scholarly journals Risk of falls associated with antiepileptic drug use in ambulatory elderly populations

2017 ◽  
Vol 150 (2) ◽  
pp. 101-111 ◽  
Author(s):  
Mira Maximos ◽  
Feng Chang ◽  
Tejal Patel
Keyword(s):  
Older Adults ◽  
Drug Use ◽  
Antiepileptic Drug ◽  
Antiepileptic Drugs ◽  
Fall Risk ◽  
Case Control ◽  
Cochrane Library ◽  
Cross Sectional ◽  
Increased Risk ◽  
Risk Of Falls

Background: Falls are a major cause of morbidity and mortality in older adults. About a third of those aged 65 years or older fall at least once each year, which can result in hospitalizations, hip fractures and nursing home admissions that incur high costs to individuals, families and society. The objective of this clinical review was to assess the risk of falls in ambulatory older adults who take antiepileptic drugs, medications that can increase fall risk and decrease bone density. Methods: PubMed, EMBASE, MEDLINE and the Cochrane Library electronic databases were searched from inception to July 2014. Case-control, quasi-experimental and observational design studies published in English that assessed quantifiable fall risk associated with antiepileptic drug use in ambulatory patient populations with a mean or median age of 65 years or older were eligible for inclusion. One author screened all titles and abstracts from the initial search. Two authors independently reviewed and abstracted data from full-text articles that met eligibility criteria. Results: Searches yielded 399 unique articles, of which 7 met inclusion criteria—4 prospective or longitudinal cohort studies, 1 cohort study with a nested case-control, 1 cross-sectional survey and 1 retrospective cross-sectional database analysis. Studies that calculated the relative risk of falls associated with antiepileptic drug use reported a range of 1.29 to 1.62. Studies that reported odds ratios of falls associated with antiepileptic drug use ranged from 1.75 to 6.2 for 1 fall or at least 1 fall and from 2.56 to 7.1 for more frequent falls. Discussion: Health care professionals should monitor older adults while they take antiepileptic drugs to balance the need for such pharmacotherapy against an increased risk of falling and injuries from falls.

Association between the use of benzodiazepines and opioids with the risk of falls and hip fractures in older adults

2017 ◽  
Vol 30 (7) ◽  
pp. 941-946 ◽  
Author(s):  
Manuel E. Machado-Duque ◽  
Juan Pablo Castaño-Montoya ◽  
Diego A. Medina-Morales ◽  
Alejandro Castro-Rodríguez ◽  
Alexandra González-Montoya ◽  
...  
Keyword(s):  
Older Adults ◽  
Hip Fracture ◽  
Hip Fractures ◽  
Case Control Study ◽  
Case Control ◽  
Increased Risk ◽  
Female Predominance ◽  
Risk Of Falls ◽  
Risk Of Fall ◽  
Control Study

ABSTRACTBackground:To determine the association between the use of opioids and benzodiazepines and the risk of falls with hip fracture in populations older than 65 years in Colombia.Methods:A case-control study with patients older than 65 years with diagnosis of hip fracture. Two controls were obtained per case. The drugs dispensed in the previous 30 days were identified. Sociodemographic, diagnostic, pharmacological (opioids and benzodiazepines), and polypharmacy variables were analyzed. A logistic regression model was used to analyze the risk of fall with hip fracture while using these drugs.Results:We included 287 patients with hip fractures and 574 controls. There was a female predominance (72.1%) and a mean age of 82.4 ± 8.0 years. Of the patients, 12.7% had been prescribed with opioids and 4.2% with benzodiazepines in the previous month. The adjusted multivariate analysis found that using opioids (OR:4.49; 95%CI:2.72–7.42) and benzodiazepines (OR:3.73; 95%CI:1.60–8.70) in the month prior to the event was significantly associated with a greater probability of suffering a fall with hip fracture.Conclusions:People who are taking opioids and benzodiazepines have increased risk for hip fracture in Colombia. Strategies to educate physicians regarding the pharmacology of older adults should be strengthened.

scholarly journals Fall risk among older adults residing in Bharatpur, Chitwan, Nepal

2020 ◽  
Vol 10 (3) ◽  
pp. 12-15
Author(s):  
Jogmaya Limbu ◽  
Sunita Poudyal
Keyword(s):  
Older Adults ◽  
Older People ◽  
Fall Risk ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
Structured Interview ◽  
Cross Sectional Study ◽  
Timed Up And Go ◽  
Cross Sectional ◽  
Risk Of Falls

Background: Falls in older people is a common serious health problem that has profound im­pact on overall health and quality of life of older people. The aim of this study was to assess the fall risk among older adults. Methods: The descriptive cross-sectional study was carried out among older adults residing in Bharatpur, Chitwan. A total of 98 older adults were selected by using simple random sampling technique. The data were collected by using structured interview schedule and fall risk was as­sessed by Timed Up and Go (TUG) test. Data were collected from 23rd June, 2019 to 7th July, 2019. Obtained data were analyzed using descriptive and inferential statistics. Results: The study findings revealed that more than half (60.2%) of the older adults were from the age group of ≤79 years, male (63.3%) and almost half (50%) were illiterate. Nearly all (96.9%) older adults were living with their family however, 50% were undernourished (BMI- <22.9). Ma­jorities (66.3%) were suffering from chronic diseases and had been taking medicine. Majority of older adults reported vision problem (64.3%) and hearing problem (60.2%). However, only 8.2% reported history of fall within last 6-12 months. More than half (59.2%) of the older adults had high risk of fall and found significant association with age (p=0.039) and vision problem (p=0.043). Conclusions: More than half of the older adults are in risk of falls. Therefore, more emphasis should be given in screening the older people for fall risk factors as preventive measures.

39 A Model of Gait and Falls in Older Adults with Dementia

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv9-iv12
Author(s):  
Weihong Zhang ◽  
Lee-Fay Low ◽  
Michael Schwenk ◽  
Nicholas Mills ◽  
Josephine Diana Gwynn ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Executive Function ◽  
Fall Risk ◽  
Cognitive Domain ◽  
Increased Risk ◽  
Gait Dysfunction ◽  
Risk Of Falls ◽  
Fall Risks ◽  
Falls In Older Adults

Abstract Background Older people with cognitive impairment are at increased risk of falls; however, fall prevention strategies have limited success in reducing fall risks in this population (Fernando E, Fraser M, Hendriksen J et al. Physiotherapy Canada. 2017; 69: 161–170). We aim to present a model of factors contributing to gait and falls in older adults with dementia. Methods The model was developed based on an in-depth review of literature on fall risk factors particularly in people with dementia, and the relationship between cognition and gait, and their joint impact on risk of falls. Results Cognitive and motor functions are closely related as they share neuroanatomy (Rosso AL, Studenski SA, Chen WG et al. J Gerontol A Biol Sci Med Sci. 2013; 68: 1379–1386). This close relationship has been confirmed by imaging, observational and interventional studies. Executive function is the cognitive domain most commonly associated with gait dysfunction (Cohen JA, Verghese J, Zwerling JL. Maturitas. 2016; 93: 73-77). The sub-domains of executive function(Sachdev PS, Blacker D, Blazer DG et al. Neurology. 2014; 10: 634-642) - attention, sensory integration and motor planning affect risk of falls through gait dysfunction; whereas other non-gait associated sub-domains of executive function - cognitive flexibility, judgement and inhibitory control affect risk of falls through risk taking behaviour. Conclusion Gait, cognition and falls are closely related. The comoridity and interaction between gait abnormality and cognitive impairment may be the underlying mechanism behind the high prevalence of falls in older adults with dementia. Gait and cognitive assessment with particular focus on executive function, should be integrated in fall risk screening. Assessment results should inform interventions developed by a multidisciplinary team and may include strategies such as customised gait training and behavioural modulation. A comprehensive multidisciplinary approach could be more effective in reducing fall risks in older adults with dementia.

scholarly journals Is functional fitness performance a useful predictor of risk of falls among community-dwelling older adults?

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Hsin-Hung Ho ◽  
I-Yao Fang ◽  
Yi-Chien Yu ◽  
Yi-Ping Huang ◽  
I-Ling Kuo ◽  
...  
Keyword(s):  
Older Adults ◽  
Fall Risk ◽  
Public Health Problem ◽  
Community Dwelling ◽  
Risk Scores ◽  
Functional Fitness ◽  
Risk Of Falling ◽  
Cross Sectional ◽  
Risk Of Falls ◽  
Community Dwelling Older Adults

Abstract Background Falls among older adults are a serious public health problem. Many studies indicate that positive functional fitness performance decreases the risk of falls. A limited amount of previous study has investigated the association between broad functional fitness and the fall risk. This study examines the associations between functional fitness and the risk of falling among community-dwelling older adults. Methods Three waves of cross-sectional data were collected from 2017 to 2019 in Taipei City, Taiwan. Six hundred sixty-five participants aged ≥65 years were randomly recruited from 12 districts of Taipei. Eight functional fitness tests (i.e., back scratch, chair-sit and-reach, 8-ft up-and-go, 30-s sit-to-stand, 30-s arm curl, 30-s single-leg stance, 2-min step, and hand grip strength tests) were performed to record the physical performance of older subjects. A Chinese version of the fall-risk questionnaire (FRQ) was used to calculate the fall risk scores. Linear regression and logistic regression were utilized to estimate the relationships of each functional fitness and fall risk. Result The results showed that 37.45% of older adults had a high risk of falling. It was found for each functional fitness that performance was linearly associated with the risk of falling. Moreover, older adults with low-performance levels in all functional fitness except back-scratching were more likely to have a higher risk of falling. Conclusions Our study indicated that functional fitness performance appears to provide valid predictive guidance for reducing the risk of falling among the older population.

scholarly journals Older Adults with Hypertension: Prevalence of Falls and Their Associated Factors

2021 ◽  
Vol 18 (16) ◽  
pp. 8257
Author(s):  
‘Atirah Az-Zahra’ Abu Bakar ◽  
Azidah Abdul Kadir ◽  
Nur Suhaila Idris ◽  
Siti Nurbaya Mohd Nawi
Keyword(s):  
Older Adults ◽  
Associated Factors ◽  
Treatment Plan ◽  
Cross Sectional Study ◽  
Medication History ◽  
Cross Sectional ◽  
Mobility Assessment ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Low Incidence

Falls are prominent health issues among older adults. Among hypertensive older adults, falls may have a detrimental effect on their health and wellbeing. The purpose of this study is to determine the prevalence of falls among hypertensive older adults and to identify the associated factors that contribute to their falls. This was a cross-sectional study conducted among two hundred and sixty-nine hypertensive older adults who were selected via systematic random sampling in two primary health clinics in Kuala Terengganu, Malaysia. Data on their socio-demographic details, their history of falls, medication history and clinical characteristics were collected. Balance and gait were assessed using the Performance Oriented Mobility Assessment (POMA). It was found that 32.2% of participants reported falls within a year. Polypharmacy (adjusted OR 2.513, 95% CI 1.339, 4.718) and diuretics (adjusted OR 2.803, 95% CI 1.418, 5.544) were associated with an increased risk of falls. Meanwhile, a higher POMA score (adjusted OR 0.940, 95% CI 0.886, 0.996) and the number of antihypertensives (adjusted OR 0.473, 95% CI 0.319, 0.700) were associated with a low incidence of falling among hypertensive older adults. Falls are common among hypertensive older adults. Older adults who are taking diuretics and have a polypharmacy treatment plan have a higher incidence of falls. However, older adults taking a higher number of anti-hypertensive medications specifically were not associated with an increased prevalence of falls.

scholarly journals Increased recurrent falls experience in older adults with coexisting of sarcopenia and knee osteoarthritis: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hirotaka Iijima ◽  
Tomoki Aoyama
Keyword(s):  
Older Adults ◽  
Knee Osteoarthritis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Knee Oa ◽  
Recurrent Falls ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Risk Factors For Falls

Abstract Background Sarcopenia and knee osteoarthritis (OA) are two major risk factors for falls in older adults. The coexistence of these two conditions may exacerbate the risk of falls. This cross-sectional study aimed to test the hypothesis that older adults with coexisting sarcopenia and knee OA displayed an increased risk of falls experience. Methods Participants recruited from an orthopedic clinic were divided into four groups according to the presence of sarcopenia and radiographic knee OA: isolated sarcopenia, isolated knee OA, sarcopenia + knee OA, and control (i.e., non-sarcopenia with non-OA) groups. We used questionnaires to assess falls experience in the prior 12 months. We performed logistic regression analyses to evaluate the relationship between the four groups and falls experience. Results Of 291 participants (age: 60–90 years, 78.7% women) included in this study, 25 (8.6%) had sarcopenia + knee OA. Participants with sarcopenia + knee OA had 4.17 times (95% confidence interval: 0.84, 20.6) higher odds of recurrent falls (≥2 falls) than controls after adjustment for age, sex, and body mass index. The increased recurrent falls experience was not clearly confirmed in participants with isolated sarcopenia and isolated knee OA. Conclusions People with coexisting of sarcopenia and knee OA displayed increased recurrent falls experience. This study suggests a new concept, “sarcopenic knee OA”, as a subgroup associated with higher risk of falls, which should be validated in future large cohort studies. Trial registration. Not applicable.

scholarly journals Associations Between Hearing Loss, Loneliness, and Social Isolation: A Systematic Review

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 318-318
Author(s):  
Jonathan Suen ◽  
Aishwarya Shukla ◽  
Adele Goman ◽  
Carrie Price ◽  
Frank Lin ◽  
...  
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Social Isolation ◽  
Psychosocial Health ◽  
Cochrane Library ◽  
Cross Sectional ◽  
Design Assessment ◽  
Aural Rehabilitation ◽  
Rehabilitation Programs ◽  
Underlying Mechanisms

Abstract Hearing loss is highly prevalent among older adults, as is occurrences of loneliness and social isolation. Both loneliness and social isolation are also associated with insidious outcomes such as earlier mortality from all-causes and higher prevalence of chronic comorbidities. The purpose of this review is to synthesize published investigations that report on the associations between hearing loss with loneliness and social isolation. A systematic search through PubMed, Embase, CINAHL Plus, PsycINFO, and the Cochrane Library identified an initial total of 2495 references. Two independent reviewers screened articles for inclusion, with a third reviewer adjudicating. Studies published in English of older adults with hearing loss that also assessed loneliness and/or social isolation using a validated measure were included. Investigators used a modified Newcastle-Ottawa Scale (NOS) to appraise study quality. A final total of 14 articles were included in the review. The majority (12/14) were cross-sectional in design. Assessment methods were varied across hearing status, loneliness, and social isolation. Despite this heterogeneity, most multivariable adjusted investigations revealed that hearing loss was significantly associated with higher risks for both phenomena. Several studies also revealed this association to vary across gender, with women showing a stronger association than men. Our findings indicate that hearing loss is associated with both loneliness and social isolation, which have important implications for the cognitive and psychosocial health of older adults. Future investigations should examine possible underlying mechanisms of these relationships, as well as the efficacy of interventions through aural rehabilitation programs in addressing loneliness and social isolation.

Executive functions in children with heart disease: a systematic review and meta-analysis

2021 ◽  
pp. 1-9
Author(s):  
William M. Jackson ◽  
Nicholas Davis ◽  
Johanna Calderon ◽  
Jennifer J. Lee ◽  
Nicole Feirsen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Executive Functions ◽  
Data Extraction ◽  
Meta Analysis ◽  
Executive Dysfunction ◽  
Cochrane Library ◽  
Planning Problem ◽  
Healthy Controls ◽  
Cross Sectional ◽  
Increased Risk

Abstract Context: People with CHD are at increased risk for executive functioning deficits. Meta-analyses of these measures in CHD patients compared to healthy controls have not been reported. Objective: To examine differences in executive functions in individuals with CHD compared to healthy controls. Data sources: We performed a systematic review of publications from 1 January, 1986 to 15 June, 2020 indexed in PubMed, CINAHL, EMBASE, PsycInfo, Web of Science, and the Cochrane Library. Study selection: Inclusion criteria were (1) studies containing at least one executive function measure; (2) participants were over the age of three. Data extraction: Data extraction and quality assessment were performed independently by two authors. We used a shifting unit-of-analysis approach and pooled data using a random effects model. Results: The search yielded 61,217 results. Twenty-eight studies met criteria. A total of 7789 people with CHD were compared with 8187 healthy controls. We found the following standardised mean differences: −0.628 (−0.726, −0.531) for cognitive flexibility and set shifting, −0.469 (−0.606, −0.333) for inhibition, −0.369 (−0.466, −0.273) for working memory, −0.334 (−0.546, −0.121) for planning/problem solving, −0.361 (−0.576, −0.147) for summary measures, and −0.444 (−0.614, −0.274) for reporter-based measures (p < 0.001). Limitations: Our analysis consisted of cross-sectional and observational studies. We could not quantify the effect of collinearity. Conclusions: Individuals with CHD appear to have at least moderate deficits in executive functions. Given the growing population of people with CHD, more attention should be devoted to identifying executive dysfunction in this vulnerable group.

scholarly journals What is the impact of multimorbidity on the risk of hospitalisation in older adults? A systematic review study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e049974
Author(s):  
Luciana Pereira Rodrigues ◽  
Andréa Toledo de Oliveira Rezende ◽  
Letícia de Almeida Nogueira e Moura ◽  
Bruno Pereira Nunes ◽  
Matias Noll ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Study Protocol ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Case Control Studies ◽  
Cross Sectional ◽  
Increased Risk ◽  
Review Study ◽  
The Impact

IntroductionThe development of multiple coexisting chronic diseases (multimorbidity) is increasing globally, along with the percentage of older adults affected by it. Multimorbidity is associated with the concomitant use of multiple medications, a greater possibility of adverse effects, and increased risk of hospitalisation. Therefore, this systematic review study protocol aims to analyse the impact of multimorbidity on the occurrence of hospitalisation in older adults and assess whether this impact changes according to factors such as sex, age, institutionalisation and socioeconomic status. This study will also review the average length of hospital stay and the occurrence of hospital readmission.Methods and analysisA systematic review of the literature will be carried out using the PubMed, Embase and Scopus databases. The inclusion criteria will incorporate cross-sectional, cohort and case–control studies that analysed the association between multimorbidity (defined as the presence of ≥2 and/or ≥3 chronic conditions and complex multimorbidity) and hospitalisation (yes/no, days of hospitalisation and number of readmissions) in older adults (aged ≥60 years or >65 years). Effect measures will be quantified, including ORs, prevalence ratios, HRs and relative risk, along with their associated 95% CI. The overall aim of this study is to widen knowledge and to raise reflections about the association between multimorbidity and hospitalisation in older adults. Ultimately, its findings may contribute to improvements in public health policies resulting in cost reductions across healthcare systems.Ethics and disseminationEthical approval is not required. The results will be disseminated via submission for publication to a peer-reviewed journal when complete.PROSPERO registration numberCRD42021229328.

scholarly journals Dual Effects of Hearing Loss and Dementia on Functional Limitations in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 214-214
Author(s):  
Michael McKee ◽  
Yunshu Zhou ◽  
Joshua Ehrlich ◽  
Elham Mahmoudi ◽  
Jennifer Deal ◽  
...  
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Self Care ◽  
Household Activity ◽  
Cross Sectional ◽  
Age Related ◽  
Increased Risk ◽  
Lower Mobility ◽  
Independent Effects ◽  
The Impact

Abstract Age-related hearing loss (HL) is both common and associated with elevated risk for cognitive decline and poorer health. To care for an aging population, it is critical to understand the effect of coexisting HL and dementia on functional activities. The effect of co-existing dementia and self-reported HL on daily functioning were assessed. A cross-sectional analysis was performed using nationally-representative data from the 2015 National Health and Aging Trends Study consisting of U.S. adults 65+. The sample included 1,829 adults with HL (22.8%) and 5,338 adults without HL. Multivariable Poisson regression was used to model the independent effects and interaction of self-reported HL and dementia status on three validated functional activity scales (self-care, mobility, and household). All analyses adjusted for sociodemographic and medical factors. HL participants were more likely to be white, older, male, less educated (p &lt;0.01). 8.4% had possible dementia and 6.5% had probable dementia. Respondents with HL or possible or probable dementia had significantly lower mobility, self-care, and household activity scores (p&lt;.001 for all comparisons) compared to their peers. A small yet significant interaction was present in all models, suggesting that HL respondents with co-occurring dementia had lower mobility, self-care, and household activity scores than predicted by the independent effects of dementia and self-reported HL (p&lt;.001 for all comparisons). Older adults with co-occurring dementia and HL are at increased risk for poor functioning and should be screened by healthcare providers. Future work should consider the impact of intervention in this vulnerable/at-risk population.

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