Efectividad de los ejercicios de equilibrio entre los adultos mayores en Depok,Indonesia

ObjectiveFalls are a serious problem for older adults. Balance impairment is one of the most significant reasons why adults fall from a standing position. This study aims to investigate the effect of an eight-week postural balance exercise intended to reduce the risk of falls among older adults in a community in Depok City, Indonesia.MethodThis quasi-experimental study employed a pre- and post-test design using a control group. The study involved an intervention group of 30 respondents and a control group of a further 30 respondents. The sample was selected using multistage random sampling. The data were analyzed using a t-test.ResultsThe balance exercise significantly affected the respondents’ postural balance and reduced their risk of falling. There were significant differences between the two groups (intervention group and control group) in postural balance (p < 0.001) and the risk of suffering a fall (p = 0.023).ConclusiónBalance exercises can be utilized as one of the preventive efforts to maintain postural balance and reduce the risk of falls among older adults. Future studies may consider the variation of age to more accurately determine the effectiveness of this balance exercise.     

The ability of gait kinematic parameters to predict falls in older adults with cognitive impairments living in long term institutions

BackgroundCognitive impairments reduce adaptive responses and may increase the risk of falls.ObjectivesTo compare gait kinematics in older adults with cognitive impairments living in long term institutions and to identify the ability of gait kinematics to predict falls in older adults with cognitive impairments living in long term institutions.MethodsData of 23 older adults with cognitive impairments living in long term institutions were considered for this study. Fifty gait cycles were recorded during walking at a self-selected pace using footswitches sensors. The variables considered for the analysis were: speed; stride length; stance, swing and stride time; and the variability of these parameters. Fall status was recorded for a 6 month-period.FindingsMANOVA found group effect (p = 0.025) for gait kinematics comparisons. Variability of stance (p = 0.01) and swing (p = 0.012) and stride time (p < 0.001) were higher in older fallers. Speed of older fallers was 31.8% slower than those of the non-fallers (p < 0.001). The kinematic variables that were able to predict falls were: stride time variability (p < 0.001), threshold of 0.4 s, sensitivity of 50% and specificity of 100%; and gait speed (p < 0.001), threshold of 0.65 m·s⁻¹, sensibility and specificity of 50%.InterpretationOlder adults living in an assisted living facility with a history of falls demonstrate increased kinematic variability while walking. However, the ability of gait kinematic parameters to predict falls was found to be weak. The results suggested that gait kinematic parameters are weak predictors of falls in older adults with cognitive impairments living in long term institutions.     

Construct validity of the Modified Gait Efficacy Scale in older females

There are few well-validated tools that focus on the assessment of walking confidence in older adults. The main objective of this study was to assess construct validity of the 10-item Modified Gait Efficacy Scale (mGES) as a measure of walking confidence in older adults. Twenty-four older females completed the mGES, the 16-item Activities-specific Balance Confidence (ABC-16) scale, and the Senior Fitness Test (SFT). Construct validity of the mGES was evaluated by quantifying relationships between the mGES and the ABC-16 and the SFT, and by examining the ability of the mGES to discriminate between known groups (no/lower fear of falling versus higher fear of falling). There was a strong correlation between mGES and the ABC-16 scale (r_s = 0.85; p < 0.001). The mGES was significantly associated with SFT components that required lower extremity strength, stepping aerobic endurance, and walking agility and dynamic balance (r_s = 0.45 to 0.61; p < 0.05). Relationships between the mGES and number of arm curls in 30 s, chair sit and reach test, and back scratch test were weak (r_s = 0.13–0.25; p > 0.05). Mean mGES score was 91.5% in a no/lower fear of falling group, while it was 81.4% in a higher fear group (p = 0.22). There was a trend toward a significant difference in the unstandardized residuals derived from regression of ranked mGES scores on ranked covariate (age and 8 foot up and go) scores, between the no/lower versus higher fear of falling group (p = 0.095). These results support construct validity of the mGES as a measure of gait self-efficacy in community-dwelling older females.     

Association between abdominal muscle stiffness,diaphragm thickness and peak expiratory flow in younger versus older adults

The present study aimed to evaluate forced expiration based on transverse abdominis (TrA) stiffness by identifying the relationship between TrA stiffness and peak expiratory flow (PEF) in both younger and older adults. We also assessed the relationship between diaphragm thickness and PEF. A total of 31 younger (21.24 ± 2.73 years) and 34 older (71.35 ± 5.26 years) adults were included in the present study. TrA muscle stiffness was measured at rest and during abdominal bracing using shear wave elastography. Diaphragm thickness was measured during deep inspiration and expiration using B-mode ultrasound, and respiratory function was assessed by measuring PEF using a spirometer. We found that TrA stiffness during bracing was significantly lower in older than younger adults (p < 0.05). Similarly, the difference in absolute stiffness of the TrA when bracing versus at rest was significantly lower in older than younger adults (p < 0.05). Additionally, TrA stiffness during bracing was positively associated with PEF in the younger group (r = 0.483), while a very weak correlation was found in the older group (r = 0.172). Similarly, PEF was moderately correlated with diaphragm thickness during expiration as well as during changes between inspiration and expiration in the younger group (r = 0.405 and r = 0.403); however, no significant correlation was found in the older group. These findings of the present study indicate that the variations in PEF between younger and older adults may be due to age-associated changes in the musculoskeletal structure and muscle fibre type.     

The relationship between functional disability and health-related quality of life in patients with a rotator cuff tear

Purpose:To determine the relationship between functional disability and health-related quality of life (HRQoL) in rotator cuff tear (RCT) patients. Method:In 67 RCT patients (mean age, 54 years; 57% males), functional disability was self-reported with the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), HRQoL with the Short-Form 36 Health Survey (SF-36), and pain by visual analogue scale. ASES results were divided into tertiles (12–38, 39–51, and 52–82). Results:Mean ASES score was 48 (range, 12–82). Patients with the highest functional disability and highest pain level had the lowest HRQoL. For the highest, middle, and lowest ASES categories, respectively, mean SF-36 Physical Component Summary (PCS) scores were 35 SD 5, 36 SD 8, and 41 SD 6 (p< 0.001) (r = 0.47 for ASES vs. PCS; p< 0.001), and Mental Component Summary (MCS) scores were 50 SD 13, 56 SD 10, and 58 SD 8 (p = 0.011) (r = 0.37 for ASES vs. MCS; p= 0.003). Conclusions: Patients with higher functional disability had lower HRQoL. RCT extensively affects patients’ lives; therefore, capturing both generic and shoulder-specific measures of RCT problems is recommended.

Implications for Rehabilitation

• Rotator cuff tears (RCTs) result from injury or degeneration, and tear prevalence increases with age.

• RCT causes disabling pain, decline in muscle strength and shoulder mobility.

• RCT patients with decreased functioning have impaired quality of life.

     

Falls and fall risk among nursing home residents

Aim and objectives. The aim of this study was to identify risk factors for falls in older people living in nursing homes. Background. Impaired cognitive function and a poor sense of orientation could lead to an increase in falls among those with impaired freedom of movement. Many accidents occur while an older person is walking or being moved. Method. The study was carried out over four years (2000–2003) and 21 nursing home units in five municipal homes for older people in Stockholm, Sweden, participated. A questionnaire was sent to staff nurses, including questions on fall risk assessments, falls, fractures, medication and freedom‐restricting measures, such as wheelchairs with belts and bed rails. The data were aggregated and not patient‐bound. The study covered 2343 reported incidents. Results. There was a significant correlation between falls and fractures (r = 0·365, p = 0·004), fall risk and use of wheelchairs (r = 0·406, p = 0·001, safety belts (r = 0·403, p = 0·001 and bed rails (r = 0·446, p = 0·000) and between the occurrence of fractures and the use of sleeping pills with benzodiazepines (r = 0·352, p = 0·005). Associations were also found between fall risk and the use of anti‐depressants (r = 0·412, p = 0·001). Conclusion. In clinical practice, patient safety is very important. Preventative measures should focus on risk factors associated with individuals, including their environment. Wheelchairs with safety belts and bed rails did not eliminate falls but our results support the hypothesis that they might be protective when used selectively with less anti‐depressants and sleeping pills, especially benzodiazepines.     

The risk of being fearful or fearless of falls in older people: An empirical validation

Purpose.?To investigate the risk of being fearful or fearless of falls in older people.

Methods.?Using a force plate, postural control in different sensory and rhythmic conditions was measured in 263 community-dwelling older people. Other assessments included fear of falling, and handgrip strength. Fall incidence was assessed at baseline and during a one-year follow-up period.

Results.?Logistic regression analysis revealed that increased lateral sway in near-tandem stance with eyes open (OR = 5.33; p < 0.01) and a worse performance on anteroposterior rhythmic weight shifts (OR = 0.65; p < 0.05) were related to falls. Univariate analyses revealed that older people with inappropriate high fear of falling according to their fall incidence had worse balance capacities on the rhythmic weight shifts (p < 0.05) but had similar static balance and physical capacities. Older people with inappropriate low fear of falling had a better hand grip (p < 0.05) but equally worse balance capacities than the comparison group.

Conclusions.?The results indicate the importance of lateral stability in relation to falls. They also suggest a substantial impact of inappropriate fear of falling on physical performance. Inappropriate high fear of falling may result in worse performance during dynamic balance tests, whereas older people with inappropriate low fear seem to overrate their capacities because of higher strength.     

Older hospital inpatients’ fall risk factors,perceptions, and daily activities to prevent falling

PurposeTo identify associations among patient fall risk factors, perceptions, and daily activities to improve patient engagement with fall prevention among hospitalized older adults.BackgroundThe risk of falling increases for older patients but few researchers have reported patient-centered measures on this topic.MethodsSurveys and chart reviews of inpatients aged ≥ 65 with Morse Falls Scale scores of ≥ 45. Measurements included validated tools and the modified Fall Behavioral Scale-Inpatient (FaB-I).ResultsA fall within 3 months before hospitalization was associated with an increased level of importance to preventing falls and higher FaB-I score (more fall prevention behaviors) but decreased level of confidence related to preventing falls (p < 0.05). Perception measures (concern: r = 0.52; patient activation: r = 0.46) were positively associated with FaB-I (p < 0.001).ConclusionsAddressing patient-centered measures such as perceptions of and daily activities for fall prevention could add value to existing fall prevention programs.     

Reliability of the LIFE-H satisfaction scale and relationship between participation and satisfaction of older adults with disabilities

Purpose.?To (1) document the test–retest reliability of the Assessment of Life Habits (LIFE-H 3.1) in measuring the satisfaction of older adults with disabilities regarding their level of participation and (2) explore the relationships between level of participation and satisfaction with the level of participation achieved.

Methods.?Thirty older adults having functional disabilities were interviewed twice using the LIFE-H. This questionnaire assesses the (1) participation in daily activities and social roles (life domains), and (2) satisfaction with this participation.

Results.?The test–retest intraclass correlation coefficients (ICC) of the satisfaction total score and its two subscores revealed high reliability (ICCs ≥ 0.84). Moderate to excellent ICCs were also obtained for the life domains (ICCs = 0.65–0.88). Satisfaction was positively associated with participation for the daily activities subscore and LIFE-H total score (p < 0.05) but not the social roles subscore. Half of the life domains showed significant correlations between participation and satisfaction scores (p < 0.01).

Conclusion.?The results support the reliability of the LIFE-H satisfaction scale in older adults having functional disabilities. Also, as satisfaction is only partly related to the level of participation, the study emphasizes the relevance of considering both participation and satisfaction of older adults with disabilities when evaluating their needs.     

Factors associated with falls in community-dwelling older adults: an analysis based on subscales of the frailty screening index

[Purpose] We aimed to obtain new findings by investigating the relationship between the presence or absence of falls and the results from the Frailty Screening Index (FSI), which can be easily carried out. [Participants and Methods] A total of 780 community-dwelling older adults (age ≥65 years) were classified based on whether they had fallen in the past year as those who had fallen at least once (fall group), and those who had not (non-fall group). We compared the study groups using sub-items of the FSI to extract more specific fall-related factors. The FSI is a questionnaire that comprises five items with simple ‘yes/no’ responses. [Results] The following three out of five sub-items of the FSI were extracted as fall-related factors: 1) “no” to the question, “Do you do physical exercise, like walking, at least once a week?”; 2) “yes” to the question, “Do you think you walk slower than before?”; and 3) “yes” to the question, “Have you felt tired for no reason (in the past two weeks)?” [Conclusion] The study results suggest the significance of paying attention to participant responses to the sub-items on the FSI, instead of merely determining their frailty risk based on their total score.Key words: Falls, Frailty, Community-dwelling older adults     

Dynamic MRI in indirect estimation of microvessel density,histologic grade,and prognosis in colorectal adenocarcinomas

The relations of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters to microvessel density (MVD), histologic grade, and presence of metastasis were evaluated to establish new prognostic indicators in colorectal cancer (CRC). Fast-low angle shot DCE-MRI parameters (time-intensity curves, TICs; maximal relative enhancement within the first minute, E_max/1; maximal relative enhancement of the entire study, E_max; steepest slope of the contrast enhancement curve; and time to peak enhancement) of 21 CRCs (seven Duke stage B, 12 Duke stage C, and two Duke stage D) were retrospectively evaluated and correlated with corresponding postoperative MVD measurements, histologic grades, and presence of metastasis at 2 years. TICs were classified as type A in nine (43%), type B in seven (33%), and type C in five cases (24%). There was a significant difference between TIC types with regard to MVD (p < 0.05–0.001). Time to peak enhancement, steepest slope of TIC, and E_max/1 were strongly correlated with MVD (r = –0.765, p < 0.01; r = 0.681, p < 0.01; r = 0.634, p < 0.01; respectively). MVD, steepest slope of the enhancement curve, E_max/1, and E_max strongly correlated with histologic grade (r = 0.475, p < 0.05; r = 0.683, p < 0.01; r = 0.687, p < 0.01; r = 0.791, p < 0.01; respectively). There was a significant difference between groups of patients with and without metastasis with regard to histologic grade (p < 0.05) and two of the DCE-MRI parameters (p < 0.005 for E_max/1 and p < 0.05 for time to peak enhancement). Discriminant analysis correctly predicted the metastatic occurrence at 2 years in 90.5% of cases using E_max/1 (p < 0.001). Histologic grade resulted in lower rates of discrimination (66.7%; p < 0.05). DCE-MRI parameters may help in the prediction of MVD and histologic grade in CRC and may be used to predict therapeutic outcome.     

The impact of falls prevention on participation in daily occupations of older adults following discharge: a systematic review and meta-analysis

Abstract

Purpose: To investigate the impact of falls intervention programmes on participation of older adults returning home to live, following discharge from hospital. Method: A systematic review of peer-reviewed articles and grey literature was completed. Limits were set for articles published in English, dated 1990–2012. Inclusion criteria included randomised control trials with older adults (≥65 years) that used an effective falls intervention and a participation measure, following discharge from hospital or emergency department. Two independent researchers assessed the studies for eligibility. Research risk of bias was evaluated using the PEDro scale (range 1–10). A meta-analysis of the selected articles was completed. Results: Five studies fulfilled the inclusion criteria and measured participation outcomes short-term (<six months post-discharge, n?=?488) and long-term (6–12 months post-discharge, n?=?571). The results indicated that falls interventions provided a positive improvement in patients’ participation level (p?=?0.042, p?=?0.026). However, the effect size was small at 0.20 and 0.21. Conclusions: The meta-analysis findings indicate that there is a causal association between falls interventions and participation in daily occupations with older adults post-discharge. Although the effect size was small, practice implications of this study suggest that participation needs to be considered in future falls prevention research.

• Implications for Rehabilitation

• Falls interventions for older adults following discharge home from hospital, increase participation in life situations to a small extent.

• Health professionals can include a focus on falls prevention programmes with older adults to promote participation.

     

Correlates and predictors of impulsivity in adults with methamphetamine use disorder

Impulsivity is known to increase the likelihood of using stimulant drugs which in turn may increase impulsivity, leading to potentially hazardous use. However, little research has been conducted on impulsivity in methamphetamine (MA) users. In this case-control cross-sectional study, 54 adults with MA use disorder (MUD) were compared to 52 matched healthy control (HC) participants using the UPPS-P Impulsive Behavior Scale (UPPS-P). Demographic and clinical correlates and predictors of impulsivity in MUD participants were also investigated. Our findings indicate that the MUD cohort had significantly increased impulsivity (p < 0.01) compared to the HCs. In the MUD cohort, the UPPS-P total score was also positively correlated with the number of comorbid mental disorders (r = 0.29, p = 0.04), and degree of family impairment (r = 0.37, p < 0.01). Multiple linear regression analysis showed that the level of family impairment associated with MUD was significantly associated with impulsivity, explaining 16% of the variance (R² = .16, F(2,51) = 4.88, p = .01). Understanding the clinical correlates and predictors of impulsivity in MUD may inform prevention, early identification, and intervention.     

Predictive value of the echocardiographic left atrial dimension in isolated ventricular septal defect

Echocardiographic left atrial dimension has been reported to correlate with left-to-right shunt (Qp/Qs) in children with isolated ventricular septal defect (VSD) or patent ductus arteriosus (PDA). In 17 children with isolated VSD, we prospectively compared Qp/Qs with the ratio of echocardiographic left atrial dimension to aortic root diameter (LAD/Ao) and with the left atrial dimension corrected for body surface area (LAD/M²). The correlation between LAD/Ao and Qp/Qs was not statistically significant (r = 0.49, p > 0.05). The LAD/M² correlated significantly with Qp/Qs (r = 0.66, p < 0.01); however, prediction intervals were excessively wide. Our findings indicate that it is inappropriate to predict Qp/Qs in these patients from echocardiographic LAD.     

Factors impacting the household and recreation participation of older adults living in the community

Abstract

Purpose: To identify demographic, physical and psychosocial determinants associated with participation in daily activities of community-dwelling older adults. Methods: A cross-sectional design of older adults (≥70 years) from Victoria, Australia, residing in their homes was drawn from a convenience sample. The outcomes were recent participation in household and recreational activities as measured by the Phone-FITT. Explanatory variables included demographics, physical and mental health functioning (Short Form-12 version 2, Geriatric Depression Scale 15). Associations were analyzed through linear regression. Results: There were 244 participants (60% female), with a mean age of 77.5 years (SD 5.7). Higher levels of depression and fewer falls (during the previous year) were independently associated with restrictions in household participation (p?<?0.001, p?<?0.001). For recreational participation, higher levels of depression were associated with restricted participation (p?<?0.001). Conclusion: Screening for depression should be a key component of health assessments with older adults. Untreated depression may lead to lower participation rates in daily activities potentially resulting in social isolation. Fewer falls and restricted household participation were associated, but no association was observed between falls and recreational participation. Further studies are required to explore this association in more detail.

• Implications for Rehabilitation

• Depression is significantly correlated with the level of participation in daily activities for older adults.

• Health professionals need to screen for depression when working with older adults.

     

Kinesiophobia and maladaptive coping strategies prevent improvements in pain catastrophizing following pain neuroscience education in fibromyalgia/chronic fatigue syndrome: An explorative study

Many patients with chronic fatigue syndrome(CFS) and/or fibromyalgia(FM) have little understanding of their condition, leading to maladaptive pain cognitions and coping strategies. These should be tackled during therapy, for instance by pain neurophysiology education (PNE). Although positive effects of PNE are well-established, it remains unclear why some patients benefit more than others. This paper aims at exploring characteristics of patients responding poor to PNE to further improve its effectiveness. Data from two RCT’s were pooled to search for baseline predictors. Subjects (n = 39) suffering from CFS/FM, as defined by the American College of Rheumatology, underwent PNE treatment. The Pain Catastrophizing Scale (PCS); Pain Coping Inventory (PCI); and Tampa Scale of Kinesiophobia (TSK) were defined as outcome measures. There was a significant negative relationship between baseline TSK and the change in both PCS total score (r = ?0.584; p < 0.001) and PCS rumination (r = ?0.346; p < 0.05). There was a significant negative relationship between the change in PCS total score and baseline PCI worrying (r = ?0.795; p < 0.001) and retreating (r = ?0.356; p < 0.05). FM/CFS patients who tend to worry allot about their pain and with high levels of kinesiophobia are likely to experience less reductions in catastrophizing following PNE. It seems that PNE alone is insufficient to reduce catastrophic thinking regarding pain, and supplementary treatment is needed.     

Characteristics of lipid metabolism under different urinary protein excretion in children with primary nephrotic syndrome

Abstract

Hyperlipidemia (HLP), a common complication, is very prevalent in children with primary nephrotic syndrome (PNS). HLP not only significantly increases the cardiovascular risk in adulthood, but also accelerates the progression of renal disease. Proteinuria as the most important pathophysiological change can reduce serum colloid osmotic pressure, which leads to an increase in the synthesis of serum proteins including lipoproteins in the liver for export to the serum. Thus, the severity of lipid abnormalities may correlate with the degree of proteinuria. A total of 378 children with PNS were divided into three groups according to their urinary protein excretion (UPE), group A (50 mg/kg/d ≤ proteinuria <100 mg/kg/d, 125 cases), group B (100 mg/kg/d ≤ proteinuria <200 mg/kg/d, 132 cases) and group C (proteinuria ≥200 mg/kg/d, 121cases). In addition, 200 healthy volunteers with neither allergic nor renal disease between 3 and 14 years of age were recruited as the control group. Fasting serum levels of lipoprotein (a) [Lp(a)], total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), apolipoprotein A1 (apoA1), apoB, and albumin (Alb) were measured. Serum low density lipoprotein cholesterol (LDL-C) was calculated by the Friedewald formula. As expected, when all patients were compared with healthy children in this study, UPE and the serum concentrations of Lp(a), TC, TG, HDL-C, LDL-C, and apoB were higher in the PNS than in the control group (p<0.01), whereas for apoA1/B ratio the opposite was observed (p<0.01). Furthermore, patients in group C exhibited significantly higher Lp(a), TC, TG, LDL-C, and apoB concentrations than those in group A or B (p<0.01), whereas for apoA1/B ratio the opposite was found (p<0.01). The increase in serum lipids was accompanied by a significant augmented UPE in all patients (p<0.05). More specifically, positive correlations were observed between serum levels of TC (r=+0.80, p<0.01), HDL (r=+0.49, p<0.01), LDL (r=+0.79, p<0.01), ApoB (r=+0.62, p<0.01) and log proteinuria in group B; additionally, a negative correlation was observed between apoA1/B ratio and log proteinuria in group B (r=?0.38, p<0.01). However, no correlation of serum lipid profiles with UPE was determined in group A and C, respectively (p>0.05). Serum Alb was negatively correlated with Lp(a) (r=?0.96, p<0.01), TC (r=?0.78, p<0.01), TG (r=?0.78, p<0.01), LDL-C (r=?0.88, p<0.01), apoA1 (r=?0.26, p<0.01), and apoB (r=?0.71, p<0.01), while positively correlated with apoA1/B (r=+0.27, p<0.01) in all nephrotic children. Furthermore, no correlation existed between serum lipid profiles and Alb in group A, B and C, respectively (p>0.05). In Conclusion, secondary dyslipidemia in children with PNS is in parallel with the degree of UPE. There are diverse characteristics of lipid metabolism under different UPE. As for the patients with medium-UPE, positive correlation between serum lipids and proteinuria is presented.     

Older people and falls: health status,quality of life,lifestyle, care networks,prevention and views on service use following a recent fall

Aim and objective. This study has investigated older people’s experiences of a recent fall, its impact on their health, lifestyle, quality of life, care networks, prevention and their views on service use. Background. Falls are common in older people and prevalence increases with age. Falls prevention is a major policy and service initiative. Design. An exploratory, qualitative design involving two time points. Method. A convenience sample of 27 older people from two primary care trusts who had a recent fall. Taped semi structured qualitative interviews were conducted and repeated at follow up to detect change over time and repeat falls. Data were collected on their experience of falls, health, activities of living, lifestyle, quality of life, use of services, prevention of falls, informal care and social networks. Content analysis of transcribed interviews identified key themes. Results. The majority of people fell indoors (n = 23), were repeat fallers (n = 22) with more than half alone when they fell (n = 15). For five people it was their first ever fall. Participants in primary care trust 1 had a higher mean age than those in primary care trust 2 and had more injurious falls (n = 12, mean age 87 years vs. n = 15, mean age 81 years). The majority of non‐injurious falls went unreported to formal services. Falls can result in a decline in health status, ability to undertake activities of living, lifestyle and quality of life. Conclusions. Local informal care and support networks are as important as formal care for older people at risk of falls or who have fallen. Access to falls prevention programmes and services is limited for people living in more rural communities. Relevance to practice. Falls prevention initiatives and services should work with local communities, agencies and informal carers to ensure equitable access and provision of information, resources and care to meet the needs of older people at risk or who have fallen.     

A study on the relationship between age and inpatient falls in Taiwan

Falls are the most frequently reported adverse hospital events. How to prevent inpatients from falling has become an important issue of patient safety in hospitals. The purpose of this study was to investigate the correlation between age and inpatient falls. A retrospective study design was used. This study, which extracted information from fall‐related incident reports, enrolled patients who had fallen during hospitalization in Taiwan. Of the 221 falls evaluated, 63.8% had occurred under companion care, 98.2% of patients had fallen once and most fall‐related injuries were minor (46.6%). Falls occurred most frequently when patients were going to the toilet, walking and being moved. There were significant correlations with age groups and fall‐related factors (P = 0.000; P < 0.05), the presence/absence of a companion (P = 0.022, P < 0.05), the situation of falls (P = 0.000; P < 0.05), and fall‐related injuries (P = 0.000, P < 0.05). Preventive interventions related to falls should vary for different age groups.