scholarly journals Lower-Limb Factors Associated with Balance and Falls in Older Adults: A Systematic Review and Clinical Synthesis

2019 ◽  
Vol 110 (5) ◽  
Author(s):  
Christopher Neville ◽  
Hung Nguyen ◽  
Kim Ross ◽  
Mariana Wingood ◽  
Elizabeth Walker Peterson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Lower Limb ◽  
Fall Risk ◽  
Community Dwelling ◽  
Sufficient Evidence ◽  
Cochrane Library ◽  
Direct Link ◽  
Age Related ◽  
Falls In Older Adults

Background Despite sufficient evidence to suggest that lower-limb–related factors may contribute to fall risk in older adults, lower-limb and footwear influences on fall risk have not been systematically summarized for readers and clinicians. The purpose of this study was to systematically review and synethesize the literature related to lower-limb, foot, and footwear factors that may increase the risk of falling among community-dwelling older adults. Methods We searched PubMed, Embase, PsycINFO, CINAHL, Web of Science, Cochrane Library, and AgeLine. To describe the trajectory toward increasing risk of falls, we examined those articles that linked age-related changes in the lower limb or footwear to prospective falls or linked them to evidenced-based fall risk factors, such as gait and balance impairment. Results This systematic review consisted of 81 articles that met the review criteria, and the results reflect a narrative review of the appraised literature for eight pathways of lower-limb–related influences on fall risk in older adults. Six of the eight pathways support a direct link to fall risk. Two other pathways link to the intermediate factors but lack studies that provide evidence of a direct link. Conclusions This review provides strong guidance to advance understanding and assist with managing the link between lower-limb factors and falls in older adults. Due to the lack of literature in specific areas, some recommendations were based on observational studies and should be applied with caution until further research can be completed.

scholarly journals The Effects of Technological Interventions on Social Participation of Community-Dwelling Older Adults with and without Dementia: A Systematic Review

2021 ◽  
Vol 10 (11) ◽  
pp. 2308
Author(s):  
Pascale Heins ◽  
Lizzy M. M. Boots ◽  
Wei Qi Koh ◽  
An Neven ◽  
Frans R. J. Verhey ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Social Isolation ◽  
Social Participation ◽  
Methodological Quality ◽  
Well Being ◽  
Community Dwelling ◽  
Cochrane Library ◽  
Technological Interventions ◽  
Community Dwelling Older Adults

Social isolation in community-dwelling older adults with dementia is a growing health issue that can negatively affect health and well-being. To date, little attention has been paid to the role of technology in improving their social participation. This systematic review aims to provide a systematic overview of the effects of technological interventions that target social participation in community-dwelling older adults with and without dementia. The scientific databases Medline (PubMed), PsycINFO, CINAHL, Web of Science, and the Cochrane Library were systematically searched and independently screened by two reviewers. Results were synthesized narratively. The methodological quality of included studies was independently assessed by two reviewers. In total, 36 studies of varying methodological quality were identified. Most studies evaluated social networking technology and ICT training programs. Three studies focused on people with dementia. Quantitative findings showed limited effects on loneliness, social isolation, and social support. Nevertheless, several benefits related to social participation were reported qualitatively. Social interaction, face-to-face contact, and intergenerational engagement were suggested to be successful elements of technological interventions in improving the social participation of community-dwelling older adults. Rigorous studies with larger sample sizes are highly needed to evaluate the long-term effects of technology on the multidimensional concept of social participation.

scholarly journals Medications & Polypharmacy Influence on Recurrent Fallers in Community: a Systematic Review

2018 ◽  
Vol 21 (1) ◽  
pp. 14-25 ◽  
Author(s):  
Yu Ming ◽  
Aleksandra Zecevic
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
High Risk Group ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Depression Symptoms ◽  
Prescription Medications ◽  
Recurrent Falls ◽  
Falls In Older Adults ◽  
The Impact

The purpose of this systematic review is to summarize information about the impact different classes of medications and polypharmacy have on recurrent falls, defined as two or more falls in a 12-month period, in community-dwelling older adults. After adjustment for confounders such as age, gender, weight or depression symptoms, the reviewed studies suggested that older adults who use antidepressants, sedatives or hypnotics and anti-epileptics were more likely to experience recurrent falls than non-users. Polypharmacy (use of four or more prescription medications daily) caused 1.5–2 times higher possibility of recurrent falls in older adults. As a high-risk group, recurrent fallers require meaningful intervention. Medications are believed to be a modifiable risk factor in falls prevention; hence, special consideration should be taken to balance the benefit and harm in initiating, continuing or increasing certain classes of medications in elderly recurrent fallers.

scholarly journals Effect of Sleep Quality on the Prevalence of Sarcopenia in Older Adults: A Systematic Review with Meta-Analysis

2019 ◽  
Vol 8 (12) ◽  
pp. 2156 ◽  
Author(s):  
Jacobo Á. Rubio-Arias ◽  
Raquel Rodríguez-Fernández ◽  
Luis Andreu ◽  
Luis M. Martínez-Aranda ◽  
Alejandro Martínez-Rodriguez ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Sleep Quality ◽  
Sleep Duration ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Short Sleep Duration ◽  
Related Condition ◽  
Age Related ◽  
Inadequate Sleep

Sarcopenia is an age-related condition. However, the prevalence of sarcopenia may increase due to a range of other factors, such as sleep quality/duration. Therefore, the aim of the study is to conduct a systematic review with meta-analysis to determine the prevalence of sarcopenia in older adults based on their self-reported sleep duration. Methods: Three electronic databases were used—PubMed-Medline, Web of Science, and Cochrane Library. We included studies that measured the prevalence of sarcopenia, divided according to sleep quality and excluded studies (a) involving populations with neuromuscular pathologies, (b) not showing prevalence values (cases/control) on sarcopenia, and (c) not including classificatory models to determine sleep quality. Results: high prevalence values in older adults with both long and short sleep duration were shown. However, prevalence values were higher in those with inadequate sleep (<6–8 h or low efficiency) (OR 0.76; 95% CI (0.70–0.83); Q = 1.446; p = 0.695; test for overall effect, Z = 6.01, p < 0.00001). Likewise, higher prevalence levels were shown in men (OR 1.61; 95% CI (0.82–3.16); Q = 11.80; p = 0.0189) compared to women (OR 0.77; 95% CI (0.29–2.03); Q = 21.35; p = 0.0003). Therefore, the prevalence of sarcopenia appears to be associated with sleep quality, with higher prevalence values in older adults who have inadequate sleep.

Exploring trajectories in dietary adequacy of the B vitamins folate, riboflavin, vitamins B6 and B12, with advancing older age: a systematic review

2020 ◽  
pp. 1-11 ◽  
Author(s):  
N. Gillies ◽  
D. Cameron-Smith ◽  
S. Pundir ◽  
C. R. Wall ◽  
A. M. Milan
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Community Dwelling ◽  
B Vitamins ◽  
Cross Sectional ◽  
Longitudinal Changes ◽  
Dietary Adequacy ◽  
Metabolism Regulation ◽  
Age Related

Abstract Maintaining nutritional adequacy contributes to successful ageing. B vitamins involved in one-carbon metabolism regulation (folate, riboflavin, vitamins B6 and B12) are critical nutrients contributing to homocysteine and epigenetic regulation. Although cross-sectional B vitamin intake in ageing populations is characterised, longitudinal changes are infrequently reported. This systematic review explores age-related changes in dietary adequacy of folate, riboflavin, vitamins B6 and B12 in community-dwelling older adults (≥65 years at follow-up). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, databases (MEDLINE, Embase, BIOSIS, CINAHL) were systematically screened, yielding 1579 records; eight studies were included (n 3119 participants, 2–25 years of follow-up). Quality assessment (modified Newcastle–Ottawa quality scale) rated all of moderate–high quality. The estimated average requirement cut-point method estimated the baseline and follow-up population prevalence of dietary inadequacy. Riboflavin (seven studies, n 1953) inadequacy progressively increased with age; the prevalence of inadequacy increased from baseline by up to 22·6 and 9·3 % in males and females, respectively. Dietary folate adequacy (three studies, n 2321) improved in two studies (by up to 22·4 %), but the third showed increasing (8·1 %) inadequacy. Evidence was similarly limited (two studies, respectively) and inconsistent for vitamins B6 (n 559; −9·9 to 47·9 %) and B12 (n 1410; −4·6 to 7·2 %). This review emphasises the scarcity of evidence regarding micronutrient intake changes with age, highlighting the demand for improved reporting of longitudinal changes in nutrient intake that can better direct micronutrient recommendations for older adults. This review was registered with PROSPERO (CRD42018104364).

scholarly journals 400Overactive bladder with/without urinary incontinence and falls in the community-dwelling elderly

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Kenji Omae ◽  
Noriaki Kurita ◽  
Taro Takeshima ◽  
Toru Naganuma ◽  
Sei Takahashi ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Fall Risk ◽  
Community Dwelling ◽  
Important Predictor ◽  
Multivariable Logistic Regression Analysis ◽  
Logistic Regression Models ◽  
Falls In Older Adults ◽  
Tree Approach

Abstract Background Little is known about the fall risk of older adults with overactive bladder (OAB), especially in the absence of urgency incontinence (UI). Methods This prospective cohort study included 630 community-dwelling, independent older adults 75 years old or older who attended a health check-up in 2017 with a 1-year follow-up. The associations of OAB with and without UI (OAB-wet and OAB-dry) with a fall history, and future fall risk compared to no OAB were assessed using logistic regression models. The contribution of OAB as a predictor of falls was examined using a random forest and decision tree approach. Results Of the 577 analyzed participants (median age 79 years), 273 were men. The prevalence of OAB-dry and OAB-wet at baseline was 15% and 14%, respectively. Multivariable logistic regression analysis revealed that both OAB-dry and OAB-wet were associated with a higher likelihood of prior falls (adjusted ORs vs no OAB 2.03 and 2.21, respectively; 95% CI 1.23–3.37 and 1.29–3.78, respectively). Among the 363 participants without a fall history, the adjusted ORs (95% CIs) of OAB-dry and OAB-wet for the occurrence of falls during the 1-year follow-up were 2.74 (1.19–6.29) and 1.35 (0.47–3.87), respectively. The tree-based approach used for all participants showed that OAB was an important predictor of falls in adults without a fall history. Conclusions OAB, even in the absence of UI, is an important predictor of falls in older adults with a low absolute fall risk. Key messages Our findings suggest that OAB is a risk factor for falls in the community-dwelling elderly irrespective of the presence of UI.

Bend Don’t Break: Stretching Improves Scores on a Battery of Fall Assessment Tools in Older Adults

2021 ◽  
Vol 30 (1) ◽  
pp. 78-84
Author(s):  
Nathan F. Johnson ◽  
Chloe Hutchinson ◽  
Kaitlyn Hargett ◽  
Kyle Kosik ◽  
Phillip Gribble
Keyword(s):  
Older Adults ◽  
Fall Risk ◽  
Community Dwelling ◽  
Assessment Tools ◽  
Static Stretching ◽  
Timed Up And Go ◽  
Sit To Stand ◽  
Age Related ◽  
Flexibility Training ◽  
Community Dwelling Older Adults

Context: Falls and loss of autonomy are often attributed in large part to musculoskeletal impairments in later adulthood. Age-related declines in flexibility contribute to late adulthood musculoskeletal impairment. The novel sitting-rising test has been proposed to be a quick, effective screening of musculoskeletal fitness, fall risk, and all-cause mortality in older adults. The timed up and go and 5 times sit-to-stand tests are two of the 3 most evidence-supported performance measures to assess fall risk. Objective: This study aimed to determine if 5 weeks of flexibility training could increase sitting-rising test, timed up and go, and 5 times sit-to-stand scores in community-dwelling older adults. Participants: Forty-seven adults aged 60 years and older (mean age = 66.7 y, SD = 4.1) participated in this study. Participants completed a static stretching protocol consisting of 3 weekly 1-hour stretching sessions. Results: The protocol improved flexibility as seen in sit-and-reach scores and improved scores on all outcome variables. Specifically, there was a significant increase in sitting-rising test scores from preintervention (M = 7.45, SD = 1.45) to postintervention (M = 8.04, SD = 1.36), t(42) = −5.21, P < .001. Timed up and go scores demonstrated a significant decrease from preintervention (M = 8.85, SD = 1.32) to postintervention (M = 8.20, SD = 1.35), t(46) = 5.10, P < .001. Five times sit-to-stand scores demonstrated a significant decrease from preintervention (M = 12.57, SD = 2.68) to postintervention (M = 10.46, SD = 2.06), t(46) = 6.62, P < .001. Finally, significant increases in sit-and-reach scores were associated with improved functional performance (r = −.308, P = .03). Conclusion: Findings suggest that flexibility training can be an effective mode of low-level exercise to improve functional outcomes. Static stretching may help to improve musculoskeletal health, promote autonomy, and decrease mortality in community-dwelling older adults.

scholarly journals Strength Training to Prevent Falls in Older Adults: A Systematic Review with Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 10 (14) ◽  
pp. 3184
Author(s):  
João Gustavo Claudino ◽  
José Afonso ◽  
Javad Sarvestan ◽  
Marcel Bahia Lanza ◽  
Juliana Pennone ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Strength Training ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Exercise Interventions ◽  
Randomized Controlled ◽  
Falls In Older Adults

We performed a systematic review with meta-analysis of randomized controlled trials (RCTs) to assess the effects of strength training (ST), as compared to alternative multimodal or unimodal exercise programs, on the number of falls in older adults (≥60 years). Ten databases were consulted (CINAHL, Cochrane Library, EBSCO, EMBASE, PEDro, PubMed, Scielo, Scopus, SPORTDiscus and Web of Science), without limitations on language or publication date. Eligibility criteria were as follows: RCTs with humans ≥60 years of age of any gender with one group performing supervised ST and a group performing another type of exercise training, reporting data pertaining falls. Certainty of evidence was assessed with Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Meta-analysis used a random effects model to calculate the risk ratio (RR) for number of falls. Five RCTs with six trials were included (n = 543, 76% women). There was no difference between ST and alternative exercise interventions for falls (RR = 1.00, 95% CI 0.77–1.30, p = 0.99). The certainty of evidence was very low. No dose–response relationship could be established. In sum, ST showed comparable RR based on number of falls in older adults when compared to other multimodal or unimodal exercise modalities, but evidence is scarce and heterogeneous, and additional research is required for more robust conclusions. Registration: PROSPERO CRD42020222908.

scholarly journals Effectiveness of Nutritional Advice for Community-Dwelling Obese Older Adults With Frailty: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Yue-Heng Yin ◽  
Justina Yat Wa Liu ◽  
Tsz Man Fan ◽  
Kit Man Leung ◽  
Man Wai Ng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Body Weight ◽  
Physical Function ◽  
Fat Mass ◽  
Meta Analysis ◽  
Well Being ◽  
Community Dwelling ◽  
Cochrane Library ◽  
Nutritional Advice

Objectives: This systematic review was aimed to examine the effectiveness of nutritional advise interventions compared with usual care, or exercise, or exercise combined with nutritional advice as a means of improving the body weight, body composition, physical function, and psychosocial well-being of frail, obese older adults.Methods: CINAHL, Cochrane Library, Embase, MEDLINE, PsycINFO, and Scopus databases were searched to identify relevant studies. The quality of the included studies was assessed using Cochrane's risk of bias tool 2. Meta-analysis was performed with respect to body weight and fat mass. Other outcomes were synthesized narratively.Results: Eight articles (from two studies) with a total of 137 participants were included in the review. The results revealed that nutritional advice was more effective than exercise in reducing body weight and fat mass. The nutritional advice was also beneficial in enhancing physical function and psychosocial well-being. However, it was less effective than exercise or combined interventions in increasing muscle strength and preventing lean mass loss.Conclusions: Nutritional advice is an essential intervention for reducing body weight and fat mass, for enhancing physical function, and for improving the psychosocial well-being of obese older adults experiencing frailty. The limited number of studies included in this review suggests that there is a need for more well-designed interventional studies in order to confirm these findings.

scholarly journals Effectiveness of Olympic Combat Sports on Balance, Fall Risk or Falls in Older Adults: A Systematic Review

Biology ◽  
2022 ◽  
Vol 11 (1) ◽  
pp. 74
Author(s):  
Pablo Valdés-Badilla ◽  
Rodrigo Ramirez-Campillo ◽  
Tomás Herrera-Valenzuela ◽  
Braulio Henrique Magnani Branco ◽  
Eduardo Guzmán-Muñoz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Fall Risk ◽  
Meta Analysis ◽  
Combat Sports ◽  
High Quality ◽  
Grade Scale ◽  
Falls In Older Adults ◽  
Final Manuscript ◽  
Meta Analyses

This systematic review and meta-analysis aimed to assess the available body of published peer-reviewed articles related to the effects of Olympic combat sports (OCS), compared with active/passive controls, on balance, fall risk, or falls in older adults. The TESTEX and GRADE scales assessed the methodological quality and certainty of the evidence. The protocol was registered in PROSPERO (code: CRD42020204034). From 1496 records, eight studies were included, involving 322 older adults (64% female; mean age = 71.1 years). The TESTEX scale revealed all studies with a score ≥ 60% (moderate-high quality). The GRADE scale indicated all studies with at least some concerns, up to a high risk of bias (i.e., was rated very low). Meta-analyses were planned, although the reduced number of studies precluded its incorporation in the final manuscript. Only two from six studies that assessed balance found improvements after OCS compared to controls. No differences were found between OCS vs. control groups for fall risk or falls. The available evidence does not allow a definitive recommendation for or against OCS interventions as an effective strategy to improve balance and reduce the fall risk or falls in older adults. Therefore, more high-quality studies are required to draw definitive conclusions.

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