Az eleséstől való félelem otthon élő idősek                     körében

Abstract: Introduction: Due to fear of falling, older people may restrict their activities, causing muscle weakness and impaired balance and, consequently, admission to an institute. Accordingly, fear of falling is a common and serious health problem among older individuals. The prevalence of the fear of falling and its associated factors as well as possible preventive and therapeutic methods have been widely investigated in geriatrics. Aim: The aim of our study was to describe the prevalence of the fear of falling and its associations with demographic (age, gender) and health factors (age-related chronic diseases, functional mobility, falling in the previous year, medications) among community-living older adults. Method: Two-hundred individuals participated in the study. The fear of falling was diagnosed based on the cut-off value of the short Falls Efficacy Scale – International (FES-I). Logistic regression analysis was used to assess associations. In total, 61 participants were diagnosed with fear of falling. Results: In our sample, the fear of falling was associated with age, the number of diseases and functional mobility. Conclusion: The short FES-I is simple, easy to fill-out and has a validated Hungarian version as well. By its use, people of higher age affected by multiple chronic illnesses are primarily worth of screening in order to identify those who are in need for further more detailed examinations and, if needed, more targeted interventions. Orv Hetil. 2019; 160(5): 191–197.

Download Full-text

Human skeletal muscle metabolic economy in vivo: effects of contraction intensity, age, and mobility impairment

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.00083.2014 ◽

2014 ◽

Vol 307 (9) ◽

pp. R1124-R1135 ◽

Cited By ~ 12

Author(s):

Anita D. Christie ◽

Anne Tonson ◽

Ryan G. Larsen ◽

Jacob P. DeBlois ◽

Jane A. Kent

Keyword(s):

Functional Mobility ◽

Older Individuals ◽

Mobility Impairment ◽

Cross Sectional ◽

Age Related ◽

Creatine Kinase Reaction ◽

Voluntary Contractions ◽

In Vivo Effects ◽

Muscle Cross Sectional Area

We tested the hypothesis that older muscle has greater metabolic economy (ME) in vivo than young, in a manner dependent, in part, on contraction intensity. Twenty young (Y; 24 ± 1 yr, 10 women), 18 older healthy (O; 73 ± 2, 9 women) and 9 older individuals with mild-to-moderate mobility impairment (OI; 74 ± 1, 7 women) received stimulated twitches (2 Hz, 3 min) and performed nonfatiguing voluntary (20, 50, and 100% maximal; 12 s each) isometric dorsiflexion contractions. Torque-time integrals (TTI; Nm·s) were calculated and expressed relative to maximal fat-free muscle cross-sectional area (cm2), and torque variability during voluntary contractions was calculated as the coefficient of variation. Total ATP cost of contraction (mM) was determined from flux through the creatine kinase reaction, nonoxidative glycolysis and oxidative phosphorylation, and used to calculate ME (Nm·s·cm−2·mM ATP−1). While twitch torque relaxation was slower in O and OI compared with Y ( P ≤ 0.001), twitch TTI, ATP cost, and economy were similar across groups ( P ≥ 0.15), indicating comparable intrinsic muscle economy during electrically induced isometric contractions in vivo. During voluntary contractions, normalized TTI and total ATP cost did not differ significantly across groups ( P ≥ 0.20). However, ME was lower in OI than Y or O at 20% and 50% MVC ( P ≤ 0.02), and torque variability was greater in OI than Y or O at 20% MVC ( P ≤ 0.05). These results refute the hypothesis of greater muscle ME in old age, and provide support for lower ME in impaired older adults as a potential mechanism or consequence of age-related reductions in functional mobility.

Download Full-text

Gastrointestinal Microbiota and Their Contribution to Healthy Aging

Digestive Diseases ◽

10.1159/000443350 ◽

2016 ◽

Vol 34 (3) ◽

pp. 194-201 ◽

Cited By ~ 21

Author(s):

Anna Maria Mello ◽

Giulia Paroni ◽

Julia Daragjati ◽

Alberto Pilotto

Keyword(s):

Old Age ◽

Healthy Aging ◽

Adverse Outcomes ◽

Microbiota Composition ◽

Older Individuals ◽

Gastrointestinal Microbiota ◽

Targeted Interventions ◽

Age Related ◽

Increased Risk ◽

Older Subjects

Studies on populations at different ages have shown that after birth, the gastrointestinal (GI) microbiota composition keeps evolving, and this seems to occur especially in old age. Significant changes in GI microbiota composition in older subjects have been reported in relation to diet, drug use and the settings where the older subjects are living, that is, in community nursing homes or in a hospital. Moreover, changes in microbiota composition in the old age have been related to immunosenescence and inflammatory processes that are pathophysiological mechanisms involved in the pathways of frailty. Frailty is an age-related condition of increased vulnerability to stresses due to the impairment in multiple inter-related physiologic systems that are associated with an increased risk of adverse outcomes, such as falls, delirium, institutionalization, hospitalization and death. Preliminary data suggest that changes in microbiota composition may contribute to the variations in the biological, clinical, functional and psycho-social domains that occur in the frail older subjects. Multidimensional evaluation tools based on a Comprehensive Geriatric Assessment (CGA) have demonstrated to be useful in identifying and measuring the severity of frailty in older subjects. Thus, a CGA approach should be used more widely in clinical practice to evaluate the multidimensional effects potentially related to GI microbiota composition of the older subjects. Probiotics have been shown to be effective in restoring the microbiota changes of older subjects, promoting different aspects of health in elderly people as improving immune function and reducing inflammation. Whether modulation of GI microbiota composition, with multi-targeted interventions, could have an effect on the prevention of frailty remains to be further investigated in the perspective of improving the health status of frail ‘high risk' older individuals.

Download Full-text

10 Fear of Falling in Community Dwelling Ambulatory Older Patients: Associations with Physiological Falls Risk, Cognition and Mood Disorders

Age and Ageing ◽

10.1093/ageing/afab028.10 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

pp. i1-i6

Author(s):

H Dolphin ◽

A McFeely ◽

S Kennelly ◽

S Mello

Keyword(s):

Mood Disorders ◽

Fear Of Falling ◽

Retrospective Chart Review ◽

Community Dwelling ◽

Rapid Decline ◽

Day Hospital ◽

Timed Up And Go ◽

Targeted Interventions ◽

Age Related ◽

Increased Risk

Abstract Introduction Fear of falling (FOF) is associated with a range of adverse health outcomes including increased risk of falls1, and more rapid decline in physical and cognitive function2. We aim to determine the prevalence of FOF amongst ambulatory community dwelling older adults attending an Age-Related Day Hospital, and to describe it’s associations with cognition, mood disorders, frailty and mobility measures. Methods A retrospective chart review was conducted on 50 patients attending the Day Hospital. Baseline demographics collected include comorbidities, medications, and falls history. Objective mobility measurements include the Timed Up and Go (TUG) test and grip strength. Patients were divided into two groups based on their answer to the question, “Are you afraid of falling?” Differences between groups were compared using chi-squared test. Results The average age of Day Hospital attendees was 85 (SD X). 62% were male. Three quarters of patients experienced a recent fall, and half admitted to FOF. Those with FOF were more likely to be dependent in personal care (27% vs 16%, p = 0.15) and use a walking aid (69% vs 58%, p = 0.02). They were also more likely to be prescribed psychoactive medications (53% vs 45%, p = 0.42), and have a diagnosis of anxiety (4% vs 0%, p = 0.03). Conclusions Both having a falls history and FOF is prevalent in our Day Hospital population. FOF is associated with high physiological risk of falling, increased dependency, and anxiety. Standardization of mobility measures and potential screening for cognitive and mood disorders in patients with FOF will aid in further development of targeted interventions.

Download Full-text

Cerebral functional networks during sleep in young and older individuals

Scientific Reports ◽

10.1038/s41598-021-84417-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Véronique Daneault ◽

Pierre Orban ◽

Nicolas Martin ◽

Christian Dansereau ◽

Jonathan Godbout ◽

...

Keyword(s):

Functional Connectivity ◽

Brain Plasticity ◽

Network Connectivity ◽

Sleep Stages ◽

Functional Networks ◽

Older Individuals ◽

Functional Magnetic Resonance ◽

Resonance Imaging ◽

Age Related ◽

Light Sleep

AbstractEven though sleep modification is a hallmark of the aging process, age-related changes in functional connectivity using functional Magnetic Resonance Imaging (fMRI) during sleep, remain unknown. Here, we combined electroencephalography and fMRI to examine functional connectivity differences between wakefulness and light sleep stages (N1 and N2 stages) in 16 young (23.1 ± 3.3y; 7 women), and 14 older individuals (59.6 ± 5.7y; 8 women). Results revealed extended, distributed (inter-between) and local (intra-within) decreases in network connectivity during sleep both in young and older individuals. However, compared to the young participants, older individuals showed lower decreases in connectivity or even increases in connectivity between thalamus/basal ganglia and several cerebral regions as well as between frontal regions of various networks. These findings reflect a reduced ability of the older brain to disconnect during sleep that may impede optimal disengagement for loss of responsiveness, enhanced lighter and fragmented sleep, and contribute to age effects on sleep-dependent brain plasticity.

Download Full-text

Fear conditioning and stimulus generalization in association with age in children and adolescents

European Child & Adolescent Psychiatry ◽

10.1007/s00787-021-01797-4 ◽

2021 ◽

Author(s):

Julia Reinhard ◽

Anna Slyschak ◽

Miriam A. Schiele ◽

Marta Andreatta ◽

Katharina Kneer ◽

...

Keyword(s):

Children And Adolescents ◽

Fear Conditioning ◽

Repeated Measures ◽

Conditioned Fear ◽

Fear Learning ◽

Stimulus Generalization ◽

Healthy Children ◽

Older Individuals ◽

Age Related ◽

Current Task

AbstractThe aim of the study was to investigate age-related differences in fear learning and generalization in healthy children and adolescents (n = 133), aged 8–17 years, using an aversive discriminative fear conditioning and generalization paradigm adapted from Lau et al. (2008). In the current task, participants underwent 24 trials of discriminative conditioning of two female faces with neutral facial expressions, with (CS+) or without (CS−) a 95-dB loud female scream, presented simultaneously with a fearful facial expression (US). The discriminative conditioning was followed by 72 generalization trials (12 CS+, 12 GS1, 12 GS2, 12 GS3, 12 GS4, and 12 CS−): four generalization stimuli depicting gradual morphs from CS+ to CS− in 20%-steps were created for the generalization phases. We hypothesized that generalization in children and adolescents is negatively correlated with age. The subjective ratings of valence, arousal, and US expectancy (the probability of an aversive noise following each stimulus), as well as skin conductance responses (SCRs) were measured. Repeated-measures ANOVAs on ratings and SCR amplitudes were calculated with the within-subject factors stimulus type (CS+, CS−, GS1-4) and phase (Pre-Acquisition, Acquisition 1, Acquisition 2, Generalization 1, Generalization 2). To analyze the modulatory role of age, we additionally calculated ANCOVAs considering age as covariate. Results indicated that (1) subjective and physiological responses were generally lower with increasing age irrespective to the stimulus quality, and (2) stimulus discrimination improved with increasing age paralleled by reduced overgeneralization in older individuals. Longitudinal follow-up studies are required to analyze fear generalization with regard to brain maturational aspects and clarify whether overgeneralization of conditioned fear promotes the development of anxiety disorders or vice versa.

Download Full-text

Monitoring Health Parameters of Elders to Support Independent Living and Improve Their Quality of Life

Sensors ◽

10.3390/s21020517 ◽

2021 ◽

Vol 21 (2) ◽

pp. 517

Author(s):

Ilia Adami ◽

Michalis Foukarakis ◽

Stavroula Ntoa ◽

Nikolaos Partarakis ◽

Nikolaos Stefanakis ◽

...

Keyword(s):

Quality Of Life ◽

Independent Living ◽

Elderly Population ◽

Well Being ◽

The Elderly ◽

Chronic Illnesses ◽

Age Related ◽

Self Sufficiency ◽

Health And Well Being

Improving the well-being and quality of life of the elderly population is closely related to assisting them to effectively manage age-related conditions such as chronic illnesses and anxiety, and to maintain their independence and self-sufficiency as much as possible. This paper presents the design, architecture and implementation structure of an adaptive system for monitoring the health and well-being of the elderly. The system was designed following best practices of the Human-Centred Design approach involving representative end-users from the early stages.

Download Full-text

Who Is Not Linking to HIV Care in Tennessee — the Benefits of an Intersectional Approach

Journal of Racial and Ethnic Health Disparities ◽

10.1007/s40615-021-01023-6 ◽

2021 ◽

Author(s):

Leslie J. Pierce ◽

Peter Rebeiro ◽

Meredith Brantley ◽

Errol L. Fields ◽

Cathy A. Jenkins ◽

...

Keyword(s):

Black Males ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Hiv Care ◽

Older Individuals ◽

Hiv Diagnosis ◽

Race And Gender ◽

Targeted Interventions ◽

And Gender ◽

Linkage To Hiv Care

Abstract Introduction Guided by an intersectional approach, we assessed the association between social categories (individual and combined) on time to linkage to HIV care in Tennessee. Methods Tennessee residents diagnosed with HIV from 2012-2016 were included in the analysis (n=3750). Linkage was defined by the first CD4 or HIV RNA test date after HIV diagnosis. We used Cox proportional hazards models to assess the association of time to linkage with individual-level variables. We modeled interactions between race, age, gender, and HIV acquisition risk factor (RF), to understand how these variables jointly influence linkage to care. Results Age, race, and gender/RF weAima A. Ahonkhaire strong individual (p < 0.001 for each) and joint predictors of time to linkage to HIV care (p < 0.001 for interaction). Older individuals were more likely to link to care (aHR comparing 40 vs. 30 years, 1.20, 95%CI 1.11-1.29). Blacks were less likely to link to care than Whites (aHR= 0.73, 95% CI: 0.67-0.79). Men who have sex with men (MSM) (aHR = 1.18, 95%CI: 1.03-1.34) and heterosexually active females (females) (aHR = 1.32, 95%CI: 1.14-1.53) were more likely to link to care than heterosexually active males. The three-way interaction between age, race, and gender/RF showed that Black males overall and young, heterosexually active Black males in particular were least likely to establish care. Conclusions Racial disparities persist in establishing HIV care in Tennessee, but data highlighting the combined influence of age, race, gender, and sexual orientation suggest that heterosexually active Black males should be an important focus of targeted interventions for linkage to HIV care.

Download Full-text

Gait Disorder among Elderly People, Psychomotor Disadaptation Syndrome: Post-Fall Syndrome, Risk Factors and Follow-Up – A Cohort Study of 70 Patients

Gerontology ◽

10.1159/000511356 ◽

2020 ◽

pp. 1-8

Author(s):

Maxence Meyer ◽

Florentin Constancias ◽

Thomas Vogel ◽

Georges Kaltenbach ◽

Elise Schmitt

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Fear Of Falling ◽

Functional Mobility ◽

General Physician ◽

Major Health ◽

Mobility Assessment ◽

Control Study ◽

Major Health Issue

Introduction: Falls among older people are a major health issue and the first cause of accidental death after 75 years of age. Post-fall syndrome (PFS) is commonly known and yet poorly studied. Objective: Identify risk factors for PFS and do a follow-up 1 year later. Methods: We included all patients over 70 years of age hospitalized after suffering a fall in a case-control study, and then followed them in a cohort study. PFS was retained in case of functional mobility decline (transferring, walking) occurring following a fall in the absence of an acute neurological, orthopedic or rheumatic pathology directly responsible for the decline. The data initially collected were: clinical (anamnestic, emergency and departmental/ward evolution, medical history, lifestyle, treatments, clinical examination items); and imaging if the patient had been subjected to brain imaging in the last 3 years prior to inclusion. Regarding the follow-up at 1 year, we collected from the general physician the occurrence and the characteristics of new falls, functional mobility assessment, hospitalization and death. Results: Inclusion took place from March 29, 2016 to June 7, 2016 and follow-up until June 30, 2017. We included 70 patients. A total of 29 patients exhibited a PFS (41.4 %). Risk factors for PFS included age, walking disorder prior to the fall, the use of a walking aid prior to the fall, no unaccompanied outdoor walk in the week before the fall, visual impairment making close reading impossible, stiffness in ankle dorsiflexion, grip strength and the fear of falling. Among patients with PFS, 52.9% could still perform a transfer at 1 year and 64.7% could still walk against 80.7% and 85.2%, respectively, for patients without PFS. Conclusion: The study showed the existence of body functions/structure impairments and activity limitations prior to the fall among patients exhibiting a PFS. This suggests the existence of a pre-fall syndrome, i.e., a psychomotor disadaptation syndrome existing prior to the fall. Among the 8 risk factors, fear of falling, vision impairment and muscle strength could be targeted for improvement. The diagnosis of PFS could be a marker of loss of functional mobility at 1 year.

Download Full-text

Effect of a Program Based on Balance Exercises on Gait, Functional Mobility, Fear of Falling, and Falls in Prefrail Older Women

Topics in Geriatric Rehabilitation ◽

10.1097/tgr.0000000000000056 ◽

2015 ◽

Vol 31 (2) ◽

pp. 113-120 ◽

Cited By ~ 7

Author(s):

Paula M. M. Arantes ◽

João Marcos D. Dias ◽

Fernanda F. Fonseca ◽

Adriana M. B. Oliveira ◽

Marina C. Oliveira ◽

...

Keyword(s):

Older Women ◽

Fear Of Falling ◽

Functional Mobility ◽

Balance Exercises

Download Full-text

Decline in rates of clearance of IgG-sensitized erythrocytes with increasing age

Blood ◽

10.1182/blood.v71.6.1726.bloodjournal7161726 ◽

1988 ◽

Vol 71 (6) ◽

pp. 1726-1730

Author(s):

KA Melez ◽

LF Fries ◽

BS Bender ◽

T Quinn ◽

MM Frank

Keyword(s):

Aging Process ◽

Elderly Population ◽

The Elderly ◽

Older Individuals ◽

Immune Functions ◽

Macrophage Function ◽

Normal Volunteers ◽

Age Related ◽

Male Subjects

Decreased immune functions have been suggested as a cause for the increased incidence of autoimmunity, malignancy, and infection in the elderly population. To assess the possible role of changes in macrophage function in the aging process we studied the Fc receptor- mediated clearance of IgG-coated erythrocytes in 56 healthy normal volunteers by following the removal of radiolabeled autologous erythrocytes. An age-related decrease in Fc-mediated clearance rates in both female and male subjects was found, which suggests a physiological decline of this macrophage function in older individuals.

Download Full-text