Assessment of risk of falls and internal risk factors in elderly patients who need heart pacemarkers

The aim is to assess the frequency of falls and intrinsic fall risk factors in patients requiring pacemakers. Methodology. The research was conducted from November 2020 to February 2021. Participated patients were hospitalized at the LUHS hospital Kauno Klinikos Department of Cardiology and required heart pacemaker implantation. Total 82 patients participated in the study. The questionnaire was composed by the authors of the research. The study was obtained by the Bioethics Permit of the Medical Academy of LUHS (No. BEC-SL (B) -42). Results. Almost half of the patients fell (45.1%) at least once a year. Elderly patients (65 years and older) are more likely to experience falls than patients under 65 years of age p=0,006. Elderly patients are more often exposed to various internal risk factors of falls: urination at night (82,9 %), weakness (82,9 %), dizziness (76,8 %). Perceived decreased leg muscle strength was found in both women and men (69.6% and 52.8%, respectively, p = 0.002). Patients older than 65 years and therefore <65 years experienced leg pain (54,9% and 7,2%, respectively, p = 0.002), urination at night (68,4% and 14,6%, respectively, p = 0.009), and experienced fatigue (63,0% and 13,6%, p = 0.028). Conclusions. Almost half of the patients who were in need of heart pacemaker implantation experienced falls. ≥ 65 years old patients experienced falls more than once a year. It has been found that these patients often experience weakness, fatigue, and dizziness. A common intrinsic fall risk factor is urination at night. ≥ 65 years old patients have more internal falls risk factors than patients under 65 years old.

Relationship between Fall History and Self-Perceived Motor Fitness in Community-Dwelling People: A Cross-Sectional Study

History of falling is an important fall risk factor. If a relationship between fall history and self-perceived motor fitness could be established, then treating it as a correctable risk of re-fall due to falls may be possible. We conducted a cross-sectional study of the relationship between fall history and self-perceived motor fitness in daily life among 670 community-dwelling people (mean age 62.0 ± 9.6 years, 277 men and 393 women) who had participated in health examinations. They completed a self-administered questionnaire that asked about their history of single or multiple falls and included a 14-item motor fitness scale. The responses were analyzed using multivariate logistic regression analysis. The results showed that in both younger and older (<65 years) subjects, a history of single or multiple falls was associated with a negative response to “being able to put on socks, pants or a skirt while standing without support”. For subjects ≥65 years, an association was also observed with “shortness of breath when climbing stairs”. Self-perceived motor fitness related to fall history can easily be noticed by an individual and may help them become aware of fall-related factors earlier in everyday life.

GAIT CHARACTERISTICS OF ELDERLY WOMEN IN OVERGROUND, ASCENT AND DESCENT WALKWAY CONDITIONS

Gait assessment is important for identification of potential faller among the elderly populations. Slope walking is associated with fall risk factor and elderly women have higher fall rate compared with elderly men. Therefore, this study investigated gait characteristics of elderly women in overground and slope walkway conditions. Thirty healthy elderly women (15 younger-elderly women and 15 older-elderly women) walked along the linear walkway including three walking conditions (overground, ascent and descent conditions). Temporal gait variables and normalized peak vertical GRF (ground reaction force) variables were derived from commercial motion analysis software. Repeated-measures analysis of variance (ANOVA) was evaluated to compare mean differences of the three conditions and mean difference between younger and older elderly women. All gait characteristics were significantly different from the slope walking conditions ([Formula: see text]). Elderly women walked with longer loading response and mid stance phase during descent walking. Also, ascent walking induced a longer terminal stance phase. Interactions of age and walkway conditions were also significant in vertical GRF, where older-elderly women were greater than younger-elderly women in ascent walkway condition ([Formula: see text]) and in descent walkway condition ([Formula: see text]). These findings suggest that specific-walkway condition should be considered for fall prevention and clinical interventions in elderly women.

FALLS AND NUTRITIONAL RISK AMONG RURAL STATE RESIDENTS

Vermont continues to have one of the nation’s highest fall rates and its rurality may be a contributing factor. The purpose of our study was to compare fall history and nutritional risk (a fall risk factor also associated with rurality) in participants from rural and metropolitan areas. We collected data at statewide community-based fall risk screenings. During the events, nutritional data was collected using the DETERMINE Your Nutritional Health Screening Tool Questionnaire. We used descriptive statistics (chi2) to examine the relationship between fall history, nutritional risk, and rurality. From 123 subjects, 67% were classified as rural residents. There was no relationship between fall history and nutritional risk (p=0.6). Compared to rural residents, a significantly higher percentage of those living in metropolitan areas reported falls (54% versus 35% p=0.05). However, metropolitan residents were not at higher nutritional risk (49% versus 54%, p=0.61). National nutritional risk rates are lacking, but food insecurity is associated with nutritional risk. Our overall reported high nutritional risk (20%) is higher than the prevalence of food insecurity, both nationally (11%) and in Vermont (9%). In conclusion, we did not identify a relationship between fall history and nutritional risk. We did find a higher percentage of metropolitan residents reporting falls. Furthermore, we identified that DETERMINE is a feasible nutritional screening tool to use at fall risk screenings. It can be used to identify community-dwelling older adults at nutritional risk, but it may not have the sensitivity to identify an association between nutritional risk and falls.