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 86 Fear of Falling as Measured by the Falls Efficacy Scale International Indicates Gait and Balance Abnormalities in Community Dwelling Older People

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i28-i29
Author(s):  
J Gibbon ◽  
H Trundle ◽  
D Green ◽  
V Strassheim ◽  
M Linsley ◽  
...  
Keyword(s):  
Older People ◽  
Fear Of Falling ◽  
Characteristic Curve ◽  
Balance Training ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Risk Of Falling ◽  
Timed Up And Go ◽  
Balance Tests ◽  
Community Dwelling Older People

Abstract Background Falls are common in community dwelling older people, and gait and balance abnormalities (GABAb) are a key modifiable risk factor, through strength and balance training. In addition, there is a strong relationship between fear of falling (FoF) and GABAb , though Falls Efficacy Scale-International version (FES-I) scores have never been examined in this context. Our aim was to determine whether FoF, as measured by the FES-I, is associated with GABAb, as determined by commonly used gait and balance tests. Methods Consecutive patients attending our community falls prevention service completed FES-I questionnaires, and had Gait Speed (GS), Five Times Sit to Stand (FTSTS) and Timed Up and Go (TUG) tests assessed as part of a multifactorial falls prevention assessment. Cut-offs for falls risk are provided in the table. Sensitivity and specificity values for a 16-item FES-I cut-off score of 23.5 (&gt;23 signifying significant FoF) were evaluated using the area under a receiver operating characteristic curve (AUROC), along with positive and negative likelihood ratios (LR+/LR-). Results There were 991 participants, 352 male, 639 female, mean age 74.5 years, mean FES-I score 28.7 and 57.0% had experienced at least one fall in the previous year. Gait and balance test scores were moderately associated with FoF per FES-I ≥23.5 as shown in the table. Specificities and sensitivities for all three are similar to commonly used diagnostic tests such as exercise testing versus coronary angiography for coronary artery disease. Conclusions FoF as measured by the FES-I is associated with scores on commonly used gait and balance tests that indicate a high risk of falling. This study highlights the potential of using FES-I as a screening tool to identify community dwelling older adults at risk of falling who may benefit from strength and balance training rather than relying on physical tests that are rarely performed outside falls clinics and physiotherapy departments. This application may have utility both in opportunistic individual screening and community screening programmes.

scholarly journals 24-Months Cluster-Randomized Intervention Trial of a Targeted Fall Prevention Program in a Primary Care Setting

2021 ◽  
Author(s):  
Christian Hentschke ◽  
Martin Halle ◽  
Barbara Geilhof ◽  
Peter Landendoerfer ◽  
Wolfgang Blank ◽  
...  
Keyword(s):  
Primary Care ◽  
High Risk ◽  
Fall Prevention ◽  
Care Setting ◽  
Primary Care Setting ◽  
Fear Of Falling ◽  
Community Dwelling ◽  
Risk Of Falling ◽  
Injurious Falls ◽  
Cluster Randomized

Abstract Background Falls and fall-related injuries are common in community-dwelling older persons. Longitudinal data on effective fall prevention programs are rare. Objective Therefore, we evaluated a 4-months multi-component exercise fall prevention program in a primary care setting on long-term effects over 24 months on falls and concomitant injuries in older community-dwelling persons with high risk of falling. Design and Setting In the Prevention of Falls (PreFalls) study, forty general practitioners in Germany were cluster-randomized (1:1) into an intervention group (IG) or control group (CG). Three hundred seventy-eight independently living people with high risk of falling (78.1 ± 5.9 years, 75% women) were assigned to IG (n = 222) or CG (n = 156). Intervention and Measurements Patients in IG took part in a 4-months multi-component exercise program comprising strength and balance exercises (28 sessions); patients in CG received no intervention. Primary outcome measure was number of falls over 24 months, analyzed by a patient-level, linear mixed Poisson model. Secondary endpoints were number of fall-related injuries, changes in physical function, fear of falling, and mortality. Results After 24 months, the IG demonstrated significantly fewer falls (IRR = 0.63, p = 0.021), injurious falls (IRR = 0.69, p = 0.034), and less fear of falling (p = 0.005). The mortality rate was 5.0% in IG and 10.3% in CG (HR = 0.51, 95% CI: 0.24 to 1.12; p = 0.094). Conclusions In older community-dwelling persons with high risk of falling, a short-term multi-component exercise intervention reduced falls and injurious falls, as well as fear of falling over 24 months.

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

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.

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.

Abstract MP048: Partner Violence is Associated with Higher Blood Pressure in Men and Women

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Cari J Clark ◽  
Susan A Everson-Rose ◽  
Resnick Michael ◽  
Iris Borowsky ◽  
Sonya S Brady ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Partner Violence ◽  
Male Victims ◽  
Men And Women ◽  
Standard Procedures ◽  
Conflict Tactics Scales ◽  
History Of ◽  
Conflict Tactics ◽  
The Relationship ◽  
Revised Conflict Tactics Scales

Introduction: Women are more likely to experience distress and injury from intimate partner violence (IPV), and may also be at greater risk of higher blood pressure than male victims. However, most prior epidemiologic research has not included men and has not examined perpetation, despite the predominance of mutually violent relationships. Therefore, this study investigates sex differences in the relationship between exposure to IPV victimization and perpetration and systolic blood pressure (SB). Methods: The study included 3447 (52% female; mean(sd) age=22(3)) participants of Waves 3 (2001–2002) and 4 (2007) of the publically-available subset of the National Longitudinal Study of Adolescent Health. Frequency of psychological, physical, sexual IPV and IPV-related injury were ascertained with the Revised Conflict Tactics Scales at Wave 3. Exposure to IPV was categorized as no IPV victimization or perpetration (ref), only low victimization and / or perpetration, high victimization and low/no perpetration, high perpetration and low/no victimization, and both high victimization and perpetration. SBP was measured at Wave 4 using standard procedures. Potential confounders (age, educational attainment, race, history of child abuse) and mediators (depressive symptoms, breakfast consumption, moderate physical exercise, BMI, smoking, alcohol consumption) were recorded at Wave 3. Multivariable weighted linear regression was used to test the relationship between SBP and IPV by adjusting for confounders then by adjusting for the proposed mediators. Analyses were stratified by sex and a multiplicative term was tested. Results: Approximately 30% of the sample reported IPV exposure (n=2050), of which 23% (n=831) experienced low victimization and or perpetration, 5% (n=157) high victimization, 6% (N=203) high perpetration, 6% (n=206) both high victimization and perpetration. Women were slightly more likely to report high perpetration and both high victimization and high perpetration (p<0.01). In separate models controlling for confounders, experiencing both high victimization and perpetration was associated with 4.02 mmHg SBP higher in men (95% CI: 0.32, 7.72) and 2.51 mmHg SBP higher in women (95% CI: 0.18, 4.84) compared to those with no IPV. In addition, reporting high perpetration was associated with 3.83 mmHg higher SBP in men (95% CI: –0.72, 8.38), while high victimization was associated with 2.94 mmHg higher SBP for women (95% CI: –0.61, 6.49). Further adjustment for the hypothesized mediators slightly attenuated the findings. The multiplicative term (IPV X sex) was marginally significant (p=0.09). Conclusions: Exposure to high levels of victimization and perpetration is associated with higher levels of SBP for men and women. High victimization alone is related to higher SBP for women while high perpetration is related to higher SBP for men.

Association between a history of falls and the ability to multi-task in community-dwelling older people

2010 ◽  
Vol 22 (5-6) ◽  
pp. 427-432 ◽  
Author(s):  
Hyuma Makizako ◽  
Taketo Furuna ◽  
Hiroyuki Shimada ◽  
Hikaru Ihira ◽  
Mika Kimura ◽  
...  
Keyword(s):  
Older People ◽  
Community Dwelling ◽  
History Of ◽  
Community Dwelling Older People

scholarly journals GENITOURINARY MYIASIS CAUSED BY MUSCA DOMESTICA: REGARDING A SINGULAR

2021 ◽  
Vol 9 (10) ◽  
pp. 444-449
Author(s):  
Fz. Lazrak ◽  
◽  
L. Darfaoui ◽  
M. Oujidi ◽  
Y. Islah ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Emergency Room ◽  
Post Partum ◽  
University Hospital ◽  
History Of Surgery ◽  
Obstetric Emergency ◽  
Iron Treatment ◽  
History Of ◽  
Parasitological Study

A 27-year-old woman from and resident in ourika(Marrakesh region – Morocco) with a history of anemia under iron treatment, without a history of surgery, has G1 P1. Presented to the Mohamed VI University Hospital on day 21 post partum of a vaginal birth at home, the evolution was marked by the appearance of urinary incontinence treated in the emergency room by placing a catheter urinary on day 6 post partum then send to her home for the COVID 19 context, then the patient consulted again at the gyneco-obstetric emergency room for deterioration of the general condition in a picture of hemodynamic shock. On physical examination, the patient was hemodynamically unstable with blood pressure figures of 70/40 mmhg, heart rate at 50 bpm, temperature at 35 ° and mucosal skin pallor.Examination of the vaginal cavity showed the presence of numerous whitish-looking maggots, a sample was taken by the biology team that collected the maggots for the purpose of a parasitological study to identify the parasite responsible.

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.

Somatosensory Impairments, Falls History and Fear of Falling in Glaucoma - A Survey Study Approach

2021 ◽  
Vol 65 (1) ◽  
pp. 11-15
Author(s):  
Caitlin O’Connell ◽  
Gadi Wollstein ◽  
Ian P. Conner ◽  
Mark S. Redfern ◽  
Kevin C. Chan ◽  
...  
Keyword(s):  
Visual Field ◽  
Older Workers ◽  
Daily Living ◽  
Fear Of Falling ◽  
Survey Study ◽  
Risk Of Falling ◽  
Study Approach ◽  
Increased Risk ◽  
Visual Field Deficits ◽  
The Relationship

The primary aim was to determine if somatosensory impairments alter the association between falls history and glaucoma severity. A secondary aim was to identify the activities of daily living that cause increased concern related to falling in glaucoma and their association with glaucoma severity. Established questionnaires about falls and fear of falling (FoF) were mailed to participants diagnosed with glaucoma. Ninety-eight participants responded. Self-reported feet numbness and tingling symptoms were used to determine the presence of somatosensory impairments. Self-reported falls in glaucoma are associated with visual field deficits in both eyes, particularly in the presence of somatosensory impairments. In addition, increased FoF levels are linked with worse visual field deficits in both eyes, especially when performing challenging walking tasks. Somatosensory impairments alter the relationship between falls risk and visual field deficits in glaucoma. This information may be helpful in identifying older workers at an increased risk of falling.

Sign in / Sign up

Export Citation Format

Share Document