Chronic pain as a moderator between fear of falling and poor physical performance among community-dwelling older adults.

This cross-sectional study examined the associations between fear of falling (FOF) and physical performance as moderated by chronic pain in older Thai adults. Participants were 365 adults, aged ≥ 60 years living in suburban Chiang Mai, Northern Thailand. Of the 365 participants, 56.2% had high levels of FOF based on the short version of the Falls Efficacy Scale International (FES-I). Participants with moderate to severe pain, moderate-to-high pain interference, or multiple site pain were more likely to have FOF than those without pain (p-value<0.05). Multivariate linear regression models indicated FOF was associated with poor physical performance after adjusting for health and demographic factors. Participants with high levels of both FOF and pain reported lower physical performance scores than those with high levels of FOF without pain. Future studies are needed to determine effective interventions to increase fall efficacy and physical activity among older adults with FOF and chronic pain.

Factors associated with nutrition risk among community-dwelling older adults in Thailand.

This study was to investigate socio-demographic, chronic conditions and health factors associated with nutrition risk among Thai community-dwelling older adults. This was a cross-sectional study, involving 330 participants aged ≥ 60 years living in low-income suburban Chiang Mai, Northern Thailand. Of the 330 participants, 54.8% were at nutritional risk based on the Mini Nutritional Assessment. Multivariate analysis indicated factors significantly associated with nutritional risk were: aged ≥80 years (OR:8.59, 95% CI = 2.94-25.11), low income (OR: 2.35, 95% CI = 1.15-4.78), living alone (OR: 2.02, 95% CI = 0.20-0.78), moderate to severe pain (OR: 5.88, 95% CI = 2.30-15.02), dyslipidemia (OR: 5.12, 95% CI = 2.23-11.77), osteoarthritis (OR: 2.49, 95% CI = 1.14-5.48), poor physical performance (OR: 1.49, 95% CI = 1.70-3.15), and ≥1 fall in the previous year (OR: 2.22, 95% CI = 1.21-4.07). Results point to the need for multifactorial interventions to reduce risk for geriatric nutrition problems. Further studies are needed to determine effective solutions to the problem of malnutrition among older adults.

Falls and Fall Prevention in Older Adults With Early-Stage Dementia: An Integrative Review.

Older adults with mild cognitive impairment (MCI) and early-stage dementia have an increased risk of falling, with risks to their health and quality of life. The purpose of the current integrative review was to evaluate evidence on fall risk and fall prevention in this population. Studies were included if they examined falls or fall risk factors in older adults with MCI or early-stage dementia, or reported interventions in this population; 40 studies met criteria. Evidence supports the increased risk of falls in individuals even in the early stages of dementia or MCI, and changes in gait, balance, and fear of falling that may be related to this increased fall risk. Interventions included exercise and multifactorial interventions that demonstrated some potential to reduce falls in this population. Few studies had strong designs to provide evidence for recommendations. Further study in this area is warranted. [Res Gerontol Nurs. 2017; 10(03):139-148.].

Best practice in fall prevention: roles of informal caregivers, health care providers and the community.

Falls are an important public health problem for older adults, resulting in significant morbidity and mortality, as well as healthcare costs. Evidence supports the assessment of older adults' fall risks and implementation of interventions to reduce these risks. Older adults are the key stakeholder in preventing falls, but need the support of their informal caregivers, healthcare providers, and community groups. This article addresses the roles of these additional stakeholders in providing and supporting best practices in fall prevention. Together these stakeholders can assist older adults in self-management of fall prevention, based on the preferences of the individual, local resources, and available programmes and healthcare services.