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Falls in older adults

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https://www.readbyqxmd.com/read/29045582/strategies-to-reduce-injuries-and-develop-confidence-in-elders-stride-a-cluster-randomized-pragmatic-trial-of-a-multifactorial-fall-injury-prevention-strategy-design-and-methods
#1
Shalender Bhasin, Thomas M Gill, David B Reuben, Nancy K Latham, Jerry H Gurwitz, Patricia Dykes, Siobhan McMahon, Thomas W Storer, Pamela W Duncan, David A Ganz, Shehzad Basaria, Michael E Miller, Thomas G Travison, Erich J Greene, James Dziura, Denise Esserman, Heather Allore, Martha B Carnie, Maureen Fagan, Catherine Hanson, Dorothy Baker, Susan L Greenspan, Neil Alexander, Fred Ko, Albert L Siu, Elena Volpi, Albert W Wu, Jeremy Rich, Stephen C Waring, Robert Wallace, Carri Casteel, Jay Magaziner, Peter Charpentier, Charles Lu, Katy Araujo, Haseena Rajeevan, Scott Margolis, Richard Eder, Joanne M McGloin, Eleni Skokos, Jocelyn Wiggins, Lawrence Garber, Steven B Clauser, Rosaly Correa-De-Araujo, Peter Peduzzi
Background: Fall injuries are a major cause of morbidity and mortality among older adults. We describe the design of a pragmatic trial to compare the effectiveness of an evidence-based, patient-centered multifactorial fall injury prevention strategy to an enhanced usual care. Methods: Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE) is a 40-month cluster-randomized, parallel-group, superiority, pragmatic trial being conducted at 86 primary care practices in 10 healthcare systems across USA...
October 14, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/29045492/multitasking-in-older-adults-with-type-2-diabetes-a-cross-sectional-analysis
#2
Jason L Rucker, Joan M McDowd, Jonathan D Mahnken, Jeffrey M Burns, Carla H Sabus, Amanda J Britton-Carpenter, Nora B Utech, Patricia M Kluding
BACKGROUND AND PURPOSE: Deficits in the ability to multitask contribute to gait abnormalities and falls in many at-risk populations. However, it is unclear whether older adults with type 2 diabetes mellitus (DM) also demonstrate impairments in multitasking. The purpose of this study was to compare multitasking performance in cognitively intact older adults with and without DM and explore its relationship to measures of gait and functional ability. METHODS: We performed a cross-sectional analysis of 40 individuals aged 60 and older with type 2 DM and a matched group of 40 cognitively intact older adults without DM...
2017: PloS One
https://www.readbyqxmd.com/read/29044480/can-physical-activity-prevent-falls-in-older-adults-with-poor-physical-performance
#3
EDITORIAL
James Judge
No abstract text is available yet for this article.
October 16, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29042825/antithrombotics-in-trauma-management-strategies-in-the-older-patients
#4
REVIEW
Henna Wong, Nicola Lovett, Nicola Curry, Ku Shah, Simon J Stanworth
The ageing population has resulted in a change in the demographics of trauma, and older adult trauma now accounts for a growing number of trauma admissions. The management of older adult trauma can be particularly challenging, and exhibits differences to that of the younger age groups affected by trauma. Frailty syndromes are closely related with falls, which are the leading cause of major trauma in older adults. Comorbid disease and antithrombotic use are more common in the older population. Physiological changes that occur with ageing can alter the expected clinical presentation of older persons after injury and their susceptibility to injury...
2017: Journal of Blood Medicine
https://www.readbyqxmd.com/read/29042378/association-between-polypharmacy-and-falls-in-older-adults-a-longitudinal-study-from-england
#5
Nafeesa N Dhalwani, Radia Fahami, Harini Sathanapally, Sam Seidu, Melanie J Davies, Kamlesh Khunti
OBJECTIVES: Assess the longitudinal association between polypharmacy and falls and examine the differences in this association by different thresholds for polypharmacy definitions in a nationally representative sample of adults aged over 60 years from England. DESIGN: Longitudinal cohort study. SETTING: The English Longitudinal Study of Ageing waves 6 and 7. PARTICIPANTS: 5213 adults aged 60 or older. MAIN OUTCOME MEASURES: Rates, incidence rate ratio (IRR) and 95% CI for falls in people with and without polypharmacy...
October 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29038360/carotid-sinus-hypersensitivity-block-of-the-sternocleidomastoid-muscle-does-not-affect-responses-to-carotid-sinus-massage-in-healthy-young-adults
#6
Matthew G Lloyd, James M Wakeling, Michael S Koehle, Robert J Drapala, Victoria E Claydon
The arterial baroreflex is crucial for short-term blood pressure control - abnormal baroreflex function predisposes to syncope and falling. Hypersensitive responses to carotid baroreflex stimulation using carotid sinus massage (CSM) are common in older adults and may be associated with syncope. The pathophysiology of this hypersensitivity is unknown, but chronic denervation of the sternocleidomastoid muscles is common in elderly patients with carotid sinus hypersensitivity (CSH), and is proposed to interfere with normal integration of afferent firing from the carotid baroreceptors with proprioceptive feedback from the sternocleidomastoids, producing large responses to CSM...
October 2017: Physiological Reports
https://www.readbyqxmd.com/read/29037625/effects-of-proprioceptive-neuromuscular-facilitation-on-balance-strength-and-mobility-of-an-older-adult-with-chronic-stroke-a-case-report
#7
Christopher S Cayco, Edward James R Gorgon, Rolando T Lazaro
This study described the effects of a proprioceptive neuromuscular facilitation (PNF) program on balance, strength, and mobility in an older adult with chronic stroke. The patient was male, aged 69 years, with right hemiplegia for 17 years, and had diminished balance, balance confidence, lower extremity (LE) strength, and gait velocity. He received 1 h of PNF-based therapy thrice a week for six weeks. Outcome measures were: Mini-BESTest, limits of stability (LOS), Activities-Specific Balance Confidence Scale (ABC), Five Time Sit-to-Stand Test (FTSST), Upright Motor Control Test (UMCT), and 10 Meter Walk Test (10 MWT)...
October 2017: Journal of Bodywork and Movement Therapies
https://www.readbyqxmd.com/read/29035965/effectiveness-of-bedrails-in-preventing-falls-among-hospitalized-older-adults-a-systematic-review
#8
Paulo Marques, Carmen Queirós, João Apóstolo, Daniela Cardoso
BACKGROUND: Falls are a major problem today affecting adults of any age, but the elderly are a population that is more susceptible to falls. Falls are the leading cause of injury or death among older adults. Hospitalized older people are particularly vulnerable to falls. Falls cause direct injuries (minor injuries, severe wounds of the soft tissues and bone fractures) to patients and increased length of stay. The prevention of falls is commonly considered an indicator of the quality of care...
October 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29031347/rehabilitation-needs-of-the-elder-with-traumatic-brain-injury
#9
REVIEW
Manuel F Mas, Amy Mathews, Ekua Gilbert-Baffoe
The incidence of traumatic brain injury (TBI) in older adults is increasing. As the expected life expectancy increases, there is a heightened need for comprehensive rehabilitation for this population. Elderly patients with TBI benefit from rehabilitation interventions at all stages of injury and can achieve functional gains during acute inpatient rehabilitation. Clinicians should be vigilant of unique characteristics of this population during inpatient rehabilitation, including vulnerability to polypharmacy, posttraumatic hydrocephalus, neuropsychiatric sequelae, sleep disturbances, and sensory deficits...
November 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/29031339/balance-problems-and-fall-risks-in-the-elderly
#10
REVIEW
Ramon Cuevas-Trisan
Falls in the elderly are an increasing problem causing a high degree of morbidity, mortality, and use of health care services. Identification of risk factors through medical assessment supports the provision of appropriate interventions that reduce rates of falling. Evaluation and intervention strategies are generally challenging because of the complex and multifactorial nature of falls. The clinician should consider screening for falls an important part of the functional evaluation in older adults. Several potential interventions have proven helpful as preventive strategies...
November 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/29031336/psychosocial-issues-in-geriatric-rehabilitation
#11
REVIEW
Ricardo M Rodriguez
Geriatric patients present multiple age-related challenges and needs that must be taken into account during the rehabilitation process to achieve expected goals. This article examines the importance of identifying and managing psychosocial issues commonly observed in older adults and presents strategies to optimize their rehabilitation process. Depression, anxiety, fear of falling, adjustment issues, neurocognitive disorders, and caregiver support are discussed as a selection of factors that are relevant for geriatric patients undergoing rehabilitation...
November 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/29029240/a-greater-extent-of-insomnia-symptoms-and-physician-recommended-sleep-medication-use-predict-fall-risk-in-community-dwelling-older-adults
#12
Tuo-Yu Chen, Soomi Lee, Orfeu M Buxton
Study Objectives: Cross-sectional studies suggest that insomnia symptoms are associated with falls in later life. This longitudinal study examines the independent and interactive effects of the extent of insomnia symptoms (i.e., multiple co-existing insomnia symptoms) and sleep medications on fall risk over a 2-year follow-up among community-dwelling older adults. Methods: Using data from the Health and Retirement Study (2006-2014, N = 6882, Mage = 74.5 years ± 6...
October 3, 2017: Sleep
https://www.readbyqxmd.com/read/29029214/sleepless-night-and-day-the-plight-of-progressive-supranuclear-palsy
#13
Christine M Walsh, Leslie Ruoff, Kathleen Walker, Alaisa Emery, Jonathan Varbel, Elissaios Karageorgiou, Phi N Luong, Irida Mance, Hilary W Heuer, Adam L Boxer, Lea T Grinberg, Joel H Kramer, Bruce L Miller, Thomas C Neylan
Objectives: To elucidate the unique sleep and waking characteristics in progressive supranuclear palsy (PSP), a neurodegenerative disease associated with motor deficits and dementia that largely affects the brainstem and thalamic regions. Methods: 20 PSP and 16 healthy older adult controls participated in this study. Participants underwent an overnight polysomnography and multiple sleep latency test (MSLT) the following day. Prior to the MSLT last trial, participants were asked to complete the Stanford Sleepiness Scale...
October 5, 2017: Sleep
https://www.readbyqxmd.com/read/29023317/effects-of-physical-exercise-in-older-adults-with-reduced-physical-capacity-meta-analysis-of-resistance-exercise-and-multimodal-exercise
#14
Chiung-Ju Liu, Wen-Pin Chang, Islene Araujo de Carvalho, Katie E L Savage, Lori W Radford, Jotheeswaran Amuthavalli Thiyagarajan
Older adults with reduced physical capacity are at greater risk of progression to care dependency. Progressive resistance strength exercise and multimodal exercise have been studied to restore reduced physical capacity. To summarize the best evidence of the two exercise regimes, this meta-analysis study appraised randomized-controlled trials from published systematic reviews. Medline, Embase, and the Cochrane Database of Systematic Review and Cochrane Central Register of Controlled Clinical Trials were searched for relevant systematic reviews...
October 11, 2017: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
https://www.readbyqxmd.com/read/29020106/can-tai-chi-training-impact-fractal-stride-time-dynamics-an-index-of-gait-health-in-older-adults-cross-sectional-and-randomized-trial-studies
#15
Brian J Gow, Jeffrey M Hausdorff, Brad Manor, Lewis A Lipsitz, Eric A Macklin, Paolo Bonato, Vera Novak, Chung-Kang Peng, Andrew C Ahn, Peter M Wayne
PURPOSE: To determine if Tai Chi (TC) has an impact on long-range correlations and fractal-like scaling in gait stride time dynamics, previously shown to be associated with aging, neurodegenerative disease, and fall risk. METHODS: Using Detrended Fluctuation Analysis (DFA), this study evaluated the impact of TC mind-body exercise training on stride time dynamics assessed during 10 minute bouts of overground walking. A hybrid study design investigated long-term effects of TC via a cross-sectional comparison of 27 TC experts (24...
2017: PloS One
https://www.readbyqxmd.com/read/29019274/effects-of-whole-body-vibration-on-balance-and-mobility-in-institutionalized-older-adults-a-randomized-controlled-trial
#16
Freddy Mh Lam, Philip Fl Chan, L R Liao, Jean Woo, Elsie Hui, Charles Wk Lai, Timothy Cy Kwok, Marco Yc Pang
OBJECTIVE: To investigate whether a comprehensive exercise program was effective in improving physical function among institutionalized older adults and whether adding whole-body vibration to the program conferred additional therapeutic benefits. DESIGN: A single-blinded randomized controlled trial was conducted. SETTING: This study was carried out in residential care units. PARTICIPANTS: In total, 73 older adults (40 women, mean age: 82...
October 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/29018904/kyphosis-and-incident-falls-among-community-dwelling-older-adults
#17
C McDaniels-Davidson, A Davis, D Wing, C Macera, S P Lindsay, J T Schousboe, J F Nichols, D M Kado
Hyperkyphosis commonly affects older persons and is associated with morbidity and mortality. Many have hypothesized that hyperkyphosis increases fall risk. Within this prospective study of older adults, kyphosis was significantly associated with incident falls over 1 year. Measures of hyperkyphosis could enhance falls risk assessments during primary care office visits. INTRODUCTION: To determine the association between four measures of kyphosis and incident and injurious falls in older persons...
October 10, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/29018817/balance-performance-is-task-specific-in-older-adults
#18
Ayelet Dunsky, Aviva Zeev, Yael Netz
Balance ability among the elderly is a key component in the activities of daily living and is divided into two types: static and dynamic. For clinicians who wish to assess the risk of falling among their elderly patients, it is unclear if more than one type of balance test can be used to measure their balance impairment. In this study, we examined the association between static balance measures and two dynamic balance field tests. One hundred and twelve community-dwelling older adults (mean age 74.6) participated in the study...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29017107/vitamin-d-and-parathyroid-hormone-are-associated-with-gait-instability-and-poor-balance-performance-in-mid-age-to-older-aged-women
#19
Marie-Louise Bird, Natalie El Haber, Frances Batchelor, Keith Hill, John D Wark
CONTEXT: Vitamin D status and parathyroid hormone (PTH) levels influence the risk of accidental falls in older people, but the mechanisms underlying this effect remain unclear. OBJECTIVE: Investigate the relationship between circulating PTH and 25 hydroxyvitamin D (25-OHD) levels and clinical tests of gait stability and balance as physical fall risk factors. We hypothesized that high levels of PTH and low 25-OHD levels would be significantly associated with gait stability and decreased balance performance...
September 28, 2017: Gait & Posture
https://www.readbyqxmd.com/read/29016420/prevention-strategies-in-post-tbi-depression-in-older-adults-a-case-study
#20
Esther Bay, Anne Marie Garbinski, Susan E Maycock
PURPOSE: The purpose of this study was to describe a theoretically focused intervention aimed toward chronic stress and depressive symptom management that is coordinated by a case manager and delivered within a home environment by the caregiver. PRIMARY PRACTICE SETTING: Home care, community setting. METHODS: A case study of an older adult with traumatic brain injury (TBI) secondary to a fall who had significant allostatic load at the time of his injury...
November 2017: Professional Case Management
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