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falls in geriatric patients

Outi Laatikainen, Sami Sneck, Risto Bloigu, Minna Lahtinen, Timo Lauri, Miia Turpeinen
Adverse drug events (ADEs) are more likely to affect geriatric patients due to physiological changes occurring with aging. Even though this is an internationally recognized problem, similar research data in Finland is still lacking. The aim of this study was to determine the number of geriatric medication-related hospitalizations in the Finnish patient population and to discover the potential means of recognizing patients particularly at risk of ADEs. The study was conducted retrospectively from the 2014 emergency department patient records in Oulu University Hospital...
2016: Frontiers in Pharmacology
Krystina Parker, Willy Aasebø, Knut Stavem
BACKGROUND: Polypharmacy is commonly applied to elderly haemodialysis patients for treating terminal renal failure and multiple co-morbidities. Potentially inappropriate medications (PIMs) in multidrug regimens in geriatric populations can be identified using specially designed screening tools. OBJECTIVE: The aims of this study were to estimate the prevalence of PIMs by applying the Screening Tool of Older Persons' Prescriptions (STOPP) criteria and the Beers criteria to elderly haemodialysis patients and to assess the association of some risk factors with the presence of PIMs...
September 2016: Drugs—Real World Outcomes
Brenda Han, Cristin Grant
With an increasing number of older people using emergency services, researchers have raised concerns about the quality of care in an environment that is not designed to address older patients' specific needs and conditions. The comprehensive geriatric assessment (CGA) model was developed to address these issues, and to optimise healthcare delivery to older adults. This article introduces a complementary mnemonic, FRAIL, that refers to important elements of health information to consider before initiating care for older patients - falls/functional decline, reactions, altered mental status, illnesses, and living situation...
October 6, 2016: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
Kilian Rapp, Johannes Ravindren, Clemens Becker, Ulrich Lindemann, Andrea Jaensch, Jochen Klenk
BACKGROUND: There is evidence about time-dependent fracture rates in different settings and situations. Lacking are data about underlying time-dependent fall risk patterns. The objective of the study was to analyse fall rates as a function of time after admission to sub-acute hospital units and to evaluate the time-dependent impact of clinical factors at baseline on fall risk. METHODS: This retrospective cohort study used data of 5,255 patients admitted to sub-acute units in a geriatric rehabilitation clinic in Germany between 2010 and 2014...
October 7, 2016: BMC Geriatrics
Katarzyna Mazur, Krzysztof Wilczyński, Jan Szewieczek
BACKGROUND: Inpatient geriatric falls are a frequent complication of hospital care that results in significant morbidity and mortality. OBJECTIVE: Evaluate factors associated with falls in geriatric inpatients after implementation of the fall prevention program. METHODS: Prospective observational study comprised of 788 consecutive patients aged 79.5±7.6 years ( [Formula: see text] ± standard deviation) (66% women and 34% men) admitted to the subacute geriatric ward...
2016: Clinical Interventions in Aging
Elizabeth A Phelan, Sally Aerts, David Dowler, Elizabeth Eckstrom, Colleen M Casey
A multifactorial approach to assess and manage modifiable risk factors is recommended for older adults with a history of falls. Limited research suggests that this approach does not routinely occur in clinical practice, but most related studies are based on provider self-report, with the last chart audit of United States practice published over a decade ago. We conducted a retrospective chart review to assess the extent to which patients aged 65+ years with a history of repeated falls or fall-related health-care use received multifactorial risk assessment and interventions...
2016: Frontiers in Public Health
Christine Cohen, Thomas Kampel, Henk Verloo
BACKGROUND: Aging at home rather than in an institution is now considered the gold standard. Public health figures document an important demographic transition to an increasingly elderly society. At the same time, this is accompanied by the emergence of significant numbers of innovative technologies to help and support home-dwelling older adults in declining health who wish to remain at home. STUDY AIM: To explore the acceptability of intelligent wireless sensor system (IWSS) among home-dwelling older adults in rapidly detecting their health issues...
2016: Patient Preference and Adherence
Bulent Yardimci, Sinan N Aran, Ismail Ozkaya, Sevki M Aksoy, Tarik Demir, Gulsen Tezcan, Aysegul Y Kaptanoglu
OBJECTIVES: To determine the relation among the risk of falls, geriatric assessment, and anthropometric measurements, including the mini mental state examination, geriatric depression scale, handgrip test, and key pinch test. METHODS: This prospective study included 89 residents hospitalized between May 2014 and September 2015 in the geriatric care unit of the Istanbul Balikli Rum Hospital, Istanbul, Turkey. Patients were followed-up for one year, and their falls were recorded...
October 2016: Saudi Medical Journal
J Amblàs-Novellas, S A Murray, J Espaulella, J C Martori, R Oller, M Martinez-Muñoz, N Molist, C Blay, X Gómez-Batiste
OBJECTIVES: 2 innovative concepts have lately been developed to radically improve the care of patients with advanced chronic conditions (PACC): early identification of palliative care (PC) needs and the 3 end-of-life trajectories in chronic illnesses (acute, intermittent and gradual dwindling). It is not clear (1) what indicators work best for this early identification and (2) if specific clinical indicators exist for each of these trajectories. The objectives of this study are to explore these 2 issues...
September 19, 2016: BMJ Open
Marcos Rossi-Izquierdo, Andrés Soto-Varela, Arne Ernst, Juan Pedro Rubio-Rodríguez, Sofía Santos-Pérez, Ángel Sesar, Miguel Alberte-Woodward, Mónica Guijarro-Del Amo, Elena San Román-Rodríguez, Ana Faraldo-García, Alfonso Zubizarreta-Gutiérrez, Dietmar Basta
OBJECTIVE: Impaired balance in patients with Parkinson's disease (PD) leads to loss of balance and frequent falls. Computerized dynamic posturography allows the assessment of stance tasks whereas mobile posturography analyzes the balance in free-field conditions, where falls among PD patients commonly occur (e.g. sitting down or standing up). The aim of the present study is to assess postural stability in PD patients with both techniques. STUDY DESIGN: Prospective study...
October 2016: Otology & Neurotology
Steve Strupeit, Arne Buss, Karin Wolf-Ostermann
BACKGROUND: Various risk assessment methods have been developed to assess fall risk. Diagnostic accuracy of fall risk assessments is low and there is a scarcity of evidence regarding clinical effectiveness. AIMS: The aim of this study was to evaluate the diagnostic accuracy and clinical effectiveness of a standardized fall risk assessment relative to clinical and self-report assessment. METHODS: A single-site, prospective, longitudinal study was performed in a group of geriatric patients...
October 2016: Worldviews on Evidence-based Nursing
Giannoula Tsakitzidis, Olaf Timmermans, Nadine Callewaert, Veronique Verhoeven, Maja Lopez-Hartmann, Steven Truijen, Herman Meulemans, Paul Van Royen
BACKGROUND: Geriatric care increasingly needs more multidisciplinary health care services to deliver the necessary complex and continuous care. The aim of this study is to summarize indicators of effective interprofessional outcomes for this population. METHOD: A systematic review is performed in the Cochrane Library, Pubmed (Medline), Embase, Cinahl and Psychinfo with a search until June 2014. RESULTS: Overall, 689 references were identified of which 29 studies met the inclusion criteria...
2016: International Journal of Integrated Care
Ashraf F Hefny, Alaa K Abbas, Fikri M Abu-Zidan
BACKGROUND: Falls are the leading cause of geriatric injury. OBJECTIVES: We aimed to study the anatomical distribution, severity, and outcome of geriatric fall-related injuries in order to give recommendations regarding their prevention. METHODS: All injured patients with an age ≥ 60 years who were admitted to Al-Ain Hospital or died in the Emergency Department due to falls were prospectively studied over a four year period. RESULTS: We studied 92 patients...
June 2016: African Health Sciences
Eric J Lenze, Alex Ramsey, Patrick J Brown, Charles F Reynolds, Benoit H Mulsant, Helen Lavretsky, Steven P Roose
OBJECTIVES: Clinical trials can benefit from patient perspectives to inform trial design, such as choice of outcome measures. We engaged older adults in focus groups and surveys to get their perspective regarding needs in clinical research. The goal was to inform the development of a new clinical trial of medication strategies for treatment-resistant depression in older adults. METHODS: Older adults with depression participated in focus groups and a subsequent survey in St...
October 2016: American Journal of Geriatric Psychiatry
Xing-Kun Zeng, Shan-Shan Shen, Jiao-Jiao Chu, Ting He, Lei Cheng, Xu-Jiao Chen
OBJECTIVE: To investigate the relationship among serum vitamin D levels, physical performance impairment, and geriatric syndromes in elders with hypertension. METHODS: According to the concentration of vitamin D levels, a total of 143 elderly patients with hypertension were classified into vitamin D deficient group (vitamin D ≤ 20 ng/mL, n = 94) and vitamin D appropriate group (vitamin D > 20 ng/mL, n = 49). Geriatric syndromes and physical performance were assessed by using comprehensive geriatric assessment (CGA)...
September 2016: Journal of Geriatric Cardiology: JGC
Justin P Turner, Hanna E Tervonen, Sepehr Shakib, Nimit Singhal, Robert Prowse, J Simon Bell
Older people with cancer are at increased risk of falling. Falls risk-increasing drugs (FRIDs), comprising psychotropics and medications that cause orthostatic hypotension, are a potentially modifiable risk factor for falls. The objective of this study was to determine the prevalence and factors associated with use of FRIDs in older people with cancer. Patients aged ≥70 years who presented to a hospital outpatient clinic between January 2009 and July 2010 were included in the study. Information on current medication use, falls in previous 6 months, and frailty criteria was collected...
August 24, 2016: Journal of Evaluation in Clinical Practice
Charlotte Cardon-Verbecq, Marine Loustau, Emilie Guitard, Marie Bonduelle, Emmanuelle Delahaye, Pierre Koskas, Agathe Raynaud-Simon
BACKGROUND: The cognitive timed up-and-go dual task (CogTUG) has been proposed to improve the performance of the timed up-and-go (TUG) test for predicting falls in older patients and as a screening tool for early detection of frailty. We aimed to determine whether the CogTUG score is associated with a history of falls in frail older outpatients with gait disorders. METHODS: This retrospective study involved outpatients >75 years old with or without previous falls who were admitted from 2012 to 2014 to a geriatric day hospital for gait disorders...
August 16, 2016: Annals of Physical and Rehabilitation Medicine
Matthew Carazo, Tina Sadarangani, Sundar Natarajan, Stuart D Katz, Caroline Blaum, Victoria Vaughan Dickson
Geriatric syndromes are common in hospitalized elders with heart failure (HF), but association with clinical outcomes is not well characterized. The purpose of this study (N = 289) was to assess presence of geriatric syndromes using Joint Commission-mandated measures, the Braden Scale (BS) and Morse Fall Scale (MFS), and to explore prognostic utility in hospitalized HF patients. Data extracted from the electronic medical record included sociodemographics, medications, clinical data, comorbid conditions, and the BS and MFS...
August 15, 2016: Western Journal of Nursing Research
Agnieszka Prusinowska, Arkadiusz Komorowski, Wiktor Przepióra, Krystyna Księżopolska-Orłowska
According to the forecasts of the Central Statistical Office of Poland, in 2030 people at the age of 65 and older will account for 23.8%, i.e. their number will amount to approx. 8.5 m people. Geriatric rheumatic patients more often decide to undergo surgical joint replacement. According to the National Health Fund, the number of joint replacement services provided in 2014 increased by 93%, as compared to 2005. Improving the physical performance of this constantly expanding group of patients requires taking into account many factors to raise their functional status, reduce the risk of falling, teach rules of proper functioning with an artificial joint and encourage unassisted physical activity...
2016: Reumatologia
O Şahap Atik, Fatih I Can, M Selçuk Şenol, Toygun K Eren
A 90-year-old female patient was admitted to our clinic complaining of pain in her left hip which occurred due to fall from a chair. Her medical history included memory loss and mental changes associated with Alzheimer's disease and depression. Patient's cooperation and orientation were weak. Range of motion of the left hip was restricted and painful. Radiographs of the left hip demonstrated subtrochanteric comminuted fracture of femur. Laboratory tests revealed anemia and liver insufficiency. Departments of internal medicine and anesthesiology reported high risk for surgery...
August 2016: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
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