Reply: Diabetes Medications Related to an Increased Risk of Falls and Fall-Related Morbidity in the Elderly

2010 ◽  
Vol 44 (12) ◽  
pp. 2039-2040
Author(s):  
Helen D Berlie ◽  
Candice L Garwood
2021 ◽  
pp. 56-57
Author(s):  
Rohit Arora ◽  
D.K Sharma

Hypertension is a common disease in the elderly associated with signicant morbidity and mortality. Due to the complexity of this population, the optimal target of blood pressure (BP) control is still controversial. In this article, we conduct a literature review of trials published in English in the last 10 years which were specically designed to study the efcacy and safety of various BP targets in patients who are 70 years or older. Using these criteria, we found that the benets in the positive studies were demonstrated even with a minimal BPcontrol (systolic BP[SBP] <150 mmHg) and continued to be reported for a SBP<120 mmHg. On the other hand, keeping SBP<140 mmHg seemed to be safely achieved in elderly patients. Although the safety of lowering SBP to <120 mmHg is debated, Systolic Blood Pressure Intervention Trial study has shown no increased risk of falls, fractures, or kidney failure in elderly patients with SBP lower than this threshold. While the recent guidelines recommended to keep BP <130/80 mmHg in the elderly, more individualized approach should be considered to achieve this goal in order to avoid undesirable complications. Furthermore, further studies are required to evaluate BPtarget in very old patients or those with multiple comorbidities.


2019 ◽  
Vol 12 ◽  
pp. 117954411988493 ◽  
Author(s):  
Anneli Teder-Braschinsky ◽  
Aare Märtson ◽  
Marika Rosenthal ◽  
Pille Taba

Objectives: Deteriorating functionality and loss of mobility, resulting from Parkinson’s disease, may be worsened by osteoarthritis, which is the most common form of joint disease causing pain and functional impairment. We assessed the association between symptomatic hip or knee osteoarthritis, falls, and the ability to walk among patients with Parkinson’s disease compared to a control group. Methods: A total of 136 patients with Parkinson’s disease in Southern Estonia and 142 controls with an average age of 76.8 and 76.3 years, respectively, were enrolled in a retrospective case-control study. Information on falls and related fractures during the previous year was collected from the patients with Parkinson’s disease and controls. Covariates included gender, age, mobility, duration of Parkinson’s disease, and fractures. Results: Patients with Parkinson’s disease were at an increased risk of falls compared to the control group, and for the higher risk of fractures. Symptomatic knee or hip osteoarthritis was a significant independent predictor of falls in both patients with Parkinson’s disease and controls. The higher risk for fractures during the previous year was demonstrated in symptomatic osteoarthritis. Risk factors for falls included also female gender, use of sleep pills, and the inability to walk 500 m. Conclusions: Symptomatic hip and knee osteoarthritis are risk factors for falls and related fractures among the elderly population with and without Parkinson’s disease. The inability to walk 500 m could be used as a simple predictive factor for the increased risk of falls among elderly populations.


Author(s):  
Lara Alves Moreira ◽  
Lívia Marcondes Faber ◽  
Marcos Eduardo Scheicher

Background: One of the consequences of the institutionalization of the elderly is the increased risk of falls. Games of video games have shown ability to improve balance in the elderly population, but there is no data on their use in institutionalized elderly. Objective: To evaluate the effects of training with Nintendo Wii on static balance and functional mobility in elderly living in Long-Term Care Facilities for Elderly. Methods: Participated in the research 10 institutionalized elderly, who underwent training with Nintendo Wii for eight weeks, twice a week. Functional mobility was assessed by the Timed Up and Go (TUG) test and the static balance by a force platform. Results: Significant improvement in TUG was observed (17.65 ± 4.38s pre-treatment and 15.30 ± 3.70s p= 0.03). There was no significant improvement in the static equilibrium variables, but there was a tendency for improvement. Conclusion: The results demonstrated that the intervention with Nintendo Wii significantly improved the functional mobility, but with no improvement in the static balance in the institutionalized elderly.


Sensors ◽  
2021 ◽  
Vol 21 (1) ◽  
pp. 278
Author(s):  
Betsy Szeto ◽  
Damiano Zanotto ◽  
Erin M. Lopez ◽  
John A. Stafford ◽  
John S. Nemer ◽  
...  

Hearing loss is a disabling condition that increases with age and has been linked to difficulties in walking and increased risk of falls. The purpose of this study is to investigate changes in gait parameters associated with hearing loss in a group of older adults aged 60 or greater. Custom-engineered footwear was used to collect spatiotemporal gait data in an outpatient clinical setting. Multivariable linear regression was used to determine the relationship between spatiotemporal gait parameters and high and low frequency hearing thresholds of the poorer hearing ear, the left ear, and the right ear, respectively, adjusting for age, sex, race/ethnicity, and the Dizziness Handicap Inventory–Screening version score. Worsening high and low frequency hearing thresholds were associated with increased variability in double support period. Effects persisted after adjusting for the effects of age and perceived vestibular disability and were greater for increases in hearing thresholds for the right ear compared to the left ear. These findings illustrate the importance of auditory feedback for balance and coordination and may suggest a right ear advantage for the influence of auditory feedback on gait.


2020 ◽  
Vol 14 ◽  
Author(s):  
Bárbara Carvalho De Hollanda ◽  
Vanessa Augusta Souza Braga ◽  
Renata Evangelista Tavares Machado

Objetivo: identificar a produção científica sobre o impacto da obesidade sarcopênica na capacidade funcional de idosos. Método: trata-se de um estudo bibliográfico, descritivo, tipo revisão integrativa, a partir da busca nas bases de dados CINAHL, LILACS, MEDLINE, SCOPUS e Web of Science e Biblioteca Virtual SciELO, entre 2014 e 2018. Procedeu-se com a análise descritiva dos resultados a partir de semelhanças dos dados, explicitados em fugura sinóptica. Resultados: incluíram-se 14 artigos que apontaram influências do agravo na velocidade da marcha, dificuldades no equilíbrio e aumento do risco para ocorrência de quedas. Mostrou-se que esses impactos eram limitadores das atividades cotidianas, aumentando a dependência e fragilidade dos idosos, com piora na qualidade de vida e ocorrência de sintomas depressivos. Conclusão: ressalta-se que os impactos negativos gerados pela obesidade sarcopênica na funcionalidade dos idosos apontam a necessidade do monitoramento da composição corporal e força muscular da população idosa, além de ações preventivas deste agravo à saúde. Descritores: Idoso; Obesidade; Sarcopenia; Fragilidade; Saúde Pública; Revisão.AbstractObjective: to identify scientific production on the impact of sarcopenic obesity on the functional capacity of the elderly. Method: this is a bibliographic, descriptive, integrative review type study, based on the search in the CINAHL, LILACS, MEDLINE, SCOPUS and Web of Science and SciELO Virtual Library databases, between 2014 and 2018. We proceeded with the descriptive analysis of the results based on similarities of the data, explained in synoptic fugue. Results: 14 articles were included that pointed out influences of the aggravation in gait speed, difficulties in balance and increased risk of falls. These impacts were shown to limit daily activities, increasing the dependence and frailty of the elderly, with worsening quality of life and occurrence of depressive symptoms. Conclusion: it is emphasized that the negative impacts generated by sarcopenic obesity on the functionality of the elderly point to the need to monitor the body composition and muscle strength of the elderly population, in addition to preventive actions for this health problem. Descriptors: Aged; Obesity; Sarcopenia; Frailty; Public Health; Review.ResumenObjetivo: identificar la producción científica sobre el impacto de la obesidad sarcopénica en la capacidad funcional de los ancianos. Método: este es un estudio de tipo de revisión bibliográfica, descriptiva e integradora, basada en la búsqueda en las bases de datos CINAHL, LILACS, MEDLINE, SCOPUS y Web of Science y Biblioteca Virtual SciELO, entre 2014 y 2018. Se procedió al análisis descriptivo de los resultados basados en similitudes de los datos, explicado en figura sinóptica. Resultados: se incluyeron 14 artículos que señalaron las influencias del agravamiento de la velocidad de la marcha, las dificultades en el equilibrio y el aumento del riesgo de caídas. Se demostró que estos impactos limitan las actividades diarias, aumentando la dependencia y la fragilidad de los ancianos, con el empeoramiento de la calidad de vida y la aparición de síntomas depresivos. Conclusión: se enfatiza que los impactos negativos generados por la obesidad sarcopénica en la funcionalidad de los ancianos apuntan a la necesidad de monitorear la composición corporal y la fuerza muscular de la población de ancianos, además de las acciones preventivas para este problema de salud. Descriptores: Anciano; Obesidad; Sarcopenia; Fragilidad; Salud Pública; Revisión.


2020 ◽  
Vol 22 (3) ◽  
pp. 34-40
Author(s):  
Ekaterina N. Dudinskaya ◽  
Natalia V. Brailova ◽  
Veronika A. Kuznetsova ◽  
Olga N. Tkacheva

Osteoporosis in the elderly and senile can be compared with the epidemic of the 21st century due to the high prevalence and increased incidence among people who have survived the 50-year threshold, which make up the bulk of patients. Osteoporosis is associated with a significant increase in the risk of falls and fractures, leading to adynamia and an increased risk of death. Despite the insufficient knowledge of the pathogenesis of the disease, the available data have already allowed the development of preventive measures and treatment principles. Currently, there are preventive and therapeutic measures aimed at reducing the risk of falls, fractures and repeated fractures, however, earlier detection of the disease in old age is often difficult due to the characteristic features of geriatric patients. The polymorbidity, unexpressed clinical picture, the development of frailty syndrome, sarcopenia, social and mental maladaptation and an increase in the frequency of depression make the population of elderly and senile people vulnerable to an increased risk of osteoporosis, falls and fractures and associated hospitalizations and mortality. This review highlights the features of pathogenesis, clinical features, principles of treatment and prevention of osteoporosis in the older age group.


Sensors ◽  
2019 ◽  
Vol 19 (2) ◽  
pp. 261 ◽  
Author(s):  
Sara Arlati ◽  
Vera Colombo ◽  
Daniele Spoladore ◽  
Luca Greci ◽  
Elisa Pedroli ◽  
...  

Frailty is a clinical condition affecting the elderly population which results in an increased risk of falls. Previous studies demonstrated that falls prevention programs are effective, but they suffer from low adherence, especially when subjects have to train unsupervised in their homes. To try to improve treatment adherence, virtual reality and social media have been proposed as promising strategies for the increase of users’ motivation and thus their willingness to practice. In the context of smart homes, this work presents SocialBike, a virtual reality-based application aimed at improving the clinical outcomes of older frail adults in their houses. Indeed, SocialBike is integrated in the “house of the future” framework and proposes a Dual Task training program in which the users are required to cycle on a stationary bike while recognizing target animals or objects appearing along the way. It also implements the possibility of training with other users, thus reducing the risk of social isolation. Within SocialBike, users can choose the multiplayer mode they prefer (i.e., collaborative or competitive), and are allowed to train following their own attitude. SocialBike’s validation, refinement, and business model are currently under development, and are briefly discussed as future works.


Author(s):  
Deise Aparecida de Almeida Pires-Oliveira ◽  
André Wilson Oliveira Gil ◽  
Laís Campos De Oliveira ◽  
Felipe Micheletti Bento ◽  
Camila Silva Tomioto Mendes ◽  
...  

Introduction: Old age brings several factors that alter the physiological system, which results in loss of functionality in the elderly. Falls are a leading cause of death in this population or activity restrictions, social isolation, decline in health and increased risk of institutionalization. The quality of life in old age is a major challenge, it is necessary for improvement in all aspects of daily. Analyze physical exercise on quality of life of older physically active drives to see how exercise influences the improvement of the basic aspects to a healthier life, referring to physical and mental aspects of the elderly, prevention of the consequences arising from the process natural aging, such as falls. Objective: The objective of this study is to analyze quality of life in elderly practitioners of physical activity and relationship with risk of falls. Method: The sample was 84 seniors, recruited from the community of Londrina PR, physical activity practitioners, aged over 60 years who roam with or without assistive device, of both sexes . The evaluation was through structured questionnaires that focused on socioeconomic - demographic questionnaire falls which was used the Timed Up and Go (TUGT), analysis of quality of life (SF-36) and analysis of the risk of falls. Results: In relationship the anthropometrics characteristics of elderly subjects analyzed, the same presentation mean age 68 years, weight 63.5 kg, height 1.52, and body mass index 27.10. Was regarding correlation between TUGT and falls in the last year (P=0,048) e correlation between TUGT and Physicals Components of SF-36 (P=0,001), and was regarding that elderly with better scores in TUGT were better scores of Physical Components of SF-36 (P=0,003). Conclusion: The quality of life is directly linked to the physical condition of the elderly, elderly practicing physical exercises have a better quality of life and less prone to falls.


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