scholarly journals Characterizing the Impact of Fear of Falling on Activity and Falls in Older Adults with Glaucoma

2020 ◽  
Vol 68 (8) ◽  
pp. 1847-1851 ◽  
Author(s):  
Jian‐Yu E ◽  
Aleksandra Mihailovic ◽  
Pei‐Lun Kuo ◽  
Sheila K. West ◽  
David S. Friedman ◽  
...  
Keyword(s):  
Older Adults ◽  
Fear Of Falling ◽  
Falls In Older Adults ◽  
The Impact

scholarly journals ONE-LEGGED STANCE BALANCE OF OLDER ADULTS WITH AND WITHOUT FALLS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S470-S470
Author(s):  
Edgar R Vieira ◽  
Márcio Oliveira ◽  
Andre Gil ◽  
Karen Fernandes ◽  
Denilson Teixeira ◽  
...  
Keyword(s):  
Older Adults ◽  
Fear Of Falling ◽  
Center Of Pressure ◽  
Area Under The Curve ◽  
Test Duration ◽  
Mobility Impairments ◽  
Eyes Open ◽  
Falls In Older Adults ◽  
Elliptical Area ◽  
Age Range

Abstract Balance impairment is a common problem among older adults. Poor balance in older adults is often associated with mobility impairments, activity limitations and fear of falling in older adults. Thus, balance assessment is useful for early detection of postural control deficits to prevent mobility impairments and falls in older adults. The aim of this study was to assess if balance measures based in center of pressure (COP) parameters during one-legged stance could differentiate between older adults with and without falls in the past 12 months. One-hundred and seventy older adults (50 fallers and 120 non-fallers, age range: 63-72 years) performed three 30s one-legged stance trials with eyes open on a force platform with 30s of rest between each trial. The following variables were evaluated: COP 95% elliptical area, COP velocity in the anterior-posterior and medio-lateral directions, and test duration (how long the participant was able to stay in one-legged stance, up to 30s). Fallers had poorer balance than non-fallers (P ≤0.004). The COP parameters presented an area under the curve between 0.65-0.72, with sensitivity varying from 66 to 78% and specificity from 54 to 68%. There were no significant differences between fallers and non-fallers on test duration (17 vs. 18s, respectively). The findings showed that the fallers had similar duration time, but poorer balance than the non-fallers during one-legged stance. The COP parameters were able to differentiate the balance between fallers and non-fallers with acceptable area under curve, sensitivity and specificity.

Vitamin D Supplementation Is Associated with a Reduction in Self-Reported Falls among Older Adults with Previous Fall History – Feasibility Study

2021 ◽  
pp. 1-7
Author(s):  
S.D. Anton ◽  
R.T. Mankowski ◽  
P. Qiu ◽  
L. You ◽  
B.A. Bensadon ◽  
...  
Keyword(s):  
Older Adults ◽  
Vitamin D ◽  
Handgrip Strength ◽  
Vitamin D Supplementation ◽  
Blood Levels ◽  
Timed Up And Go ◽  
Vitamin D Levels ◽  
Falls In Older Adults ◽  
One Year ◽  
The Impact

Background: Vitamin D insufficiency contributes to muscle weakness and a higher risk of falls in older adults. Objectives: This study explored the impact of vitamin D supplementation on self-reported falls and physical function in older adults with low vitamin D levels and a recent fall history. Materials and Methods: Twenty-five older adults ≥ 70 years with two or more falls during the past year, low vitamin D blood levels (≥10 ng/ml and < 30 ng/mL), and slow gait speed (1.2 m/s) participated in a 6-month vitamin D supplementation (800 IU/day) study. A modified version of the Morse Fall Scale questionnaire was used to assess frequency of falls over one-year prior to study enrollment. Functional outcomes (short physical performance battery, handgrip strength, gait Timed Up and Go, and six-minute walk), and vitamin D levels were assessed at baseline and 6-month follow-up. Results: Based on diaries and pill counts, participants were generally adherent to the intervention (6 of 7 days per week). Supplementation with 800 IU/day of vitamin D for 6 months increased blood vitamin D levels from 23.25±4.8 ng/ml to 29.13±6.9 ng/ml (p<0.001). Self-reported number of falls decreased from an average of 3.76 ± 2.2 falls in one-year to 0.76 ± 1.4 falls (p <0.0001) over the 6-month intervention. No changes in functional outcome measures were observed. Conclusions: Vitamin D supplementation at the currently recommended dose of 800 IU/day increased blood vitamin D levels and reduced frequency of falls in older adults with low vitamin D levels and a recent fall history.

scholarly journals THE EFFECT OF YOGA ON FALL PREVENTION OUTCOMES IN ADULTS 50 YEARS AND OLDER: A SYSTEMATIC REVIEW OF THE LITERATURE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S289-S290
Author(s):  
Chinelo K Nsobundu ◽  
Margaret J Foster ◽  
Yan Hong
Keyword(s):  
Older Adults ◽  
Fall Prevention ◽  
Fear Of Falling ◽  
Final Analysis ◽  
Exclusion Criteria ◽  
Face To Face ◽  
Ovid Medline ◽  
The Impact ◽  
Fall Prevention Intervention

Abstract Falls constitute a multitude of injuries irrespective of age. To combat these challenges, older adults are encouraged to engage in recreational activities. Yoga has been identified as an effective physical activity to promote mobility and balance for older adults. This study aims to systematically review the literature about yoga as a fall prevention intervention and synthesize the outcomes. Major databases (Ovid Medline & CINAHL) were searched for relevant articles. Studies were included if they met the criteria of 1) being a face to face yoga program, 2) aimed to recruit participants 50 years or older, and 3) reported at least one fall-related outcome (e.g., balance, mobility, fear of falling) as a result of the yoga program. 57 studies were identified: 32 from Ovid Medline and 25 from CINAHL. After removing the duplicates and applying a strict inclusion and exclusion criteria, 11 articles were included in the final analysis. A detailed synthesis of the results will be presented and quality assessment of included articles will be performed using the Modified Downs and Black checklist which appraises the methodological quality of both randomized and non-randomized studies. More research is needed to understand the impact of yoga in preventing falls among older adults at least 50 years of age. Additionally, research should establish a gold standard index that identifies which specific yoga programs ( based on type- individual vs. group; hatha, iyengar, kundalini, ashtanga, and etc.; frequency, and duration) have an enhanced effect on fall prevention.

scholarly journals Medications & Polypharmacy Influence on Recurrent Fallers in Community: a Systematic Review

2018 ◽  
Vol 21 (1) ◽  
pp. 14-25 ◽  
Author(s):  
Yu Ming ◽  
Aleksandra Zecevic
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
High Risk Group ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Depression Symptoms ◽  
Prescription Medications ◽  
Recurrent Falls ◽  
Falls In Older Adults ◽  
The Impact

The purpose of this systematic review is to summarize information about the impact different classes of medications and polypharmacy have on recurrent falls, defined as two or more falls in a 12-month period, in community-dwelling older adults. After adjustment for confounders such as age, gender, weight or depression symptoms, the reviewed studies suggested that older adults who use antidepressants, sedatives or hypnotics and anti-epileptics were more likely to experience recurrent falls than non-users. Polypharmacy (use of four or more prescription medications daily) caused 1.5–2 times higher possibility of recurrent falls in older adults. As a high-risk group, recurrent fallers require meaningful intervention. Medications are believed to be a modifiable risk factor in falls prevention; hence, special consideration should be taken to balance the benefit and harm in initiating, continuing or increasing certain classes of medications in elderly recurrent fallers.

scholarly journals Characterizing Longitudinal Change in Physical Activity and Fear of Falling in Glaucoma

2020 ◽  
Author(s):  
Jian-Yu E ◽  
Aleksandra Mihailovic ◽  
Jennifer A. Schrack ◽  
Tianjing Li ◽  
David S. Friedman ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Visually Impaired ◽  
Linear Models ◽  
Longitudinal Research ◽  
Fear Of Falling ◽  
Longitudinal Change ◽  
Longitudinal Changes ◽  
Injurious Falls ◽  
The Impact

Abstract Background: Older adults with visual impairments experience a higher risk of falling, and are more vulnerable to adverse health consequences associated with falls than those with normal vision. This study aims to characterize the longitudinal changes of objectively measured physical activity and self-reported fear of falling (FoF) related to types of falls in visually impaired older adults. Methods: We obtained data from the Falls in Glaucoma Study (FIGS), a prospective cohort study that recruited 234 participants at the Johns Hopkins Wilmer Eye Institute from 2013 to 2015. Falls were defined as unintentionally coming to rest on the ground or a lower level, and injurious falls were determined though follow-up calls. Study participants were categorized into three groups – fallers with injurious consequences, fallers without injurious consequences, and non-fallers based on fall status in the first year. Physical activity was assessed using a waist-bound accelerometer (Actical). FoF was evaluated by questionnaire, with Rasch modeling generating FoF scores where higher scores reflected worse FoF. The three-year longitudinal changes of physical activity and FoF were modeled using mixed-effects models. Results: In linear models fully adjusted for visual field damage and other covariates, physical activity among injurious fallers declined 425 steps/year (95% confidence interval [CI]: -793, -57), 13 active minutes/year (95% CI: -21, -6), and 3 minutes/year of moderate/vigorous activity (95% CI: -5, 0) more over the three-year study period compared to non-fallers; however, physical activity did not decline among non-injurious fallers. No longitudinal increases in FoF scores were observed in injurious or non-injurious fallers.Conclusions: Among visually impaired older adults, injurious falls identified prospectively over 12 months contributed to a significant decline in physical activity over a three-year period, while no significant increases were observed for FoF. Further longitudinal research is warranted to better understand how different groups respond to falls, either via behavioral changes and/or changes in FoF, and to characterize the impact of reduced physical activity in fallers.

scholarly journals Home Safety Evaluation Model for Older Adults With Recurrent Falls

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 265-265
Author(s):  
Willy Marcos Valencia ◽  
Kimberly Cabrera ◽  
Vincent Hsu
Keyword(s):  
Older Adults ◽  
Fear Of Falling ◽  
Evaluation Model ◽  
Safety Evaluation ◽  
Falls Prevention ◽  
Home Safety ◽  
Recurrent Falls ◽  
History Of ◽  
The Impact

Abstract Recurrent falls are a major threat in older adults. Home environment can be a hazard, but it is potentially modifiable/reversible. In Miami VA, occupational therapists conduct home safety evaluations (HSE) to ascertain the need for modifications to reduce falls risk. We reviewed the cohort of high-risk, recurrent falls patients evaluated at our Falls Prevention Clinic (FPC) between August 2017 to November 2019, to evaluate the impact of HSE. We identified 48 Veterans, age 76.5±6.9 years, of whom 15 (31.3%) reported 1-2 falls/year, 18 (37.5%) reported 3-4 falls/year, and 15 (31.3%) reported ≥5 falls/year. Twenty-eight (58.3%) were offered a HSE. Within these subjects, 74.2% reported falling at least once within their home, 43.8% had fear of falling, 5 (17.9%) had a history of substance or alcohol abuse. We observed that 29 (60.4%) would benefit from the addition of grab bars and 26 (54.2%) could benefit from toilet adjustments. Twelve (25.0%) were recommended to install bed rails. Only 15 (31.3%) Veterans agreed to all recommendations, 25 (52.1%) declined due to preference, and 8 (16.7%) declined for other reasons. Only 8 (16.7%) of these Veterans lived alone. Another factor is that 11 (22.9%) Veterans were renting and 32 (66.7%) owned their homes. Addressing and improving environmental hazards may ameliorate the risk for recurrent falls. Our next steps are to evaluate the extent of home modifications, and the long-term changes in falls/year. Further research needs to determine the long-term efficacy and cost-effectiveness of HSE, and how it can be more accessible to the community.

Integrating Social and Health Services for People, Communities, Homes, and Places

2021 ◽  
pp. 21-66
Author(s):  
Maddalena Illario ◽  
Vincenzo De Luca ◽  
Regina Roller-Wirnsberger
Keyword(s):  
Older Adults ◽  
Technological Innovation ◽  
Circular Economy ◽  
Fear Of Falling ◽  
Healthcare Services ◽  
Ageing Population ◽  
Ageing Society ◽  
Regional Policies ◽  
Framework Approach ◽  
The Impact

The challenge of an ageing population requires a paradigmatic shift in the way we provide social and healthcare services, demanding the need to prioritize the functionality and independence of older adults. The risk and subsequent fear of falling is one of the most high-risk states for older adults, as it generates a destabilizing effect on their health that is often hard to recover. It is essential to thoroughly address their risk factors and mitigators. This discussion needs to be made in light of a person-centered perspective that goes beyond fragilities to capitalize on the strengths of the older adults. The chapter provides examples of how to connect assessment, interventions, and monitoring to a coherent framework approach that mitigates the risks and the impact of falls on an ageing society. The authors explore how technological innovation, urban planning, and regional policies that are culturally relevant can be incorporated in creating a circular economy while meeting the needs of an aging population and preventing falls and cognitive decline.

scholarly journals Predictors of Falls in Older Adults With and Without Dementia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 447-448
Author(s):  
Safiyyah Okoye ◽  
Chanee Fabius ◽  
Jennifer Wolff
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Fear Of Falling ◽  
Depression Symptoms ◽  
Socioeconomic Indicators ◽  
Caregiver Education ◽  
Recurrent Falls ◽  
Fall Risk Factors ◽  
Falls In Older Adults ◽  
Risk Factors For Falls

Abstract Persons living with dementia (PLWD) have up to twice the risk for falling and three-times the risk of serious fall-related injuries as those without dementia. Falls are a leading cause of hospitalizations among PLWD, who are more likely to incur high costs and experience negative health consequences (e.g, delirium, in-hospital falls) than persons without dementia. Few studies have examined risk factors for falls comparing Americans with and without dementia. We used data from the 2015 and 2016 rounds of the National Health and Aging Trends Study (n=5,581) to prospectively identify risk factors for a single fall and recurrent (2+) falls over a 12-month period among community-living older adults ≥65 years with and without dementia in a series of bivariate logistic regressions. Overall, we identified fewer predictors of single or recurrent falls among PLWD compared to persons without dementia. For example, socioeconomic indicators (e.g., income, financial hardship) predicted recurrent falls in persons without dementia, but not in PLWD. Among PLWD, falling in the previous year was associated with both single (odds ratio (OR): 3.38, 95% confidence interval (CI): 1.77, 6.49) and recurrent falls (OR: 6.19, 95% CI: 3.50, 10.93). PLWD who experienced recurrent falls were also more likely to be identified as having a fear of falling (OR: 2.17, 95% CI: 1.33, 3.54), physical function impairments, depression symptoms (OR: 2.23, 95% CI: 1.34, 3.71), and anxiety symptoms (OR: 1.73, 95% CI: 1.14, 2.62). Further study of fall-risk factors could inform screening, caregiver education and support, and prevention strategies for PLWD.

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