Dizziness is a predictor factor for the risk of falls in institutionalised older adults in Brazil

2021 ◽  
Author(s):  
Felipe Lima Rebêlo ◽  
Luiz Fellipe de Souza Silva ◽  
Heitor Gomes de Araújo Filho ◽  
André Sales Barreto ◽  
Jullyana Souza Siqueira Quintans
Keyword(s):  
Older Adults ◽  
Risk Of Falls ◽  
Predictor Factor

scholarly journals Effects of Dance Therapy on Balance and Risk of Falls in Older Persons

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 234-235
Author(s):  
Esha Chakravarty ◽  
Indrani Chakravarty ◽  
Ipsito Chakravarty ◽  
Prasenjit Bhattacharjee
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Day Care ◽  
Dance Therapy ◽  
Daily Living ◽  
Older Persons ◽  
Healthy Ageing ◽  
Risk Of Falls ◽  
Day Care Centres ◽  
Therapy Sessions

Abstract Loss of balance and risk of falls is a major problem in older persons. Literature shows increasing use of yoga practices and dance therapy across Indian oldage homes and day care centres to improve balance and reduce risk of falls in older persons. Aim of this study is to evaluate the effects of dance therapy with focus on therapeutic movements derived from Indian classical dances on balance and risk of falls in older adults of Day Care Centres in Calcutta Metropolitan Institute of Gerontology, under Ministry of Social Justice and Empowerment, Govt. of India. Total of 24 older adults across 2 day care centres participated in the study attending dance therapy sessions for 3 months. All of them self reported problems of balance and repeated falls alongwith difficulties in performing Activities of Daily Living. Twenty one of them were females and 3 males. The mean age of the participants was 75.5 years. Limits of Stabililty (LOS) was used to measure balance and pre tests and post tests were performed. Results showed that the Limits of Stability were significantly higher (17.5%) in older persons after participating in the dance therapy sessions. This study supports that dance therapy using movements derived from Indian classical dance forms can support older persons to function with reduced risk of falls, improved balance, safely carry out mobility tasks and perform better Activities of Daily Living . Further studies can show how dance therapy can facilitate healthy ageing and influence State policies on healthy ageing.

scholarly journals Inappropriate medications and physical function: a systematic review

2021 ◽  
Vol 12 ◽  
pp. 204209862110303
Author(s):  
Elizabeth Manias ◽  
Md Zunayed Kabir ◽  
Andrea B. Maier
Keyword(s):  
Older Adults ◽  
Physical Function ◽  
Physical Performance ◽  
Inappropriate Medication ◽  
Functional Independence ◽  
Potentially Inappropriate Medications ◽  
Timed Up And Go ◽  
Risk Of Falls ◽  
Prescribing Omissions ◽  
Inappropriate Medications

Background and aims: Inappropriate medication prescription is highly prevalent in older adults and is associated with adverse health outcomes. The aim of this study was to examine the associations between potentially inappropriate medications (PIMS) and potential prescribing omissions with physical function in older adults situated in diverse environments. Methods: A systematic search was completed using the following databases: MEDLINE, CINAHL, PsycINFO, EMBASE and COCHRANE. Results were extracted from the included studies. Results: In total, 55 studies reported on 2,767,594 participants with a mean age of 77.1 years (63.5% women). Study designs comprised 26 retrospective cohort studies, 21 prospective cohort studies and 8 cross-sectional studies. Inappropriate medications in community and hospital settings were significantly associated with higher risk of falls (21 out of 30 studies), higher risk of fractures (7 out of 9 studies), impaired activities of daily living (ADL; 8 out of 10 studies) and impaired instrumental ADL (IADL) score (4 out of 6 studies). Five out of seven studies also showed that PIMs were associated with poorer physical performance comprising the Timed Up and Go test, walking speed, grip strength, time to functional recovery, functional independence and scale of functioning. Many medication classes were implicated as PIMs in falls, fractures and impairment in physical performance including antipsychotic, sedative, anti-anxiety, anticholinergic, antidiabetic, opioid and antihypertensive medications. For patients not receiving musculoskeletal medications, such as calcium, vitamin D and bisphosphonates, older adults were found to be at risk of a hospital admission for a fall or fracture. Conclusion: Inappropriate medication prescriptions are associated with impaired physical function across longitudinal and cross-sectional studies in older adults situated in diverse settings. It is important to support older people to reduce their use of inappropriate medications and prevent prescribing omissions. Plain language summary Inappropriate medications and physical function Background and aims: The use of inappropriate medications is very common in older adults and is associated with harmful health problems. The aim was to examine associations between potentially inappropriate medications and potential prescribing omissions with physical function in older adults situated in diverse environments. Methods: Library databases were examined for possible studies to include and a systematic search was completed. Relevant information was obtained from the included studies. Results: In total, 55 studies reported on 2,767,594 participants who were an average age of 77.1 years and about 6 out of 10 were women. A variety of different study designs were used. Inappropriate medication prescriptions in community and hospital settings were significantly associated with higher risk of falls (21 out of 30 studies), higher risk of fractures (7 out of 9 studies), problems with activities of daily living (ADL), such as eating, bathing, dressing, grooming, walking and toileting (8 out of 10 studies) and problems with instrumental ADL such as managing medications, house cleaning and shopping (4 out of 6 studies). Five out of seven studies also showed that inappropriate medications were associated with poorer physical performance involving the Timed Up and Go test, walking speed, grip strength, time to functional recovery, functional independence and scale of functioning. Many types of medication classes were shown to be associated with a risk of falls, fractures and problems with physical performance. Omitted medications were also associated with falls and fractures. Conclusion: Inappropriate medication prescriptions are associated with problems relating to physical function. It is important to support older people to reduce their use of inappropriate medications and prevent prescribing omissions.

Timed up and go test and risk of falls in older adults: A systematic review

2011 ◽  
Vol 15 (10) ◽  
pp. 933-938 ◽  
Author(s):  
Olivier Beauchet ◽  
B. Fantino ◽  
G. Allali ◽  
S. W. Muir ◽  
M. Montero-Odasso ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Timed Up And Go ◽  
Risk Of Falls ◽  
Falls In Older Adults

Authors’ Reply to Kahlaee et al: “A Systematic Review and Meta-Analyses of the Association Between Anti-hypertensive Classes and the Risk of Falls Among Older Adults”

Drugs & Aging ◽  
2018 ◽  
Vol 36 (1) ◽  
pp. 95-101
Author(s):  
Ka Keat Lim ◽  
Hui Ting Ang ◽  
Yu Heng Kwan ◽  
Chuen Seng Tan ◽  
Truls Ostbye ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Risk Of Falls ◽  
Meta Analyses

scholarly journals Analysis of Falls in Older Adults with Multiple Myeloma Undergoing First-Line Therapy

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 5886-5886
Author(s):  
Kelly L. Schoenbeck ◽  
Tanya M. Wildes ◽  
Mark A. Fiala
Keyword(s):  
Older Adults ◽  
Multiple Myeloma ◽  
Peripheral Neuropathy ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Falls In Older Adults ◽  
First Line Treatment

Background: Patients with multiple myeloma are frequently treated with bortezomib, a proteasome inhibitor, which is associated with treatment-related peripheral neuropathy. Older adults are at increased risk of falls compared to the general population, often leading to associated morbidity and mortality. While an association between peripheral neuropathy and falls in older adults is well-established, the relationship between bortezomib and falls in older multiple myeloma patients is unknown. Our primary aim was to determine if older patients with multiple myeloma treated with bortezomib as first-line therapy had an increased incidence of falls within the first 12 months after starting treatment. Our secondary aim was to assess the overall survival of patients who fell compared to those who did not among patients who lived more than 12 months after initiating treatment. Methods: We analyzed the SEER-Medicare database for all patients 65 years old or older diagnosed with multiple myeloma between 2007 and 2013 and were enrolled in fee-for-service Medicare part A, B and D plans. The patients' corresponding Medicare claims data were analyzed through 2014 for myeloma treatments, fall claims, and covariates of interest. The primary outcome was accidental falls (E880-E888) occurring between 14 days to 12 months after starting multiple myeloma treatment. First-line therapy was defined as any anti-myeloma treatment administered within 14 days of starting multiple myeloma treatment, with bortezomib treatment being the focal independent variable. Cox regression was performed to determine the relative risk of having a fall after controlling for other covariates. Patients who started bortezomib after first-line therapy were censored at time of bortezomib commencement. The survival analysis included only patients who survived more than 12 months of starting treatment to allow landmark analysis of falls in the first year. Results: Of 4,084 older adults with new multiple myeloma diagnoses undergoing first-line therapy, the median age was 75 (range 65-97) with 51% males. Bortezomib was used in first-line therapy for 2,052 (50%) patients, of which 157 (8%) patients experienced a fall within 12 months after starting treatment compared to 102 (5%) of patients not receiving bortezomib (p < 0.001). Bortezomib was associated with a 28% increase risk of falls (HR 1.29; 95% CI 1.00-1.65; p = 0.047). In multivariate analysis, bortezomib was not associated with an increased incidence of falls after controlling for age, gender, race, proxies for Charlson Comorbidity Index (CCI) and poor performance status, pre-existing peripheral neuropathy, falls within the 12 months prior to starting first-line myeloma treatment, depression, polypharmacy, and first-line treatment with lenalidomide (Table 1). Advancing age, history of fall(s), depression, and polypharmacy (defined as more than 10 unique prescription medications at initiation of first-line treatment), were all associated with an increased risk of falls, consistent with prior literature. In a landmark analysis of those who survived 12 months following the start of treatment, a fall was associated with a 26% increased risk of hazard for death (aHR 1.26; 95% CI 1.02-1.56; p = 0.033) after controlling for other covariates. The median OS of those with a fall was 35.7 months (95% CI 29.1-48.4) compared to 49.1 months (95% CI 47.1-52.8) for those without (p < 0.0001). Conclusion: In older adults with multiple myeloma, treatment with bortezomib was not associated with increased risk of a patient having a diagnostic code for falls. However, experiencing a fall within the year after starting treatment was associated with decreased overall survival. Limitations of the study include that the incidence of falls is likely underestimated in billing data, given prior data from our group showing a rate of self-reported falls of 26% in the year after diagnosis. Additional research, including prospective trials involving fall assessments, should be considered in older patients with multiple myeloma. Disclosures Wildes: Janssen: Research Funding; Carevive: Consultancy. Fiala:Incyte: Research Funding.

scholarly journals Inappropriate Medication Use In Older Adults According To Beers Criteria In A Tertiary Referral Hospital, In Bolu, Turkey

2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Burcin M. Atak ◽  
Gulali Aktas ◽  
Tuba T. Duman ◽  
Ozge Kurtkulagi ◽  
Satilmis Bilgin ◽  
...  
Keyword(s):  
Older Adults ◽  
Inappropriate Medication ◽  
Bleeding Risk ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Tertiary Referral Hospital ◽  
Inappropriate Use ◽  
Increased Risk ◽  
Risk Of Falls ◽  
Inappropriate Medications

Aims — We aimed to study the medications used by older adults for any potentially inappropriate medications. Material and Methods — A hundred and four consecutive subjects over 65 years of age who visited our clinic were enrolled in the study. Possible inappropriate medications were defined according to Beers Criteria. Results — A total of 57 women and 49 men were enrolled in the study. Mean ages of the women and men were 78.6±6.1 years and 77.4±5.4 years, respectively (p=0.30). While 18 subjects (17%) had no increased risk due to inappropriate use of medications, 30 were on inappropriate medications that increased renal failure risk, 5 were on inappropriate medication that amplified neurological side effects, 12 were on inappropriate medications that augmented bleeding risk, 20 were on inappropriate medication that lack safety and efficacy data, and 30 were on inappropriate medication that amplified the risk of falls. The number of increased risks according to Beers Criteria was significantly and positively correlated with number of medications used (r=0.366, p<0.001) and the number of comorbidities (r=0.312, p=0.001). Conclusion — The number of increased risks due to inappropriate use of medicines in older adults is positively correlated with the number of medicines used and the number of accompanied diseases. Therefore we suggest that the medicines used by older people should be reviewed in all settings, and unnecessary drugs should be avoided to be prescribed.

scholarly journals Reliability of HOME FAST BRAZIL—Self-Reported Version for Community-Dwelling Older Adults

2021 ◽  
Vol 9 ◽  
Author(s):  
Karina Stella Aoki Ferreira ◽  
Tamires Terezinha Gallo da Silva ◽  
Jarbas Melo Filho ◽  
Natacha Verônica Bazanella ◽  
Audrin Said Vojciechowski ◽  
...  
Keyword(s):  
Older Adults ◽  
Cross Sectional Study ◽  
Environmental Risks ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Rater Reliability ◽  
Risk Of Falls ◽  
History Of ◽  
Spearman Test ◽  
Community Dwelling Older Adults

Objective: Verify the intra- and inter-rater reliability of the HOME FAST BRAZIL—Self-reported version and correlate household environmental risks with the history of falls by community-dwelling older adults.Method: Cross sectional study with 50 community-dwelling older adults who were screened by the cut-off point of the Mini Mental State Exam and replied to the HOME FAST BRAZIL—Self-reported version using two evaluators, on three occasions. The reliability analysis was determined by the Intra-class Correlation Coefficient (ICC), considering ICC &gt; 0.70 as adequate. To test the correlations, the Spearman test was used.Results: The mean age of the participants was 73.2 ± 5.8 years. The inter- rater reliability of HOME FAST BRAZIL—Self-reported version was ICC 0.83 (IC95%, 0.70–0.90) and the Intra- reliability ICC 0.85 (IC95%, 0.74–0.91). A risk of falls was verified in 88% of the sample and four environmental risks presented significant correlations with the history of falls.Conclusions: The HOME FAST BRAZIL—Self-reported version presented adequate reliability for the evaluation of household environmental risks for community-dwelling older adults. Risks such as inadequate armchairs/ sofas, the absence of anti-slip mats in the shower recess, the presence of pets and inadequate beds require attention in the evaluation of household risks, due to their correlation with the occurrence of falls.

scholarly journals Influence of the length of institutionalization on older adults' postural balance and risk of falls: a transversal study

2014 ◽  
Vol 22 (4) ◽  
pp. 645-653 ◽  
Author(s):  
Wagner Oliveira Batista ◽  
Edmundo de Drummond Alves Junior ◽  
Flávia Porto ◽  
Fabio Dutra Pereira ◽  
Rosimere Ferreira Santana ◽  
...  
Keyword(s):  
Older Adults ◽  
Postural Control ◽  
Postural Balance ◽  
Center Of Pressure ◽  
Berg Balance Scale ◽  
Clinical Tests ◽  
Risk Of Falls ◽  
Elliptical Area ◽  
Professional Model ◽  
Transversal Study

OBJECTIVE: to ascertain the influence of the length of institutionalization on older adults' balance and risk of falls.METHOD: to evaluate the risk of falls, the Berg Balance Scale and the Timed Get Up and Go test were used; and for measuring postural balance, static stabilometry was used, with acquisition of the elliptical area of 95% and mean velocities on the x and y axes of center of pressure displacement. Parametric and nonparametric measures of association and comparison (α<0.05) were used.RESULTS: there was no significant correlation between the length of institutionalization and the tests for evaluation of risk of falling, neither was there difference between groups and within subgroups, stratified by length of institutionalization and age. In the stabilometric measurements, there was a negative correlation between the parameters analyzed and the length of institutionalization, and difference between groups and within subgroups.CONCLUSION: this study's results point to the difficulty of undertaking postural control tasks, showing a leveling below the clinical tests' reference scores. In the stabilometric behavior, one should note the reduction of the parameters as the length of institutionalization increases, contradicting the assumptions. This study's results offer support for the development of a multi-professional model for intervention with the postural control and balance of older adults living in homes for the aged.

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