scholarly journals Is orthostatic hypotension and co-existing supine and seated hypertension associated with future falls in community-dwelling older adults? Results from The Irish Longitudinal Study on Ageing (TILDA)

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0252212
Author(s):  
Orna A. Donoghue ◽  
Matthew D. L. O’Connell ◽  
Robert Bourke ◽  
Rose Anne Kenny
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Longitudinal Study ◽  
Orthostatic Hypotension ◽  
Community Dwelling ◽  
Effect Sizes ◽  
Important Indicator ◽  
Supine Hypertension ◽  
Risk Of Falls ◽  
Community Dwelling Older Adults

Orthostatic hypotension (OH) often co-exists with hypertension. As increasing age affects baroreflex sensitivity, it loses its ability to reduce blood pressure when lying down. Therefore, supine hypertension may be an important indicator of baroreflex function. This study examines (i) the association between OH and future falls in community-dwelling older adults and (ii) if these associations persist in those with co-existing OH and baseline hypertension, measured supine and seated. Data from 1500 community-dwelling adults aged ≥65 years from The Irish Longitudinal Study on Ageing (TILDA) were used. Continuous beat-to-beat blood pressure was measured using digital photoplethysmography during an active stand procedure with OH defined as a drop in systolic blood pressure (SBP) ≥20 mmHg and/or ≥10 mm Hg in diastolic blood pressure (DBP) within 3 minutes of standing. OH at 40 seconds (OH40) was used as a marker of impaired early stabilisation and OH sustained over the second minute (sustained OH) was used to indicate a more persistent deficit, similar to traditional OH definitions. Seated and supine hypertension were defined as SBP ≥140 mm Hg or DBP ≥90 mm Hg. Modified Poisson models were used to estimate relative risk of falls (recurrent, injurious, unexplained) and syncope occurring over four year follow-up. OH40 was independently associated with recurrent (RR = 1.30, 95% CI = 1.02,1.65), injurious (RR = 1.43, 95% CI = 1.13,1.79) and unexplained falls (RR = 1.55, 95% CI = 1.13,2.13). Sustained OH was associated with injurious (RR = 1.55, 95% CI = 1.18,2.05) and unexplained falls (RR = 1.63, 95% CI = 1.06,2.50). OH and co-existing hypertension was associated with all falls outcomes but effect sizes were consistently larger with seated versus supine hypertension. OH, particularly when co-existing with hypertension, was independently associated with increased risk of future falls. Stronger effect sizes were observed with seated versus supine hypertension. This supports previous findings and highlights the importance of assessing orthostatic blood pressure behaviour in older adults at risk of falls and with hypertension. Observed associations may reflect underlying comorbidities, reduced cerebral perfusion or presence of white matter hyperintensities.

Judgment Capacity, Fear of Falling, and the Risk of Falls in Community-Dwelling Older Adults: The Progetto Veneto Anziani Longitudinal Study

2020 ◽  
Vol 23 (3) ◽  
pp. 237-244 ◽  
Author(s):  
Caterina Trevisan ◽  
Bruno M. Zanforlini ◽  
Stefania Maggi ◽  
Marianna Noale ◽  
Federica Limongi ◽  
...  
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Fear Of Falling ◽  
Community Dwelling ◽  
Risk Of Falls ◽  
Community Dwelling Older Adults

scholarly journals Association between Physical Frailty Subdomains and Oral Frailty in Community-Dwelling Older Adults

2021 ◽  
Vol 18 (6) ◽  
pp. 2931
Author(s):  
Ryo Komatsu ◽  
Koutatsu Nagai ◽  
Yoko Hasegawa ◽  
Kazuki Okuda ◽  
Yuto Okinaka ◽  
...  
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Community Dwelling ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Physical Frailty ◽  
Cross Sectional ◽  
Important Indicator ◽  
Community Dwelling Older Adults ◽  
Oral Frailty

This cross-sectional study aimed to demonstrate the association between physical frailty subdomains and oral frailty. This study involved community-dwelling older adults (aged ≥65 years). Physical frailty was assessed with the Japanese version of the Cardiovascular Health Study criteria. Oral frailty was defined as limitations in at least three of six domains. Logistic regression analysis was used to analyze the association between physical frailty risk and oral frailty. In addition, we examined the association between physical frailty subdomains (gait speed, grip strength, exhaustion, low physical activity, and weight loss) and oral frailty. A total of 380 participants were recruited for this study. Overall, 18% and 14% of the participants were at risk of physical frailty and had oral frailty, respectively. Physical frailty risk (odds ratio (OR) = 2.40, 95% confidence interval (CI): 1.22–4.75, p = 0.012) was associated with oral frailty in multivariate analysis. In secondary analysis, among physical frailty subdomains, gait speed (OR = 0.85, 95% CI: 0.73–0.97, p = 0.019) was associated with oral frailty. The present findings suggest that physical frailty is closely related to oral frailty. Among physical frailty subdomains, decreased gait speed in particular is an important indicator related to the development of oral frailty.

scholarly journals Reliability of HOME FAST BRAZIL—Self-Reported Version for Community-Dwelling Older Adults

2021 ◽  
Vol 9 ◽  
Author(s):  
Karina Stella Aoki Ferreira ◽  
Tamires Terezinha Gallo da Silva ◽  
Jarbas Melo Filho ◽  
Natacha Verônica Bazanella ◽  
Audrin Said Vojciechowski ◽  
...  
Keyword(s):  
Older Adults ◽  
Cross Sectional Study ◽  
Environmental Risks ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Rater Reliability ◽  
Risk Of Falls ◽  
History Of ◽  
Spearman Test ◽  
Community Dwelling Older Adults

Objective: Verify the intra- and inter-rater reliability of the HOME FAST BRAZIL—Self-reported version and correlate household environmental risks with the history of falls by community-dwelling older adults.Method: Cross sectional study with 50 community-dwelling older adults who were screened by the cut-off point of the Mini Mental State Exam and replied to the HOME FAST BRAZIL—Self-reported version using two evaluators, on three occasions. The reliability analysis was determined by the Intra-class Correlation Coefficient (ICC), considering ICC > 0.70 as adequate. To test the correlations, the Spearman test was used.Results: The mean age of the participants was 73.2 ± 5.8 years. The inter- rater reliability of HOME FAST BRAZIL—Self-reported version was ICC 0.83 (IC95%, 0.70–0.90) and the Intra- reliability ICC 0.85 (IC95%, 0.74–0.91). A risk of falls was verified in 88% of the sample and four environmental risks presented significant correlations with the history of falls.Conclusions: The HOME FAST BRAZIL—Self-reported version presented adequate reliability for the evaluation of household environmental risks for community-dwelling older adults. Risks such as inadequate armchairs/ sofas, the absence of anti-slip mats in the shower recess, the presence of pets and inadequate beds require attention in the evaluation of household risks, due to their correlation with the occurrence of falls.

Association of Systolic and Diastolic Blood Pressure With All-Cause Mortality Among Community-Dwelling Older Adults: A Prospective Observational Study

2021 ◽  
pp. 089826432110552
Author(s):  
Qian Lian ◽  
Tazeen H. Jafar ◽  
John C. Allen ◽  
Stefan Ma ◽  
Rahul Malhotra
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Diastolic Blood Pressure ◽  
Mortality Risk ◽  
Cox Regression ◽  
Community Dwelling ◽  
Representative Study ◽  
Hazard Ratios ◽  
Nationally Representative ◽  
Community Dwelling Older Adults

Objectives To assess the association of systolic blood pressure (SBP) and diastolic blood pressure (DBP) with mortality among older adults in Singapore. Methods Association of SBP and DBP measured in 2009 for 4443 older adults (69.5±7.4 years; 60–97 years) participating in a nationally representative study with mortality risk through end-December 2015 was assessed using Cox regression. Results Higher mortality risk was observed at the lower and upper extremes of SBP and DBP. With SBP of 100–119 mmHg as the reference, multivariable mortality hazard ratios [HRs (95% confidence interval)] were SBP <100 mmHg: 2.41 (1.23–4.72); SBP 160–179 mmHg: 1.51 (1.02–2.22); and SBP ≥180 mmHg: 1.78 (1.12–2.81). With DBP of 70–79 mmHg as the reference, HRs were DBP <50 mmHg: 2.41 (1.28–4.54) and DBP ≥110 mmHg: 2.16 (1.09–4.31). Discussion Management of high blood pressure among older adults will likely reduce their mortality risk. However, the association of excessively low SBP and DBP values with mortality risk needs further evaluation.

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

The effect of group exercises on balance, mobility, and depressive symptoms in older adults with mild cognitive impairment: a randomized controlled trial

2018 ◽  
Vol 33 (3) ◽  
pp. 439-449 ◽  
Author(s):  
Chandra da Silveira Langoni ◽  
Thais de Lima Resende ◽  
Andressa Bombardi Barcellos ◽  
Betina Cecchele ◽  
Juliana Nunes da Rosa ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Mild Cognitive Impairment ◽  
Intervention Group ◽  
Depression Scale ◽  
Community Dwelling ◽  
Effect Sizes ◽  
Control Group ◽  
Community Dwelling Older Adults

Objective: To determine the effects of group exercises on balance, mobility, and depressive symptoms in community-dwelling older adults with mild cognitive impairment. Design: Single blinded, randomized, matched pairs clinical trial. Setting: Four primary healthcare units. Subjects: Fifty-two sedentary subjects with mild cognitive impairment were paired (age, sex, body mass index, and Addenbrooke’s Cognitive Examination Revised score), tested, and then randomized into an intervention group ( n = 26) and a control group ( n = 26). Intervention: The intervention group performed strength (ankle weights, elastic bands, and dumbbells) and aerobic exercises (walking) in their communities’ public spaces, twice a week (60 minutes each), during 24 weeks. The control group maintained its usual routine. Main measures: Balance (Berg Balance Scale (BBS)), mobility (Timed Up and Go Test (TUG)), and depressive symptoms (Geriatric Depression Scale-15) were assessed before and after the intervention. Results: Before the intervention, the two groups did not differ statistically. After, the intervention group showed significant improvement ( P < 0.05) in balance (before: 53 ± 3; after: 55.1 ± 1.1 points), mobility (before: 10.7 ± 2.9 seconds; after: 8.3 ± 2 seconds), and depressive symptoms (median punctuation (interquartile range) before: 4 (1.8–6); after: 2.5 (1–4)). The control group presented a significant increase in their depressive symptoms (median before: 3.5 (2–7.3); after: 4 (2–5.3)), while their balance and mobility showed no significant modification. Small effect sizes were observed in the intervention group and control group depressive symptoms, as well as in the control group’s mobility and balance. Large effect sizes were observed the intervention group’s mobility and balance. Conclusion: Group exercises improved balance, mobility, and depressive symptoms in community-dwelling older adults with mild cognitive impairment.

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