falls in geriatric patients

Falls are common among older adults. However, not much is known about the prevalence of falls among older patients with cancer. In 2015, older patients with cancer referred to Geriatrics service for preoperative evaluation were assessed for fall history, basic and instrumental activities of daily living (ADL and IADL), KPS, and use of assistive device. Of 806 patients, 215 (26.7%) patients reported fall. Incidence of last fall inside and outside home was 54.4% and 45.5%, respectively. Among patients with no falls, 33...

OBJECTIVES: The management of cancer in aging people remains a challenge for physicians. Specialists agree on the assistance provided by a multidimensional geriatric assessment (MGA) to guide the cancer treatment decision-making process. We aim to explore the use of MGA in treatment decision and to identify MGA parameters likely to influence the planned cancer treatment. MATERIAL AND METHODS: We conducted a single-site retrospective study in patients older than 65 years suffering from various types of cancer who underwent MGA before cancer treatment decision...

OBJECTIVE: Anxiety symptoms are common in older adults with depression, but whether severe anxiety is associated with poorer outcomes of depression is unknown. The objective of the present study was to examine the association between severity of anxiety and severity of depression and physical illness, suicidality, and physical and cognitive functioning in older adults with depression. METHODS: We included 218 older adults with diagnoses of a depressive disorder according to the ICD-10 criteria; their mean age (SD) was 75...

Background: Urinary incontinence is involuntary leakage of urine and can affect people of all ages. Incidence rises as people age, often because of reduced mobility or conditions affecting the nervous system, such as dementia and stroke. Urinary incontinence can be a distressing condition and can harm a person's physical, financial, social, and emotional well-being. People with urinary incontinence are susceptible to skin irritation, pressure sores, and urinary tract infections. Urinary incontinence is also associated with an increased risk of falls in older adults...

Objective: Lumbosacral alignment is a crucial factor for an appropriate spinal function. Changes in spinal alignment lead to diminished body biomechanics. Additionally, lumbosacral alignment may affect quality of life, sagittal balance and fall risk in elderly. In this study, we aimed to compare lumbosacral alignment in geriatric and non-geriatric patients suffering from low back pain. Methods: A total of 202 (120 male and 82 female) patients who visited to physical medicine and rehabilitation clinic with low back pain between January 2017 and August 2017 were enrolled in this study...

Purpose To provide guidance regarding the practical assessment and management of vulnerabilities in older patients undergoing chemotherapy. Methods An Expert Panel was convened to develop clinical practice guideline recommendations based on a systematic review of the medical literature. Results A total of 68 studies met eligibility criteria and form the evidentiary basis for the recommendations. Recommendations In patients ≥ 65 years receiving chemotherapy, geriatric assessment (GA) should be used to identify vulnerabilities that are not routinely captured in oncology assessments...

BACKGROUND/OBJECTIVES: Multicomponent exercise programs are the cornerstone in preventing gait and balance impairments and falls in older adults. However, the effects of these programs in usual clinical practice have been poorly analyzed. DESIGN: 4-Month, twice-a-week multicomponent exercise program cohort study in real-life. SETTING: Falls Unit, Complejo Hospitalario Universitario of Albacete, Spain. PARTICIPANTS: Sixty-seven participants who had experienced a fall in the previous year were included...

Objective: The aim of the study was to evaluate the usefulness of the Polish version of the Care Dependency Scale (CDS) in predicting care needs and health risks of elderly patients admitted to a geriatric unit. Methods: This was a cross-sectional study of 200 geriatric patients aged ≥60 years, chronologically admitted to a geriatrics unit in Poland. The study was carried out using the Polish version of the CDS questionnaire to evaluate biopsychosocial needs and the level of care dependency...

WHAT IS KNOWN AND OBJECTIVE: Anticholinergic drugs are associated with risks of falls, confusion and cognitive dysfunction. However, the effect of anticholinergic drug use on rehabilitation outcomes after a stroke is poorly documented. We therefore aimed to establish whether the anticholinergic load was associated with functional recovery among geriatric patients convalescing after stroke. METHOD: Consecutive geriatric stroke patients admitted and discharged from a convalescence rehabilitation ward between 2010 and 2016 were included in this retrospective cohort study...

BACKGROUND: High rates of unplanned hospital readmissions are a burden on healthcare systems and individuals. This study examined factors at, and after initial hospital discharge and their associations with unplanned hospital readmission for older adults up to six months post-discharge from subacute care. METHODS: Older subacute care patients were surveyed prior to discharge, and assessed monthly post-discharge for six months. Data included the Geriatric Depression Scale, Phone-Fitt sub-scales, Friendship Scale, modified Lubben Social Network Scale, unplanned hospital readmission, self-reported physical capacity and falls in the last month were collected...

Objective: To identify clinical or demographic variables that influence long-term mortality, as well as in-hospital mortality, with a particular focus on the effects of age. Summary and Background Data: Cervical spine fractures with or without spinal cord injury (SCI) disproportionately impact the elderly who constitute an increasing percentage of the US population. Methods: We analyzed data collected for 10 years at a state-designated level I trauma center to identify variables that influenced in-hospital and long-term mortality among elderly patients with traumatic cervical spine fracture with or without SCI...

Background: The contents of the guidelines for the use of non-benzodiazepines (Z-drugs) differ slightly between THE JAPANESE SOCIETY OF SLEEP RESEARCH and THE JAPAN GERIATRIC SOCIETY, and the recommended directions are conflicting. Therefore, we analyzed the use of the Japanese Adverse Drug Event Report database (JADER) for identifying adverse events (AEs) caused by Z-drugs and clarifying their occurrence trend and prognosis. Methods: The signal value for comparison was calculated by using the proportional reporting ratio (PRR) and chi-squared test (χ2 ) results of data of elderly and non-elderly patients...

This paper discusses the rationale behind performing a brief geriatric assessment as a first step in the management of older patients in primary care practice. While geriatric conditions are considered by older patients and health professionals as particularly relevant for health and well-being, they remain too often overlooked due to many patient- and physician-related factors. These include time constraints and lack of specific training to undertake comprehensive geriatric assessment. This article discusses the epidemiologic rationale for screening functional, cognitive, affective, hearing and visual impairments, and nutritional status as well as fall risk and social status...

BACKGROUND/SIGNIFICANCE: Because of their decreased physical reserve and increased risk of complications, the geriatric trauma patient (GTP) population warrants heightened awareness by clinical staff. PURPOSE: The purpose of this study is to determine whether the institution of a third-tier trauma protocol results in a change in GTP outcomes, complications, and mortality rates. METHODS: Researchers conducted a retrospective review of 2 years of data from the trauma registry, hospital quality improvement audits, and patient charts to examine what, if any, patient outcomes were impacted by the institution of the expanded GTP protocol...

Pharmacotherapy for older and geriatric patients is a challenge, especially because older and geriatric patients are particularly prone to adverse drug reactions and the evidence for drug use is limited for this patient group; therefore, several list-based recommendations have recently been developed in order to improve appropriate pharmacotherapy. These lists of recommendations differ in their criteria and the compilation of drugs, for example in terms of potentially inappropriate medication, drugs increasing the risk of falling and anticholinergic effects...

One in three older adults falls each year. There are approximately 2.5 million falls among older adults treated in emergency departments. Falls account for 87% of all fractures in this age group. The biggest risk factor for falling is a history of falls. Other risk factors include frailty, sedative and anticholinergic drugs, polypharmacy, and a variety of medical conditions. Current recommendations are that all patients age 65 years and older should be asked about falls each year. Patients also can be screened for fall risk with a variety of approaches including questionnaires and the Timed Up & Go test...

BACKGROUND: Falls in older adults with cancer are common, yet factors associated with fall-risk are not well-defined and may differ from the general geriatric population. This study aims to develop and validate a model of factors associated with prior falls among older adults with cancer. METHODS: In this cross-sectional secondary analysis, two cohorts of patients aged ≥ 65 with cancer were examined to develop and validate a model of factors associated with falls in the prior 6 months...

BACKGROUND: While there is a general consensus of the impact of an orthogeriatric organisation in terms of elderly patient mortality post hip fracture, it is unclear which, among these various care models, is the most optimal. METHODS: A systematic review of the literature was undertaken using the keywords "Femoral fractures or total hip replacements or Accidental, falls" and "Aged, 80 and over" and "Mortality". The review is presented following PRISMA guidance...

INTRODUCTION: Increasing numbers of older adults are presenting with acute surgical disease to the unselected general surgical take. General surgeons have little training to manage these patients. We developed a pilot service of proactive geriatrician input into older emergency general surgical patients in a single institution. We wanted to demonstrate if geriatricians improve the management of these patients. METHODS: Patients aged 70 years or older admitted acutely under the general surgeons were assessed proactively by a geriatrician using comprehensive geriatric assessment (CGA)...

Falls in hospital are common and up to 70% result in injury, leading to increased length of stay and accounting for 10% of patient safety-related deaths. Yet, high-quality evidence guiding best practice is lacking. Fall prevention strategies have worked in some trials but not in others. Differences in study setting (acute, subacute, rehabilitation) and sampling of patients (cognitively intact or impaired) may explain the difference in results. This article discusses these important issues and describes the strategies to prevent falls in the acute hospital setting we have studied, which engage the cognitively impaired who are more likely to fall...