scholarly journals A Simple Clinical Scale to Stratify Risk of Recurrent Falls in Community-Dwelling Adults Aged 65 Years and Older

2010 ◽  
Vol 90 (4) ◽  
pp. 550-560 ◽  
Author(s):  
Severine Buatois ◽  
Christine Perret-Guillaume ◽  
Rene Gueguen ◽  
Patrick Miget ◽  
Guy Vançon ◽  
...  
Keyword(s):  
Community Dwelling ◽  
Added Value ◽  
Clinical Scale ◽  
Moderate Risk ◽  
Stand Test ◽  
Sit To Stand ◽  
Balance Tests ◽  
Recurrent Falls ◽  
Group A ◽  
Group B

BackgroundCorrect identification of people at risk for recurrent falls facilitates the establishment of preventive and rehabilitative strategies in older adults.ObjectiveThe purposes of this study were: (1) to develop and validate a simple clinical scale to stratify risk for recurrent falls in community-dwelling elderly people based on easily obtained social and clinical items and (2) to evaluate the added value of 3 clinical balance tests in predicting this risk.DesignThis was a prospective measurement study.MethodsA population of 1,618 community-dwelling people over 65 years of age underwent a health checkup, including performance of 3 clinical balance tests: the One-Leg-Balance Test, the Timed “Up & Go” Test, and the Five-Times-Sit-to-Stand Test. Falls were recorded using a self-administered questionnaire that was completed a mean (SD) of 25±5 months after the visit. Participants were randomly divided into either group A (n=999), which was used to develop the scale, or group B (n=619), which was used to prospectively validate the scale.ResultsLogistic regression analysis identified 4 variables that independently predicted recurrent falls in group A: history of falls, living alone, taking ≥4 medications per day, and female sex. Thereafter, 3 risk categories of recurrent falls (low, moderate, and high) were determined. Predicted probability of recurrent falls increased from 4.1% to 30.1% between the first and third categories. This scale subsequently was validated with great accuracy in group B. Only the Five-Times-Sit-to-Stand Test provided added value in the estimation of risk for recurrent falls, especially for the participants who were at moderate risk, in whom failure on the test (duration of >15 seconds) doubled the risk.LimitationsFalls were assessed only once, and length of follow-up was heterogeneous (18–36 months).ConclusionsClinicians could easily classify older patients in low-, moderate-, or high-risk groups of recurrent falls by using 4 easy-to-obtain items. The Five-Times-Sit-to-Stand Test provides added value to stratify risk for falls in people at moderate risk.

scholarly journals Incidence and multidimensional predictors of occasional and recurrent falls among Malaysian community‐dwelling older persons

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Theng Choon Ooi ◽  
Devinder Kaur Ajit Singh ◽  
Suzana Shahar ◽  
Nor Fadilah Rajab ◽  
Divya Vanoh ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Older Persons ◽  
Test Score ◽  
Community Dwelling ◽  
Chair Stand ◽  
Stand Test ◽  
Chair Stand Test ◽  
Recurrent Falls ◽  
History Of

Abstract Background Falls incidence rate and comprehensive data on factors that predict occasional and repeated falls from large population-based studies are scarce. In this study, we aimed to determine the incidence of falls and identify predictors of occasional and recurrent falls. This was done in the social, medical, physical, nutritional, biochemical, cognitive dimensions among community-dwelling older Malaysians. Methods Data from 1,763 Malaysian community-dwelling older persons aged ≥ 60 years were obtained from the LRGS-TUA longitudinal study. Participants were categorized into three groups according to the presence of a single fall (occasional fallers), ≥two falls (recurrent fallers), or absence of falls (non-fallers) at an 18-month follow-up. Results Three hundred and nine (17.53 %) participants reported fall occurrences at an 18-month follow-up, of whom 85 (27.51 %) had two or more falls. The incidence rate for occasional and recurrent falls was 8.47 and 3.21 per 100 person-years, respectively. Following multifactorial adjustments, being female (OR: 1.57; 95 % CI: 1.04–2.36), being single (OR: 5.31; 95 % CI: 3.36–37.48), having history of fall (OR: 1.86; 95 % CI: 1.19–2.92) higher depression scale score (OR: 1.10; 95 % CI: 1.02–1.20), lower hemoglobin levels (OR: 0.90; 95 % CI: 0.81-1.00) and lower chair stand test score (OR: 0.93; 95 % CI: 0.87-1.00) remained independent predictors of occasional falls. While, having history of falls (OR: 2.74; 95 % CI: 1.45–5.19), being a stroke survivor (OR: 8.57; 95 % CI: 2.12–34.65), higher percentage of body fat (OR: 1.04; 95 % CI: 1.01–1.08) and lower chair stand test score (OR: 0.87; 95 % CI: 0.77–0.97) appeared as recurrent falls predictors. Conclusions Having history of falls and lower muscle strength were predictors for both occasional and recurrent falls among Malaysian community-dwelling older persons. Modifying these predictors may be beneficial in falls prevention and management strategies among older persons.

FIVE TIMES SIT TO STAND TEST IS A PREDICTOR OF RECURRENT FALLS IN HEALTHY COMMUNITY-LIVING SUBJECTS AGED 65 AND OLDER

2008 ◽  
Vol 56 (8) ◽  
pp. 1575-1577 ◽  
Author(s):  
Severine Buatois ◽  
Darko Miljkovic ◽  
Patrick Manckoundia ◽  
Rene Gueguen ◽  
Patrick Miget ◽  
...  
Keyword(s):  
Community Living ◽  
Stand Test ◽  
Sit To Stand ◽  
Recurrent Falls ◽  
Healthy Community

scholarly journals Daily sitting time and physical performance in oldest adults

2018 ◽  
Vol 32 (1) ◽  
pp. 17-24
Author(s):  
Lucélia Justino Borges ◽  
Renata Da Conceição ◽  
Vandrize Meneghini ◽  
Tiago Rosa de Souza ◽  
Aline Rodrigues Barbosa
Keyword(s):  
Physical Performance ◽  
Age Groups ◽  
Community Dwelling ◽  
Sitting Time ◽  
Limiting Factor ◽  
Cross Sectional ◽  
Men And Women ◽  
Stand Test ◽  
Sit To Stand ◽  
The Mean

The aim of this study was to verify the physical performance (PP) and daily sitting time in the oldest population in a rural community dwelling in southern Brazil. In addition, to analyze the association between physical performance tests (PPT) and daily sitting time (ST). This was a cross-sectional, population-based household study. All residents aged 80 years and older were examined in 2010. PPT included standing balance (four measures of static balance), five times “sit-to-stand” test and “pick up a pen” test (assessed by time). Daily ST was estimated by questionnaire. Women of the younger age groups displayed better results in the PPT compared to older women. The men had good results in the tests, independent from their age group (except for 95-100 years of age). For women, the mean time in the “sit to stand” test decreased with the advancing age, whereas for men, we observed the opposite. Men and women displayed similar means in the “pick up a pen” test. The mean daily ST increased with the advancement of age. After adjustment for sex, age, and number of morbidities, the daily ST was ~52 minutes lower for those with better balance (β -52.6; p = 0.001). For those with better performance in the “sit to stand” test, the time was ~35 minutes lower (β -35.8; p = 0.001). Men and women differ in the rate of decline in PPT. The results suggest that longer sitting time is a limiting factor of good performance in tests for the oldest of the population.

P1011Electrophysiological trends in Wolff-Parkinson-White patients: a 33 years follow-up study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
F Fioravanti ◽  
R Fenici ◽  
A R Sorbo ◽  
D Brisinda
Keyword(s):  
Watchful Waiting ◽  
Atrioventricular Node ◽  
Clinical Information ◽  
Atrial Pacing ◽  
Moderate Risk ◽  
Non Invasive ◽  
Follow Up Study ◽  
Group A ◽  
Group B

Abstract Background The Wolff-Parkinson-White (WPW) syndrome can be associated with sudden cardiac death, therefore risk assessment (RA) with electrophysiological (EP) testing (EPT) is mandatory to identify patients (pts) requiring catheter ablation (CAb). Our retrospective cohort study aimed to evaluate the variability of EP parameters during follow-up of WPW pts and the reliability of trans-esophageal EPT (TEEPT) for RA, evaluation of treatment efficacy, and EP follow-up of untreated athletes/pts. Method Data of 335 WPW pts, studied with TEEPT between 1985 and 2018, were retrospectively analyzed. Anterograde effective refractory period (ERP) of accessory pathways (AP) and of the atrioventricular node, Wenckebach point, shortest preexcited RR intervals (SPERRI) during atrial fibrillation (AF) and/or atrial pacing (At-P) and inducibility of supraventricular arrhythmias were assessed, at rest (supine and standing) and during effort. An AP was defined at high arrhythmogenic risk (HAR) if the anterograde AP-ERP and/or SPERRI (in AF or At-P) were ≤240 ms at rest or ≤200 ms during effort test. All patients were followed-up as outpatients or telephonically, as clinically required. 195 pts (17% female) were included, having exhaustive clinical information, two or more TEEPT and exhaustive clinical follow-up until late 2018. Time-evolution of EP parameters was evaluated, using parametric and non-parametric tests, as appropriate. Results and discussion Median age at first TEEPT was 20 years (IQR 16–29 years). Median follow- up was 44.3 months (IQR 16.4–122.9 months). Two pts (both identified at HAR and scheduled for surgery when ablation was unavailable) died suddenly, at rest. No other serious arrhythmic complication occurred, during the FU. Out of 19 pts (9.7% - Group A) showing enhanced AP conductivity at follow-up (mean ERP/SPERRI shortening: 30.8 ms, range 10–80 ms), 4 pts were found at HAR and underwent CAb. 176 pts (90.3% – Group B) showed a stable or impaired (25% under pharmacological treatment) AP conductivity during the follow-up. Their mean ERP/SPERRI increase was 39.7 ms (range 0–130 ms). Group A pts were significantly younger (20 vs 28 years old; 88% of Group A pts were <30 years old) and more frequently male (94.1% vs 80.6%). A non-significant trend toward Group A was found for antero-septal APs (35% Group A vs 15.4% Group B). Conclusions TEEPT is a safe, non-invasive tool to stratify arrhythmogenic risk of WPW pts. Our data suggest that a watchful waiting is safe for low to moderate risk pts. Younger males with an antero-septal Kent bundle may deserve a more intensive EP follow-up. Aggressive therapy should be considered as mandatory only for symptomatic HAR pts, taking into account complications, risk/benefit ratio and pts' preferences. In other cases, medical therapy and watchful observation could be applied safely under periodical TEEPT, as appropriate.

scholarly journals Automatic and Real-Time Computation of the 30-Seconds Chair-Stand Test without Professional Supervision for Community-Dwelling Older Adults

Sensors ◽  
2020 ◽  
Vol 20 (20) ◽  
pp. 5813
Author(s):  
Antonio Cobo ◽  
Elena Villalba-Mora ◽  
Rodrigo Pérez-Rodríguez ◽  
Xavier Ferre ◽  
Walter Escalante ◽  
...  
Keyword(s):  
Older Adults ◽  
Older People ◽  
Low Cost ◽  
Community Dwelling ◽  
Chair Stand ◽  
Stand Test ◽  
Professional Supervision ◽  
Chair Stand Test ◽  
Sit To Stand ◽  
Community Dwelling Older Adults

The present paper describes a system for older people to self-administer the 30-s chair stand test (CST) at home without supervision. The system comprises a low-cost sensor to count sit-to-stand (SiSt) transitions, and an Android application to guide older people through the procedure. Two observational studies were conducted to test (i) the sensor in a supervised environment (n = 7; m = 83.29 years old, sd = 4.19; 5 female), and (ii) the complete system in an unsupervised one (n = 7; age 64–74 years old; 3 female). The participants in the supervised test were asked to perform a 30-s CST with the sensor, while a member of the research team manually counted valid transitions. Automatic and manual counts were perfectly correlated (Pearson’s r = 1, p = 0.00). Even though the sample was small, none of the signals around the critical score were affected by harmful noise; p (harmless noise) = 1, 95% CI = (0.98, 1). The participants in the unsupervised test used the system in their homes for a month. None of them dropped out, and they reported it to be easy to use, comfortable, and easy to understand. Thus, the system is suitable to be used by older adults in their homes without professional supervision.

scholarly journals Validation of Caprini’s Saphenous Ablation Scores

2021 ◽  
Vol 6 (3) ◽  
pp. 1-4
Author(s):  
Fakhry A ◽  
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Vein Surgery ◽  
Moderate Risk ◽  
Vte Prophylaxis ◽  
Group A ◽  
Group B ◽  
Deep Vein

Introduction: Deep Vein Thrombosis (DVT) after varicose vein surgery is well recognized. Less well documented is Endovenous Heat-Induced Thrombosis (EHIT), thrombus extension into a deep vein after superficial venous thermo ablation. There is no current agreement on the routine use of thromboprophylaxis in patients undergoing varicose vein surgery. more data on the incidence of VTE, and the need for postoperative thromboprophylaxis are necessary to formulate evidence-based clinical guidelines. Aim of the study: Comparison of the use of Caprini's Saphenous Ablation Scores versus Standard Caprini’s Score for the prophylaxis of VTE in EVLA. Patients & Methods: 60 patients admitted to Royal Vascular Center, Alexandria - Egypt. From Jan. 1st, 2021, to June 30th 2021 divided in 3 groups. - Group A) Treated by ablation of Great saphenous vein and received VTE prophylaxis according to Caprini’s Saphenous Ablation Scores Fig 1-A & B -Group B) Treated by ablation of Great saphenous vein and received VTE prophylaxis according to Standard Caprini’s Risk Assessment Score for VTE Fig 2-A&B - C) Treated by ablation of Great saphenous vein without VTE prophylaxis Ablation was done using radial 1480 YAG laser fibers and Post-operative Duplex was done one day, 3 month and one-year. Results: Age: 35.6+0.2, 34.3+0.5 and 37.6+0.09 years in the 3 groups M/F: 6/14, 8/12 and 7/13. In group A) all patients showed absent reflux post operatively and in all follow up visits. Duplex examination revealed significant reflux in the great saphenous veins in all patients and ranged from 0.7:0.9 Sec. and mean duration 0.7+0.09 Sec. Vein diameter ranged from (0.6: 0.9,X+0.76 CM.) in group A), (0.6: 0.8,X+0.7 CM.) in group B) , (0.5: 0.8,X+0.65 CM.) in group C) According to Caprini’s saphenous score 14 patients 70% were classified as low risk, 4 patients 20% were of moderate risk and 2 patients 10% of high-risk in Group A, while applying standard Caprini’s Score in group B patients revealed: 6 patients 30% were of moderate risk and 14 patients 70% of high risk in Group B ) . 3 patients developed superficial thrombophlebitis 15% and one patient 5% developed left calf DVT in Group C, while no VTE events were shown in both A&B Groups Significant drop in CVSS in patients in the three groups. Conclusion: Risk assessment of patients undergoing varicose veins ablation should be done and applying Caprini’s saphenous score as a better alternative to Standard Caprini’s score for VTE prophylaxis and is considered a safe and cost-effective tool in VTE prevention in these patients.

scholarly journals 234 The role of preprocedural assessment of aortic valve calcium volume for the optimization of percutaneous aortic bioprosthesis implantation (TAVI)

2020 ◽  
Vol 22 (Supplement_N) ◽  
pp. N52-N63
Author(s):  
Tiziana Attisano ◽  
Mario Ferraioli ◽  
Angelo Silverio ◽  
Michele Bellino ◽  
Luca Esposito ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Pacemaker Implantation ◽  
Added Value ◽  
Valve Prosthesis ◽  
Axial Tomography ◽  
Composite Event ◽  
Valvular Stenosis ◽  
Group A ◽  
Group B

Abstract Aims Paravalvular leaks (PVL) and conduction disorders requiring permanent pacemaker implantation (PPI) in patients with severe Aortic Valvular Stenosis (SA) undergoing percutaneous aortic valve prosthesis (TAVI) still have a significant and unacceptable incidence for patients at medium and low surgical risk, who represent, with increasing scientific evidence, the prevalent population. The appearance of these complications seems to be related to clinical, anatomical and procedural factors, which influence the decision-making process of the type and size of bioprosthesis to be implanted. Particular attention has been paid to the role of the volume of calcium present at the native aortic valve (VCA) as a predictor of these complications, in order to optimize the percutaneous procedure. The VCA can be quantified using algorithms derived from Multilayer Computed Computed Axial Tomography (MSCT), an examination that has become a pivotal element in the evaluation of the patient's eligibility for TAVI.The aim of our study was to document the pre-procedural added value of VCA in terms of possible containment of adverse events and how much it may affect the choice of the type of bioprosthesis to be implanted. Methods and results 111 patients underwent TAVIs at the Interventional Cardiology Unit of the AOU S. Giovanni di Dio and Ruggi D'Aragona, between 2017 and 2020, subsequently divided into 2 groups: group A (self-expandable bioprosthesis, Medtronic Evolut R or Evolut Pro) and group B (balloon expandable bioprosthesis, Edward Sapien 3).The clinical, electrocardiographic, echocardiographic and anatomical parameters of the enrolled patients were analyzed, and the VCA in the preprocedural phase was quantified for each of them, using an algorithm extracted from the MSCT reading software, OsiriX (OsiriX-MD v.2.8.2 64-bit). A univariate logistic regression analysis was performed for the risk of developing the composite event of significant PVL and IPP.In Group B, no significant variables were found, while in Group A, the VCA (OR: 1.001; 95% CI, 1.000-1.002; p &lt; 0.043) and incomplete left branch block (OR: 5.781; 95% CI, 0.013-32.988; p &lt; 0.048) were significant. Subsequently, these two variables were tested in a multivariate regression model according to which only the VCA emerged as an independent predictor for the composite event (OR: 1.001; 95% CI, 1.000-1.002; p &lt; 0.039). Conclusion VCA is significantly associated with the risk of moderate to severe PVL and rhythm disturbances requiring PPI, in the group of patients in whom a self-expandable bioprosthesis was implanted, unlike patients who received a balloon-expandable bioprosthesis where this association is not significant.

scholarly journals Appraisal of the faecal haemoglobin, age and sex test (FAST) score in assessment of patients with lower bowel symptoms: an observational study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jayne Digby ◽  
Judith A. Strachan ◽  
Craig Mowat ◽  
Robert J. C. Steele ◽  
Callum G. Fraser
Keyword(s):  
Primary Care ◽  
Bowel Disease ◽  
Added Value ◽  
Advanced Adenoma ◽  
Individual Risk ◽  
First Year ◽  
Lower Bowel ◽  
Bowel Symptoms ◽  
Group A ◽  
Group B

Abstract Background Many patients present in primary care with lower bowel symptoms, but significant bowel disease (SBD), comprising colorectal cancer (CRC), advanced adenoma (AA), or inflammatory bowel disease (IBD), is uncommon. Quantitative faecal immunochemical tests for haemoglobin (FIT), which examine faecal haemoglobin concentrations (f-Hb), assist in deciding who would benefit from colonoscopy. Incorporation of additional variables in an individual risk-score might improve this approach. We investigated if the published f-Hb, age and sex test score (FAST score) added value. Methods Data from the first year of routine use of FIT in primary care in one NHS Board in Scotland were examined: f-Hb was estimated using one HM-JACKarc FIT system (Kyowa Medex Co., Ltd., Tokyo, Japan) with a cut-off for positivity ≥10 μg Hb/g faeces. 5660 specimens were received for analysis in the first year. 4072 patients were referred to secondary care: 2881 (70.6%) of these had returned a FIT specimen. Of those referred, 1447 had colonoscopy data as well as the f-Hb result (group A): 2521 patients, also with f-Hb, were not immediately referred (group B). The FAST score was assessed in both groups. Results 1196 (41.7%) of patients who returned a specimen for FIT analysis had f-Hb ≥10 μg Hb/g faeces. In group A, 252 of 296 (85.1%) with SBD had f-Hb > 10 μg Hb/g faeces, as did 528 of 1151 (45.8%) without SBD. Using a FAST score > 2.12, which gives high clinical sensitivity for CRC, only 1143 would have been referred for colonoscopy (21.0% reduction in demand): 286 of 296 (96.6%) with SBD had a positive FAST score, as did 857 of 1151 (74.5%) without SBD. However, one CRC, five AA and four IBD would have been missed. In group B, although 95.2% had f-Hb < 10 μg Hb/g faeces, 1371 (53.7%) had FAST score ≥ 2.12: clinical rationale led to only 122 of group B completing subsequent bowel investigations: a FAST score > 2.12 was found in 13 of 15 (86.7%) with SBD. Conclusions The performance characteristics of the FAST score did not seem to enhance the utility of f-Hb alone. Locally-derived formulae might confer desired benefits.

scholarly journals Optimal Cutoff Values for Anthropometric Adiposity Measures of Sri Lankan Adult Women

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Nirmala Rathnayake ◽  
Gayani Alwis ◽  
Janaka Lenora ◽  
Sarath Lekamwasam
Keyword(s):  
Community Dwelling ◽  
World Health ◽  
Accurate Estimation ◽  
Sri Lankan ◽  
Adult Women ◽  
Optimal Cutoff ◽  
Cutoff Values ◽  
Prevalence Of Obesity ◽  
Group A ◽  
Group B

Anthropometric adiposity measures (AAMs) such as body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) are used to evaluate obesity status. Country-specific cutoff values of AAMs would provide more accurate estimation of obesity prevalence. This cross-sectional study was designed to determine the optimal cutoff values for AAMs, BMI, WC, hip circumference (HC), and WHR, of Sri Lankan adult women. The study was conducted in Galle, Sri Lanka, with 350 healthy community-dwelling middle-aged women aged 30–60 years, divided into two groups (Group A, n = 175 and Group B, n = 175). Total body fat percentage (TBFP) (kg) was measured with DXA. Body weight (kg), height (m), and WC and HC (cm) were measured. BMI (kg/m2) and WHR were calculated. Optimal cutoff values were determined by area under curve (AUC) in Receiver-Operating Characteristic (ROC) curve analysis using TBFP as the criterion at the TBFP level of 33% and 35% using the women in Group A. Then, the prevalence of obesity was determined in Group B while comparing the prevalence based on the cutoff values recommended by the World Health Organization (WHO) for Asians and the newly developed cutoff values for Sri Lankan women. Optimal cutoff values of AAMs which correspond to TBFP 33% are BMI, 24.5 kg/m2; WC, 80 cm; HC, 95 cm; and WHR, 0.83. TBFP 35% corresponds to the optimal cutoff values of BMI, 25.0 kg/m2; WC, 85 cm; HC, 100 cm; and WHR, 0.83. Prevalence of obesity (number, %) according to the WHO and newly defined cutoff values that correspond to TBFP 33% and 35% were as follows: BMI = 83 (47.4%), 98 (56.0%), 83 (47.4%); WC = 106 (60.6%), 106 (60.6%), 72 (41.1%); and WHR = 140 (80.0%), 106 (60.6%), 106 (60.6%). The observed cutoff values of BMI and WC in this study were within the ranges of those described by the WHO for Asian populations which correspond to the 33% and 35% TBFP levels, respectively. However, the WHR cutoff value of WHO (Asians) is lower when compared to the newly determined value for Sri Lankan females while overestimating the prevalence. More studies are needed to confirm these values before clinical use.

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