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1.
Clin Interv Aging ; 19: 857-871, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38770185

RESUMO

Purpose: Multiple falls preventions exercise programs have been rolled out globally, however, few studies have explored the factors necessary for their implementation. This study aimed to investigate the factors influencing the implementation of "Steady Feet" (SF), a 12-week community fall prevention exercise intervention, for older adults living in Singapore. Material and Methods: This study utilized purposive sampling to recruit two participant groups: (i) older adults who declined or withdrew from the program and (ii) providers of the program (eg, instructors). We conducted 22 semi-structured interviews, recordings were transcribed and translated, followed by thematic analysis. Data collection and analysis were informed by the PRECEDE-PROCEED framework, focusing on predisposing, enabling, and reinforcing factors. Results: Findings revealed two predisposing, four enabling, and two reinforcing themes. Predisposing themes encompassed (i) knowledge, attitudes, and practices of older adults towards exercises and falls prevention, and (ii) perceptions and attitudes of providers towards SF. Both older adults and providers identified several enabling elements in implementing SF, emphasizing the significance of (i) accessibility, availability, and affordability. Providers highlighted (ii) tools and structural support for continual engagement, (iii) minimizing variations in capabilities through a competency development program, and (iv) fostering synergistic partnerships. Positive reinforcement included (i) the role of providers in engaging and promoting participation, (ii) family support, social networks, and (iii) incentives for older adults. Conversely, both groups highlighted negative reinforcements, including (iv) communication issues and (v) repetitive exercises, while providers specifically identified (vi) labor constraints as a deterrent for implementation. Conclusion: Findings indicate that effective implementation necessitates a multifaceted approach. Promoting participation involves engaging instructors, emphasizing social bonds and family involvement, offering incentives, and providing subsidized or free classes. A competency development program proved effective in reducing variations in providers' capabilities. Strengthening community partnerships, with management support, was crucial for ensuring the availability and accessibility of falls prevention programs.


Assuntos
Acidentes por Quedas , Terapia por Exercício , Vida Independente , Pesquisa Qualitativa , Humanos , Acidentes por Quedas/prevenção & controle , Idoso , Feminino , Masculino , Singapura , Terapia por Exercício/métodos , Conhecimentos, Atitudes e Prática em Saúde , Entrevistas como Assunto , Idoso de 80 Anos ou mais , Pessoa de Meia-Idade , Exercício Físico
2.
PLoS One ; 19(5): e0303362, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38718002

RESUMO

The use of physiotherapy (PT) in the hospital emergency department (ED) has shown positive results including improvements in patient waiting time, treatment initiation, discharge type, patient outcomes, safety and acceptability of the intervention by medical staffs. These findings originate from studies that primarily focus on musculoskeletal and orthopaedic conditions. Despite a significant number of people visiting the ED, there is a shortage of literature evaluating PT in the ED for elderly populations. The objective of this study is the evaluate the effect of delivering PT in the ED (versus no delivery) in patients aged 75 and over with 'falls' complaints. The main objective is the evaluate the effect on the discharge disposition (discharge home, hospitalization). Secondarily, we will evaluate the effect delivering PT on patient-length of stay, the number of falls at 7 days after admission to the ED, changes between the initial and final medical decision regarding patient orientation, and medical staff satisfaction. This study will follow a prospective longitudinal design involving participants aged 75 years and over. We plan to recruit a total n = 336 patients admitted to the ED with a 'fall' chief complaint. After consent, participants will be randomized into either the 'PT-group' (receiving a prescription and execution of PT within the ED), or to the 'no-PT group' (no delivery of PT within the ED). The PT intervention will involve a standardized assessment of motor capacities using validated clinical examinations, and the delivery of rehabilitative exercises based on individual needs. Outcomes will be recorded from the patient's medical record, and a phone call at 7 days. A questionnaire will be sent to medical staff. The results of this study will help to determine whether PT might be beneficial for the management of this increasing proportion of individuals who come to the ED. Trial registration: (Trial registration number: ClinicalTrials.gov NCT05753319). https://classic.clinicaltrials.gov/ct2/show/NCT05753319.


Assuntos
Acidentes por Quedas , Serviço Hospitalar de Emergência , Modalidades de Fisioterapia , Humanos , Idoso , Feminino , Masculino , Idoso de 80 Anos ou mais , Estudos Prospectivos , Tempo de Internação , Ensaios Clínicos Controlados Aleatórios como Assunto
3.
BMC Surg ; 24(1): 146, 2024 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-38734618

RESUMO

OBJECTIVES: To retrospectively investigate and analyze the characteristics of male bulbar urethral strictures or occlusions resulting from straddle injuries caused by falling from heights and riding activities. METHODS: The study included 56 patients with a history of straddle injury, who were divided into two groups: the falling group (n = 29) and the riding group (n = 27). All patients underwent urethroscopy and X-ray urethrography, followed by urethrotomy and anastomotic procedure. Both urethral and suprapubic catheters were retained for one month postoperatively. Subsequent follow-up assessments were conducted within one month to one year after surgery. RESULTS: The clinical data of two groups were analyzed. The average ages were 40.1 ± 11.2 (falling group, aged 18-59) and 26.8 ± 4.4 (riding group, aged 19-35), P < 0.05. In the falling group, 21 cases (72.4%) had offspring, while in the riding group, only 3 cases (11.1%) had offspring, P < 0.05. The stricture segments in the falling group were predominantly located in the proximal part of the bulbar region (89.7%), whereas in the riding group they mainly found in the distal part (96.3%), P < 0.05. In terms of urethrography results, the average lengths of stricture segments were measured as 17.6 ± 2.8 mm and 15.5 ± 4.6 mm respectively, P < 0.05. During surgery, the average lengths of stricture segments were recorded as 19.0 ± 2.5 mm and 17.4 ± 6.1 mm, P > 0.05. In the falling group, 20 cases (69.0%) involved bulbocavernosus muscle injury, P < 0.05. In the riding group, 5 cases (18.5%) involved corpus cavernosum injury, P < 0.05. After one month of the operation, all cases were able to pass through the 16Fr urethroscope without any apparent urethral strictures or complications observed in urethrography results. The maximum urinary flow rate for all cases exceeded 15 ml/s. Two months and one year after the operation, all cases experienced smooth urinary flow and ejaculation without any disorders reported. 3 cases (10.3%) in the falling group and 7 cases (25.9%) in the riding group complained of urethral stretching pain during erection, P > 0.05. CONCLUSIONS: Male bulbar urethral strictures or occlusions resulting from straddle injuries associated with falling from heights and riding activities exhibit distinct characteristics, necessitating the development of a comprehensive surgical plan tailored to the specific features of each condition and the diverse age groups affected.


Assuntos
Estreitamento Uretral , Humanos , Masculino , Estreitamento Uretral/etiologia , Estreitamento Uretral/cirurgia , Adulto , Estudos Retrospectivos , Pessoa de Meia-Idade , Adolescente , Adulto Jovem , Acidentes por Quedas , Uretra/lesões
4.
Ig Sanita Pubbl ; 80(2): 30-40, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38739439

RESUMO

Falls are a widespread concern in hospitals settings. In Italy, falls are the fourth frequent damage claim type after surgical, diagnostic and therapeutic error and 90% of falls are avoidable. The first necessary action for the prevention of falls consists in identifying the possible risk factors, in relation to the characteristics of the patient and those of the environment and the structure that hosts him, in terms of safety, organization and adequacy of the process welfare. In this work we wanted to evaluate the extent, frequency and characteristics of the phenomenon of falls in the population hospitalized at the Local Health Authority called "Roma 2", with the aim of analyzing the critical issues to allow the identification of possible preventive and improvement interventions as well as reducing the risk of falls.


Assuntos
Acidentes por Quedas , Gestão de Riscos , Humanos , Acidentes por Quedas/prevenção & controle , Acidentes por Quedas/estatística & dados numéricos , Itália , Gestão de Riscos/métodos , Idoso , Masculino , Feminino , Fatores de Risco , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Adulto
5.
J Prev Med Hyg ; 65(1): E83-E92, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38706770

RESUMO

Introduction: Falling is a serious problem for all ages. There are several tests to assess balance. Mini-BESTest and brief-BESTest are balance tests for which there are no normative values for Iranian people. We aimed to provide the normative values of mini-BESTest and brief-BESTest among healthy Iranian adults. Methods: A cross-sectional study was designed. Three hundred healthy adults (150 males and 150 females) in six age groups (18-29, 30-39, 40-49, 50-59, 60-69, +70 years) completed the tests using Persian mini-BESTest and brief-BESTest. Normative values were calculated for age groups. Results: Normative values of mini-BESTest and brief- BESTest decreased significantly with age (from 27 to 21.9 for mini-BESTest and from 22.9 to 15.4 for brief BESTest). There were no significant differences between genders except for females in 30-39 and 40-49 years age groups which scored better on brief-BESTest and mini-BESTest, respectively. Males had significantly scored better in brief- BESTest in 60-69 and ≥ 70 age groups. Conclusions: The normative values of the mini-BESTest and brief-BESTest provided for healthy Iranian adults can help clinicians when assessing subjects with balance dysfunction.


Assuntos
Equilíbrio Postural , Humanos , Masculino , Feminino , Adulto , Irã (Geográfico) , Pessoa de Meia-Idade , Estudos Transversais , Idoso , Adulto Jovem , Adolescente , Valores de Referência , Acidentes por Quedas/prevenção & controle , Fatores Etários
6.
Home Healthc Now ; 42(3): 130-139, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38709579

RESUMO

High fall rates among older adults in combination with prolonged time on the floor after a fall have created an urgent need to preventatively address fall recovery strategies. The purpose of this study is to describe the outcomes of a novel safe fall recovery (SFR) educational module provided by physical therapists to older adults in their homes. A pre- and post-test descriptive study used a convenience sample to recruit 30 adults (≥65 years). A baseline assessment and SFR in-home education were provided. Pre- and post-education measures included the Steps for Safe Fall Recovery (Steps for SFR) tool, the Activity Specific Balance Confidence (ABC) scale, and a fall confidence survey. The Wilcoxon matched-pairs signed-rank test determined significance (P < .05). Participants were age 77.2 (6.8) years and 20 females. Eight reported a fall during the prior year. Statistically significant improvements were identified in the Steps to SFR tool (P = .001), the ABC scale (P = .004), and the fall recovery confidence survey (P = .001). Integration of an SFR educational intervention delivered to an older adult population in their home demonstrated improved safety and confidence to recover from a fall.


Assuntos
Acidentes por Quedas , Humanos , Acidentes por Quedas/prevenção & controle , Feminino , Masculino , Idoso , Idoso de 80 Anos ou mais , Educação de Pacientes como Assunto/métodos
8.
JBJS Rev ; 12(5)2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38748810

RESUMO

¼ Patient falls in the hospital are one of the leading sentinel events identified by the Joint Commission.¼ Hospital falls affect orthopaedic patients of older age at higher rates, and up to 34% of falls lead to injury such as fractures.¼ Patients often misperceive their fall risk, and modalities aimed at educating patients to address the incongruence between perceived and actual fall risk significantly reduce fall rate and injurious fall rate.¼ Adequate communication with patients and their families with the goal of educating them may diminish the physical, psychological, and emotional detriment to orthopaedic patients.


Assuntos
Acidentes por Quedas , Pacientes Internados , Educação de Pacientes como Assunto , Humanos , Acidentes por Quedas/prevenção & controle
9.
J Biomech ; 168: 112123, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38696984

RESUMO

Motorized treadmills have been extensively used in investigating reactive balance control and developing perturbation-based interventions for fall prevention. However, the relationship between perturbation intensity and its outcome has not been quantified. The primary purpose of this study was to quantitatively analyze how the treadmill belt's peak velocity affects the perturbation outcome and other metrics related to the reactive balance in young adults while the total belt displacement is controlled at 0.36 m. Thirty-one healthy young adults were randomly assigned into three groups with different peak belt speeds: low (0.9 m/s), medium (1.2 m/s), and high (1.8 m/s). Protected by a safety harness, participants were exposed to a forward support surface translation while standing at an unexpected timing on an ActiveStep treadmill. The primary (perturbation outcome: fall vs. recovery) and secondary (dynamic stability, hip descent, belt distance at liftoff, and recovery step latency) outcome measures were compared among groups. Results revealed that a higher perturbation intensity is correlated with a greater faller rate (p < 0.001). Compared to the low- and medium-intensity groups, the high-intensity group was less stable (p < 0.001) with a larger hip descent (p < 0.001) and a longer belt distance (p < 0.001) at the recovery step liftoff. The results suggest that the increased perturbation intensity raises the risk of falling with larger instability and poorer reactive performance after a support surface translation-induced perturbation in healthy young adults. The findings could furnish preliminary guidance for us to design and select the optimal perturbation intensity that can maximize the effects of perturbation-based training protocols.


Assuntos
Acidentes por Quedas , Equilíbrio Postural , Humanos , Equilíbrio Postural/fisiologia , Acidentes por Quedas/prevenção & controle , Masculino , Feminino , Adulto , Adulto Jovem , Posição Ortostática , Fenômenos Biomecânicos , Teste de Esforço/métodos
10.
J Biomech ; 168: 112122, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38703516

RESUMO

As the recovery from gait perturbations is coordinatively complex and error-prone, people often adopt anticipatory strategies when the perturbation is expected. These anticipatory strategies act as a first line of defence against potential balance loss. Since age-related changes in the sensory and neuromotor systems could make the recovery from external perturbations more difficult, it is important to understand how older adults implement anticipatory strategies. Therefore, we exposed healthy young (N = 10, 22 ± 1.05 yrs.) and older adults (N = 10, 64.2 ± 6.07 yrs.) to simulated slips on a treadmill with consistent properties and assessed if the reliance on anticipatory control differed between groups. Results showed that for the unperturbed steps in between perturbations, step length decreased and the backward (BW) margin of stability (MOS) increased (i.e., enhanced dynamic stability against backward loss of balance) in the leg that triggered the slip, while step lengths increased and BW MOS decreased in the contralateral leg. This induced step length and BW MOS asymmetry was significantly larger for older adults. When exposed to a series of predictable slips, healthy older adults thus rely more heavily on anticipatory control to proactively accommodate the expected backward loss of balance.


Assuntos
Marcha , Equilíbrio Postural , Humanos , Masculino , Feminino , Equilíbrio Postural/fisiologia , Pessoa de Meia-Idade , Idoso , Marcha/fisiologia , Acidentes por Quedas/prevenção & controle , Adulto , Envelhecimento/fisiologia , Antecipação Psicológica/fisiologia , Fenômenos Biomecânicos , Adulto Jovem , Caminhada/fisiologia
11.
BMC Geriatr ; 24(1): 418, 2024 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-38730402

RESUMO

BACKGROUND: The public health measures associated with the COVID-19 pandemic may have indirectly impacted other health outcomes, such as falls among older adults. The purpose of this study was to examine trends in fall-related hospitalizations and emergency department visits among older adults before and during the COVID-19 pandemic in Ontario, Canada. METHODS: We obtained fall-related hospitalizations (N = 301,945) and emergency department visit (N = 1,150,829) data from the Canadian Institute for Health Information databases from 2015 to 2022 for adults ages 65 and older in Ontario. Fall-related injuries were obtained using International Classification of Diseases, 10th edition, Canada codes. An interrupted time series analysis was used to model the change in weekly fall-related hospitalizations and emergency department visits before (January 6, 2015-March 16, 2020) and during (March 17, 2020-December 26, 2022) the pandemic. RESULTS: After adjusting for seasonality and population changes, an 8% decrease in fall-related hospitalizations [Relative Rate (RR) = 0.92, 95% Confidence Interval (CI): 0.85, 1.00] and a 23% decrease in fall-related emergency department visits (RR = 0.77, 95%CI: 0.59, 1.00) were observed immediately following the onset of the pandemic, followed by increasing trends during the pandemic for both outcomes. CONCLUSIONS: Following an abrupt decrease in hospitalizations and emergency department visits immediately following the onset of the pandemic, fall-related hospitalizations and emergency department visits have been increasing steadily and are approaching pre-pandemic levels. Further research exploring the factors contributing to these trends may inform future policies for public health emergencies that balance limiting the spread of disease among this population while supporting the physical, psychological, and social needs of this vulnerable group.


Assuntos
Acidentes por Quedas , COVID-19 , Serviço Hospitalar de Emergência , Hospitalização , Humanos , COVID-19/epidemiologia , Acidentes por Quedas/prevenção & controle , Ontário/epidemiologia , Idoso , Estudos Retrospectivos , Hospitalização/tendências , Masculino , Feminino , Serviço Hospitalar de Emergência/tendências , Idoso de 80 Anos ou mais , Pandemias
13.
Otol Neurotol ; 45(5): 572-579, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38728561

RESUMO

INTRODUCTION: Studies on incidence and prevalence of vestibular disorders tend to focus on small pockets of patients recruited from specialized clinics and often exclude measures of vestibular function. The objectives of the study were to characterize patients with common vestibular disorders, estimate the prevalence of common vestibular disorders, and ascertain whether patients with vestibular disorders experience increased risks of falls and morbidity. MATERIALS AND METHODS: This retrospective cohort study includes both inpatient and outpatient routine clinical care data culled from a nationally representative, population-based sample. Patients were included if their record in the TriNetX Diamond Cohort comprised at least one vestibular function test or vestibular diagnosis. The main outcome measures were diagnosis with a vestibular disorder, a fall, or a common medical comorbidity (e.g., diabetes, cerebrovascular disease). RESULTS: The cohort includes n = 4,575,724 patients, of which 55% (n = 2,497,136) had a minimum of one vestibular diagnosis. Patients with vestibular diagnoses were 61.3 ± 16.6 years old (mean ± standard deviation), 67% women, 28% White race (69% unknown race), and 30% of non-Hispanic or Latino ethnicity (66% unknown ethnicity). The prevalence of vestibular disorders was estimated at 2.98% (95% confidence interval [CI]: 2.98-2.98%). Patients with vestibular diagnoses experienced a significantly greater odds of falls (odds ratio [OR] = 1.04; 95% CI: 1.02-1.05), cerebrovascular disease (OR = 1.42; 95% CI: 1.40-1.43), ischemic heart disease (OR = 1.17; 95% CI: 1.16-1.19), and diabetes (OR = 1.14; 95% CI: 1.13-1.15), among others. DISCUSSION: Vestibular disorders affect an estimated 3% of the U.S. population, after weighting. Patients with these disorders are at greater risk for many common, consequential medical conditions.


Assuntos
Acidentes por Quedas , Comorbidade , Doenças Vestibulares , Humanos , Doenças Vestibulares/epidemiologia , Feminino , Pessoa de Meia-Idade , Masculino , Idoso , Estudos Retrospectivos , Prevalência , Adulto , Acidentes por Quedas/estatística & dados numéricos , Transtornos Cerebrovasculares/epidemiologia , Transtornos Cerebrovasculares/complicações , Estudos de Coortes , Diabetes Mellitus/epidemiologia , Idoso de 80 Anos ou mais
14.
JMIR Hum Factors ; 11: e52575, 2024 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-38717810

RESUMO

BACKGROUND: More than one-third of older adults (aged ≥65 y) experience falls every year. The prevalent modifiable risk factors for falling are malnutrition and physical inactivity, among others. The involvement of older adults in the prevention of falls can decrease injuries, hospitalizations, and dependency on health care professionals. In this regard, eHealth can support older adults' self-management through more physical activity and adequate food intake. eHealth must be tailored to older adults' needs and preferences so that they can reap its full benefits. Therefore, it is necessary to gain insight into the knowledge, skills, and mindset of older adults living at home who are at risk of falls regarding eHealth. OBJECTIVE: This qualitative study aims to explore older adults' use of everyday digital services and technology and how they acquire knowledge about and manage their nutritional intake and physical activity in relation to their health. METHODS: Semistructured interviews were conducted with 15 older adults (n=9, 60% women; n=6, 40% men; age range 71-87 y) who had all experienced falls or were at risk of falling. These individuals were recruited from a geriatric outpatient clinic. The interviews were analyzed using deductive content analysis based on a modification of the Readiness and Enablement Index for Health Technology framework. RESULTS: The qualitative data showed that the informants' social networks had a positive impact on their self-management, use of technology, and mindset toward nutritional intake and physical activity. Although the informants generally lived active lives, they all lacked knowledge about how their food intake influenced their physical health, including their risk of falling. Another finding was the large diversity in the use of technology among the informants, which was related to their mindset toward technology. CONCLUSIONS: Older adults can use technology for everyday purposes, but some need additional introduction and support to be able to use it for managing their health. They also need to learn about the importance of proper nutritional intake and physical activity in preventing falls. Older adults need a more personalized introduction to technology, nutrition, and physical activity in their contact with health professionals.


Assuntos
Acidentes por Quedas , Exercício Físico , Conhecimentos, Atitudes e Prática em Saúde , Pesquisa Qualitativa , Humanos , Acidentes por Quedas/prevenção & controle , Idoso , Feminino , Masculino , Idoso de 80 Anos ou mais , Exercício Físico/psicologia , Entrevistas como Assunto , Telemedicina/métodos
15.
Clinics (Sao Paulo) ; 79: 100382, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38759438

RESUMO

INTRODUCTION: An accurate assessment of balance problems is critical for decreasing the risk of falling in patients with Parkinson's Disease (PD). Reliable diagnostic tools such as Computerized Dynamic Posturography (CDP) are not feasible for the clinical setting. Therefore, the present study's aim was to assess the correlation between the clinical Balance Evaluation Systems Test (BESTest) and CDP. METHODS: 20 male older adults with Parkinson's Disease (PD) were included in this study. Participants first executed the Sit-To-Stand (STS), Step/Quick turn (SQT), and Step Up and Over (SUO) tests on a Balance Master® force platform, followed by a clinical balance evaluation using the BESTest. RESULTS: Four outcomes of the CDP were negatively correlated with one or more BESTest domains or total BESTest score: STS sway velocity was negatively correlated with the anticipatory postural adjustment (p = 0.02) and sensory orientation (p = 0.01) domains. SQT turn time was negatively correlated with biomechanical restriction (for turns to the left, p = 0.01, and right, p = 0.03, respectively), postural response (p = 0.01, p = 0.01), dynamic balance during gait (p = 0.007, p = 0.001), and total score (p = 0.02, p = 0.01). Step over time to the right in SUP was negatively correlated with the limits of the stability domain (p = 0.002) and total BESTest score (p = 0.020). SUO impact index was negatively correlated with the anticipatory postural adjustment domain (p = 0.01). CONCLUSION: This study shows that several BESTest domains are significantly correlated with CDP outcomes, demonstrating that the BESTest can be used as a more clinically feasible alternative for computerized posturography, without loss of information.


Assuntos
Doença de Parkinson , Equilíbrio Postural , Humanos , Equilíbrio Postural/fisiologia , Masculino , Doença de Parkinson/fisiopatologia , Idoso , Pessoa de Meia-Idade , Acidentes por Quedas/prevenção & controle , Valores de Referência , Estatísticas não Paramétricas
16.
Braz J Med Biol Res ; 57: e13469, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38775548

RESUMO

Older adults have a high prevalence of falls due to a decline in physiological functions and various chronic diseases. This study aimed to investigate the prevalence of and risk factors for falls among older individuals in the Chinese Longitudinal Healthy Longevity Survey (CLHLS). We collected information from 9737 older individuals (average age=84.26 years) from the CLHLS and used binary logistic regression analysis to explore the independent risk factors and protective factors for falls. The logistic regression analysis results are reported as adjusted odds ratios (aORs) and 95% confidence intervals (95%CIs). The prevalence of falls among older adults in China was 21.6%, with women (24.6%) having a higher prevalence than men (18.1%). Logistic regression analysis revealed that never (or rarely) eating fresh fruit, difficulty with hearing, cataracts, and arthritis were the common independent risk factors for falls in older Chinese men and women. Among men, age ≥80 years (aOR=1.86), never doing housework (aOR=1.36), and dyslipidemia (aOR=1.47) were risk factors, while eating milk products once a week was a protective factor. Alcohol consumption (aOR=1.40), physical labor (aOR=1.28), and heart disease (aOR=1.21) were risk factors for falls in women, while a daily sleep duration of 6-12 h and garlic consumption once a week were protective factors. The prevalence of falls among older adults in China is 21.6% and is greater in women than in men. These risk and protective factors can be used to formulate reasonable recommendations for living habits, diet, and chronic disease control strategies.


Assuntos
Acidentes por Quedas , Humanos , Acidentes por Quedas/estatística & dados numéricos , Masculino , Feminino , Fatores de Risco , Prevalência , China/epidemiologia , Idoso de 80 Anos ou mais , Idoso , Estudos Longitudinais , Modelos Logísticos , População do Leste Asiático
17.
Age Ageing ; 53(5)2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38776214

RESUMO

INTRODUCTION: Fall prevention is a global health priority. Strength and balance exercise programmes are effective at reducing falls. Emerging literature suggests dance is an enjoyable and sociable form of exercise. However, there is little evidence that dance reduces fall incidence. METHODS: Systematic review and meta-analysis examining effectiveness and cost-effectiveness of dance for falls prevention in older adults. Five databases were searched with no restrictions on publication date or intervention settings. Risk of bias was assessed using variants of Cochrane Risk of bias tools, Mixed-Methods Appraisal and Drummond checklist as appropriate. Certainty of evidence was assessed using GRADE. RESULTS: Forty-one studies were included (19 RCTs, 13 quasi-experimental, two mixed-method, seven observational studies, 2,451 participants). Five types of dance interventions were identified: ballroom and Latin dance, dance exercise, cultural dance, dance therapy, and low-impact dance. Meta-analysis was only possible for functional outcome measures: Timed-Up-and-Go (dance versus usual care, mean difference (MD) = 1.36; 95% CI -3.57 to 0.85), Sit-to-Stand (dance versus exercise MD = -0.85; 95% CI -2.64 to 0.93: dance versus education MD = -1.64; 95% CI -4.12 to 0.85), Berg Balance Scale (dance versus usual care MD = 0.61; 95% CI -4.26 to 5.47). There was unexplained variance in effects and no significant differences between intervention and control groups. Overall, certainty of evidence was very low; we are uncertain about the effect of dance interventions in reducing falls. CONCLUSIONS: There is very low certainty evidence for dance as an alternative to strength and balance training if the aim is to prevent falls. No robust evidence on the cost-effectiveness of dance interventions for the prevention of falls was found. PROSPERO REGISTRATION: CRD42022382908.


Assuntos
Acidentes por Quedas , Análise Custo-Benefício , Dançaterapia , Dança , Humanos , Acidentes por Quedas/prevenção & controle , Idoso , Dançaterapia/métodos , Masculino , Feminino , Equilíbrio Postural , Resultado do Tratamento , Fatores de Risco , Fatores Etários , Idoso de 80 Anos ou mais
18.
BMC Geriatr ; 24(1): 413, 2024 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-38730354

RESUMO

BACKGROUND: There is growing evidence linking the age-adjusted Charlson comorbidity index (aCCI), an assessment tool for multimorbidity, to fragility fracture and fracture-related postoperative complications. However, the role of multimorbidity in osteoporosis has not yet been thoroughly evaluated. We aimed to investigate the association between aCCI and the risk of osteoporosis in older adults at moderate to high risk of falling. METHODS: A total of 947 men were included from January 2015 to August 2022 in a hospital in Beijing, China. The aCCI was calculated by counting age and each comorbidity according to their weighted scores, and the participants were stratified into two groups by aCCI: low (aCCI < 5), and high (aCCI ≥5). The Kaplan Meier method was used to assess the cumulative incidence of osteoporosis by different levels of aCCI. The Cox proportional hazards regression model was used to estimate the association of aCCI with the risk of osteoporosis. Receiver operating characteristic (ROC) curve was adapted to assess the performance for aCCI in osteoporosis screening. RESULTS: At baseline, the mean age of all patients was 75.7 years, the mean BMI was 24.8 kg/m2, and 531 (56.1%) patients had high aCCI while 416 (43.9%) were having low aCCI. During a median follow-up of 6.6 years, 296 participants developed osteoporosis. Kaplan-Meier survival curves showed that participants with high aCCI had significantly higher cumulative incidence of osteoporosis compared with those had low aCCI (log-rank test: P < 0.001). When aCCI was examined as a continuous variable, the multivariable-adjusted model showed that the osteoporosis risk increased by 12.1% (HR = 1.121, 95% CI 1.041-1.206, P = 0.002) as aCCI increased by one unit. When aCCI was changed to a categorical variable, the multivariable-adjusted hazard ratios associated with different levels of aCCI [low (reference group) and high] were 1.00 and 1.557 (95% CI 1.223-1.983) for osteoporosis (P <  0.001), respectively. The aCCI (cutoff ≥5) revealed an area under ROC curve (AUC) of 0.566 (95%CI 0.527-0.605, P = 0.001) in identifying osteoporosis in older fall-prone men, with sensitivity of 64.9% and specificity of 47.9%. CONCLUSIONS: The current study indicated an association of higher aCCI with an increased risk of osteoporosis among older fall-prone men, supporting the possibility of aCCI as a marker of long-term skeletal-related adverse clinical outcomes.


Assuntos
Acidentes por Quedas , Osteoporose , Humanos , Masculino , Idoso , Osteoporose/epidemiologia , Osteoporose/diagnóstico , Estudos Retrospectivos , Idoso de 80 Anos ou mais , Incidência , Medição de Risco/métodos , Fatores de Risco , Comorbidade , China/epidemiologia , Fatores Etários
19.
Sensors (Basel) ; 24(9)2024 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-38732796

RESUMO

Gait speed and timed-up-and-go (TUG) predict cognitive decline, falls, and mortality. Dual-tasks may be useful in cognitive screening among people living with dementia (PWD), but more evidence is needed. This cross-sectional study aimed to compare single- and dual-task performance and determine the influence of dementia severity on dual-task performance and interference. Thirty PWD in two residential care facilities (Age: 81.3 ± 7.1 years; Montreal Cognitive Assessment: 10.4 ± 6.0 points) completed two trials of single- (feet apart) and dual-task posture (feet apart while counting backward), single- (walk 4 m) and dual-task gait (walk 4m while naming words), and single- (timed-up-and-go (TUG)), and dual-task functional mobility (TUG while completing a category task) with APDM inertial sensors. Dual-tasks resulted in greater sway frequency, jerk, and sway area; slower gait speed; greater double limb support; shorter stride length; reduced mid-swing elevation; longer TUG duration; reduced turn angle; and slower turn velocity than single-tasks (ps < 0.05). Dual-task performance was impacted (reduced double limb support, greater mid-swing elevation), and dual-task interference (greater jerk, faster gait speed) was related to moderate-to-severe compared to mild PWD. Moderate-to-severe PWD had poorer dynamic stability and a reduced ability to appropriately select a cautious gait during dual-tasks than those with mild PWD, indicating the usefulness of dual-tasks for cognitive screening.


Assuntos
Demência , Marcha , Postura , Humanos , Masculino , Demência/fisiopatologia , Projetos Piloto , Marcha/fisiologia , Feminino , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Postura/fisiologia , Análise e Desempenho de Tarefas , Instituições Residenciais , Equilíbrio Postural/fisiologia , Índice de Gravidade de Doença , Acidentes por Quedas/prevenção & controle
20.
Sensors (Basel) ; 24(9)2024 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-38733024

RESUMO

The Timed-Up and Go (TUG) test is widely utilized by healthcare professionals for assessing fall risk and mobility due to its practicality. Currently, test results are based solely on execution time, but integrating technological devices into the test can provide additional information to enhance result accuracy. This study aimed to assess the reliability of smartphone-based instrumented TUG (iTUG) parameters. We conducted evaluations of intra- and inter-device reliabilities, hypothesizing that iTUG parameters would be replicable across all experiments. A total of 30 individuals participated in Experiment A to assess intra-device reliability, while Experiment B involved 15 individuals to evaluate inter-device reliability. The smartphone was securely attached to participants' bodies at the lumbar spine level between the L3 and L5 vertebrae. In Experiment A, subjects performed the TUG test three times using the same device, with a 5 min interval between each trial. Experiment B required participants to perform three trials using different devices, with the same time interval between trials. Comparing stopwatch and smartphone measurements in Experiment A, no significant differences in test duration were found between the two devices. A perfect correlation and Bland-Altman analysis indicated good agreement between devices. Intra-device reliability analysis in Experiment A revealed significant reliability in nine out of eleven variables, with four variables showing excellent reliability and five showing moderate to high reliability. In Experiment B, inter-device reliability was observed among different smartphone devices, with nine out of eleven variables demonstrating significant reliability. Notable differences were found in angular velocity peak at the first and second turns between specific devices, emphasizing the importance of considering device variations in inertial measurements. Hence, smartphone inertial sensors present a valid, applicable, and feasible alternative for TUG assessment.


Assuntos
Smartphone , Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Reprodutibilidade dos Testes , Acidentes por Quedas/prevenção & controle
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