Relationship between fear of falling and quality of life in nursing home residents: The role of activity restriction.

This study investigates the mediating role of activity restriction in the relationship between the fear of falling and health outcomes. This was a cross-sectional study with convenience sampling of 316 nursing home residents. Generalized structural equation modeling was conducted to test the mediating role. The results showed that residents with fear of falling were more likely to restrict their activities and residents who often or always restricted activities reported lower levels of quality of life and higher levels of depression. Severe activity restriction accounted for 75 % of the total effect of fear of falling on quality of life and 69 % of the total effect of fear of falling on depression. Fall prevention efforts should focus on strategies or interventions to reduce residents' excessive fear of falling and promote activity engagement. Physical and social activities will not only prevent future falls but also improve residents' quality of life and mental health.

Association between Perceived Activity Restriction Due to People's Perception of Aging and Unmet Medical Needs among Middle-Aged and Elderly People: A Population-Based Study.

Background and Objectives: The older members of a population might experience unmet medical needs, despite desiring medical care due to activity limitations driven by their perception of aging. This study conducted a cross-sectional analysis of the association between perceived activity restriction (PAR) due to people's own perception of aging and unmet medical needs (UMN) in late middle-aged and older Koreans based on the Korean National Health and Nutrition Examination Survey (KNHANES). Materials and Methods: The 2016-2020 KNHANES was used to analyze a total of 2008 participants among groups aged 45 years or older by applying individual weights imposed from the raw data. The independent variable of PAR was assessed using self-reported questionnaires based on the global activity limitation indicator. Also, the dependent variable of UMN, referring to the state in which a patient's medical care or service was insufficient, inadequate, or lacking, was assessed using a single question. After excluding missing values, the data on 2008 individuals were analyzed using a chi-square test, weighted logistic regression, and a stratified analysis of gender, age, and the presence of chronic illnesses. Results: The group that experienced PAR had an OR 2.13 higher (odds ratio [OR]: 2.13; 95% confidence interval [CI]: 1.27-3.56) to present UMN than the group that did not experience PAR. Furthermore, the results of the stratified analysis indicated that, in the group of female participants with chronic illness and in the group of elderly people, experiencing PAR was associated with a higher experience of UMN. Conclusions: There was a close association between PAR and UMN. In particular, when PAR occurred in the group of female participants with chronic illness and in the group of elderly people, the incidence rate of UMN was also found to be high. This finding highlights the need for policies and institutional measures to reduce UMN within vulnerable groups with an increased risk of medical inaccessibility due to activity restriction.

Construction and validation of a nomogram for predicting fear of falling related activity restrictions in community-dwelling older adults.

Fear of falling related activity restrictions are widespread among older adults, leading to several adverse effects. Given these consequences, there is an urgent need for a comprehensive assessment tool that integrates various risk factors to predict the likelihood of older adults experiencing such activity restrictions. This cross-sectional study investigated fear of falling related activity restrictions and its influencing factors, simultaneously constructed and validated a nomogram among older adults residing in the communities in China. The model includes variables like age, gender, self-rated health, past year injurious falls, gait stability, anxiety, and cognitive impairment. It showed an AUC of 0.892. Internal validation had an AUC of 0.893, and external validation had an AUC of 0.939. Calibration curve showed good fit, and decision curve showed high clinical benefits. It's an intuitive tool for medical professionals to identify older adults at high risk of activity restrictions due to fear of falling.

Longitudinal Relationship between Mobility Device Use, Falls and Fear of Falling (FOF) Differed by Frailty Status among Community-Dwelling Older Adults.

OBJECTIVES: This study examined the longitudinal relationship between mobility device use, falls and fear of falling (FOF) among community-dwelling older adults by frailty status over a one-year follow-up. DESIGN: A longitudinal cohort study. SETTING: Communities in the United States. PARTICIPANTS: Community-dwelling older adults from the National Health and Aging Trends Study, a nationally representative survey of Medicare Beneficiaries in the United States (N=5,896). MEASUREMENTS: Based on yes or no response to the corresponding items for the variables, fall-related outcomes were determined separately including falls and FOF. Falls were assessed by asking participants whether they had a fall and if they had fallen down more than one time. FOF was measured by asking participants whether they worried about falling and if this worry ever limited activities. Mobility device use was determined by asking whether participants used any type of mobility devices and the number of devices used, including cane, walker, wheelchair and scooter. Frailty was assessed using the frailty phenotype. Multinomial logistic regression models were conducted to examine the association between mobility device use and fall-related outcomes among older adults by frailty status. RESULTS: At Year 1, 28.6% of participants reported using mobility devices. Among robust participants, using one mobility device had 3.58 times higher risks of FOF with fear-related activity restriction (FAR) than non-device users (95% CI: 1.10-11.65). Cane-only robust users had 5.94 and 2.18 times higher risks of FOF with and without FAR (95% CI: 1.80-19.57; 95% CI: 1.12-4.22) than non-device users. Among pre-frail participants, using one mobility device was associated with recurrent falls and FOF with FAR (RRR=2.02, 95% CI: 1.30-3.14; RRR=2.13, 95% CI: 1.25-3.63). Using ≥2 devices was associated with one fall (RRR=2.08, 95% CI: 1.30-3.33), recurrent falls (RRR=2.92, 95% CI: 1.62-5.25) and FOF with FAR (RRR=2.84, 95% CI: 1.34-6.02). Pre-frail cane-only users were more likely to have one fall (RRR=1.57, 95% CI: 1.06-2.32), recurrent falls (RRR=2.36, 95% CI: 1.48-3.77) and FOF with FAR (RRR=2.08, 95% CI: 1.12-3.87) than non-device users. The number of mobility device used and the use of canes failed to be significantly associated with fall-related outcomes among frail participants. CONCLUSION: The number of mobility devices used and the only use of canes were associated with fall-related outcomes among robust and pre-frail individuals. Further research is needed to develop targeted strategies for preventing falls and FOF among older adults with mobility device use, particularly for those in the early stages of frailty.

Tracking behavioral changes of confined sows from the first mating to the third parity.

The occurrence pattern of stereotypic behavior in high-parity confined sows is still unclear. We continually observed the behavioral changes in activity-restricted sows from the first mating to the end of the third parity. The results showed that the second- or third-parity weaned sows exhibited more vacuum chewing and total oral behavior than the first-parity sows. The vacuum chewing of sows in the second and third pregnancies was significantly more than that of the first-pregnancy sows at each stage of pregnancy, and the total oral behavior changed similarly. The sitting of sows in the second and third pregnancies was significantly more than that of the first-pregnancy sows in the early stage of pregnancy, whereas sitting behavior in the third pregnancy was significantly more than that in the middle stages of the first and second pregnancies. Vacuum chewing or sitting was positively correlated with confinement duration. In summary, vacuum chewing and sitting behaviors in sows confined from the first mating were significantly affected by parity. From the late stage of the first pregnancy to the middle stage of the second pregnancy is the key period of stereotypic behavior development for low-parity sows.

Thermal Plasticity in Behavioral Traits Mediates Mating and Reproductive Dynamics in an Ectotherm.

AbstractEnvironmental temperatures potentially influence reproductive performance and sexual selection by restricting opportunities for activity. However, explicit tests of the behavioral mechanisms linking thermal variation to mating and reproductive performance are rare. We address this gap in a temperate lizard by combining social network analysis with molecular pedigree reconstruction in a large-scale thermal manipulation experiment. Populations exposed to cool thermal regimes presented fewer high-activity days compared with populations exposed to a warmer regime. While plasticity in thermal activity responses in males masked overall differences in activity levels, prolonged restriction nevertheless affected the timing and consistency of male-female interactions. Females were less capable than males of compensating for lost activity time under cold stress, and less active females in this group were significantly less likely to reproduce. While sex-biased activity suppression appeared to limit male mating rates, this did not correspond to a heightened intensity of sexual selection or shifts in the targets of sexual selection. In many populations facing thermal activity restriction, sexual selection on males may play a limited role relative to other thermal performance traits in facilitating adaptation.

Effects of COVID-19 lockdown on physical, mental and emotional parameters among sportspersons.

Background: The coronavirus disease 2019 (COVID-19) lockdown was a strange and new occurrence, which left many individuals ill-equipped to cope with the new way of living. Sportspersons had to adapt to a new training style within a new environment, both physically and mentally. Aim: The purpose of this study was to understand the physical, mental and emotional parameters among sportspersons during the COVID-19 lockdown regulations. Setting: The study consisted of 105 regular sportspersons (from South Africa). Methods: This was a quantitative research study design using an online questionnaire. An online questionnaire was adapted and distributed via online social platforms (WhatsApp, Twitter and Instagram) to collect data in which sportspersons (n = 105) answered questions about the effects that they experienced during lockdown on their physical, mental and emotional well-being. Results: Sportspersons participated in cardiovascular training, flexibility training, strength training and bodybuilding exercises during pre-lockdown. During lockdown, more than 74% of sportspersons had adequate training space, equipment and the time to perform physical activity. However, more than 43% of these sportspersons experienced a decrease in flexibility, muscle mass and muscle strength. Exercise was used as a form of stress relief by 77.1% of sportspersons throughout lockdown. In addition, sportspersons who used exercise as a form of stress relief continued to experience an increase in stress throughout lockdown. Conclusion: The outcomes from this study demonstrated how the COVID-19 lockdown had adverse effects on the overall health and well-being of most sportspersons. Other outcomes included the effects that physical inactivity had among sportspersons, including changes in diet and sleep. Contribution: This study highlights the urgency for the sports fraternity to adopt measures to provide various methods of stress relief (as well as opportunities for physical activity) during similar periods of lockdown (or exercise restrictions) for those who rely on exercise as their daily physical, mental and emotional outlet.

Bidirectional relationship between fear of falling and frailty among community-dwelling older adults: A longitudinal study.

This study aims to examine the bidirectional association between fear of falling (FOF) and frailty among community-dwelling older adults. Longitudinal analyses were conducted over a representative sample of 5,829 community-dwelling individuals ≥65 years from the National Health and Aging Trends Study. FOF was ascertained by asking participants whether they worried about falling and if this worry ever limited their activities. Frailty status was assessed based on frailty phenotype. At baseline, 71.4% of participants reported no FOF, 16.7% reported FOF without fear-related activity restriction (FAR), and 11.9% reported FOF with FAR. The proportion of robust, pre-frail and frail respondents at baseline was 36.1%, 48.7% and 15.2%, respectively. Multinomial logistic regression models indicated FOF with and without FAR predicted pre-frailty and frailty. Pre-frailty predicted FOF with and without FAR, while frailty only predicted FOF with FAR. Tailored intervention strategies are needed for preventing adverse outcomes of FOF and frailty among the older population.

Predicting Disability Using a Nomogram of the Tilburg Frailty Indicator (TFI).

Disability is associated with lower quality of life and premature death in older people. Therefore, prevention and intervention targeting older people living with a disability is important. Frailty can be considered a major predictor of disability. In this study, we aimed to develop nomograms with items of the Tilburg Frailty Indicator (TFI) as predictors by using cross-sectional and longitudinal data (follow-up of five and nine years), focusing on the prediction of total disability, disability in activities of daily living (ADL), and disability in instrumental activities of daily living (IADL). At baseline, 479 Dutch community-dwelling people aged ≥75 years participated. They completed a questionnaire that included the TFI and the Groningen Activity Restriction Scale to assess the three disability variables. We showed that the TFI items scored different points, especially over time. Therefore, not every item was equally important in predicting disability. 'Difficulty in walking' and 'unexplained weight loss' appeared to be important predictors of disability. Healthcare professionals need to focus on these two items to prevent disability. We also conclude that the points given to frailty items differed between total, ADL, and IADL disability and also differed regarding years of follow-up. Creating one monogram that does justice to this seems impossible.

Activity Restriction and Hospitalization in Pregnancy: Can Bed-Rest Exercise Prevent Deconditioning? A Narrative Review.

Evidence suggests that exercise during pregnancy is beneficial to both parent and fetus. However, there are high-risk pregnancy conditions that may warrant hospitalization. In our narrative review, we first describe the clinical implications for activity restriction in pregnancy, the effects of hospitalization, and the impact of bed rest on non-pregnant individuals. We provide examples of a 30 min bed-rest exercise program for hospitalized pregnant patients using the principal of suggested frequency, intensity, time (duration) of activity, and type of activity (FITT) using a resistance tool while in bed. If the individual is able to ambulate, we recommend short walks around the ward. Every minute counts and activity should be incorporated into a program at least 3 times per week, or every day if possible. As in all exercise programs, motivation and accountability are essential. Flexibility in timing of the exercise intervention is important due to the scheduling of medical assessments that may occur throughout the day for these hospitalized patients. Evidence suggests that by improving physical and emotional health through a bed-rest exercise program during a hospitalized pregnancy may help the individual resume demanding daily activity in the postpartum period and improve quality of life once birth has occurred. More research is necessary to improve the health of those individuals who are hospitalized during pregnancy, with follow up and support into the postpartum period.

Activity patterns related to depression symptoms in stressed dementia caregivers.

OBJECTIVES: Self-reported activity restriction is an established correlate of depression in dementia caregivers (dCGs). It is plausible that the daily distribution of objectively measured activity is also altered in dCGs with depression symptoms; if so, such activity characteristics could provide a passively measurable marker of depression or specific times to target preventive interventions. We therefore investigated how levels of activity throughout the day differed in dCGs with and without depression symptoms, then tested whether any such differences predicted changes in symptoms 6 months later. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: We examined 56 dCGs (mean age = 71, standard deviation (SD) = 6.7; 68% female) and used clustering to identify subgroups which had distinct depression symptom levels, leveraging baseline Center for Epidemiologic Studies of Depression Scale-Revised Edition and Patient Health Questionnaire-9 (PHQ-9) measures, as well as a PHQ-9 score from 6 months later. Using wrist activity (mean recording length = 12.9 days, minimum = 6 days), we calculated average hourly activity levels and then assessed when activity levels relate to depression symptoms and changes in symptoms 6 months later. RESULTS: Clustering identified subgroups characterized by: (1) no/minimal symptoms (36%) and (2) depression symptoms (64%). After multiple comparison correction, the group of dCGs with depression symptoms was less active from 8 to 10 AM (Cohen's d ≤ -0.9). These morning activity levels predicted the degree of symptom change on the PHQ-9 6 months later (per SD unit ß = -0.8, 95% confidence interval: -1.6, -0.1, p = 0.03) independent of self-reported activity restriction and other key factors. CONCLUSIONS: These novel findings suggest that morning activity may protect dCGs from depression symptoms. Future studies should test whether helping dCGs get active in the morning influences the other features of depression in this population (i.e. insomnia, intrusive thoughts, and perceived activity restriction).

Psychological Factors Associated With Fear of Falling Avoidance Behavior in Parkinson's Disease: The Role of Depression, Anxiety, and Catastrophizing.

PURPOSE: The purpose of this study was to examine the relationship between psychological factors (depression, anxiety, and catastrophizing) and fear of falling avoidance behavior (FFAB) among individuals with Parkinson's disease (PD). METHODS: A secondary analysis of cross-sectional data from 59 individuals with PD using hierarchical multiple regression. RESULTS: Disease severity (Movement Disorder Society - Unified PD Rating Scale) and catastrophizing (Consequences of Falling Questionnaire (CoF)) explained approximately 48.2% of the variance in the FFAB Questionnaire scores (P < .001). Catastrophizing was the only significant psychological variable (P < .001). The damage to identity subscale of the CoF was significant in the final model (P < .001). CONCLUSIONS: Catastrophizing about the consequences of falls explained the largest portion of variability in FFAB after controlling for disease severity. Catastrophizing about the immediate consequences of falling may play a prominent role in FFAB and may be a potential treatment target for mitigating FFAB.

Changes in the body composition of boys aged 11-18 years due to COVID-19 measures in the Czech Republic.

BACKGROUND: The lockdown measures related to coronavirus disease 2019 (COVID) impacted the health of adolescents by reducing physical activity (PA). The physical changes in response to decreases in PA can be measured with full body composition analysis. The aim of this study was to evaluate the effects of long-term PA restrictions on body fat (BF), fat-free mass (FFM) and skeletal muscle mass (SMM) in adolescents. METHODS: A total of 1669 boys (before PA restriction (G1): 998; after PA restrictions ended (G2): 671; between the ages of 11 and 18 were included. The measured parameters were body mass (BM), visceral fat area (VFA), BF, FFM and SMM. The whole-body composition was evaluated using bioelectrical impedance analysis (BIA). RESULTS: Compared to G1, G2 exhibited an increase in BF between 1.2 and 5.1%. This difference was significant in boys aged 13 to 18 years (p < 0.05). VFA increased between 5.3 and 20.5 cm2; this increase was significant in boys aged 13 to 18 years (p < 0.05). SMM decreased between 2.6 and 3.8%, and this decrease was significant in all age groups (p < 0.05). Changes in body composition were not accompanied by any significant changes in BM. CONCLUSIONS: COVID-19 restrictions reduced PA, resulting in a significant decrease in SMM. This decrease may impact boys' ability to engage in sufficiently varied PA, which may lead to a further decline in PA and subsequent medical consequences in adulthood.

Service Delivery Models for the Management of Pediatric and Adolescent Concussion: A Systematic Review.

Objective: To examine the current peer-reviewed literature on pediatric concussion and mild traumatic brain injury (mTBI) service delivery models (SDMs) and relevant cost analyses. Data Sources: PubMed, Embase (Elsevier), CINAHL Plus (EBSCO), APA PsycINFO (EBSCO), and Web of Science Core Collection, limited to human trials published in English from January 1, 2001, to January 10, 2022. Study Selection: Included articles that (1) were peer-reviewed; (2) were evidence-based; (3) described service delivery and/or associated health care costs; and (4) focused on mTBI, concussion, or postconcussion symptoms of children and adolescents. Studies describing emergency department-based interventions, adults, and moderate to severe brain injuries were excluded. Data Extraction: The initial search resulted in 1668 articles. Using Rayyan software, 2 reviewers independently completed title and abstract screening followed by a full-text screening of potentially included articles. A third blinded reviewer resolved inclusion/exclusion conflicts among the other reviewers. This resulted in 28 articles included. Data Synthesis: Each of the 28 articles were grouped into 1 of the following 3 categories: generalist-based services (7), specialist-based services (12), and web/telemedicine services (6). One article discussed both generalists and specialists. It was clear that specialists are more proactive in their treatment of concussion than generalists. Most of the research on generalists emphasized the need for education and training. Four studies discussed costs relevant to SDMs. Conclusions: This review highlights the need for more discussion and formalized evaluation of SDMs to better understand concussion management. Overall there is more literature on specialist-based services than generalist-based services. Specialists and generalists have overarching similarities but differ often in their approach to pediatric concussion management. Cost analysis data are sparse and more research is needed.

[The dynamics of disability of population in the Russian Federation].

The analysis of disability indicators allows to draw conclusions about both level of medical care and quality of therapeutic measures and about level of social economic development of society as a whole. Furthermore, disability is a complex problem including social, economic, medical and other components.The study is devoted to analysis of official statistical data by set of such methods as exploration and generalization of experience, analytical and statistical techniques, monographic description.The study established decreasing of total number of the disabled in the Russian Federation in 2015-2020 in absolute values with simultaneous increasing of both absolute value and share of disabled children. The analysis of the number of the disabled in the Federal Okrugs of the Russian Federation permitted to conclude about retained general trends specific to the Russian Federation. In the structure of disability among individuals recognized as disabled for the first time, share of individuals with the disability group I increased. In individuals recognized as disabled for the first time, the most common diseases are malignant neoplasms (Chapter II) and diseases of cardiovascular system (Chapter IX). Among main persistent functional disorders in individuals recognized as disabled (both for the first time and repeatedly), first rank positions are occupied by conditions encoded in the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, in Chapter III (dysfunction of the blood system and immune system), Chapter XIII (violation of neuromuscular, skeletal and movement-related functions), Chapter IX (violation of functions of cardiovascular system).

Impact of social activity restriction and routine patient screening as a preventive measurement for tertiary referral hospital staff in a country with high COVID-19 incidence.

Background: Measuring COVID-19 incidence among hospital staff and the influencing factors and preventative measures affecting outcomes is important given their high risk of exposure and potential impacts on health service provision. Method: Study participants included all hospital staff with COVID-19 confirmed by real-time reverse transcription-polymerase chain reaction (RT-PCR) from March 2020 to July 2021. Data were collected on age, gender, occupation, working area, symptoms and vaccination status. We also collected data on pediatric oncology patients and their caregivers to review the hospital screening policy. Results: Approximately 59% of positive cases among hospital staff occurred in the green zone; 75% were fully vaccinated. Whole-genome sequencing indicated that staff infections in June 2021 were Delta variant. A decrease in cases coincided with government implementation of social activity restriction. When RT-PCR was performed in suspected cases, 3 of 36 pediatric oncology patients and 10 staff tested positive. After routine screening, 8 of 121 patients, 3 patient caregivers, and 5 staff tested positive, all were asymptomatic, and all were infected in the community. Conclusions: Routine testing for staff, patients and caregivers, vaccination booster programs, continuing education of health care workers, and government policy, such as social activity restriction, are needed to protect frontline workers.

High success rate of nocturnal enuresis treatment during the stay-home period for COVID-19.

OBJECTIVES: To clarify whether enuresis treatment was more effective during the stay-home period for the coronavirus disease 2019 pandemic, when restrictions on activities enabled patients to concentrate on treatment. METHODS: We performed a retrospective, nonrandomized cohort study for monosymptomatic enuresis during the coronavirus disease 2019 pandemic (March-June 2020) and a 2-year comparator period (March-June 2018 and March-June 2019). Primary outcome was treatment response, defined as a change in the number of wet nights per week within 6 months following enrollment. The time-dependent occurrence of treatment response was evaluated with the Kaplan-Meier method and the log-rank test. The Cox proportional hazards regression model was used to identify risk factors for treatment response. The range of appropriate sample sizes for this primary outcome was 39-48. RESULTS: Of our 41 enrolled patients, 28 (68%) were male and mean age was 8.8 years. The complete response rate was 73% during the coronavirus disease 2019 pandemic period and 27% during the comparator period. Log-rank tests showed a higher cumulative incidence of complete response in the pandemic period (P = 0.020). Cox regression analysis identified treatment during the coronavirus disease 2019 pandemic (hazard ratio 2.533; 95% confidence interval 1.069-6.006) and dinner before 19:00 (hazard ratio 4.184; 95% confidence interval 1.56-11.252) as significantly associated with treatment response. CONCLUSIONS: The rate of enuresis treatment response was uncommonly high during the stay-home period for the coronavirus disease 2019 pandemic. Restrictions on daily life may provide opportunities to concentrate on treatments for chronic illnesses, leading to more success.

Activities-specific performance frequency can accurately detect fallers in elderly populations: an alternative method for quantifying activity restrictions.

BACKGROUND: The high prevalence of falling among older adults constitutes a major public and clinical health concern. Many elderly persons may develop activities-specific restriction due to the risk of falling. This highlights the need for relevant evaluative tools. METHODS: This cross-sectional study used activities-specific performance frequency indicators to quantify activity restrictions in elderly participants, with all measures based on items from the Activities-Specific Balance Confidence (ABC) scale. Specifically, we tested for correlations between activities-specific performance frequency and balance confidence, functional balance/mobility, and fall history. There were 88 elderly participants, including 28 with stroke, 30 with Parkinson's disease, and 30 with no neurological diseases. In addition to their activities-specific performance frequency measures, we collected a series of demographic and health-related characteristics from each participant. We analyzed between-group differences in activities-specific performance frequency and other demographic and health-related characteristics via the one-way analysis of variance and Kruskal-Wallis test. Next, we used the Spearman's rank correlation test and binary logistic regression to investigate the correlations between activities-specific performance frequency and demographic/other health-related characteristics. RESULTS: There were significant group differences in performance frequency for all ABC activity items except for walking around the house, average ABC scores, and functional balance/mobility among normal older adults, participants with strokes and those with Parkinson's disease. Activities-specific performance frequency showed stronger correlations with activities-relevant functional mobility (r=0.250-0.713 for 15 items with significant correlations, 13 activity items with r≧0.4) than with balance confidence (r=0.279-0.668 for 13 items with significant correlations, 10 activity items with r≧0.4). The performance frequency of walking in crowds/bumped was the most sensitive measure for predicting fallers (odd ratio=3.310, p<0.05). CONCLUSIONS: This study proposed and validated the usage of activities-specific performance frequency as an alternative method for quantifying activity restrictions among older adults.

Perceived stress and support preferences during bed rest in twin pregnancies: A cross-sectional online survey.

OBJECTIVE: To identify the most prominent sources of stress, examine correlates of stress, and assess support preferences to inform future interventions among women pregnant with twins who are on bed rest. MATERIALS AND METHODS: A cross-sectional online survey was administered to pregnant and postpartum women who were recommended bed rest during their twin pregnancy. Total stress while on bedrest was assessed using an adapted version of the Antepartum Hospital Stressors Inventory (AHSI). Bivariate analyses were used to compare total stress scores across participant characteristics using linear regression, Spearman's correlation, and one-way ANOVA. Qualitative content regarding women's bed rest experiences and future intervention preferences was analyzed into themes. FINDINGS: Women's (N = 104, mean age 30.6 years ± 4.6) most prominent sources of stress while on bed rest included thinking about babies' health, feeling dependent on others, and feeling uncertain about the outcome. Women who were recommended bed rest earlier in their pregnancy or were recommended both home and hospital bedrest had higher stress scores, while women with monochorionic/monoamniotic pregnancies had lower stress scores. Approximately 64% of women indicated interest in a bed rest support program, with 88% indicating a preference for online support and 70% wanting support from family. KEY CONCLUSIONS: Women pregnant with twins who are recommended bed rest identify many sources of stress. Our findings suggest a need for stress-management interventions targeting this population.

Association between activity restriction due to fear of falling and mortality: Results from the Korean longitudinal study of aging.

AIM: To analyze the correlation between activity restriction due to fear of falling and mortality among Koreans aged ≥45 years. METHODS: After excluding missing values, the data of 411 participants from the first to sixth waves of the Korean Longitudinal Study of Aging were analyzed using the χ2 -test, log-rank tests and Cox proportional hazards model. RESULTS: In model 1, which did not include activity restriction due to fear of falling as an independent variable, the death rate increased by 1.024-fold (hazard ratio 1.024, 95% confidence interval 1.000-1.050, P = 0.0498) as the number of falls increased by one. In model 2, which included activity restriction due to fear of falling as an independent variable, participants with experience of activity restriction showed 1.993-fold higher mortality (hazard ratio 1.993, 95% confidence interval 1.112-3.572, P = 0.0205) than those without such experience. In addition, as the number of falls in the group with chronic diseases increased by one, the mortality rate increased by 1.028-fold (hazard ratio 1.028, 95% confidence interval 1.001-1.057, P = 0.043). CONCLUSIONS: There was a close relationship between activity restriction due to fear of falling and mortality. Therefore, this study can serve as the foundation for policies and institutional measures to reduce the mortality rate of groups with activity restrictions due to fear of falling. Geriatr Gerontol Int 2022; 22: 168-174.