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Falls risk elder

Martin M Grajower
Hypoglycemia is the major side effect of insulin therapy. The elderly are especially vulnerable to episodes of hypoglycemia, and with greater risks of complications such as falls. Two new long-acting basal insulins, glargine-300 (Gla-300) and degludec, are associated with lower incidences of hypoglycemia than previously available basal insulins. One of them, Gla-300, was studied in the elderly and has a lower incidence of hypoglycemia in patients over 65 years old. These new data should be incorporated into decision making when treating the elderly patient with insulin, whether they have type 1 or 2 diabetes...
March 2018: Endocrine Practice
Elisa Pelosin, Ambra Bisio, Thierry Pozzo, Giovanna Lagravinese, Oscar Crisafulli, Roberta Marchese, Giovanni Abbruzzese, Laura Avanzino
Postural reactions can be influenced by concomitant tasks or different contexts and are modulated by a higher order motor control. Recent studies investigated postural changes determined by motor contagion induced by action observation (chameleon effect) showing that observing a model in postural disequilibrium induces an increase in healthy subjects' body sway. Parkinson's disease (PD) is associated with postural instability and impairments in cognitively controlled balance tasks. However, no studies investigated if viewing postural imbalance might influence postural stability in PD and if patients are able to inhibit a visual postural perturbation...
2018: Frontiers in Neurology
Steven Morrison, Karl M Newell
This study was designed to examine the effect of increasing age and type 2 diabetes on the average responses and inter- and intraindividual variability of falls risk, reaction time, strength, and walking speed for healthy older adults and older persons with type 2 diabetes (T2DM). Seventy-five older individuals (controls) and 75 persons with T2DM aged between 50 and 79 years participated in the study. Assessments of falls risk, reaction time (RT), knee extension strength, and walking speed were conducted. The results revealed that advancing age for both control and T2DM groups was reflected by a progressive increase in falls risk, decreased leg strength and a decline (i...
March 14, 2018: Journal of Motor Behavior
Peixia Cheng, Liheng Tan, Peishan Ning, Li Li, Yuyan Gao, Yue Wu, David C Schwebel, Haitao Chu, Huaiqiong Yin, Guoqing Hu
BACKGROUND: Falls are a major threat to older adults worldwide. Although various effective interventions have been developed, their comparative effectiveness remains unreported. METHODS: A systematic review and network meta-analysis was conducted to determine the most effective interventions to prevent falls in community-dwelling adults aged 60 and over. Combined odds ratio (OR) and 95% credible interval (95% CrI) were calculated. RESULTS: A total of 49 trials involving 27,740 participants and 9271 fallers were included...
March 12, 2018: International Journal of Environmental Research and Public Health
Angela-María Benjumea, Carmen-Lucía Curcio, Gustavo Duque, Fernando Gómez
BACKGROUND: The role of sarcopenia and dynapenia in disability in older persons from falls and bone health clinics remain unknown. AIM: This study aims to compare the association of sarcopenia and dynapenia with physical and instrumental disability in a population of older persons attending a falls and fractures clinic. METHODS: This is a cross-sectional study in Manizales, Andes Mountains, Colombia. A cohort of 534 subjects (mean age = 74, 75% female) Sarcopenia was measured according to the European Working Group on Sarcopenia in Older People (EWGSOP) including an index of skeletal mass, muscle strength, and gait speed...
February 15, 2018: Open Access Macedonian Journal of Medical Sciences
M Fernández, C Valbuena, C Natal
OBJECTIVES: To describe the risk factors and the effect of medication use on the risk of falls in a population of 65 years or older. MATERIAL AND METHODS: Descriptive study of falls in the elderly population. The risk factors and consequences of the fall were recorded. Hypnotic and sedative risk drugs, opioids, and the simultaneous consumption of six or more drugs were considered. Diuretics were also included. The cumulative incidence for each group and the corresponding relative risks of falls were analysed from the cases registered between June and November 2016...
March 9, 2018: Revista de Calidad Asistencial: Organo de la Sociedad Española de Calidad Asistencial
Manuel E Machado-Duque, Juan Pablo Castaño-Montoya, Diego A Medina-Morales, Alejandro Castro-Rodríguez, Alexandra González-Montoya, Jorge E Machado-Alba
BACKGROUND/OBJECTIVE: To determine the association between the use of anticholinergic drugs and the risk of falls with hip fracture in a population older than 60 years. METHODS: A case-control study in patients older than 60 years with a diagnosis of hip fracture. All drugs dispensed during the previous 30 days were identified. Sociodemographic, clinical, pharmacological (drugs according to the Anticholinergic Risk Scale [ARS]), and polypharmacy variables were analyzed...
January 1, 2018: Journal of Geriatric Psychiatry and Neurology
Namki Hong, Chang Oh Kim, Yoosik Youm, Hyeon Chang Kim, Yumie Rhee
In a community-dwelling elderly cohort (Korean Urban Rural Elderly), low peak jump power was associated with elevated odds of dysmobility syndrome and its components, independent of age and comorbidities. Jump power measurement improved discrimination of individuals with dysmobility syndrome when added to conventional risk factors. INTRODUCTION: Dysmobility syndrome was proposed to encompass the risks affecting musculoskeletal outcomes. Jump power measurement is a safe, reproducible high-intensity test for physical function in elderly...
March 8, 2018: Osteoporosis International
M Galler, M Zellner, C Roll, C Bäuml, B Füchtmeier, F Müller
BACKGROUND: The proximal femoral fracture is one of the most common injuries in the elderly. Nevertheless, no results beyond the second year post surgery have been reported in the literature. Therefore, the purpose of this study was to evaluate any revision and mortality within 10 years follow-up as well as the walking ability of still alive patients. METHODS: A total of 200 consecutive patients were included. A prospective database was first used to collect the demographic data...
February 26, 2018: Injury
Emma Wheeler, Constance L Coogle, Robert C Fix, Myra G Owens, Leland H Waters
AIMS: Evaluate changes in physical therapy (PT) and occupational therapy (OT) practice following evidence-based practice (EBP) interprofessional modules that teach assessments and interventions to reduce falls in community-dwelling older adults. METHODS: Medical records of post-fall patients in three Programs of All-Inclusive Care for the Elderly (PACE) sites were analyzed to assess differences in documented falls and the OT and PT use of EBP assessment and interventions implemented following fall prevention training...
2018: Journal of Allied Health
Rune Rasmussen, Mette Midttun, Tine Kolenda, Anne-Mette Ragle, Thea Winther Sørensen, Anders Vinther, Bo Zerahn, Maria Pedersen, Karsten Overgaard
BACKGROUND: Fall accidents are a major cause of mortality among the elderly and the leading cause of traumatic brain injury. After a fall, many elderly people never completely recover and need help in coping with everyday life. Due to the increasing older population in the world, injuries, disabilities, and deaths caused by falls are a growing worldwide problem. Muscle weakness leads to greatly increased risk of falling, decreased quality of life, and decline in functional capacity. Muscle mass and muscle power decrease about 40% from age 20 to 80 years, and the level of testosterone decreases with age and leads to impaired muscle mass...
March 2, 2018: JMIR Research Protocols
Cecília de Morais Barbosa, Manoel Barros Bértolo, Juliana Zonzini Gaino, Michael Davitt, Zoraida Sachetto, Eduardo de Paiva Magalhães
Background: Aging is associated with reduced postural stability and increased fall risk. Foot orthoses have been reported as an adjuvant intervention to improve balance by stimulating foot plantar mechanical receptors and thus increasing somatosensory input. Purpose: The aim of this study is to evaluate the effect of flat and textured insoles on the balance of primary care elderly people. Design: Prospective, parallel, randomized, and single-blind trial...
2018: Clinical Interventions in Aging
D Bouccara, F Rubin, P Bonfils, Q Lisan
Balance disorders presenting with symptoms of dizziness and vertigo are due to various diseases. Clinical approach gives the opportunity to identify emergency situations and most common causes, among them the first one being the benign paroxysmal positional vertigo. Oculomotor assessment is pertinent as major clinical orientation, particularly between peripheral and central diseases. These clinical findings support the respective indication of modern imaging and/or vestibular tests, focused on the direction of presupposed diagnosis...
February 26, 2018: La Revue de Médecine Interne
Lívia Maria Santiago, Robbert J J Gobbens, Marcel A L M van Assen, Cleber Nascimento Carmo, Daniele Bittencourt Ferreira, Inês Echenique Mattos
PURPOSE: This study aimed to determine the predictive value of the Brazilian Tilburg Frailty Indicator (TFI) for adverse health outcomes (falls, hospitalization, disability and death), in a follow-up period of twelve months. METHODS: This longitudinal study was carried out with a sample of people using primary health care services in Rio de Janeiro, Brazil. At baseline the sample consisted of 963 people aged 60 years and older. A subset of all respondents participated again one year later (n = 640, 66...
February 22, 2018: Archives of Gerontology and Geriatrics
Ippei Nojima, Tatsunori Watanabe, Kotaro Saito, Shigeo Tanabe, Hoshinori Kanazawa
The voluntary step execution task is a popular measure for identifying fall risks among elderly individuals in the community setting because most falls have been reported to occur during movement. However, the neurophysiological functions during this movement are not entirely understood. Here, we used electromyography (EMG) to explore the relationship between EMG-EMG coherence, which reflects common oscillatory drive to motoneurons, and motor performance associated with stepping tasks: simple reaction time (SRT) and choice reaction time (CRT) tasks...
2018: Frontiers in Human Neuroscience
Ioannis Bargiotas, Julien Audiffren, Nicolas Vayatis, Pierre-Paul Vidal, Stephane Buffat, Alain P Yelnik, Damien Ricard
The fact that almost one third of population >65 years-old has at least one fall per year, makes the risk-of-fall assessment through easy-to-use measurements an important issue in current clinical practice. A common way to evaluate posture is through the recording of the center-of-pressure (CoP) displacement (statokinesigram) with force platforms. Most of the previous studies, assuming homogeneous statokinesigrams in quiet standing, used global parameters in order to characterize the statokinesigrams. However the latter analysis provides little information about local characteristics of statokinesigrams...
2018: PloS One
Hossein Ehsani, Jane Mohler, Vladimir Marlinski, Ehsan Rashedi, Nima Toosizadeh
Fall prevention has an indispensable role in enhancing life expectancy and quality of life among older adults. The first step to prevent falls is to devise reliable methods to identify individuals at high fall risk. The purpose of the current study was to assess alterations in local postural muscle and central sensory balance control mechanisms due to low-frequency externally applied vibration among elders at high fall risk, in comparison with healthy controls, as a potential tool for assessing fall risk. Three groups of participants were recruited: healthy young (n = 10; age = 23 ± 2 years), healthy elders (n = 10; age = 73 ± 3 years), and elders at high fall risk (n = 10; age = 84 ± 9 years)...
February 3, 2018: Journal of Biomechanics
Savannah V Wooten, Joseph F Signorile, Sohil S Desai, Amelia K Paine, Kiersten Mooney
OBJECTIVE: Yoga has been shown to improve muscle strength, flexibility, and balance. However, the impact of meditation on dynamic factors such as gait, reactive balance and proprioception has yet to be examined. The purpose of this study was to test if a novel yoga meditation program (YoMed) is as effective as a standard proprioceptive training in improving proprioception, balance and power in older individuals who have fallen. DESIGN: Sixteen older persons were randomly assigned to either the YoMed Group (YM) or Proprioception Training Group (PT)...
February 2018: Complementary Therapies in Medicine
J A H R Claassen
- Orthostatic hypotension is a condition in which there is insufficient recovery of the blood pressure drop which occurs after getting up, which causes a temporary reduction of cerebral perfusion. This increases the risk of falls resulting in injuries.- Orthostatic hypotension is most common in the elderly. The cause is usually multifactorial (including reduced circulating volume, reduced peripheral resistance and limited heart rate increase). Orthostatic hypotension caused by autonomic dysfunction is called neurogenic orthostatic hypotension...
2018: Nederlands Tijdschrift Voor Geneeskunde
Rebecca S Crow, Matthew C Lohman, Dawna Pidgeon, Martha L Bruce, Stephen J Bartels, John A Batsis
OBJECTIVES: To compare the ability of frailty status to predict fall risk with that of community fall risk screening tools. DESIGN: Analysis of cross-sectional and longitudinal data from NHATS. SETTING: National Health and Aging Trend Study (NHATS) 2011-2015. PARTICIPANTS: Individuals aged 65 and older (N = 7,392). MEASUREMENTS: Fall risk was defined according to the Stopping Elderly Accidents, Deaths and Injuries (STEADI) initiative...
February 10, 2018: Journal of the American Geriatrics Society
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