scholarly journals Effect of vitamin D level and polypharmacy on the risk of falls in the elderly

2021 ◽  
Vol 4 (2) ◽  
pp. 81-88
Author(s):  
Gamze Dilek ◽  
Yalkin Calik ◽  
Kagan Ozkuk
Keyword(s):  
2020 ◽  
Author(s):  
Jagjit S Soar

he current COVID-19 pandemic now believed to be based on the mutation of the SARS-CoV virus (first reported in 2002) to SARS-CoV-2 emerging in 2019, is naturally causing extreme worry and concern around the world with sometimes mixed and incoherent messages on how to deal with it. There is a plethora of information from previous epidemics caused by other coronaviruses such as severe acute respiratory syndrome, SARS (2002) and Middle East respiratory syndrome MERS (2012) from which we can extrapolate guidance on how to deal with the current pandemic. In the current absence of specific pharmaceutical agents, we propose assessing the extended tools that we already possess in our biological armoury to combat, prevent and control the spread of this virus. Using a set of precise criteria to locate such possible contenders, we conducted literature searches to find compounds that met these criteria. We have now reduced this to a shortlist of three agents that may be the best candidates. We propose vitamin C, vitamin D and Curcumin fit our criteria well. These compounds are widely available to the general public. They are available online and over-the-counter as supplements. Otherwise healthy individuals are safely able to self-administer these agents as a prophylactic to protect themselves and to enhance their immune response. This would be especially desirable for the elderly and at risk groups. These agents can also be used as adjunct therapy, particularly for those who may have early symptoms. This preventative therapy could be implemented whilst awaiting specific pharmaceutical drugs to emerge as a treatment for COVID-19. Our suggested compounds are a highly cost-effective way to potentially reduce the mortality that is regretfully mounting as a result of COVID-19 infection. The biological mode of action and the dosing of these compounds are summarised.


2021 ◽  
pp. 1-9
Author(s):  
In-Gyu Yoo ◽  
Ji-Hye Do

BACKGROUND: Posture control involves complex reactions of dynamic and static movements, and various sensory inputs. There is evidence that exercise using multisensory stimulation is moderately effective in improving the balance of the elderly. OBJECTIVE: The main purpose of this paper was to examine the existing literature to validate the effectiveness and applicability of multisensory stimulation training. METHODS: All relevant literature published as of June 1, 2020 in four prominent databases was searched (Embase, PubMed, PsycINFO, and Web of science) using the five-stage review framework proposed by Arksey and O’Malley. RESULTS: Multisensory stimulation training was more effective when vestibular and somatosensory were combined with visual stimuli, and differences in effectiveness compared to the effectiveness of existing treatments were confirmed. However, most of the reviewed papers are compared to simple strength training, and studies that compare the effects of multisensory stimulation training by setting a control group are still lacking. CONCLUSION: Further research is required to further elucidate the training conditions and treatment environment for multisensory training for the elderly at risk of falls and to provide strategies to improve treatment methods. In addition, a study that can evaluate user satisfaction in a way that best shows the treatment effect using qualitative research methods will be needed.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 758-759
Author(s):  
Jennifer Schrack ◽  
Lawrence Appel ◽  
Lewis Lipsitz

Abstract Each year, 2.8 million older adults are treated for falls, with over 800,000 hospitalized. Evidence suggests vitamin D supplementation might reduce the risk of falls, potentially through improvements in skeletal muscle function; however, results are inconsistent. In 2013 the NIA issued a request for applications to assess the efficacy and dose-response of vitamin D supplementation for fall prevention across a range of doses and serum 25(OH)D concentrations, resulting in the funding of STURDY (Study To Understand Fall Reduction and Vitamin D in You). STURDY was a seamless dose-finding and confirmatory, double-masked, response adaptive Bayesian randomized trial designed to find the best dose of vitamin D supplementation for fall prevention. Participants (n=688, ≥70 years with serum 25(OH)D of 10-29 ng/mL) were randomized to 200 (control), 1000 , 2000, or 4000 IU/day of vitamin D3.The first participant was randomized on 10/30/2015 and data collection ended on 5/31/2019. The primary outcome was time to first fall or death, and the secondary outcome was gait speed. Dr. Appel will present the main findings of the effect of vitamin D supplementation on time to first fall. Dr. Wanigatunga will present a more detailed analysis of the effect of vitamin D supplementation on fall characteristics, including indoor vs. outdoor falls, consequential falls, and repeat fall risk. Dr. Guralnik will present the effect of vitamin D supplementation on physical functioning, including gait speed, SPPB, 6-minute walk, and TUG performance. Dr. Schrack will present the effect of vitamin D supplementation on objectively measured physical activity.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 759-759
Author(s):  
Lawrence Appel ◽  
Jennifer Schrack ◽  
Erin Michos ◽  
Christine Mitchell ◽  
Stephen Juraschek ◽  
...  

Abstract STURDY was a Bayesian, response-adaptive trial with dose-finding and confirmatory stages. Participants (n=688; ≥70years with serum 25(OH)D of 10-29ng/mL) were randomized to 200 (control), 1000, 2000, or 4000 IU/day of vitamin D3. The primary outcome was time to first fall or death over 2 years. During dose-finding, the best non-control dose was determined to be 1000IU/day based on higher primary outcome event rates in the 2000 and 4000IU/day doses than the 1000IU/day dose (posterior probability of being best dose=0.90; hazard ratios[HR] were 1.86 [95%CI: 1.16-2.97] and 1.68 [95%CI: 1.05-2.69], respectively). Participants were then switched from other non-control doses to 1000IU/day, and event rates did not differ between the pooled higher doses and control groups (HR=1.02, P=0.84). There was no heterogeneity by baseline 25(OHD). In conclusion, high-dose vitamin D supplementation ≥1000IU/day did not prevent falls. Whether vitamin D doses >2000IU/day increase the risk of falls is uncertain.


Bone ◽  
1994 ◽  
Vol 15 (6) ◽  
pp. 727-728 ◽  
Author(s):  
J.A. Kanis ◽  
C. Cooper ◽  
R. Francis ◽  
N. Hamdy ◽  
P. Selby ◽  
...  

2007 ◽  
Vol 22 (3) ◽  
pp. 359-364 ◽  
Author(s):  
Ming HUO ◽  
Dongmei CHANG ◽  
Hitoshi MARUYAMA
Keyword(s):  

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.


Author(s):  
JÚLIO BENVENUTTI BUENO DE CAMARGO ◽  
RAFAEL SAKAI ZARONI ◽  
TIAGO VOLPI BRAZ ◽  
MOISÉS DIEGO GERMANO ◽  
JHENIPHER MONIKY ROSOLEM ◽  
...  

Aging is characterized by a progressive decline in function and morphological aspects of biological tissues, with especial regards to cardiovascular and musculoskeletal systems. In this sense, exercise has been shown to strongly counteract these aging-induced detrimental effects. Endurance exercise (EE) has been shown to reduce the rate of decline of factors related to cardiorespiratory fitness. In addition, the adoption of resistance training (RT) may also induce relevant adaptations, especially related to increased muscle strength and power levels, that have shown to positively influence functional aspects as improved balance and reduced risk of falls in the elderly population. Then, the aim of the present study is to briefly review the exercise literature regarding its mechanisms that could potentially present “antiaging” effects.


Author(s):  
Betsy Szeto ◽  
Chris Valentini ◽  
Anil K Lalwani

ABSTRACT Background The elderly are at increased risk of both hearing loss (HL) and osteoporosis. Bone mineral density (BMD) has been putatively linked to HL. However, the roles of serum calcium concentrations and vitamin D status have yet to be elucidated. Objectives The purpose of this study was to examine the relation between vitamin D status, parathyroid hormone (PTH), total calcium, BMD, and HL in a nationally representative sample of elderly adults. Methods Using the NHANES (2005–2010), audiometry and BMD data of 1123 participants aged ≥70 y were analyzed in a cross-sectional manner. HL was defined as pure tone averages &gt;25 dB HL at 500, 1000, and 2000 Hz (low frequency); 500, 1000, 2000, and 4000 Hz (speech frequency); and 3000, 4000, 6000, and 8000 Hz (high frequency) in either ear. Multivariable logistic regression was used to examine the relation between HL and total 25-hydroxyvitamin D [25(OH)D], PTH, total calcium, and BMD, adjusting for covariates. Results In multivariable analyses, total 25(OH)D &lt; 20 ng/mL was found to be associated with greater odds of low-frequency HL (OR: 2.02; 95% CI: 1.28, 3.19) and speech-frequency HL (OR: 1.96; 95% CI: 1.12, 3.44). A 1-unit decrease in femoral neck BMD (OR: 4.55; 95% CI: 1.28, 16.67) and a 1-unit decrease in total spine BMD (OR: 6.25; 95% CI: 1.33, 33.33) were found to be associated with greater odds of low-frequency HL. Serum PTH and total calcium were not found to be associated with HL. Conclusions In the elderly, low vitamin D status was associated with low-frequency and speech-frequency HL. Low vitamin D status may be a potential risk factor for age-related HL.


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