scholarly journals 10 Fear of Falling in Community Dwelling Ambulatory Older Patients: Associations with Physiological Falls Risk, Cognition and Mood Disorders

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i1-i6
Author(s):  
H Dolphin ◽  
A McFeely ◽  
S Kennelly ◽  
S Mello
Keyword(s):  
Mood Disorders ◽  
Fear Of Falling ◽  
Retrospective Chart Review ◽  
Community Dwelling ◽  
Rapid Decline ◽  
Day Hospital ◽  
Timed Up And Go ◽  
Targeted Interventions ◽  
Age Related ◽  
Increased Risk

Abstract Introduction Fear of falling (FOF) is associated with a range of adverse health outcomes including increased risk of falls1, and more rapid decline in physical and cognitive function2. We aim to determine the prevalence of FOF amongst ambulatory community dwelling older adults attending an Age-Related Day Hospital, and to describe it’s associations with cognition, mood disorders, frailty and mobility measures. Methods A retrospective chart review was conducted on 50 patients attending the Day Hospital. Baseline demographics collected include comorbidities, medications, and falls history. Objective mobility measurements include the Timed Up and Go (TUG) test and grip strength. Patients were divided into two groups based on their answer to the question, “Are you afraid of falling?” Differences between groups were compared using chi-squared test. Results The average age of Day Hospital attendees was 85 (SD X). 62% were male. Three quarters of patients experienced a recent fall, and half admitted to FOF. Those with FOF were more likely to be dependent in personal care (27% vs 16%, p = 0.15) and use a walking aid (69% vs 58%, p = 0.02). They were also more likely to be prescribed psychoactive medications (53% vs 45%, p = 0.42), and have a diagnosis of anxiety (4% vs 0%, p = 0.03). Conclusions Both having a falls history and FOF is prevalent in our Day Hospital population. FOF is associated with high physiological risk of falling, increased dependency, and anxiety. Standardization of mobility measures and potential screening for cognitive and mood disorders in patients with FOF will aid in further development of targeted interventions.

Motor Imagery Deficits in High-Functioning Older Adults and its Impact on Fear of Falling and Falls

2021 ◽  
Author(s):  
Ryota Sakurai ◽  
Manuel Montero-Odasso ◽  
Suzuki Hiroyuki ◽  
Susumu Ogawa ◽  
Yoshinori Fujiwara
Keyword(s):  
Older Adults ◽  
Motor Imagery ◽  
Fear Of Falling ◽  
Motor Planning ◽  
Community Dwelling ◽  
Timed Up And Go ◽  
Increased Risk ◽  
Fast Pace ◽  
The Difference

Abstract Background Older adults at risk of falling or who have fear of falling (FoF) present a discrepancy between “imagined” and “performed” actions. Using the gait-related motor imagery (MI) paradigm, we investigated whether prediction accuracy in motor execution is associated with the onset of FoF and with prospective falls among older adults with FoF. Methods A cohort of 184 community-dwelling older adults was tested for imaginary and executed Timed Up and Go (TUG) tests at a fast pace at baseline. They were first asked to imagine performing TUG and estimate the time taken to complete it (iTUG), and then, to perform the actual trial (aTUG); the difference between the two times was calculated. Prospective falls were monitored between baseline and 2-year follow-up of FoF assessment. Results At follow-up, 27 of 85 participants without FoF at baseline (31.8%) had developed FoF. Twenty-seven of 99 participants (27.2%) with FoF at baseline experienced falls. A significantly shorter iTUG duration, when compared with aTUG, was observed in those who developed FoF or experienced multiple prospective falls, indicating overestimation of their TUG performance. The adjusted logistic regression model showed that a greater ΔTUG (i.e., tendency to overestimate) at baseline was associated with an increased risk of new-onset FoF among those without FoF at baseline and multiple prospective falls among those with FoF at baseline. Conclusions Deficits in MI (i.e., overestimation of physical capabilities), reflecting impairment in motor planning, could provide an additional explanation of the high risk of FoF and recurrent falls among people with FoF.

Gastrointestinal Microbiota and Their Contribution to Healthy Aging

2016 ◽  
Vol 34 (3) ◽  
pp. 194-201 ◽  
Author(s):  
Anna Maria Mello ◽  
Giulia Paroni ◽  
Julia Daragjati ◽  
Alberto Pilotto
Keyword(s):  
Old Age ◽  
Healthy Aging ◽  
Adverse Outcomes ◽  
Microbiota Composition ◽  
Older Individuals ◽  
Gastrointestinal Microbiota ◽  
Targeted Interventions ◽  
Age Related ◽  
Increased Risk ◽  
Older Subjects

Studies on populations at different ages have shown that after birth, the gastrointestinal (GI) microbiota composition keeps evolving, and this seems to occur especially in old age. Significant changes in GI microbiota composition in older subjects have been reported in relation to diet, drug use and the settings where the older subjects are living, that is, in community nursing homes or in a hospital. Moreover, changes in microbiota composition in the old age have been related to immunosenescence and inflammatory processes that are pathophysiological mechanisms involved in the pathways of frailty. Frailty is an age-related condition of increased vulnerability to stresses due to the impairment in multiple inter-related physiologic systems that are associated with an increased risk of adverse outcomes, such as falls, delirium, institutionalization, hospitalization and death. Preliminary data suggest that changes in microbiota composition may contribute to the variations in the biological, clinical, functional and psycho-social domains that occur in the frail older subjects. Multidimensional evaluation tools based on a Comprehensive Geriatric Assessment (CGA) have demonstrated to be useful in identifying and measuring the severity of frailty in older subjects. Thus, a CGA approach should be used more widely in clinical practice to evaluate the multidimensional effects potentially related to GI microbiota composition of the older subjects. Probiotics have been shown to be effective in restoring the microbiota changes of older subjects, promoting different aspects of health in elderly people as improving immune function and reducing inflammation. Whether modulation of GI microbiota composition, with multi-targeted interventions, could have an effect on the prevention of frailty remains to be further investigated in the perspective of improving the health status of frail ‘high risk' older individuals.

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 Differential associations of functional and cognitive health outcomes with pre-frailty and frailty states in community-dwelling older adults

2018 ◽  
Vol 25 (8) ◽  
pp. 1057-1063 ◽  
Author(s):  
Caitlin Sleight ◽  
Roee Holtzer
Keyword(s):  
Older Adults ◽  
New York ◽  
Health Outcomes ◽  
Verbal Memory ◽  
Community Dwelling ◽  
Functional Health ◽  
Targeted Interventions ◽  
Health Decline ◽  
Age Related ◽  
Perceived Difficulty

This study examined associations of pre-frailty and frailty states with cognitive and functional health outcomes among community-residing older adults ( N = 457) in the Bronx, New York. Results: older adults who met criteria for frailty demonstrated poorer performance in attention, verbal memory, and overall global cognitive functioning compared to healthy controls. Moreover, pre-frail and frail older adults had significantly worse health outcomes including greater perceived difficulty with lower and upper extremity functioning and perceived limitations in completing daily activities, suggesting the need for targeted interventions in the community that may ameliorate age-related health decline.

Fear of Falling and Balance Ability in Older Men: The Priest Study

2013 ◽  
Vol 21 (4) ◽  
pp. 375-386 ◽  
Author(s):  
Dennis W. Klima ◽  
Roberta A. Newton ◽  
Emily A. Keshner ◽  
Adam Davey
Keyword(s):  
Fear Of Falling ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Berg Balance Scale ◽  
Community Dwelling ◽  
Assistive Device ◽  
Timed Up And Go ◽  
Age Cohorts ◽  
Balance Confidence ◽  
Balance Ability

Studies examining fear of falling among older adult men remain limited. The objectives of this study were to compare balance confidence in 2 age cohorts of older clergy and identify predictive determinants of balance confidence in a liturgical research initiative. Participants included 131 community-dwelling Roman Catholic priests age 60–97 yr living in religious communities in 10 mid-Atlantic states. Subjects completed the Activities-specific Balance Confidence Scale (ABC), Berg Balance Scale (BBS), timed up-and-go (TUG) test, and 15-item Geriatric Depression Scale (GDS). Younger priests (60–74 yr) demonstrated a significantly higher ABC score than the older cohort (75 and above yr) of priests (89.1 ± 12.6 vs.78.4 ± 13.9,p= .001). Confidence was significantly correlated with BBS (rho = .69,p< .01), TUG (r= –.58,p< .01), and GDS (r= –.39,p< .01) scores. A stepwise-regression model demonstrated that balance ability, mood, assistive-device use, and physical activity predicted 52% of the variance in balance confidence.

scholarly journals Hearing Care Disparities in Dementia: Access and Usability in the Coming Era of OTC Hearing Aids

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 746-746
Author(s):  
Carrie Nieman ◽  
Jennifer Deal ◽  
Sara Czaja ◽  
Esther Oh
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Neuropsychiatric Symptoms ◽  
Community Dwelling ◽  
Structured Interviews ◽  
Hearing Aid Use ◽  
Age Related ◽  
Care Partners ◽  
Increased Risk

Abstract Age-related hearing loss is highly prevalent among persons with dementia (PwDs) and is associated with an increased risk of neuropsychiatric symptoms. However, few use hearing aids and disparities exist. PwDs and, in particular, minority older adults, have some of the lowest rates of hearing aid use. Recent federal legislation created the designation of over-the-counter hearing aids, which will debut by 2020-2021, and represents an opportunity to advance accessibility. This presentation will share estimates of hearing aid use among community-dwelling PwDs from two cohorts, where hearing aid use ranges from 7-11% among African Americans versus 33-45% among whites. To explore this gap, the presentation will share findings from semi-structured interviews with care partners of PwDs and hearing loss around barriers and facilitators of hearing care, including device usability. With growing understanding of sensory health, a changing hearing care landscape represents a critical opening to increase access to hearing care for PwDs. Part of a symposium sponsored by the Alzheimer’s Disease Research Interest Group.

scholarly journals Does the shoe really fit? Characterising ill-fitting footwear among community dwelling older adults: an observational cross-sectional study

2020 ◽  
Author(s):  
Brian O'Rourke ◽  
Mary E Walsh ◽  
Rachael Brophy ◽  
Shanice Vallely ◽  
Niamh Murphy ◽  
...  
Keyword(s):  
Older Adults ◽  
Older People ◽  
Demographic Data ◽  
Functional Independence ◽  
Community Dwelling ◽  
Day Hospital ◽  
Timed Up And Go ◽  
Shoe Size ◽  
Foot Length ◽  
At Home

Abstract Background : Falls in older people are common and can result in loss of confidence, fear of falling, restriction in activity and loss of independence. Causes of falls are multi-factorial. There is a paucity of research assessing the footwear characteristics among older people who are at high risk of falls, internationally and in the Irish setting. The aim of this study was to examine the proportion of older adults attending a geriatric day hospital in Ireland who were wearing incorrectly sized shoes. Methods : A consecutive sample of 111 older adults aged 60 years and over attending a geriatric day hospital in a large Irish teaching hospital was recruited. Demographic data including age, mobility, medications, co-habitation status, footwear worn at home and falls history were recorded. Shoe size and foot length were measured in millimetres using an internal shoe gauge and SATRA shoe size stick, respectively. Participants’ self-reported shoe size was recorded. Footwear was assessed using the Footwear Assessment Form (FAF). A Timed Up and Go (TUG) score was recorded. Functional independence was assessed using the Nottingham Extended Activities of Daily Living (NEADL) Scale. The primary outcome of interest in this study was selected as having footwear within the suggested range (10 to 15mm) on at least one foot. Participants who met this definition were compared to those with ill-fitting footwear on both feet using Chi-square tests, T-tests or Mann–Whitney U tests. Results : The mean difference between shoe length and foot length was 18.6mm (SD: 9.6mm). Overall, 72% of participants were wearing footwear that did not fit correctly on both feet, 90% had shoes with smooth, partly worn or fully worn sole treading and 67% reported wearing slippers at home. Participant age, TUG score and NEADL score were not associated with ill-fitting footwear. Conclusions : Wearing incorrectly fitting shoes and shoes with unsafe features was common among older adults attending geriatric day services in this study. A large number of participants reported wearing slippers at home.

scholarly journals Gonadotropins at Advanced Age - Perhaps They Are Not So Bad? Correlations Between Gonadotropins and Sarcopenia Indicators in Older Adults

2021 ◽  
Vol 12 ◽  
Author(s):  
Agnieszka Guligowska ◽  
Zuzanna Chrzastek ◽  
Marek Pawlikowski ◽  
Malgorzata Pigłowska ◽  
Hanna Pisarek ◽  
...  
Keyword(s):  
Gait Speed ◽  
Handgrip Strength ◽  
Functional Decline ◽  
Treatment Strategies ◽  
Community Dwelling ◽  
Blood Levels ◽  
Timed Up And Go ◽  
Female Community ◽  
Age Related ◽  
European Working

Many hormones fluctuate during the aging process. It has been suggested that gonadotropins, which increase with age, contribute to the occurrence of many diseases and syndromes in older life, such as cardiovascular diseases, obesity, frailty syndrome and osteoporosis. This study aims to assess the relationship between circulating gonadotropins and other hormones potentially contributing to age-related functional decline and sarcopenia indicators in 39 male and 61 female community-dwelling seniors, mean age 80 years. According to the definition developed by the second European Working Group on Sarcopenia in Older People (EWGSOP2), the following indicators of the sarcopenia were assessed: bioimpedance-measured body composition, gait speed, handgrip strength, timed up and go test (TUG), chair stand test, Short Physical Performance Battery (SPPB). Blood levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, testosterone, dehydroepiandrosterone sulphate (DHEAS) and cortisol were also measured. In the men, FSH and partially LH correlated positively with muscle mass percentage, gait speed, handgrip strength and SPPB, and negatively with percent body fat. Additionally, testosterone and DHEAS correlated negatively with the percentage of fat mass in men. Whereas in the women, FSH and LH were mainly negatively associated with body mass and adipose tissue measures. Cortisol did not show any relationship with the examined indicators. The study shows that the indicators of sarcopenia are strongly associated with levels of gonadotropins, sex hormones and DHEAS, especially in older men. The obtained results, after being confirmed in a larger group, may modify prevention and treatment strategies of sarcopenia.

scholarly journals Az eleséstől való félelem otthon élő idősek körében

2019 ◽  
Vol 160 (5) ◽  
pp. 191-197
Author(s):  
Éva Kovács ◽  
Réka Laura Erdős ◽  
Anna Niké Petridisz ◽  
Franciska Rozs ◽  
András Simon
Keyword(s):  
Fear Of Falling ◽  
Chronic Illnesses ◽  
Functional Mobility ◽  
Older Individuals ◽  
Targeted Interventions ◽  
Age Related ◽  
Health Factors ◽  
Gender And Health ◽  
Impaired Balance ◽  
Hungarian Version

Abstract: Introduction: Due to fear of falling, older people may restrict their activities, causing muscle weakness and impaired balance and, consequently, admission to an institute. Accordingly, fear of falling is a common and serious health problem among older individuals. The prevalence of the fear of falling and its associated factors as well as possible preventive and therapeutic methods have been widely investigated in geriatrics. Aim: The aim of our study was to describe the prevalence of the fear of falling and its associations with demographic (age, gender) and health factors (age-related chronic diseases, functional mobility, falling in the previous year, medications) among community-living older adults. Method: Two-hundred individuals participated in the study. The fear of falling was diagnosed based on the cut-off value of the short Falls Efficacy Scale – International (FES-I). Logistic regression analysis was used to assess associations. In total, 61 participants were diagnosed with fear of falling. Results: In our sample, the fear of falling was associated with age, the number of diseases and functional mobility. Conclusion: The short FES-I is simple, easy to fill-out and has a validated Hungarian version as well. By its use, people of higher age affected by multiple chronic illnesses are primarily worth of screening in order to identify those who are in need for further more detailed examinations and, if needed, more targeted interventions. Orv Hetil. 2019; 160(5): 191–197.

scholarly journals Does self-report of multimorbidity in later life predict impaired physical functioning, and might this be useful in clinical practice?

2020 ◽  
Vol 32 (8) ◽  
pp. 1443-1450
Author(s):  
Michael A. Clynes ◽  
Gregorio Bevilacqua ◽  
Karen A. Jameson ◽  
Cyrus Cooper ◽  
Elaine M. Dennison
Keyword(s):  
Older Adults ◽  
Physical Function ◽  
Physical Functioning ◽  
Later Life ◽  
Community Dwelling ◽  
Self Report ◽  
Timed Up And Go ◽  
Increased Risk ◽  
Community Dwelling Older Adults ◽  
Function Testing

Abstract Background Multimorbidity has been shown in several studies to relate to impaired physical function in later life. Aims To examine if self-report of multimorbidity predicts impaired physical functioning, as assessed by formal physical function testing, in community-dwelling older adults. Methods Non-communicable diseases (NCDs) were self-reported by 443 older community-dwelling UK adults via questionnaire, asking the question: ‘Have you been told by a doctor that you have any of the following conditions?’ Assessments of walking speed, chair stands and balance allowed us to create a composite score (0–12) on which impaired physical functioning was defined as ≤ 9. Results The mean age of participants was 75.5 ± 2.5 years for men and 75.8 ± 2.6 for women. The proportion of individuals with impaired physical functioning was 71.2% in women and 56.9% in men. Having four or more NCDs was associated with an increased risk of poor physical function in men and women (p < 0.05). The number of medications and medicated systems was associated with gait speed (p < 0.03 and < 0.02, respectively) and timed up-and-go tests (p < 0.03 and < 0.02, respectively) in women but not men. Discussion and conclusion Self-report of 4 or more NCDs was associated with an increased risk of poor physical function, an outcome which has previously been associated with adverse clinical sequelae. This observation may inform development of a simple screening tool to look for poor physical function in older adults.

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