FRAILTY AND RISK OF FALLS IN COMMUNITY-DWELLING OLDER ADULTS LIVING IN A RURAL SETTING. THE ATAHUALPA PROJECT

2019 ◽  
pp. 1-5
Author(s):  
O.H. Del Brutto ◽  
R.M. Mera ◽  
C.D. Peinado ◽  
M. Zambrano ◽  
M.J. Sedler
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Univariate Analysis ◽  
Correlation Coefficients ◽  
Community Dwelling ◽  
Rural Setting ◽  
Risk Of Falls ◽  
History Of ◽  
Falls In Older Adults ◽  
The Impact

Background: Data supporting a link between frailty and risk of falls is mostly confined to individuals living in urban centers, where risk factors and lifestyles are different from that of rural settings. Objective: To assess the association between frailty and risk of falls in older adults living in rural Ecuador. Design: Population-based cross-sectional study. Participants: Community-dwellers aged ≥60 years living in a rural Ecuadorian village, in whom frail status and risk of falls were assessed. Measurements: Frailty was evaluated by the Edmonton Frailty Scale (EFS) and risk of falls by the Downton Fall Risk Index (DFRI). Multivariate models were fitted to evaluate whether frailty was associated with risk of falls (dependent variable), after adjusting for demographics, alcohol intake, cardiovascular risk factors, sleep quality, symptoms of depression, and history of an overt stroke. Correlation coefficients were constructed to assess confounders modifying this association. Results: A total of 324 participants (mean age: 70.5±8 years) were included. The mean EFS score was 4.4±2.5 points, with 180 (56%) participants classified as robust, 76 (23%) as pre-frail and 68 (21%) as frail. The DFRI was positive in 87 (27%) participants. In univariate analysis, the EFS score was higher among participants with a positive DFRI (p<0.001). The number of frail individuals was higher (p<0.001), while that of robust individuals was lower (p<0.001) among those with a positive DFRI. Adjusted logistic regression models showed no association between frailty and the DFRI. Correlation coefficients showed that age, high glucose levels, and history of an overt stroke tempered the association between frailty and the risk of falls found in univariate analyses. Conclusions: Frailty is not independently associated with risk of falls in older adults living in a remote rural setting. Further studies are needed to assess the impact of frailty on the risk of falls in these populations.

scholarly journals Assessing the Impact of a Hilly Environment on Depressive Symptoms among Community-Dwelling Older Adults in Japan: A Cross-Sectional Study

2021 ◽  
Vol 18 (9) ◽  
pp. 4520
Author(s):  
Takafumi Abe ◽  
Kenta Okuyama ◽  
Tsuyoshi Hamano ◽  
Miwako Takeda ◽  
Masayuki Yamasaki ◽  
...  
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Rural Setting ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Impact ◽  
Community Dwelling Older Adults

Although some neighborhood environmental factors have been found to affect depressive symptoms, few studies have focused on the impact of living in a hilly environment, i.e., land slope, on depressive symptoms among rural older adults. This cross-sectional study aimed to investigate whether a land slope is associated with depressive symptoms among older adults living in rural areas. Data were collected from 935 participants, aged 65 years and older, who lived in Shimane prefecture, Japan. Depressive symptoms were assessed using the Zung Self-Rating Depression Scale (SDS) and defined on the basis of an SDS score ≥ 40. Land slopes within a 400 m network buffer were assessed using geographic information systems. Odds ratios (ORs) with 95% confidence intervals (CIs) of depressive symptoms were estimated using logistic regression. A total of 215 (23.0%) participants reported depressive symptoms. The land slope was positively associated with depressive symptoms (OR = 1.04; 95% CI = 1.01–1.08) after adjusting for all confounders. In a rural setting, living in a hillier environment was associated with depressive symptoms among community-dwelling older adults in Japan.

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 &gt; 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.

scholarly journals Medications & Polypharmacy Influence on Recurrent Fallers in Community: a Systematic Review

2018 ◽  
Vol 21 (1) ◽  
pp. 14-25 ◽  
Author(s):  
Yu Ming ◽  
Aleksandra Zecevic
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
High Risk Group ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Depression Symptoms ◽  
Prescription Medications ◽  
Recurrent Falls ◽  
Falls In Older Adults ◽  
The Impact

The purpose of this systematic review is to summarize information about the impact different classes of medications and polypharmacy have on recurrent falls, defined as two or more falls in a 12-month period, in community-dwelling older adults. After adjustment for confounders such as age, gender, weight or depression symptoms, the reviewed studies suggested that older adults who use antidepressants, sedatives or hypnotics and anti-epileptics were more likely to experience recurrent falls than non-users. Polypharmacy (use of four or more prescription medications daily) caused 1.5–2 times higher possibility of recurrent falls in older adults. As a high-risk group, recurrent fallers require meaningful intervention. Medications are believed to be a modifiable risk factor in falls prevention; hence, special consideration should be taken to balance the benefit and harm in initiating, continuing or increasing certain classes of medications in elderly recurrent fallers.

scholarly journals Sex differences in impact of sarcopenia on falls in community-dwelling Korean older adults

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yunsoo Soh ◽  
Chang Won Won
Keyword(s):  
Older Adults ◽  
Sex Differences ◽  
Diagnostic Algorithm ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Sectional Study ◽  
Cross Sectional ◽  
History Of ◽  
Adjusted Model ◽  
The Impact

Abstract Background Falls are one of the most serious health problems among older adults. Sarcopenia is characterized by a decrease in muscle mass, strength, and physical function. Due to potentially age-related conditions, both falls and sarcopenia have common risk factors. However, the association between sarcopenia and falls is controversial. Moreover, the sex differences in the impact of sarcopenia on falls is not yet clear. This study aimed to investigate the sex differences in the impact of sarcopenia, defined by the Asian Working Group for Sarcopenia (AWGS), on falls in Korean older adults. Methods In this cross-sectional study, we used data from the Korean Frailty and Aging Cohort Study; 2323 community-dwelling older adults (1111 males and 1212 females) aged 70–84 years were recruited in this cross-sectional study. To evaluate sarcopenia, the AWGS diagnostic algorithm was used. We compared the faller and non-faller groups. We performed unadjusted and fully adjusted logistic regression analyses to evaluate the relationship between sarcopenia, falls, and fall-related fractures. Results A total of 239 (24.1%) females in the faller group had a history of falls in the past year, which was statistically higher than that in males (176, 15.8%). In the fully adjusted model, handgrip strength (odds ratio [OR] = 1.508, 95% confidence interval [CI] = 1.028–2.211), and short physical performance battery (OR = 2.068, 95% CI = 1.308–3.271) were significantly lower in the male faller group. However, in the fully adjusted model, the female faller group only showed a significantly low appendicular skeletal muscle mass index (OR = 1.419, 95% CI = 1.058–1.903). Conclusions This large cohort study aimed to identify the sex differences in the incidence of sarcopenia in the older Korean population, using the AWGS diagnostic algorithm, and its correlation with falls and fall-related fractures. The incidence of falls did not increase in the sarcopenia group. Among the sarcopenia components, sex differences affect the history of falls. Therefore, when studying the risk of falls in old age, sex differences should be considered.

scholarly journals Risk factors associated with cognitive frailty among community-dwelling older adults: A scoping review

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 824-825
Author(s):  
Sumi Lee ◽  
JuHee Lee
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Community Dwelling ◽  
Physical Factors ◽  
Inclusion Criteria ◽  
Cognitive Frailty ◽  
Factors Associated ◽  
Health Related ◽  
The Impact ◽  
Community Dwelling Older Adults

Abstract Objectives This study aimed to explore the risk factors associated with cognitive frailty(CF) among community-dwelling older adults, and to provide the impact of CF on health-related outcomes. Methods PubMed, EMBASE, Cochrane, PsycINFO, CINAHL, RISS, DBpia, NDSL, and KoreaMed databases were searched to retrieve studies. Two reviewers independently screened titles, abstracts and articles. The inclusion criteria are peer-reviewed articles written in English or Korean for community-dwelling older adults with both physical frailty and cognitive impairment present at the same time. Results A total of 3,513 were searched, and the final 33 were extracted according to the inclusion criteria. Physical factors affecting CF were the number of chronic disease, cardiovascular disease, activity of daily living(ADL), making telephone calls and shopping during instrumental ADL, and a Mini Nutrition Assessment–Short Form score. Psychological factor was depressive symptoms. Significant behavioral factors included self-reported physical activity, low vitamin D, smoking, frequent insomnia, and sedentary lifestyle. In social factors, social participation such as volunteering was identified as a protective factor. Mortality, followed by dementia was health related outcomes on CF, including ADL dependence, poor quality of life, and hospitalization. However, the CF-related fall was inconsistent. Conclusion A wide variety of factors have been presented in studies related to CF. In order to understand CF and improve health-related outcomes, older adults in CF should be screened as high-risk group. When the risk factors and protective factors of CF managed, better health-related outcomes will lead to successful aging of community-dwelling older adults.

scholarly journals Postural changes versus balance control and falls in community-living older adults: a systematic review

2018 ◽  
Vol 31 (0) ◽  
Author(s):  
Viviane Lemos Silva Fernandes ◽  
Darlan Martins Ribeiro ◽  
Luciana Caetano Fernandes ◽  
Ruth Losada de Menezes
Keyword(s):  
Older Adults ◽  
Observational Studies ◽  
Lumbar Lordosis ◽  
Community Dwelling ◽  
Spinal Curvature ◽  
Community Living ◽  
Postural Changes ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Falls In Older Adults

Abstract Introduction: Since falls are considered to be a public health problem, it is important to identify whether postural changes over time contribute to the risk of falls in older adults. Objective: To investigate whether postural changes increase fall risk and/or postural imbalance in healthy, community-dwelling older adults. Methods: In April 2016, two reviewers independently searched the PubMed, Web of Science, SPORTDiscus, and CINAHL databases for studies in English published in the previous 10 years, using the following combined keywords: “posture” or (“kyphosis”,“lumbar lordosis”,“flexed posture”,“spinal curvature”,“spinal sagittal contour”) AND “elderly” AND “fall”. Study quality was assessed according to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines for observational studies. Results: The search retrieved 1,734 articles. Only observational studies that assessed posture, balance, and/or falls in older adults were considered eligible for review. The final sample included 17 articles: reliability and reproducibility of the instruments were not reported in five studies, while two studies offered a questionable description of the instruments used. Fourteen articles analyzed postural changes at the trunk level and three articles assessed them at the ankles and feet. Most studies found a positive association between postural changes and an increased risk for loss of balance and falls. Conclusion: Thoracic hyperkyphosis, loss of lumbar lordosis, and decreased plantar arch seem to contribute to greater postural instability, and thus to a higher risk of falls in community-living older adults.

Poor Sleep and Risk of Falls in Community-Dwelling Older Adults: A Systematic Review

2016 ◽  
Vol 37 (9) ◽  
pp. 1059-1084 ◽  
Author(s):  
Yaena Min ◽  
Patricia W. Slattum
Keyword(s):  
Older Adults ◽  
Sleep Problems ◽  
Community Dwelling ◽  
Poor Sleep ◽  
Short Sleep Duration ◽  
Exclusion Criteria ◽  
Future Studies ◽  
Risk Of Falls ◽  
Falls In Older Adults ◽  
Community Dwelling Older Adults

Concerns about sleep problems and falls in older adults are significant. This article reviews the association between sleep problems and falls in community-dwelling adults aged 65 years or older. Multiple databases were searched from inception until 2015 using sleep, sleep disorders, and falls as keywords, limiting to studies published in English in peer-reviewed journals. After screening and assessing for eligibility, 18 articles were selected based on the inclusion and exclusion criteria. Findings of an association between sleep problems and risk of falls are conflicting, but some specific sleep problems such as extremely short sleep duration, daytime sleepiness and naps appear to be significantly related to falls in older adults. Methodological limitations including variability in covariates included in the analyses and measurement of the exposure and outcome variables were identified. The results of this review identified the need to have comparable definitions, validated tools, and rigorous design of future studies.

Abstract 15730: Ankle-Brachial Index and Physical Function in Community-Based Older Adults: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Kunihiro Matsushita ◽  
Shoshana Ballew ◽  
Yingying Sang ◽  
Corey Kalbaugh ◽  
Laura Loehr ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Function ◽  
Independent Living ◽  
Ankle Brachial Index ◽  
Poor Performance ◽  
Community Dwelling ◽  
Atherosclerosis Risk In Communities ◽  
Logistic Regression Models ◽  
History Of ◽  
The Impact

Background: Lower extremity peripheral artery disease (PAD), commonly defined by an ankle-brachial index (ABI) <0.9, increases mortality risk and also reduces physical function. All prior studies of the impact of PAD on objectively measured physical function have been in restricted populations with known PAD or physical inactivity, leaving uncertainty regarding its impact in the community. Methods: We studied 5,351 ARIC participants (age 71-90 years during 2011-2013) who underwent the assessment of ABI and the Short Physical Performance Battery (SPPB, 0-12 scale), a summary measure of physical function based on three domains (4-meter walk velocity, timed chair stands, and standing balance). Logistic regression models examined the association of ABI with poor physical function (SPPB score <6), adjusting for potential confounders including a history of other cardiovascular diseases. Results: There were 463 participants (8.2%) with ABI <0.9 and 506 participants (9.0%) with ABI ≥1.3, a potential manifestation of PAD reflecting noncompressible pedal arteries. Both ABI <0.9 and ≥1.3 were significantly and independently associated with higher odds of having poor physical function compared to those with a normal ABI (1.1-1.2). The 469 participants (8.8%) with a “borderline” low ABI (0.9-1.0) also demonstrated significantly poor physical function. Low ABI was significantly associated with poor performance in every SPPB domain, whereas none were statistically significant for high ABI. The results were largely consistent among those without a history of stroke or heart failure. Conclusion: In our population of community-dwelling older adults, ~25% had low, borderline low, or high ABI suggestive of PAD and demonstrated poorer physical function compared to those with normal ABI. Since physical function is a key element for independent living in older adults and several therapeutic options for PAD exist, our findings may have broad and important implications.

scholarly journals Risk factors for recurrent falls in older adults: a study protocol for a systematic review with meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e033602
Author(s):  
Deborah A Jehu ◽  
Jennifer C Davis ◽  
Teresa Liu-Ambrose
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Older Adults ◽  
Prospective Studies ◽  
Meta Analysis ◽  
Grey Literature ◽  
Community Dwelling ◽  
Recurrent Falls ◽  
Falls In Older Adults ◽  
Community Dwelling Older Adults

IntroductionOlder adults who fall recurrently (i.e., >1 fall/year) are at risk for functional decline and mortality. Key risk factors for recurrent falls in community-dwelling older adults are not well established due to methodological limitations, such as recall bias. A better understanding of the risk factors for recurrent falls will aid in refining clinical practice guidelines for secondary fall prevention strategies. The primary objective of this systematic review with meta-analysis is to examine the risk factors for recurrent falls in prospective studies among community-dwelling older adults.Methods and analysisA comprehensive search for articles indexed in MEDLINE, EMBASE, PsycINFO and CINAHL databases as well as grey literature was conducted on April 25, 2019. We will use MeSH and keyword search terms around the following topics: falls, recurrence, fall-risk, ageing and prospective studies. Prospective studies with monthly falls monitoring for 12 months, investigating risk factors for recurrent falls in older adults will be included. One author will complete the search. Two authors will remove duplicates and screen the titles and abstracts for their potential inclusion against the eligibility criteria. Two authors will screen the full texts and extract the data using a piloted extraction sheet. Included studies will be evaluated for the risk of bias with the Joanna Briggs Institute Prevalence Critical Appraisal tools. The quality of reporting will be determined with the Strengthening the Reporting of OBservational studies in Epidemiology. The data extraction will include study characteristics as well as sociodemographic, balance and mobility, sensory and neuromuscular, psychological, medical, medication and environmental factors. The results will be presented via figures, summary tables, meta-analysis (when possible) and narrative summaries.Ethics and disseminationNo ethics approval will be required. Findings will be disseminated through publication and media.PROSPERO registration numberCRD42019118888; Pre-results.

Changes in self-estimated step-over ability among older adults: A 3-year follow-up study

2020 ◽  
Author(s):  
Ryota Sakurai ◽  
Yoshinori Fujiwara ◽  
Hiroyuki Suzuki ◽  
Susumu Ogawa ◽  
Takahiro Higuchi ◽  
...  
Keyword(s):  
Older Adults ◽  
Estimation Error ◽  
Low Frequency ◽  
Community Dwelling ◽  
Physical Ability ◽  
Age Related ◽  
Risk Of Falls ◽  
Falls In Older Adults ◽  
Step Over

Abstract Objectives There is a growing body of literature examining age-related overestimation of one’s own physical ability, which is a potential risk of falls in older adults, but it is unclear what leads them to overestimate. This study aimed to examine 3-year longitudinal changes in self-estimated step-over ability, along with one key risk factor: low frequency of going outdoors (FG), which is a measure of poor daily physical activity. Method This cohort study included 116 community-dwelling older adults who participated in baseline and 3-year follow-up assessments. The step-over test was used to measure both the self-estimated step-over bar height (EH) and the actual bar height (AH). Low FG was defined as going outdoors either every few days or less at baseline. Results The number of participants who overestimated their step-over ability (EH&gt;AH) significantly increased from 10.3% to 22.4% over the study period. AH was significantly lower at follow-up than at baseline in both participants with low and high FGs. Conversely, among participants with low FG, EH was significantly higher at follow-up than at baseline, resulting in increased self-estimation error toward overestimation. Regression model showed that low FG was independently associated with increased error in estimation (i.e., tendency to overestimate) at follow-up. Discussion The present study indicated that self-overestimated physical ability in older adults is not only due to decreased physical ability but also due to increased self-estimation of one’s ability as a function of low FG. Active lifestyle may be critical for maintaining accurate estimations of one’s own physical ability.

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