scholarly journals Risk Factors for Injurious Falls in Older Adults: The Role of Sex and Length of Follow-Up

2018 ◽  
Vol 67 (2) ◽  
pp. 246-253 ◽  
Author(s):  
Stina Ek ◽  
Debora Rizzuto ◽  
Laura Fratiglioni ◽  
Amaia Calderón-Larrañaga ◽  
Kristina Johnell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Injurious Falls ◽  
Falls In Older Adults

scholarly journals The association between injurious falls and older adults’ cognitive function: the role of depressive mood and physical performance

2021 ◽  
Author(s):  
Caterina Trevisan ◽  
Enrico Ripamonti ◽  
Giulia Grande ◽  
Federico Triolo ◽  
Stina Ek ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Physical Performance ◽  
Walking Speed ◽  
Depressive Mood ◽  
Time Interval ◽  
Injurious Falls

Abstract Background The impact of falls on cognitive function is unclear. We explored whether injurious falls are associated with cognitive decline in older adults, and evaluated the role of changes in psychological and physical health as mediators of such association. Methods This prospective study involved 2,267 community-dwelling participants in the Swedish National study on Aging and Care in Kungsholmen (≥60 years). Data on injurious falls (i.e., falls requiring medical attention) during each 3-year time interval of follow-up were obtained from national registers. Assessment of cognitive function (Mini-Mental State Examination[MMSE]), depressive mood (Montgomery-Åsberg Depression Rating Scale), and physical performance (walking speed) were carried out every 3 or 6 years over a 12-year follow-up. The association between falls and cognition was estimated through linear mixed effects models, and the mediating role of changes in depressive mood and physical performance was tested using mediation analysis. Results After adjusting for potential confounders, individuals who experienced injurious falls had a greater annual decline in MMSE in the subsequent time interval (β=-1.49, 95%CI:-1.84;-1.13), than those who did not. The association increased with the occurrence of ≥2 falls (β=-2.13, 95%CI:-2.70;-1.56). Worsening of walking speed and depressive mood explained around 26% and 8%, respectively, of the association between falls and cognitive decline. Conclusions Injurious falls are associated with greater cognitive decline, and this association is partly mediated by worsening of physical performance and, in a lesser extent, of depressive mood. These findings suggest that physical deficits and low mood are potential therapeutic targets for mitigating the association between falls and cognitive decline.

Peak Expiratory Flow and the Risk of Injurious Falls in Older Adults: The Role of Physical and Cognitive Deficits

2020 ◽  
Vol 21 (9) ◽  
pp. 1288-1294.e4
Author(s):  
Caterina Trevisan ◽  
Debora Rizzuto ◽  
Stina Ek ◽  
Stefania Maggi ◽  
Giuseppe Sergi ◽  
...  
Keyword(s):  
Older Adults ◽  
Peak Expiratory Flow ◽  
Cognitive Deficits ◽  
Injurious Falls ◽  
Falls In Older Adults ◽  
Expiratory Flow

scholarly journals Chronic Pain and Risk of Injurious Falls in Community-Dwelling Older Adults

2020 ◽  
Author(s):  
Yurun Cai ◽  
Suzanne G Leveille ◽  
Ling Shi ◽  
Ping Chen ◽  
Tongjian You
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Community Dwelling ◽  
Pain Interference ◽  
Fall Injuries ◽  
Injurious Falls ◽  
Increased Risk ◽  
Falls In Older Adults ◽  
Pain Characteristics

Abstract Background Fall injuries are a leading cause of death in older adults. The potential impact of chronic pain characteristics on risk for injurious falls is not well understood. This prospective cohort study examined the relationship between chronic pain and risk for injurious falls in older adults. Method The MOBILIZE Boston Study enrolled 765 community-dwelling adults aged 70 years and older living in and around Boston, Massachusetts. Chronic pain characteristics, including pain severity, pain interference, and pain distribution, were measured at baseline using the Brief Pain Inventory subscales and a joint pain questionnaire. Occurrence of falls and fall-related injuries were recorded using monthly fall calendar postcards and fall follow-up interviews during the 4-year follow-up period. Results Negative binomial regression models showed that pain interference and pain distribution, but not pain severity, independently predicted injurious falls adjusting for potential confounders. Participants in the highest third of pain interference scores had a 61% greater risk of injurious falls compared to those reporting little or no pain interference. Compared to no pain, multisite pain was associated with a 57% greater risk of injurious falls. Stratified by gender, the association was only significant in women. In the short term, moderate-to-severe pain in a given month was associated with increased risk of injurious falls in the subsequent month. Conclusions Global pain measures are associated with increased risk of injurious falls in older adults. Pain assessment should be incorporated into fall risk assessments. Interventions are needed to prevent fall injuries among elders with chronic pain.

Psychological Resilience Provides No Independent Protection From Suicidal Risk

Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 130-139 ◽  
Author(s):  
Danica W. Y. Liu ◽  
A. Kate Fairweather-Schmidt ◽  
Richard Burns ◽  
Rachel M. Roberts ◽  
Kaarin J. Anstey
Keyword(s):  
Risk Factors ◽  
Well Being ◽  
Current Status ◽  
Psychological Resilience ◽  
Cross Sectional ◽  
Life Project ◽  
Resilience Factors ◽  
First Time

Abstract. Background: Little is known about the role of resilience in the likelihood of suicidal ideation (SI) over time. Aims: We examined the association between resilience and SI in a young-adult cohort over 4 years. Our objectives were to determine whether resilience was associated with SI at follow-up or, conversely, whether SI was associated with lowered resilience at follow-up. Method: Participants were selected from the Personality and Total Health (PATH) Through Life Project from Canberra and Queanbeyan, Australia, aged 28–32 years at the first time point and 32–36 at the second. Multinomial, linear, and binary regression analyses explored the association between resilience and SI over two time points. Models were adjusted for suicidality risk factors. Results: While unadjusted analyses identified associations between resilience and SI, these effects were fully explained by the inclusion of other suicidality risk factors. Conclusion: Despite strong cross-sectional associations, resilience and SI appear to be unrelated in a longitudinal context, once risk/resilience factors are controlled for. As independent indicators of psychological well-being, suicidality and resilience are essential if current status is to be captured. However, the addition of other factors (e.g., support, mastery) makes this association tenuous. Consequently, resilience per se may not be protective of SI.

scholarly journals Effects of the visual-feedback-based force platform training with functional electric stimulation on the balance and prevention of falls in older adults: a randomized controlled trial

PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e4244 ◽  
Author(s):  
Zhen Li ◽  
Xiu-Xia Wang ◽  
Yan-Yi Liang ◽  
Shu-Yan Chen ◽  
Jing Sheng ◽  
...  
Keyword(s):  
Older Adults ◽  
Visual Feedback ◽  
Electric Stimulation ◽  
Controlled Trial ◽  
Intervention Group ◽  
Berg Balance Scale ◽  
Force Platform ◽  
Eyes Open ◽  
Falls In Older Adults

Background Force platform training with functional electric stimulation aimed at improving balance may be effective in fall prevention for older adults. Aim of the study is to evaluate the effects of the visual-feedback-based force platform balance training with functional electric stimulation on balance and fall prevention in older adults. Methods A single-centre, unblinded, randomized controlled trial was conducted. One hundred and twenty older adults were randomly allocated to two groups: the control group (n = 60, one-leg standing balance exercise, 12 min/d) or the intervention group (n = 60, force platform training with functional electric stimulation, 12 min/d). The training was provided 15 days a month for 3 months by physical therapists. Medial–lateral and anterior–posterior maximal range of sway with eyes open and closed, the Berg Balance Scale, the Barthel Index, the Falls Efficacy scale-International were assessed at baseline and after the 3-month intervention. A fall diary was kept by each participant during the 6-month follow-up. Results On comparing the two groups, the intervention group showed significantly decreased (p < 0.01) medial–lateral and anterior–posterior maximal range of sway with eyes open and closed. There was significantly higher improvement in the Berg Balance Scale (p < 0.05), the Barthel Index (p < 0.05) and the Falls Efficacy Scale-International (p < 0.05), along with significantly lesser number of injurious fallers (p < 0.05), number of fallers (p < 0.05), and fall rates (p < 0.05) during the 6-month follow-up in the intervention group. Conclusion This study showed that the visual feedback-based force platform training with functional electric stimulation improved balance and prevented falls in older adults.

The role of meaning in life in community-dwelling older adults with depression and relationship to other risk factors

2017 ◽  
Vol 23 (1) ◽  
pp. 100-106 ◽  
Author(s):  
Jana Volkert ◽  
Martin Härter ◽  
Maria Christina Dehoust ◽  
Berta Ausín ◽  
Alessandra Canuto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Meaning In Life ◽  
Community Dwelling ◽  
Community Dwelling Older Adults

scholarly journals Risk factors for hospital readmission in older adults within 30 days of discharge – a comparative retrospective study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Maria Glans ◽  
Annika Kragh Ekstam ◽  
Ulf Jakobsson ◽  
Åsa Bondesson ◽  
Patrik Midlöv
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Retrospective Study ◽  
Home Care ◽  
Hospital Readmission ◽  
Patient Characteristics ◽  
Transition Of Care ◽  
Discharge Transition ◽  
Surgical Unit

Abstract Background The area of hospital readmission in older adults within 30 days of discharge is extensively researched but few studies look at the whole process. In this study we investigated risk factors related, not only to patient characteristics prior to and events during initial hospitalisation, but also to the processes of discharge, transition of care and follow-up. We aimed to identify patients at most risk of being readmitted as well as processes in greatest need of improvement, the goal being to find tools to help reduce early readmissions in this population. Methods This comparative retrospective study included 720 patients in total. Medical records were reviewed and variables concerning patient characteristics prior to and events during initial hospital stay, as well as those related to the processes of discharge, transition of care and follow-up, were collected in a standardised manner. Either a Student’s t-test, χ2-test or Fishers’ exact test was used for comparisons between groups. A multiple logistic regression analysis was conducted to identify variables associated with readmission. Results The final model showed increased odds of readmission in patients with a higher Charlson Co-morbidity Index (OR 1.12, p-value 0.002), excessive polypharmacy (OR 1.66, p-value 0.007) and living in the community with home care (OR 1.61, p-value 0.025). The odds of being readmitted within 30 days increased if the length of stay was 5 days or longer (OR 1.72, p-value 0.005) as well as if being discharged on a Friday (OR 1.88, p-value 0.003) or from a surgical unit (OR 2.09, p-value 0.001). Conclusion Patients of poor health, using 10 medications or more regularly and living in the community with home care, are at greater risk of being readmitted to hospital within 30 days of discharge. Readmissions occur more often after being discharged on a Friday or from a surgical unit. Our findings indicate patients at most risk of being readmitted as well as discharging routines in most need of improvement thus laying the ground for further studies as well as targeted actions to take in order to reduce hospital readmissions within 30 days in this population.

A Group-Based Walking Study to Enhance Physical Activity Among Older Adults: The Role of Social Engagement

2020 ◽  
pp. 016402752096361
Author(s):  
Yujun Liu ◽  
Margie E. Lachman
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Social Engagement ◽  
Treatment Condition ◽  
Social Comparisons ◽  
Text Messages ◽  
Control Group ◽  
Group Members

Objectives. The aim of this study was to explore social engagement and social comparisons as mechanisms to increase physical activity among older adults. Methods. Participants (N = 60, mean age = 65.7) were randomly assigned to one of two conditions. Participants in the treatment condition used the application to track their daily walking steps and interact via text messages with their group members for 4 weeks. Participants in the control group used the application only to track their own walking steps. Outcome variables included mean weekly steps, exercise self-efficacy, and social engagement. Results. The results revealed that participants in the experimental condition significantly increased their mean weekly steps and social engagement from the pretest to the posttest whereas the control group did not. These effects were maintained at the 1-month follow up. Discussion. The study expands our understanding of the motivational role of social engagement and social comparison in increasing PA among older adults.

scholarly journals Multidimensional Sleep and Mortality in Older Adults: A Machine-Learning Comparison With Other Risk Factors

2019 ◽  
Vol 74 (12) ◽  
pp. 1903-1909 ◽  
Author(s):  
Meredith L Wallace ◽  
Daniel J Buysse ◽  
Susan Redline ◽  
Katie L Stone ◽  
Kristine Ensrud ◽  
...  
Keyword(s):  
Machine Learning ◽  
Risk Factors ◽  
Older Adults ◽  
Cardiovascular Mortality ◽  
Predictive Ability ◽  
Future Research ◽  
Applied Machine Learning ◽  
Predictive Variables ◽  
Time In Bed

Abstract Background Sleep characteristics related to duration, timing, continuity, and sleepiness are associated with mortality in older adults, but rarely considered in health recommendations. We applied machine learning to: (i) establish the predictive ability of a multidimensional self-reported sleep domain for all-cause and cardiovascular mortality in older adults relative to other established risk factors and (ii) to identify which sleep characteristics are most predictive. Methods The analytic sample includes N = 8,668 older adults (54% female) aged 65–99 years with self-reported sleep characterization and longitudinal follow-up (≤15.5 years), aggregated from three epidemiological cohorts. We used variable importance (VIMP) metrics from a random survival forest to rank the predictive abilities of 47 measures and domains to which they belong. VIMPs > 0 indicate predictive variables/domains. Results Multidimensional sleep was a significant predictor of all-cause (VIMP [99.9% confidence interval {CI}] = 0.94 [0.60, 1.29]) and cardiovascular (1.98 [1.31, 2.64]) mortality. For all-cause mortality, it ranked below that of the sociodemographic (3.94 [3.02, 4.87]), physical health (3.79 [3.01, 4.57]), and medication (1.33 [0.94, 1.73]) domains but above that of the health behaviors domain (0.22 [0.06, 0.38]). The domains were ranked similarly for cardiovascular mortality. The most predictive individual sleep characteristics across outcomes were time in bed, hours spent napping, and wake-up time. Conclusion Multidimensional sleep is an important predictor of mortality that should be considered among other more routinely used predictors. Future research should develop tools for measuring multidimensional sleep—especially those incorporating time in bed, napping, and timing—and test mechanistic pathways through which these characteristics relate to mortality.

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