Osteoporosis, Fear of Falling, and Restrictions in Daily Living. Evidence From a Nationally Representative Sample of Community-Dwelling Older Adults

Osteopenia/osteoporosis and sarcopenia are common geriatric diseases among older adults and harm activities of daily living (ADL) and quality of life (QOL). Osteosarcopenia is a unique syndrome that is a concomitant of both osteopenia/osteoporosis and sarcopenia. This review aimed to summarize the related factors and clinical outcomes of osteosarcopenia to facilitate understanding, evaluation, prevention, treatment, and further research on osteosarcopenia. We searched the literature to include meta-analyses, reviews, and clinical trials. The prevalence of osteosarcopenia among community-dwelling older adults is significantly higher in female (up to 64.3%) compared to male (8–11%). Osteosarcopenia is a risk factor for death, fractures, and falls based on longitudinal studies. However, the associations between osteosarcopenia and many other factors have been derived based on cross-sectional studies, so the causal relationship is not clear. Few studies of osteosarcopenia in hospitals have been conducted. Osteosarcopenia is a new concept and has not yet been fully researched its relationship to clinical outcomes. Longitudinal studies and high-quality interventional studies are warranted in the future.

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Prospective Associations of Physical Frailty With Future Falls and Fear of Falling: A 48-Month Cohort Study

Physical Therapy ◽

10.1093/ptj/pzab059 ◽

2021 ◽

Author(s):

K Makino ◽

S Lee ◽

S Bae ◽

I Chiba ◽

K Harada ◽

...

Keyword(s):

Older Adults ◽

Cohort Study ◽

Fear Of Falling ◽

Community Dwelling ◽

Cardiovascular Health Study ◽

Physical Frailty ◽

Frailty Status ◽

Community Dwelling Older Adults ◽

The Relationship

Abstract Objective The present study aimed to examine the prospective associations of physical frailty with future falls and fear of falling (FOF) among community-dwelling older adults. Methods A prospective cohort study with a 48-month follow-up was conducted in a Japanese community. Participants were 2469 community-dwelling older adults aged 65 years or older who completed baseline and follow-up assessments at intervals of 48±2 months. Primary outcomes were recent falls (defined as at least one fall within the past year) and FOF (determined by response to “Are you afraid of falling?”) at follow-up survey. Physical frailty, operationalized by the frailty phenotype (slowness, weakness, exhaustion, weight loss, and low activity) based on the criteria of the Japanese version of the Cardiovascular Health Study (J-CHS), was also assessed as a predictor of future falls and FOF. Results Multivariate logistic regression showed that pre-frailty or frailty increase the risk of not only future falls (OR: 1.57; 95%CI = 1.20-2.05) but also FOF (OR: 1.33; 95%CI = 1.05-1.69). In addition, the relationship between baseline frailty status and future falls remained significant after adjusting for baseline FOF (OR: 1.55; 95%CI = 1.19-2.02), and the relationship between baseline frailty status and future FOF also remained significant after adjusting for baseline falls (OR: 1.32; 95%CI = 1.04-1.68). Conclusions Frailty status may predict future falls and FOF among community-dwelling older adults. Strategies to prevent frailty may be beneficial to prevent not only future falls but also future FOF in a community setting. Impact Falls and FOF have a close relationship but a different clinical meaning. Older adults with physical frailty may require monitoring as high-risk not only for falls but also for FOF.

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The effectiveness of exergames on fear of falling in community-dwelling older adults: a systematic review

Aging & Mental Health ◽

10.1080/13607863.2021.1950615 ◽

2021 ◽

pp. 1-12

Author(s):

Lanying Ge ◽

Tai-Te Su ◽

Yu An ◽

Shannon T. Mejía

Keyword(s):

Systematic Review ◽

Older Adults ◽

Fear Of Falling ◽

Community Dwelling ◽

Community Dwelling Older Adults

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Effect of Aspirin on Activities of Daily Living Disability in Community-Dwelling Older Adults

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa316 ◽

2020 ◽

Author(s):

Robyn L Woods ◽

Sara Espinoza ◽

Le T P Thao ◽

Michael E Ernst ◽

Joanne Ryan ◽

...

Keyword(s):

Older Adults ◽

Activities Of Daily Living ◽

Daily Living ◽

Low Dose ◽

Community Dwelling ◽

Dose Aspirin ◽

Low Dose Aspirin ◽

Adl Disability ◽

Community Dwelling Older Adults ◽

Aspirin Group

Abstract Background Cerebrovascular events, dementia and cancer can contribute to physical disability with activities of daily living (ADL). It is unclear whether low-dose aspirin reduces this burden in aging populations. In a secondary analysis, we now examine aspirin’s effects on incident and persistent ADL disability within a primary prevention aspirin trial in community-dwelling older adults. Methods The ASPREE (ASPirin in Reducing Events in the Elderly) trial of daily 100mg aspirin versus placebo recruited 19,114 healthy adults aged 70+ years (65+ years if U.S. minority) in Australia and the U.S. Six basic ADLs were assessed every six months. Incident ADL disability was defined as inability or severe difficulty with ≥1 ADL; persistence was confirmed if the same ADL disability remained after six months. Proportional hazards modelling compared time to incident or persistent ADL disability for aspirin versus placebo; death without prior disability was a competing risk. Results Over a median 4.7 years, incident ADL disability was similar in those receiving aspirin (776/9525) and placebo (787/9589) with walking, bathing, dressing and transferring the most commonly reported. Only 24% of incident ADL disability progressed to persistent. Persistent ADL disability was lower in the aspirin group (4.3 versus 5.3 events/1000py; HR=0.81, 95% CI:0.66-1.00), with bathing and dressing the most common ADL disabilities in both groups. Following persistent ADL disability there were more deaths in the aspirin group (24 versus 12). Discussion Low-dose aspirin in initially healthy older people did not reduce risk of incident ADL disability, although there was evidence of reduced persistent ADL disability.

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Factors influencing Fear of Falling in Community-Dwelling Older Adults in Singapore: A Cross-Sectional Study

10.21203/rs.3.rs-963330/v1 ◽

2021 ◽

Author(s):

Jacqueline Giovanna De Roza ◽

David Wei Liang Ng ◽

Blessy Koottappal Mathew ◽

Teena Jose ◽

Ling Jia Goh ◽

...

Keyword(s):

Older Adults ◽

Fear Of Falling ◽

Cross Sectional Study ◽

Community Dwelling ◽

Clinical Factors ◽

Cross Sectional ◽

Frail Older Adults ◽

History Of ◽

The Mean ◽

Community Dwelling Older Adults

Abstract BackgroundFalls in older adults is a common problem worldwide. Fear of falling (FoF) is a consequence of falls which has far-reaching implications including activity restriction, functional decline and reduced quality of life. This study aimed to determine the factors associated with FoF in a segment of Singapore’s community-dwelling older adults. MethodsThis descriptive cross-sectional study recruited a convenience sample of adults aged 65 and above from 4 primary care clinics from September 2020 to March 2021. Data were collected on demographic factors and clinical factors including history of falls and frailty as determined by the Clinical Frailty Scale (CFS). FoF was measured using the Short Falls Efficacy Scale–International (Short FES-I), cut-off score of 14 and above indicated high FoF. Logistic regression was used to determine predictors of high FoF.ResultsOut of 360 older adults, 78.1% were Chinese and 59.7% females. The mean age was 78.3 years and 76 (21.1%) had a history of falls in the past six months. Almost half (43.1%) were mildly to moderately frail and most (80.6%) had three or more chronic conditions. The mean FoF score was 15.5 (SD 5.97) and 60.8% reported high FoF. Logistic regression found that Malay ethnicity (OR = 5.81, 95% CI 1.77 – 19.13), use of walking aids (OR = 3.67, 95% CI = 1.54 – 8.77) and increasing frailty were significant predictors for high FoF. The odds of high FoF were significantly higher in pre frail older adults (OR = 6.87, 95% CI = 2.66 – 17.37), mildly frail older adults (OR =18.58, 95% CI = 4.88 – 70.34) and moderately frail older adults (OR = 144.78, 95% CI = 13.86 – 1512.60).ConclusionsFoF is a prevalent and compelling issue in community-dwelling older adults, particularly those with frailty. The demographic and clinical factors identified in this study will be helpful to develop targeted and tailored interventions for FoF.

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Prevalence of fear of falling and associated factors among Japanese community-dwelling older adults

Medicine ◽

10.1097/md.0000000000009721 ◽

2018 ◽

Vol 97 (4) ◽

pp. e9721 ◽

Cited By ~ 17

Author(s):

Yoshihito Tomita ◽

Kazuhiko Arima ◽

Ritsu Tsujimoto ◽

Shin-ya Kawashiri ◽

Takayuki Nishimura ◽

...

Keyword(s):

Older Adults ◽

Associated Factors ◽

Fear Of Falling ◽

Community Dwelling ◽

Community Dwelling Older Adults

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

Journal of Aging and Health ◽

10.1177/08982643211055245 ◽

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.

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The Location Learning Test-Revised is associated with informant-reported everyday functioning in a sample of community-dwelling older adults

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acaa061 ◽

2020 ◽

Author(s):

Jennifer L Thompson ◽

Romola S Bucks ◽

Michael Weinborn ◽

Steven Paul Woods

Keyword(s):

Older Adults ◽

Activities Of Daily Living ◽

Daily Living ◽

Community Dwelling ◽

Object Location ◽

Everyday Functioning ◽

Ecological Relevance ◽

Learning Test ◽

Community Dwelling Older Adults ◽

Learning Trials

Abstract Objective Object location learning and memory may be important for older adults to successfully complete some everyday activities. Method This cross-sectional, correlational study investigated the ecological relevance of the Location Learning Test-Revised (LLT-R) in 195 community-dwelling, older adults in Western Australia. The LLT-R assesses object location learning and memory for everyday objects over five learning trials and after a 30-min delay. Knowledgeable informants provided structured ratings of participants’ activities of daily living and memory symptoms. Results A greater number of errors on LLT-R total learning trials were associated with mild problems in activities of daily living (particularly in travel and household domains), but not with memory symptoms. The LLT-R’s association with activities of daily living was accompanied by a small-to-medium effect size and was not better explained by demographics, global cognitive functioning, mood, or chronic medical conditions. Conclusions Findings provide some support for the ecological relevance of the LLT-R among older community-dwelling adults and suggest that object location learning may play a role in some everyday functioning problems that accompany typical aging.

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Childhood infectious diseases and old age cognitive functioning: a nationally representative sample of community-dwelling older adults

International Psychogeriatrics ◽

10.1017/s1041610220001404 ◽

2020 ◽

pp. 1-8

Author(s):

A. Rotstein ◽

S. Z. Levine

Keyword(s):

Risk Factors ◽

Older Adults ◽

Infectious Diseases ◽

Cognitive Functioning ◽

Old Age ◽

Early Life ◽

Representative Sample ◽

Community Dwelling ◽

Sensitivity Analyses ◽

Nationally Representative

ABSTRACT Background: Cumulative evidence suggests that health-related risk factors during midlife and old-age are associated with cognitive impairment. However, studies are needed to clarify the association between early-life risk factors and impaired cognitive functioning to increment existing knowledge. Objective: To examine the association between childhood infectious diseases and late-life cognitive functioning in a nationally representative sample of older adults. Participants: Eligible respondents were 2994 community-dwelling individuals aged 65–85. Measurements: Cognitive functioning was assessed using the Mini-Mental State Examination (MMSE). Childhood infectious diseases (i.e. chicken pox, measles, and mumps) were self-reported. The study covariates were age, sex, highest educational level achieved, smoking status, body mass index, and depression. The primary statistical analysis examined the association between the number of childhood infectious diseases and total MMSE scores, accounting for all study covariates. Regression models of progressive complexity were examined for parsimony. The robustness of the primary results was tested in 17 sensitivity analyses. Results: The most parsimonious model was a linear adjusted model (Bayesian Information Criterion = 12646.09). Late-life cognitive functioning significantly improved as the number of childhood infectious diseases increased (β = 0.18; 95% CI = 0.11, 0.26; p < 0.001). This effect was not significantly attenuated in all sensitivity analyses. Conclusion: The current study results are consistent with prior ecological findings indicating that some childhood infectious diseases are associated with better cognitive functioning in old-age. This points to an early-life modifiable risk factor associated with older-life cognitive functioning. Our results may reflect selective mortality and/or beneficial effects via hormetic processes.

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