Risk factors for falls among community-dwelling elderly attending the elderly health centre

2002 ◽  
Author(s):  
Kit-chee, Christina Maw
Keyword(s):  
Risk Factors ◽  
Health Centre ◽  
The Elderly ◽  
Community Dwelling ◽  
Elderly Health ◽  
Risk Factors For Falls

Anemia in the Elderly and the Risk of Injurious Falls.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 1333-1333
Author(s):  
Mei S. Duh ◽  
Samir H. Mody ◽  
Patrick Lefebvre ◽  
Richard C. Woodman ◽  
Sharon Buteau ◽  
...  
Keyword(s):  
Risk Factors ◽  
Linear Trend ◽  
Head Injuries ◽  
The Elderly ◽  
Community Dwelling ◽  
Significant Linear Trend ◽  
Injurious Falls ◽  
Risk Of Falls ◽  
Increasing Risk ◽  
Risk Factors For Falls

Abstract Background: Anemia commonly occurs in the elderly (≥65), and has been associated with a number of adverse consequences. Thirty percent of the community-dwelling elderly fall annually and this risk increases to 50% by the age of 80. Serious injuries caused by a fall, such as fractures and head injuries, are sustained by about 10% of the elderly and often lead to functional disability, increased health care costs, and increased mortality. Identification of reversible risk factors is critical for the management of falls and related injuries. The purpose of the current study is to investigate whether anemia increases the risk of injurious falls (IF) in the elderly. Methods: Health claims data from over 30 health plans from 01/1999 through 04/2004 were used. Patients ≥65 years with ≥1 hemoglobin (Hb) measurement were selected. IF were defined as a fall claim followed by an injurious event claim within 30 days after the fall. Injurious events were defined as fractures of the hip, pelvis, femur, vertebrae, ribs, humerus, and lower limbs, Colle’s fracture, head injuries, or hematomas. An open-cohort design was employed to classify patients’ observation periods by: (1) by anemia status based on WHO criteria (< 12 g/dL for women; < 13 g/dL for men), and (2) by Hb level: <10, 10-<12, 12-<13, and ≥13 g/dL. The incidence rates (IF events / person-years of observation) were compared by anemia status and Hb levels, respectively. Subset analyses based on IF of the hip (including pelvis and femur) and the head were further conducted. The association of IF with anemia and Hb levels, respectively, was analyzed using both univariate and multivariate (adjusted for age, gender, health plan, comorbidities, concomitant medications) approaches. Results: Among the 47,530 study subjects, a statistically significant linear trend of increasing risk of falls (i.e., IF and non-IF events) with decreasing Hb was observed (p<.0001). The incidence of IF was 15.8, 14.0, 9.8, and 6.5 per 1,000 person-years for Hb levels of <10, 10-<12, 12-<13, and ≥13 g/dL, respectively (trend: p<.0001). Based on the univariate analysis, anemia increased the risk of IF by 1.66 times (95% CI: 1.41–1.95) compared to no anemia, and the effects of anemia on IF of the hip and head were more pronounced (rate ratio (RR)=2.25 [95% CI: 1.74–2.89] and 1.77 [95% CI: 1.22–2.55], respectively, (p<.01 for both)). Multivariate analysis revealed that Hb levels were significantly associated with the risk of IF (RR = 1.57, 1.48, 1.17 for Hb levels of <10, 10-<12, 12-<13 g/dL, respectively, compared to Hb≥ 13 g/dL), and the negative linear trend of the risk of IF by Hb levels remained statistically significant (p<.0001). In the subset of hip and head IF, the association with anemia was even stronger (Hip: RR=3.37, 1.83, 1.36 for Hb levels of <10, 10-<12, 12-<13 g/dL, respectively; Head: RR=1.65, 1.47, 1.18, respectively), with a statistically significant linear trend observed (Hip: p<.0001; Head: p=0.07). Anemia (esp. Hb < 10) had comparable risk to other well-known risk factors for falls such as Alzheimer’s disease, Parkinson’s disease, and osteoarthritis. Conclusion: Anemia was significantly and independently associated with an increasing risk for IF, especially IF to the hip and head, in elderly persons. Furthermore, the risk of IF increased as the anemia worsened. The impact of anemia correction on the risk of falls and IF needs to be evaluated.

scholarly journals Efektivitas Promosi Kesehatan Menggunakan Media Audiovisual Terhadap Keaktifan Lansia ke Posyandu Lansia

2019 ◽  
Vol 7 (2) ◽  
pp. 85-95
Author(s):  
Sri Astutik Andayani ◽  
Husnul Khotimah ◽  
Sry Desy ◽  
Arif Eko Trilianto ◽  
Hefniy Razaq
Keyword(s):  
Health Promotion ◽  
Health Center ◽  
Health Centre ◽  
Control Design ◽  
Sampling Technique ◽  
The Elderly ◽  
Visual Media ◽  
P Value ◽  
Whitney Test ◽  
Elderly Health

Implemented posyandu elderly there are obstacles that often faced is low visit, one of cause factor is low of knowledge of elderly so that beneficiary of posyandu elderly still not maximal. The purpose of this research is to know the influence of health promotion about elderly posyandu by use audio visual media toward liveliness of elderly in following elderly posyandu. The design use in this research is Quasy Experimental with pretest-posttest with control design. This research was conducted at Maesan Bondowoso health center with 55 respondents with total sampling technique. This analysis used Wilcoxon and Mann-Whitney test. The results showed that health promotion was effective to increase the member of ekderly visit to the elderly health center with p value 0,000. Keywords  : Health Promotion, Elderly Health Centre, elderly active

Geriatric Trauma

2019 ◽  
Author(s):  
Sigrid Burruss ◽  
Lillian Min ◽  
Areti Tillou
Keyword(s):  
Risk Factors ◽  
Care Coordination ◽  
Unintentional Injury ◽  
The Elderly ◽  
Geriatric Trauma ◽  
Trauma Patients ◽  
Age Related ◽  
Trauma Population ◽  
Downward Spiral ◽  
Risk Factors For Falls

The geriatric trauma population continues to grow as life expectancy and unintentional injury increase. Age-related physiologic changes and complex comorbidities may not only lead to injury but also may precipitate a downward spiral. The injury patterns, presentation of life-threatening injury, and response to injury are unique in the elderly trauma population, and dedicated evaluation of elderly trauma patients at a trauma center may be beneficial. Aggressive, early intervention with a focus on geriatric-specific needs and care coordination are an integral part of the management to reduce morbidity and mortality. Much of the unintentional injuries may be preventable with identification of risk factors for falls and fall prevention programs. Frailty measurements may be used to predict morbidity and functional status. Surgeons must become familiar with geriatric-specific issues and how best to treat the geriatric trauma population.  This review contains 3 figures, 2 tables, and 133 references. Key Words: care coordination, elderly, frailty, geriatric, injury, prevention, risk factors, trauma, triage

scholarly journals Major GI bleeding in older persons using aspirin: incidence and risk factors in the ASPREE randomised controlled trial

Gut ◽  
2020 ◽  
pp. gutjnl-2020-321585 ◽  
Author(s):  
Suzanne E Mahady ◽  
Karen L Margolis ◽  
Andrew Chan ◽  
Galina Polekhina ◽  
Robyn L Woods ◽  
...  
Keyword(s):  
Risk Factors ◽  
Randomised Controlled Trial ◽  
Absolute Risk ◽  
Controlled Trial ◽  
Bleeding Risk ◽  
The Elderly ◽  
Community Dwelling ◽  
Gi Bleeding ◽  
Prophylactic Use ◽  
Randomised Controlled

ObjectiveThere is a lack of robust data on significant gastrointestinal bleeding in older people using aspirin. We calculated the incidence, risk factors and absolute risk using data from a large randomised, controlled trial.DesignData were extracted from an aspirin versus placebo primary prevention trial conducted throughout 2010–2017 (‘ASPirin in Reducing Events in the Elderly (ASPREE)’, n=19 114) in community-dwelling persons aged ≥70 years. Clinical characteristics were collected at baseline and annually. The endpoint was major GI bleeding that resulted in transfusion, hospitalisation, surgery or death, adjudicated independently by two physicians blinded to trial arm.ResultsOver a median follow-up of 4.7 years (88 389 person years), there were 137 upper GI bleeds (89 in aspirin arm and 48 in placebo arm, HR 1.87, 95% CI 1.32 to 2.66, p<0.01) and 127 lower GI bleeds (73 in aspirin and 54 in placebo arm, HR 1.36, 95% CI 0.96 to 1.94, p=0.08) reflecting a 60% increase in bleeding overall. There were two fatal bleeds in the placebo arm. Multivariable analyses indicated age, smoking, hypertension, chronic kidney disease and obesity increased bleeding risk. The absolute 5-year risk of bleeding was 0.25% (95% CI 0.16% to 0.37%) for a 70 year old not on aspirin and up to 5.03% (2.56% to 8.73%) for an 80 year old taking aspirin with additional risk factors.ConclusionAspirin increases overall GI bleeding risk by 60%; however, the 5-year absolute risk of serious bleeding is modest in younger, well individuals. These data may assist patients and their clinicians to make informed decisions about prophylactic use of aspirin.Trial registration numberASPREE. NCT01038583.

scholarly journals Parkinson’s Disease and Symptomatic Osteoarthritis Are Independent Risk Factors of Falls in the Elderly

2019 ◽  
Vol 12 ◽  
pp. 117954411988493 ◽  
Author(s):  
Anneli Teder-Braschinsky ◽  
Aare Märtson ◽  
Marika Rosenthal ◽  
Pille Taba
Keyword(s):  
Risk Factors ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Knee Osteoarthritis ◽  
The Elderly ◽  
Control Group ◽  
Increased Risk ◽  
Symptomatic Knee ◽  
Risk Of Falls ◽  
Risk Factors For Falls

Objectives: Deteriorating functionality and loss of mobility, resulting from Parkinson’s disease, may be worsened by osteoarthritis, which is the most common form of joint disease causing pain and functional impairment. We assessed the association between symptomatic hip or knee osteoarthritis, falls, and the ability to walk among patients with Parkinson’s disease compared to a control group. Methods: A total of 136 patients with Parkinson’s disease in Southern Estonia and 142 controls with an average age of 76.8 and 76.3 years, respectively, were enrolled in a retrospective case-control study. Information on falls and related fractures during the previous year was collected from the patients with Parkinson’s disease and controls. Covariates included gender, age, mobility, duration of Parkinson’s disease, and fractures. Results: Patients with Parkinson’s disease were at an increased risk of falls compared to the control group, and for the higher risk of fractures. Symptomatic knee or hip osteoarthritis was a significant independent predictor of falls in both patients with Parkinson’s disease and controls. The higher risk for fractures during the previous year was demonstrated in symptomatic osteoarthritis. Risk factors for falls included also female gender, use of sleep pills, and the inability to walk 500 m. Conclusions: Symptomatic hip and knee osteoarthritis are risk factors for falls and related fractures among the elderly population with and without Parkinson’s disease. The inability to walk 500 m could be used as a simple predictive factor for the increased risk of falls among elderly populations.

scholarly journals Effects of the falls and fractures clinic as an integrated multidisciplinary model of care in Australia: a pre–post study

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e027013 ◽  
Author(s):  
Fernando Gomez ◽  
Carmen Lucia Curcio ◽  
Sharon Lee Brennan-Olsen ◽  
Derek Boersma ◽  
Steven Phu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Fracture Prevention ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Care Plan ◽  
Secondary Outcome ◽  
Clinical Approach ◽  
Model Of Care ◽  
Mineral Density ◽  
Risk Factors For Falls

ObjectivesTraditionally, the approach to fracture prevention has focused on increasing bone mineral density while typically lacking a combined clinical approach to falls prevention and vice versa. To resolve this gap, we implemented and evaluated a novel combined model of care to the assessment and prevention of osteoporosis and falls in the outpatients setting.SettingFalls and Fractures Clinic (FFC) at Nepean Hospital (Penrith, NSW, Australia).ParticipantsPre-effects and posteffects assessment of 106 community-dwelling older patients referred from the community.Primary and secondary outcome measuresPrevious falls and fractures were recorded. Clinical, functional and paraclinical evaluations were performed. A comprehensive multidisciplinary care plan was then tailored based on the presence of risk factors. Six-month follow-ups were performed assessing the incidence of falls and fractures, change in risk factors for falls and level of risk, with the recommended plan.ResultsWe report that 97% of patients had a fall in the preceding 6 months, 47.6% of whom experienced a fracture from the fall. Furthermore, 64% of patients had a marked risk for falling by Physiological Profile Assessment (PPA), 90% had intermediate–high 10-year probability of fracture according to FRAX and 78% had sarcopenia. At 6-month follow-up, we observed more than an 80% reduction in falls and recurrent falls, and 50% reduction in fractures. In addition, 65% of patients had reduced PPA and a 57% reduction in 10-year fracture probability.ConclusionsIn conclusion, we suggest that a multidisciplinary FFC can provide substantial reductions in falls and fractures for high-risk older people, even over a relatively short 6-month time period. The current model of service provision via traditional falls clinics could be significantly improved by encompassing fracture prevention within the multifactorial approach to interventions.

Falls and Risk Factors for Falls in Community-Dwelling Adults With Dementia (NutriAlz Trial)

2012 ◽  
Vol 26 (1) ◽  
pp. 74-80 ◽  
Author(s):  
Antoni Salvà ◽  
Marta Roqué ◽  
Xavier Rojano ◽  
Marco Inzitari ◽  
Sandrine Andrieu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Community Dwelling ◽  
Risk Factors For Falls

Prevalence of Impaired Kidney Function in the German Elderly: Results from the Berlin Aging Study II (BASE-II)

Gerontology ◽  
2017 ◽  
Vol 63 (3) ◽  
pp. 201-209 ◽  
Author(s):  
Maximilian König ◽  
Maik Gollasch ◽  
Ilja Demuth ◽  
Elisabeth Steinhagen-Thiessen
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
The Elderly ◽  
Community Dwelling ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Increased Risk ◽  
Aging Study

Background: In aging populations with an ever-growing burden of risk factors such as obesity, diabetes, and hypertension, chronic kidney disease (CKD) is on the rise. However, little is known about its exact prevalence among elderly adults, and often albuminuria is not included in the definition of CKD. Moreover, novel equations for the estimated glomerular filtration rate (eGFR) have recently emerged, which have not been applied comprehensively to older adults. Data on CKD awareness among the elderly are sparse. Objectives: To determine the prevalence of CKD among older adults by eGFR and albumin/creatinine ratio (ACR), compare the performance of 6 established and novel eGFR formulas, explore risk factors, and determine the awareness of CKD in a large cohort of community-dwelling elderly from Germany. Methods: A total of 1,628 subjects from the Berlin Aging Study II (BASE-II) were included in this analysis (mean age 68.7 years; 51.2% female). Extensive cross-sectional data on sociodemographics, lifestyle, medication, and diagnoses were inquired during structured interviews and a medical examination, and blood and urine parameters were measured. Results: In all, 77.1% of the subjects had hypertension, 12.4% had diabetes, and 18.3% were obese. The prevalence of CKD strongly depended on the eGFR equations used: 25.4% (full age spectrum [FAS] equation), 24.6% (Berlin Initiative Study), 23.1% (Lund-Malmö revised), 19.3% (Cockcroft-Gault), 16.4% (Chronic Kidney Disease-Epidemiology Collaboration [CKD-EPI]), and 14.7% (Modification of Diet in Renal Disease [MDRD]). Of the subjects with an eGFRFAS <60 mL/min/1.73 m2 and/or an ACR >30 mg/g, only 3.9% were aware of having CKD. Polypharmacy, age, BMI, coronary artery disease, non-HDL cholesterol, and female sex were independently associated with CKD. Conclusions: CKD is prevalent among older adults in Germany, but awareness is low. The FAS equation detects higher rates of CKD than MDRD and CKD-EPI, which are most widely used at present. Also, when CKD is defined based on eGFR and albuminuria, considerably more people are identified than by eGFR alone. Finally, polypharmacy is associated with an increased risk for CKD in the elderly.

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