a significant negative effect of driving license withdrawal on SWB. However, the results imply that qualitative aspects other than the relationship between the frequencies of trips and activities might also affect SWB, and more research on this subject is needed.

Cervicothoracic Mechanical Impairment as Part of Complete Neurological Fall Risk Appraisal

2020 ◽  
pp. 1-9
Author(s):  
Janine L. Johnston ◽  
Graham Featherstone ◽  
Shane L. Harms ◽  
Glen T. D. Thomson
Keyword(s):  
Risk Factors ◽  
Soft Tissue ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Musculoskeletal Symptoms ◽  
Risk Of Falling ◽  
Risk Appraisal ◽  
Fall Risk Factors ◽  
Increased Risk ◽  
Restricted Mobility

ABSTRACT: Background: Assessment of individuals at risk for falling entails comprehensive neurological and vestibular examinations. Chronic limitation in cervical mobility reduces gaze accuracy, potentially impairing navigation through complex visual environments. Additionally, humans with scoliosis have altered otolithic vestibular responses, causing imbalance. We sought to determine whether dynamic cervical mobility restrictions or static cervicothoracic impairments are also fall risk factors. Methods: We examined 435 patients referred for soft-tissue musculoskeletal complaints; 376 met criteria for inclusion (mean age 52; 266 women). Patients were divided into nonfallers, single fallers, and multiple fallers, less or greater than 65 years old. Subject characteristics, dynamic cervical rotations, and static cervicothoracic axial measurements were compared between groups. Fear of falling was evaluated using the Falls Efficacy Scale-International questionnaire. Results: Long-standing cervicothoracic pain and stiffness conferred increased risk of falling. Neck rotation amplitudes decreased with longer duration musculoskeletal symptoms and were significantly more restricted in fallers, doubling the risk of falling and contributing to increased fear of falling. Mid-thoracic scoliosis amplitudes increased over time, but static axial abnormalities were not greater among fallers, although thoracic kyphoscoliosis heightened fear of falling. Conclusion: In patients at fall risk, thoracic kyphoscoliosis and dynamic neck movements should be assessed, in addition to standard vestibular and neurological evaluations. Additionally, patients with soft tissue cervicothoracic pain and restricted mobility have increased fall frequency and fear of falling, independent of other fall risk factors and should undergo complete fall risk appraisal.

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