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falls in geriatric patients

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https://www.readbyqxmd.com/read/28442246/prognostic-impact-of-nutritional-risk-assessment-in-patients-with-chronic-schizophrenia
#1
Ming-Tsun Tsai, Tien-Hao Chang, Bo-Jian Wu
Protein-energy wasting is associated with poor outcome in various clinical settings. However, the prevalence of malnutrition and the prognostic impact of nutritional status are poorly understood in institutionalized patients with chronic schizophrenia. This study aimed to assess the predictive ability of the Geriatric Nutritional Risk Index and Onodera's Prognostic Nutritional Index for long-term outcomes in patients with chronic schizophrenia. All measurements, including nutritional scores, were performed at baseline after the enrollment of 542 (64...
April 22, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28436194/impact-of-living-arrangements-on-clinical-outcomes-among-older-patients-with-dementia-or-cognitive-impairment-admitted-to-the-geriatric-evaluation-and-management-unit-in-taiwan
#2
Cheng-Hao Hung, Ting-Ching Tang, Chih-Jen Wang, Li-Kuo Liu, Li-Ning Peng, Liang-Kung Chen
AIM: To evaluate the impact of living arrangements on mortality and functional decline among older patients with dementia or cognitive impairment after discharge from a geriatric evaluation and management unit (GEMU) in Taiwan. METHODS: The present retrospective cohort study used data from the Veteran Affairs Comprehensive Geriatric Assessment from January 2015 to May 2016 for analysis. Data of patients aged 65 years and older with dementia or cognitive impairment at admission to the GEMU of Taipei Veterans General Hospital during the study period were retried for study...
April 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28436184/delaying-cognitive-and-physical-decline-through-multidomain-interventions-for-residents-with-mild-to-moderate-dementia-in-dementia-care-units-in-taiwan-a-prospective-cohort-study
#3
Chih-Kuang Liang, Ming-Yueh Chou, Liang-Yu Chen, Kuei-Yu Wang, Shih-Yi Lin, Liang-Kung Chen, Yu-Te Lin, Tsung-Yun Liu, Ching-Hui Loh
AIM: To develop experimental multi-domain interventions for older people with mild-to-moderate dementia, and to evaluate the effect of delaying cognitive and physical decline, and improvement or prevention of geriatric syndromes during 1-year follow up. METHODS: Participants aged 65 years and older with mild-to-moderate dementia (clinical dementia rating [CDR] 1 or 2) were grouped as intervention in Jia-Li Veterans Home and usual care model in the community (Memory clinic)...
April 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28433450/a-retrospective-cohort-study-of-concomitant-ipsilateral-extra-capsular-and-intra-capsular-fractures-of-the-proximal-femur-are-they-casual-findings-or-an-undervalued-reality
#4
Miquel Videla-Cés, José-Miguel Sales-Pérez, Joan Girós-Torres, Rubén Sánchez-Navés, Sebastián Videla
BACKGROUND: Fractures of the proximal femur constitute a major public health problem, with an annual incidence in Spain of 7.6 cases per 1000 inhabitants over 65 years of age. Hip fractures are frequent in elderly patients, related to osteoporosis and with low energy trauma, which means that they can be considered a geriatric syndrome. Simultaneous ipsilateral extra- and intra-articular hip fractures are considered as very rare are, and generally speaking, classified as extra- or intra-capsular fractures...
April 13, 2017: Injury
https://www.readbyqxmd.com/read/28415881/hip-and-pelvic-fracture-patients-with-fear-of-falling-development-and-description-of-the-step-by-step-treatment-protocol
#5
Karin Kampe, Michaela Kohler, Diana Albrecht, Clemens Becker, Martin Hautzinger, Ulrich Lindemann, Klaus Pfeiffer
OBJECTIVE: Based on a theoretical framework and sound evidence, this article describes a rehabilitation programme for patients with fear of falling after hip and pelvic fracture. RATIONALE: Based on exercise science principles, current knowledge from fall prevention, emotion regulation, and the Health Action Process Approach we developed a theoretical framework, from which the components of the intervention were derived. Description of the intervention: The intervention consists of 6 components: (1) relaxation, (2) meaningful activities and mobility-based goals, (3) falls related cognitions and emotions, coping with high risk tasks and situations, (4) individual exercise programme, (5) planning and implementing exercises and activities, and (6) fall risks and hazards...
May 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28388276/a-formative-evaluation-of-a-nurse-practitioner-led-interprofessional-geriatric-outpatient-clinic
#6
Kevin T Hansen, Cheryl McDonald, Sue O'Hara, Leslie Post, Susan Silcox, Iris A Gutmanis
The number of older adults with multiple complex comorbidities and frailty is expected to increase dramatically in the coming decades, which will necessitate a concomitant increase in the need for skilled clinicians who are able to manage complex geriatric needs. Many physicians, however, lack the required formal training, often leading to long wait-lists for specialist clinics. Yet, clinics led by non-physician professionals specialising in geriatric care could decrease these delays. This article describes the development and evaluation of a nurse practitioner-led interprofessional geriatric outpatient clinic (Inter-D Clinic)...
April 7, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28372591/cooperation-between-geriatricians-and-general-practitioners-for-improved-pharmacotherapy-in-home-dwelling-elderly-people-receiving-polypharmacy-the-coop-study-study-protocol-for-a-cluster-randomised-controlled-trial
#7
Rita Romskaug, Espen Molden, Jørund Straand, Hege Kersten, Eva Skovlund, Kaisu H Pitkala, Torgeir Bruun Wyller
BACKGROUND: Polypharmacy and inappropriate drug use is associated with negative health outcomes among older people. Various interventions for improving drug treatment have been evaluated, but the majority of studies are limited by the use of surrogate outcomes or suboptimal design. Thus, the potential for clinically significant improvements from different interventions is still unclear. The main objective of this study is therefore to evaluate the effect upon patient-relevant endpoints of a cooperation between geriatricians and general practitioners on complex drug regimens in home-dwelling elderly people...
April 4, 2017: Trials
https://www.readbyqxmd.com/read/28340250/improving-safety-culture-in-hospitals-facilitators-and-barriers-to-implementation-of-systemic-falls-investigative-method-sfim
#8
Aleksandra A Zecevic, Alvin Ho-Ting Li, Charity Ngo, Michelle Halligan, Anita Kothari
Objective: The purpose of this study was to assess the facilitators and barriers to implementation of the Systemic Falls Investigative Method (SFIM) on selected hospital units. Design: A cross-sectional explanatory mixed methods design was used to converge results from a standardized safety culture survey with themes that emerged from interviews and focus groups. Findings were organized by six elements of the Ottawa Model of Research Use framework. Setting: A geriatric rehabilitation unit of an acute care hospital and a neurological unit of a rehabilitation hospital were selected purposefully due to the high frequency of falls...
March 17, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28338866/the-growing-challenge-of-major-trauma-in-older-people-a-role-for-comprehensive-geriatric-assessment
#9
James Michael Fisher, Charlotte Bates, Jay Banerjee
In this commentary article, we describe the impact that an ageing population is having on the nature of major trauma seen in emergency departments. The proportion of major trauma victims who are older people is rapidly increasing and a fall from standing is now the most common mechanism of injury in major trauma. Potential barriers to effective care of this patient group are highlighted, including: a lack of consensus regarding triage criteria; potentially misleading physiological parameters within triage criteria; non-linear patient presentations and diagnostic nihilism...
March 10, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28320331/a-multi-component-cognitive-behavioural-intervention-for-the-treatment-of-fear-of-falling-after-hip-fracture-fit-hip-protocol-of-a-randomised-controlled-trial
#10
Maaike N Scheffers-Barnhoorn, Jolanda C M van Haastregt, Jos M G A Schols, Gertrudis I J M Kempen, Romke van Balen, Jan H M Visschedijk, Wilbert B van den Hout, Eve M Dumas, Wilco P Achterberg, Monica van Eijk
BACKGROUND: Hip fracture is a common injury in the geriatric population. Despite surgical repair and subsequent rehabilitation programmes, functional recovery is often limited, particularly in individuals with multi-morbidity. This leads to high care dependency and subsequent use of healthcare services. Fear of falling has a negative influence on recovery after hip fracture, due to avoidance of activity and subsequent restriction in mobility. Although fear of falling is highly prevalent after hip fracture, no structured treatment programme is currently available...
March 20, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28318406/use-of-a-shoulder-abduction-brace-after-arthroscopic-rotator-cuff-repair-a-study-on-gait-performance-and-falls
#11
Yuma Sonoda, Takashi Nishioka, Ryo Nakajima, Shinji Imai, Piers Vigers, Taku Kawasaki
BACKGROUND: Fall prevention is essential in patients after arthroscopic rotator cuff repair because of the high risk of re-rupture. However, there are no reports related to falls that occur during the early postoperative period, while the affected limb is immobilized. OBJECTIVES: This study assessed gait performance and falls in patients using a shoulder abduction brace after arthroscopic rotator cuff repair. STUDY DESIGN: Prospective cohort and postoperative repeated measures...
March 1, 2017: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/28296910/examining-the-construct-and-known-group-validity-of-a-composite-endpoint-for-the-older-persons-and-informal-caregivers-survey-minimum-data-set-topics-mds-a-large-scale-data-sharing-initiative
#12
Cynthia S Hofman, Jennifer E Lutomski, Han Boter, Bianca M Buurman, Anton J M de Craen, Rogier Donders, Marcel G M Olde Rikkert, Peter Makai, René J F Melis
BACKGROUND: Preference-weighted multi-faceted endpoints have the potential to facilitate comparative effectiveness research that incorporates patient preferences. The Older Persons and Informal Caregivers Survey-Composite endpoint (TOPICS-CEP) is potentially a valuable outcome measure for evaluating interventions in geriatric care as it combines multiple outcomes relevant to older persons in a single metric. The objective of this study was to validate TOPICS-CEP across different study settings (general population, primary care and hospital)...
2017: PloS One
https://www.readbyqxmd.com/read/28288563/is-independence-of-older-adults-safe-considering-the-risk-of-falls
#13
Dorota Talarska, Magdalena Strugała, Marlena Szewczyczak, Sławomir Tobis, Michał Michalak, Izabela Wróblewska, Katarzyna Wieczorowska-Tobis
BACKGROUND: Falls affect approx. 30% of elderly population per year. They cause major injuries and reduce independence of the older adults' functioning. The main objective of the study was to evaluate the degree of independence and find the fall risk factors in the study group. METHODS: The study included 506 - older adults. The study group included patients from GP clinics and members of two senior centers. The study duration was 12 months. Our study tools included EASY- Care Standard 2010 questionnaire, Abbreviated Mental Test Score (AMTS), Index Barthel, Instrumental Activities of Daily Living Scale (IADL), Geriatric Depression Scale (GDS), Timed Up and Go (TUG)...
March 14, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28270270/a-review-of-suvorexant-doxepin-ramelteon-and-tasimelteon-for-the-treatment-of-insomnia-in-geriatric-patients
#14
Chelsey Edmonds, Michael Swanoski
Geriatric patients often experience insomnia because of physiological and neurological changes that occur during the aging process. Use of benzodiazepines, nonbenzodiazepine hypnotics, and diphenhydramine for the treatment of insomnia pose an increased risk of cognitive impairment, falls, and fractures in this patient population. Therapeutic alternatives approved by the Food and Drug Administration include suvorexant, doxepin, ramelteon, and tasimelteon, which have shown efficacy and safety in various studies...
March 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28258036/use-of-ace-inhibitors-and-falls-in-patients-with-parkinson-s-disease
#15
Alice Laudisio, Maria Rita Lo Monaco, Maria Caterina Silveri, Anna Rita Bentivoglio, Davide L Vetrano, Maria Stella Pisciotta, Vincenzo Brandi, Roberto Bernabei, Giuseppe Zuccalà
Falls represent a major concern in patients with Parkinson's disease (PD); however, currently acknowledged treatments for PD are not effective in reducing the risk of falling. The aim was to assess the association of use of ACE-inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) with falls among patients with PD. We analysed data of 194 elderly with PD attending a geriatric Day Hospital. Self-reported history of falls that occurred over the last year, as well as use of drugs, including ACEIs and angiotensin II receptor blockers (ARBs) were recorded...
February 22, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28255514/initial-preoperative-management-of-geriatric-hip-fractures
#16
REVIEW
Tochukwu C Ikpeze, Stephen Mohney, John C Elfar
Hip fractures are a common emergency among the geriatric population and often requires immediate hospitalization for proper assessment. More than 90% of the time, hip fractures are suffered by individuals older than 65 and are usually precipitated predominantly by falls. Current studies show that the average individual over 65 years falls at least once a year, and roughly 1 out of every 4 of these individuals succumb to their injuries just 12 months following surgical treatment. Moreover, timely treatment and management of these hip fractures have shown to decrease mortality by reducing cardiopulmonary and venous thromboembolic complications that often accompany hip surgeries...
March 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28241769/instrumented-gait-analysis-a-measure-of-gait-improvement-by-a-wheeled-walker-in-hospitalized-geriatric-patients
#17
Samuel Schülein, Jens Barth, Alexander Rampp, Roland Rupprecht, Björn M Eskofier, Jürgen Winkler, Karl-Günter Gaßmann, Jochen Klucken
BACKGROUND: In an increasing aging society, reduced mobility is one of the most important factors limiting activities of daily living and overall quality of life. The ability to walk independently contributes to the mobility, but is increasingly restricted by numerous diseases that impair gait and balance. The aim of this cross-sectional observation study was to examine whether spatio-temporal gait parameters derived from mobile instrumented gait analysis can be used to measure the gait stabilizing effects of a wheeled walker (WW) and whether these gait parameters may serve as surrogate marker in hospitalized patients with multifactorial gait and balance impairment...
February 27, 2017: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/28225741/redefining-the-association-between-old-age-and-poor-outcomes-after-trauma-the-impact-of-frailty-syndrome
#18
Bellal Joseph, Tahereh Orouji Jokar, Ahmed Hassan, Asad Azim, Martha Jane Mohler, Narong Kulvatunyou, Shirin Siddiqi, Herb Phelan, Mindy Fain, Peter Rhee
BACKGROUND: Frailty syndrome (FS) is a well-established predictor of outcomes in geriatric patients. The aim of this study was to quantify the prevalence of FS in geriatric trauma patients and to determine its association with trauma readmissions, repeat falls, and mortality at 6 months. METHODS: we performed a 2-year (2012-2013) prospective cohort analysis of all consecutive geriatric (age, ≥ 65 years) trauma patients. FS was assessed using a Trauma-Specific Frailty Index (TSFI)...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28224694/the-clinical-relevance-of-orthostatic-hypotension-in-elderly-patients
#19
Laura Hartog, Nanne Kleefstra, Rene Luigies, Sophia de Rooij, Henk Bilo, Kornelis van Hateren
AIM: Orthostatic hypotension (OH) is highly prevalent in old age. The impact of OH on orthostatic complaints and falling is questionable. We wondered if the consensus definition of OH plays an essential role in the accuracy and direction of the prediction of these endpoints. We aimed to explore the relation between different definitions of OH, including relative decrease of blood pressure, and orthostatic complaints and falling. METHODS: A cross-sectional study was performed with 1415 participants aged ≥65 years visiting a mobile fall-prevention team...
February 22, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28206931/a-comprehensive-investigation-of-comorbidities-mechanisms-injury-patterns-and-outcomes-in-geriatric-blunt-trauma-patients
#20
COMPARATIVE STUDY
Carlos V R Brown, Kevin Rix, Amanda L Klein, Brent Ford, Pedro G R Teixeira, Jayson Aydelotte, Ben Coopwood, Sadia Ali
The geriatric population is growing and trauma providers are often tasked with caring for injuries in the elderly. There is limited information regarding injury patterns in geriatric trauma patients stratified by mechanism of injury. This study intends to investigate the comorbidities, mechanisms, injury patterns, and outcomes in geriatric blunt trauma patients. A retrospective study of the 2012 National Trauma Databank was performed. Adult blunt trauma patients were identified; geriatric (>/=65) patients were compared with younger (<65) patients regarding admission demographics and vital signs, mechanism and severity of injury, and comorbidities...
November 1, 2016: American Surgeon
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