scholarly journals Associations between Daily Movement Distribution, Bone Structure, Falls, and Fractures in Older Adults: A Compositional Data Analysis Study

2021 ◽  
Vol 18 (7) ◽  
pp. 3757
Author(s):  
Ana Moradell ◽  
Irene Rodríguez-Gómez ◽  
Ángel Iván Fernández-García ◽  
David Navarrete-Villanueva ◽  
Jorge Marín-Puyalto ◽  
...  
Keyword(s):  
Older Adults ◽  
Bone Mass ◽  
Cortical Thickness ◽  
Compositional Data ◽  
Fear Of Falling ◽  
Movement Behavior ◽  
Risk Of Falling ◽  
Mineral Density ◽  
Exercise Interventions ◽  
History Of

With aging, bone density is reduced, increasing the risk of suffering osteoporosis and fractures. Increasing physical activity (PA) may have preventive effects. However, until now, no studies have considered movement behaviors with compositional data or its association to bone mass and structure measured by peripheral computed tomography (pQCT). Thus, the aim of our study was to investigate these associations and to describe movement behavior distribution in older adults with previous falls and fractures and other related risk parameters, taking into account many nutritional and metabolic confounders. In the current study, 70 participants above 65 years old (51 females) from the city of Zaragoza were evaluated for the EXERNET-Elder 3.0 project. Bone mass and structure were assessed with pQCT, and PA patterns were objectively measured by accelerometry. Prevalence of fear of falling, risk of falling, and history of falls and fractures were asked through the questionnaire. Analyses were performed using a compositional data approach. Whole-movement distribution patterns were associated with cortical thickness. In regard to other movement behaviors, moderate-to-vigorous PA (MVPA) showed positive association with cortical thickness and total true bone mineral density (BMD) at 38% (all p < 0.05). In addition, less light PA (LPA) and MVPA were observed in those participants with previous fractures and fear of falling, whereas those at risk of falling and those with previous falls showed higher levels of PA. Our results showed positive associations between higher levels of MVPA and volumetric bone. The different movement patterns observed in the groups with a history of having suffered falls or fractures and other risk outcomes suggest that different exercise interventions should be designed in these populations in order to improve bone and prevent the risk of osteoporosis and subsequent fractures.

The Relationship Between Fear of Falling and Functional Fitness among Older Adults Living in Rest Home

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
H Tuna ◽  
Ö Bozan ◽  
B Gürpınar ◽  
N İlçin
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Dynamic Balance ◽  
Upper Body ◽  
Functional Fitness ◽  
Fall Risk Factors ◽  
Rest Home ◽  
History Of

Objective: This study aimed to report the fear of falling and assess its associations with several fall-related characteristics and functional fitness parameters among older adults living in the rest home. Methods: Seventy-eight older adults aged between 65-94 years were included in the study. History of falling and the number of risk factors for falling were recorded. Fear of falling was evaluated with The Falls Efficacy ScaleInternational. Functional fitness was assessed with Senior Fitness Test, including tests for the functional measurement of strength, flexibility, aerobic endurance and dynamic balance. Result: The mean age of participants was 78.46±7.16 years. There were correlations exist between fear of falling and number of fall risk factors, dynamic balance, upper body flexibility and aerobic endurance (p<0.05). Multiple linear regression analysis showed that the parameters with the highest determinants of fear of falling were the dynamic balance and history of falling (p<0.05). Conclusions: In our study, history of falling, number of fall risk factors, flexibility for the upper body, aerobic endurance and dynamic balance were parameters related to fear of falling among older adults, but the most influential factors in fear of falling were dynamic balance and history of falling.

scholarly journals Assessment of muscle mass, risk of falls and fear of falling in elderly people with diabetic neuropathy

2015 ◽  
Vol 28 (4) ◽  
pp. 677-683 ◽  
Author(s):  
Hudson Azevedo Pinheiro ◽  
Karla Helena Coelho Vilaça ◽  
Gustavo de Azevedo Carvalho
Keyword(s):  
Diabetic Neuropathy ◽  
Lean Body Mass ◽  
Muscle Mass ◽  
Body Mass ◽  
Fear Of Falling ◽  
Berg Balance Scale ◽  
Elderly Adults ◽  
Risk Of Falling ◽  
Risk Of Falls ◽  
History Of

Abstract Objective : To assess muscle mass, risk of falls and fear of falling in elderly adults with diabetic neuropathy (DNP). Methods : 50 elderly patients with diabetes mellitus (DM) and diabetic neuropathy (NPD) participated in this study. Risk of falling was assessed using the Berg Balance Scale (BBS). Fear of falling was assessed by means of the Falls Efficacy Scale-International (FES-I). Muscle mass was assessed by tetrapolar bioimpedance analysis (BIA) and Janssen's equation. Subjects were divided into two groups: one with a history of falls in the six months before study enrollment (G1) and the other without history of falls (G2). Results : There were statistically significant differences between G1 and G2 regarding lean body mass (p < 0.05), risk of falls as measured by the BBS (p < 0.01), and fear of falling as measured by the FES-I (p < 0.01). In addition, there was a significant correlation between the BBS and BIA (r = 0.45 and p < 0.01), showing that the greater the lean body mass, the lower the risk of falling. Conclusions : We found an association between lean mass, risk of falls and fear of falling in elderly adults with DNP and a history of falls from own height.

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

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.

scholarly journals PROTOCOL: Exercise interventions to improve back shape/posture, balance, falls and fear of falling in older adults with hyperkyphosis: A systematic review

2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Roongtip Duangkaew ◽  
Josette Bettany‐Saltikov ◽  
Paul Schaik ◽  
Gokulakannan Kandasamy ◽  
Julie Hogg
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Fear Of Falling ◽  
Exercise Interventions

scholarly journals 13 Effects of Benzodiazepines on Orthostatic Blood Pressure in Older People

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Giulia Rivasi ◽  
Rose Anne Kenny ◽  
Andrea Ungar ◽  
Roman Romero-Ortuno
Keyword(s):  
Blood Pressure ◽  
Older People ◽  
Fear Of Falling ◽  
Community Dwelling ◽  
University Hospital ◽  
Risk Of Falling ◽  
Non Invasive ◽  
Orthostatic Blood Pressure ◽  
History Of ◽  
The Relationship

Abstract Background Older people taking benzodiazepines (BDZs) have higher risk of falling, which is mainly attributed to unfavorable drug-related effects on cognition and psychomotor functioning. BDZs may also have hypotensive effects, but evidence concerning the relationship between BDZs and orthostatic blood pressure (BP) behaviour in older people is scarce. We investigated the effects of BDZs on BP response to an orthostatic active stand test. Methods We performed a retrospective analysis of data from an outpatient research clinic in an Irish university hospital, where people aged 60 or older underwent a comprehensive geriatric assessment between August 2007 and May 2009. Non-invasive beat-to-beat orthostatic BP was measured during active stand, with systolic BP assessed at each 10-second interval. Information on regular BDZs use was collected. Factors independently associated with orthostatic systolic BP were investigated using multiple linear regression. Results Of 624 community-dwelling people who underwent a clinic assessment, orthostatic active stand data was collected in 541. Information on regular BDZs use was available in 538 people. Of 538 participants, mean age was 72.7±7.2, 67.7% were female and 33 (6.1%) reported regular use of BDZs. History of falls (p=0.027) and fear of falling (p<0.001) were more prevalent in this subgroup. During active stand, participants on BDZs showed a significantly greater systolic BP drop 10 seconds after the posture change (“immediate” BP drop). No significant differences were detected in orthostatic systolic BP in the latter phases of the active stand. After adjusting for possible confounders, BDZs use was independently associated with a mean immediate systolic BP drop of 12 mmHg after standing. Conclusion BDZs may confer higher risk of an immediate systolic BP drop after standing in older people, which may contribute to their known falls risk. BDZ should be avoided in older people at risk of falling.

scholarly journals Evaluación de causas secundarias de baja masa ósea en mujeres colombianas con osteoporosis posmenopáusica

2017 ◽  
Vol 3 (4) ◽  
pp. 12-16
Author(s):  
Edwin Antonio Wandurraga ◽  
Lisseth Fernanda Marín Carrillo ◽  
Annie Katherine Natera Melo ◽  
Claudia Milena Gómez Giraldo ◽  
Juan Camilo Mendoza Díaz
Keyword(s):  
Alkaline Phosphatase ◽  
Bone Loss ◽  
Bone Mass ◽  
Postmenopausal Osteoporosis ◽  
Inverse Correlation ◽  
Low Bone Mass ◽  
Mineral Density ◽  
History Of ◽  
Las Mujeres ◽  
Secondary Causes

Introducción: La osteoporosis posmenopáusica puede coexistir con otras entidades que aumentan la pérdida ósea.Objetivo: Determinar la frecuencia de causas secundarias de baja masa ósea en mujeres con osteoporosis posmenopáusica en una población colombiana.Diseño: Estudio descriptivo retrospectivo.Población: Mujeres mayores de 50 años con diagnóstico reciente de osteoporosis posmenopáusica antes de iniciar tratamiento.Mediciones: Se incluyeron variables demográficas, densitométricas y bioquímicas como hemoglobina, fosfatasa alcalina, transaminasas, creatinina, 25-hidroxivitamina D, calcio, fósforo, magnesio, calciuria en 24 horas, PTH y TSH.Resultados: Se incluyeron 129 mujeres con edad promedio de 67+/-8,8 años. Cuarenta y nueve mujeres (36%) presentaban antecedente de fractura por fragilidad. En el 86,8% se encontró al menos una alteración bioquímica asociada con pérdida de masa ósea, documentándose insuficiencia de vitamina D en 71,8%, hiperparatiroidismo normocalcémico en 18,1% e hipercalciuria en 6,4%. Las mujeres con antecedente de fractura presentaron valor promedio de fosfatasa alcalina superior (111,6 +/- 61,3 vs 87,1 +/- 30,4 U/L, p= 0,0143) y promedio de hemoglobina inferior (12,9 +/- 1,2 vs. 14,2 +/- 1,2gr/dl, p<0,0001) al compararse con las mujeres sin fractura. Se encontró correlación inversa entre los niveles de fosfatasa alcalina y la densidad mineral ósea de la columna lumbar (p<0,001) y la cadera (p=0,003).Conclusiones: Las causas secundarias de baja masa ósea en mujeres con OPM son frecuentes en nuestro medio. Con base en una frecuencia de alteraciones mayor al 5%, sugerimos la evaluación de toda mujer con OPM con hemoglobina, calcio, calciuria en 24 horas, 25-hidroxivitamina D, AST, PTH y TSH.Abstract Introduction: Postmenopausal osteoporosis can coexist with other entities that increase bone loss. Aim: To determine the frequency of secondary causes of low bone mass in women with postmenopausal osteoporosis in a Colombian population. Materials and methods: A retrospective descriptive study was conducted, including women over 50 years with newly diagnosed postmenopausal osteoporosis without treatment. Demographic, densitometric and biochemical variables such as hemoglobin, alkaline phosphatase, transaminases, creatinine, 25 hydroxivitamin D, calcium, phosphorus, magnesium, calciuria in 24 hours, PTH and TSH were evaluated.Results: 129 women with a mean age of 67 +/- 8,8 years were included. 49 patients (36%) had history of fragility fracture. At least one biochemical disorder associated with bone loss was reported in 86,8% of cases, vitamin D insufficiency was documented in 71,8%, normocalcemic hyperparathyroidism in 18,1% and hypercalciuria in 6,4%. Women with history of fracture showed higher average value of alkaline phosphatase (111,6 +/- 61,3 vs 87,1 +/- 30,4 U/L, p=0,0143) and lower mean hemoglobin (12,9 +/- 1,2 vs 14,2 +/- 1,2 gr/dl, p<0,0001) compared with women without fracture. Inverse correlation was found between levels of alkaline phosphatase and bone mineral density of lumbar spine (p<0,001) and hip (p=0,003). Conclusions: Secondary causes of low bone mass in women with PMO are frequent in our clinical practice. Based on a frequency of laboratory abnormalities greater than 5%, we suggest that all women with PMO should be studied with hemoglobin, serum calcium, urinary calcium in 24 hours, 25 hydroxivitamin D, AST, PTH and TSH. Keywords: ; ; etiology;; .

scholarly journals COGNITIVE APPRAISAL AND KNOWLEDGE AS RISK FACTORS FOR HIGH FEAR OF FALLING IN OLDER AND MIDDLE-AGED ADULTS IN SINGAPORE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S473-S473
Author(s):  
Pey June Tan ◽  
Reuben Ng ◽  
Angelique Chan ◽  
Jagadish U Mallya ◽  
Noor Hafizah Ismail ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Fall Risk ◽  
Cognitive Appraisal ◽  
Fear Of Falling ◽  
Age Groups ◽  
Fall Risk Factors ◽  
History Of ◽  
Middle Aged Adults ◽  
Balance Problems

Abstract Fear-of-falling (FOF) can be adaptive or maladaptive depending on one’s appraisal of knowledge and beliefs, but few have elucidated this cognitive process in older adults surrounding falls. We aim to identify risk factors for high FOF amongst community-dwelling older adults (OA) and middle-aged adults (MA) in Singapore. This was a cross-sectional survey of a nationally-representative sample of OA (≥60 years) and MA (40-59 years) identified by stratified random sampling. Primary outcome was high FOF measured by a single-item (4-point scale). Independent variables were history-of-falls, quality-of-life, fall-related cognitive appraisal (balance problems, importance to restrict activities to prevent falls) and knowledge indicators (knowledge of other OA who fell, ability to identify out of 13 fall risk factors). MA were also asked if they’re caregivers. Multiple logistic regressions identified risk factors for high FOF separately by age-groups, adjusting for socio-demographics and comorbidities. The final analysis included 549 OA (70.6±6.88 years) and 309 MA (49.7±5.89 years). No differences in high FOF was found among OA and MA (37% vs. 38%, p=0.305), but there were more falls among OA (19% vs 12%, p=0.010). Higher knowledge of fall risk factors and self-reported balance problems were significant risk factors for high FOF among OA only, while a history-of-falls and being a caregiver were significant among MA only. Perceived importance to restrict activities was associated with high FOF in both age-groups. Although findings suggest differences in the mechanism of high FOF between OA and MA, both age-groups have maladaptive appraisal tendencies related to restrict activities to prevent falls.

scholarly journals Semi-automated approach in the evaluation of low bone mass using clavicle radiogrammetry technique

2018 ◽  
Vol 7 (2.8) ◽  
pp. 169
Author(s):  
U Snekhalatha ◽  
D Ashok Kumar ◽  
Padma Javasan
Keyword(s):  
Bone Mineral Density ◽  
Bone Mass ◽  
Bone Mineral ◽  
Cortical Thickness ◽  
Total Population ◽  
Low Bone Mass ◽  
Mineral Density ◽  
X Ray ◽  
Post Menopausal ◽  
The Right

Background: Low bone mineral density increasing with age is a universally observed phenomenon. This leads to osteoporosis, which is a regressive change that occurs in the bone and it is diagnosed before the occurrence of fractures. The dual energy x -ray absorptiometry (DXA) is considered to be the standard measurement for the detection of bone mineral density (BMD).Objectives: To measure the various bone mass indices in the clavicle bone by radiogrammetric method from a posterior-to-anterior (PA) view of chest digital X-ray using semi- automated method.Methods: Forty women whose mean age was found to be 46.05±15.53 years were included in this study. For the total population (n=40), the right femur BMD was acquired by DXA scanner. The digital chest radiographs were taken for all the subjects. In all cases, the geometrical variables such as periosteal width (CLR-D), endosteal width (CLR-d), cortical thickness (CLR-CT) and percentage cortical thickness %(CLR-CT) were measured in the right clavicle bone region by semi-automated method approach developed in MATLAB software.Results: The CLR-CT (r=0.77) as well as with % CLR-CT (r=0.72) has provided statistically significant correlation (p < 0.01) with the total hip BMD in the total population studied. The pre-menopausal and post-menopausal of the studied population demonstrated a high significance value of (p < 0.01).Conclusion: The semi-automated measurement of low bone mass indices in clavicle radiogrammetry will be useful in the evaluation of low bone mass in post-menopausal women and elderly aged population. This method can be used as a screening tool for mass population, especially in rural India.

scholarly journals Home Safety Evaluation Model for Older Adults With Recurrent Falls

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 265-265
Author(s):  
Willy Marcos Valencia ◽  
Kimberly Cabrera ◽  
Vincent Hsu
Keyword(s):  
Older Adults ◽  
Fear Of Falling ◽  
Evaluation Model ◽  
Safety Evaluation ◽  
Falls Prevention ◽  
Home Safety ◽  
Recurrent Falls ◽  
History Of ◽  
The Impact

Abstract Recurrent falls are a major threat in older adults. Home environment can be a hazard, but it is potentially modifiable/reversible. In Miami VA, occupational therapists conduct home safety evaluations (HSE) to ascertain the need for modifications to reduce falls risk. We reviewed the cohort of high-risk, recurrent falls patients evaluated at our Falls Prevention Clinic (FPC) between August 2017 to November 2019, to evaluate the impact of HSE. We identified 48 Veterans, age 76.5±6.9 years, of whom 15 (31.3%) reported 1-2 falls/year, 18 (37.5%) reported 3-4 falls/year, and 15 (31.3%) reported ≥5 falls/year. Twenty-eight (58.3%) were offered a HSE. Within these subjects, 74.2% reported falling at least once within their home, 43.8% had fear of falling, 5 (17.9%) had a history of substance or alcohol abuse. We observed that 29 (60.4%) would benefit from the addition of grab bars and 26 (54.2%) could benefit from toilet adjustments. Twelve (25.0%) were recommended to install bed rails. Only 15 (31.3%) Veterans agreed to all recommendations, 25 (52.1%) declined due to preference, and 8 (16.7%) declined for other reasons. Only 8 (16.7%) of these Veterans lived alone. Another factor is that 11 (22.9%) Veterans were renting and 32 (66.7%) owned their homes. Addressing and improving environmental hazards may ameliorate the risk for recurrent falls. Our next steps are to evaluate the extent of home modifications, and the long-term changes in falls/year. Further research needs to determine the long-term efficacy and cost-effectiveness of HSE, and how it can be more accessible to the community.

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