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1.
Background and aimFalling threatens the health, independence and quality of life of older adults. Information about characteristics and predisposing factors of falls is essential to develop and implement effective preventing measure. The aim of this study was to examine the prevalence, circumstances and consequences of falls among community-dwelling older adults in Tehran, Iran, and scrutinize factors (e.g. demographics) associated with falls.MethodsA cross-sectional study was conducted in Tehran. A total of 653 individuals aged 65 years and over were selected by a stratified random sampling as representing older adults in Tehran. All required data were collected through face-to-face interviews using questionnaires.ResultsThe prevalence of falls was 39.7% and higher in women than in men. For both sexes, most of the falls occurred in the afternoon (n = 135, 52.1%) and at home (n = 209, 80.7%). One-fourth of the falls (23.2%) occurred in a forward direction, mostly among women (60%). For both sexes, one-third of the causes of falls were loss of balance, mostly among women and the oldest persons. Two-hundred and twelve of the fallers reported injuries. The logistic regression showed that female gender, low education and constant worries about living expenses were significantly associated with falls.ConclusionsThis study may have provided new insights into the characteristics/ circumstances/ consequences of injurious falls and their relation with age, gender and injury severity in Iran. It may be useful for health policy makers and health providers when designing falls intervention and prevention programs at the community level.  相似文献   

2.
BackgroundThe chances of experiencing a fall among those aged 60 years and older increase as risk factors accumulate. In the last few decades, several studies have identified different risk factors for falls in older people, including the role of social isolation and loneliness. This systematic review provides an overview of published literature that analyzes the bidirectional relation between falls and social isolation or loneliness.Material and methodsTwo databases (PubMed and Europe PMC) were used to search for publications investigating the relationship between falls, social isolation and/or loneliness in older people. Similar articles and references were screened against the inclusion criteria.Results17 studies met the inclusion criteria and were included. Only a few studies assessed the association between falls and social isolation/loneliness among older people. Therefore, articles examining the association between falls and living alone status among people aged 60 and older were included as well. In all studies loneliness, social isolation, and living alone were significantly associated with falls in older people.ConclusionsThe findings emphasize the importance of the relationship between falls and social isolation, loneliness and living alone among older people. As there are only a few studies assessing the relationship between falls and loneliness or social isolation, further research in this field should be conducted. In particular, longitudinal studies that utilize standardized measurement instruments should be carried out.  相似文献   

3.
BackgroundFalls and fear of falling (FOF) have serious adverse effects for older adults. Culturally-specific and environmentally-tailored interventions may help address the problems of falls and FOF. No such interventions are however available for use in the African context.ObjectiveTo explore falls and FOF among older adults in an assisted-living facility, as a foundation for developing interventions to address falls and FOF.MethodsThis qualitative study involved purposefully recruiting nine older adults and four caregivers at an assisted-living facility in Southeast Nigeria. Focus group discussions were conducted separately for older adults and the caregivers. Data were analysed using an Inductive Approach.ResultsFour themes emerged: incidence of falls and fear of falling; factors associated with falls and fear of falling; health implications of falls and fear of falling; and coping strategies to deal with falls and fear of falling. Older adults were experiencing a high prevalence of falls and FOF perceived to be caused by both cultural/environmental/institutional-related factors (poorly lit environment at night; poor ambulatory surfaces; unwillingness to accept age-related changes in physical capacity; poor disposition towards walking aids; poor treatment of injuries; misconceptions; poor physical activity participation; and external perturbation) and intrinsic factors (psychological/emotional, concentration/attention, socio-demographic and morbidity-related).ConclusionThe older adults were experiencing a high prevalence of falls and FOF which has a multifactorial origin of common and cultural/societal/institutional/environmental-related factors. The need for a multicomponent and culturally and environmentally-specific interventions to address falls and FOF in this sample is thus highlighted.  相似文献   

4.
Purpose of the studyFrailty leads to serious adverse outcomes including falls. The relationship between frailty and falls has not been evaluated in the context of the side effects of drugs with anticholinergic properties. The aim of this study was to examine the potential association of anticholinergic burden (ACB) with the risk of falls among frail older adults.Design and methodsCommunity-dwelling older adults were consecutively selected from the geriatrics outpatient clinic. Based on a fall history in the last 12 months, the participants were grouped as fallers and non-fallers. Frailty status was assessed by Fried’s phenotype method. Exposure to anticholinergic medications was estimated using the ACB scale, and the participants were classified into ACB_0 (none), ACB_1 (possible) and ACB_2+ (definite).ResultsThe study included 520 older adults (mean age 77.7 years, 62.7 % female), with a fall prevalence of 25.8 % 12 months past. The proportions of frailty and pre-frailty were 33.1 % and 57.4 %, respectively. After adjustment for study confounders, receiving at least 1 drug with either possible or definite anticholinergic properties was independently associated to falls in frail [OR = 3.84 (1.48−9.93), p = 0.006] and pre-frail participants [OR = 2.71 (1.25−5.89); p = 0.012], but not in robust subjects. Moreover, ACB was significantly associated with the frailty components on adjusted analysis (p’s<0.05).ImplicationsCurrent study showed that the use of any drugs with possible or definite anticholinergic properties was associated with an increased risk of falls in frail older adults. The results emphasize the importance of medication management with respect to fall prevention in these patients.  相似文献   

5.
IntroductionOne of the main risk factor for falls is a history of falls itself. Henceforth, preventing a fall is an important strategy for the prevention of new ones. The objective of the present study was to determine whether personal self-perception questions and functional tests might represent risk factors for a fall during the year following a year without any falls among independent community-dwelling older adults, considering a period of 12 prospective months.MethodsA total of 101 community-dwelling older adults without a fall in the previous year underwent an initial evaluation (sample characterization, self-perception questionnaire and functional tests) and monthly monitoring of prospective fall episodes by telephone contact. We determined the association between the occurrence of prospective falls (dependent variable) and personal questions and functional tests (independent variables) with multiple binary logistic regression adjusted for confounding variables.ResultsOnly age (p = 0.005) and self-perception of general health (p = 0.019) showed association with the occurrence of prospective falls.ConclusionOur results showed that the only factors bearing an association with the occurrence of prospective falls were age and general health self-perception, which demonstrates the importance of administrating self-perception measures in clinical practice or in epidemiological studies for the prevention of a fall during the year following a year without any falls in older adults.  相似文献   

6.
BackgroundWhile heart failure (HF) in older adults is associated with fall risk, little is known about this in the U.S.ObjectiveTo examine the independent effect of functional impairments related to HF on falls among community-dwelling older adults in the U.S.MethodsA retrospective cohort study was conducted with 17,712 community-dwelling older adults aged 65 and above with (n = 1693) and without HF, using mixed-effects logistic regression to examine the association between HF and falls.ResultsHF patients had 14% greater odds of falling than those without HF. Moreover, HF patients with functional difficulties in mobility, large muscle difficulty, instrumental activities of daily living difficulty, poor vision, and urinary incontinence demonstrated an increased likelihood of falling.ConclusionCommunity-dwelling older adults with HF and functional difficulties have a higher fall risk than those without HF, indicating that fall prevention programs should be developed, tested, and implemented for this population.  相似文献   

7.
BackgroundFalls in older adults, notably those with Alzheimer’s dementia (AD), are prevalent. Vision and balance impairments are prominent falls risk factors in older adults. However, recent literature in the cognitively impaired suggests that executive function (EF) is important for falls risk assessments. The study objectives were to: 1) to compare balance among people with AD, healthy older adults (OA), and healthy young adults (YA) and 2) to quantify the interaction of visual acuity and EF on postural stability.MethodsWe recruited 165 individuals (51 YA, 48 OA, and 66 AD). Trail Making Tests (A and B) quantified EF and the Colenbrander mixed contrast chart measured high and low contrast visual acuity. Accelerometers recorded postural sway during the Modified Test for Sensory Integration. A two-way repeated measures ANOVA examined postural sway differences across groups. Mediation analysis quantified the association of EF in the relationship between contrast sensitivity and postural sway.ResultsSignificant EF and visual acuity between-group differences were observed (p < 0.001). For postural sway, a significant interaction existed between group and balance condition (p < 0.001). In general, EF was a significant mediator between visual acuity and postural sway.Visual acuity, EF and postural sway was worse with increased age, particularly in the AD group.ConclusionsMediation analysis revealed that individuals with poorer visual acuity had poorer EF, and those with poorer executive function had poorer balance control. These results highlight the importance of assessing not only vision and balance but also EF, especially in older individuals living with AD.  相似文献   

8.
Background/objectivesSelf-medication, despite some benefits, carries many risks, especially when practiced by older adults who are polymedicated. Information addressing the prevalence and associated factors of self-medication in older age in a European context is scarce and sometimes contradictory. This paper aims to estimate the prevalence of self-medication among older adults across Europe and to identify its predictive factors.DesignCross-sectional study.SettingMicro-data from the European Health Interview Survey (2006–2009) was used.ParticipantsThe sample comprised 31,672 community-dwelling individuals aged 65 and over living in private households in 14 European countries.MeasurementsThe analyses explored the use, over the last two weeks, of any medicines, supplements, or vitamins that were not prescribed by a doctor.ResultsThe mean self-medication prevalence was 26.3 %, being the highest in Poland (49.4 %) and the lowest in Spain (7.8 %). Greater odds of self-medication were found for women and for participants who were younger, divorced, or presented a higher educational degree. The presence of long-standing illness and physical pain or not using prescribed medication also significantly increased the possibility of self-medication. A wide variation in the odds of self-medication between countries was also observed (up to 8 times more for Poland, compared to Spain).ConclusionSelf-medication is a prevalent problem among older Europeans, and even though some think it is risk-free, dangers tend to be greater with advancing age. This study will help identify the groups most likely to have this behavior so that we can focus on targeted educative and preventive initiatives.  相似文献   

9.
BackgroundThe phenomenon of empty-nest older adults has raised growing concerns in contemporary Chinese society. In this study, we examined the prevalence and related influencing factors of depression symptoms among empty-nest older adults in China at a national level.MethodsThe database of the 2015 China Health and Retirement Longitudinal Study (N = 8549, aged ≥ 60) was used. The 10-item version of the Centre for Epidemiologic Studies Depression Scale was employed to measure depression symptoms.ResultsThe prevalence of depression symptoms was 34.7 % for empty-nest respondents, 32.2 % for respondents living with a spouse only and 43.4 % for those living alone. Multivariable logistic regression indicated that, compared with the non-empty-nest respondents, older adults living alone were more susceptible to depression symptoms (OR 1.194, 95 %CI 1.016–1.405) whereas older adults living with a spouse only were not exposed to an elevated probability of being depressed (OR 0.945, 95 %CI 0.847–1.055). Multivariable logistic regression also suggested that empty nesters who were female, lived in rural areas, had a lower frequency of children’s visits, had lower socioeconomic status and had worse physical health conditions were more vulnerable to depression symptoms.ConclusionsThe association between empty-nest status and later-life depression is mixed. More concerns should be raised about the mental health of empty nesters living alone. Increased attention should also be paid to empty nesters who are female, rural residents and have low contact frequency with their children, disadvantaged socioeconomic status and poor physical health conditions.  相似文献   

10.
BackgroundCoronary calcium is a marker of coronary atherosclerosis and established predictor of cardiovascular risk in general populations; however, there are limited studies examining its prognostic value among older adults (≥75 years) and even less regarding its utility in older males compared with females. Accordingly, we sought to examine the prognostic significance of both absolute and percentile coronary calcium scores among older adults.MethodsThe multicenter Coronary Artery Calcium Consortium consists of 66,636 asymptomatic patients without cardiovascular disease. Participants ages ≥75 were included in this study and stratified by sex. Multivariable Cox regression models were constructed to assess cardiovascular and all-cause mortality risk by Agatston coronary calcium scores and percentiles.ResultsAmong 2,474 asymptomatic patients (mean age 79 years, 10.4-year follow-up), prevalence of coronary artery calcium was 92%. For both sexes, but in females more so than males, higher coronary calcium score and percentiles were associated with increased cardiovascular and all-cause mortality risk. Those at the lowest coronary calcium categories (0-9 and <25 percentile) had significantly lower risk of cardiovascular and all-cause mortality relative to the rest of the population. Multivariable analyses of traditional cardiovascular risk factors and coronary artery calcium variables revealed that age and coronary calcium were the strongest independent predictors for adverse outcomes.ConclusionsBoth coronary artery calcium scores and percentiles are strongly predictive of cardiovascular and all-cause mortality among older adults, with greater risk-stratification among females than males. Both low coronary artery calcium scores 0-9 and <25th percentile define relatively low risk older adults.  相似文献   

11.
Rapid socioeconomic development in the countries of the Gulf Cooperation Council (GCC) has resulted in demographic and epidemiological transitions, with obesity, diabetes and other chronic diseases becoming the leading causes of morbidity and mortality. This emerging disease pattern is often attributed to physically inactive lifestyles. Given that there is no consolidated evidence on physical activity participation, we reviewed studies to examine prevalence and gender differences among GCC adults. PubMed, CINAHL and reference list searches identified eight relevant studies. Based on the best‐available data, the prevalence of adults being physically active for at least 150 min week?1 (based on the international standard definition) ranged from 39.0% to 42.1% for men and 26.3% to 28.4% for women. Men were significantly more active than were women. Prevalence estimates for participation in physical activity in the GCC States are considerably lower than those for many developed countries. Studies using standardized methodologies with nationally representative samples are urgently required. Identifying prevalence and gender variations provides the basis for understanding the unique socio‐cultural and environmental factors contributing to physical inactivity among adults in the countries of the GCC. This understanding must then inform population‐health strategies to address the rising prevalence of obesity, type 2 diabetes and other chronic diseases.  相似文献   

12.
ObjectivesTo examine if family ties are strong predictors of functional limitation in older adults in Europe.MethodsCross sectional data were used and included 14 European countries from the second wave (w2) of the survey on Health, Ageing, and Retirement in Europe. 13,974 adults aged 50+ (45.2% males and 54.8%females) were included in the study. Functional limitation was assessed using activities of daily living (ADL), instrumental activities of daily living (i-ADL) and mobility sensory index. Family ties were based on a customized model of family structural aspects. Multiple logistic regression analyses were used to examine the risk of functional limitations.ResultsFunctional limitation was associated with females, age, self-rated health, and an increased number of chronic conditions, disease symptoms and depressive symptoms but not with few family ties. After controlling for potential confounders, respondents with lower family contacts showed higher risk for functional limitation. Southern and Mediterranean countries have both closer family ties and adults with higher functional limitation.ConclusionFunctional limitation is associated with biological and demographic factors as well as little contact with family members. Further longitudinal research is required in order to determine the association and the causal relationship between functional limitation and family ties.  相似文献   

13.
ObjectivesTo study the fall prevalence, time trends and related risk factors among elderly people in the Chinese mainland from 2011 to 2013.MethodsOur data were from China Health and Retirement Longitudinal Study in 2011 and 2013. The population sample included people aged 60 years and over. Whether the person had experienced fall accident in the last two years was used to measure fall incidence. The time trend and age groups were investigated through the chi-square test. The related risk factors were examined based on the binary logistic regression model.ResultsIn 2011, 19.64% (95% CI, 18.66%, 20.67%) of elderly people experienced fall incidents and in 2013, 19.28% (95% CI, 18.46%, 20.13%) of elderly people experienced fall incidents. However, no significant difference was seen in the fall prevalence between 2011 and 2013. The fall prevalence among elderly people aged 66–70 declined significantly while that among people aged over 80 showed an increasing time trend. The fall prevalence was affected significantly by factors including age (66–70), gender, marital status, self-rated health, quantity of chronic diseases, quantity of disability items, activities of daily living and physical functioning.ConclusionsIt is revealed the fall prevalence showed no increment from 2011 to 2013 but at a high level. More efforts should be made to reduce the fall prevalence, and special attention should be paid to the elderly people aged over 80 and older.  相似文献   

14.
IntroductionNutrition screening is an initial procedure in which the risk of malnutrition is identified. The aims of this review were to identify malnutrition risk from nutrition screening studies that have used validated nutrition screening tools in community living older adults; and to identify types of nutrition interventions, pathways of care and patient outcomes following screening.MethodsA systematic literature search was performed for the period from January 1994 until December 2013 using SCOPUS, CINAHL Plus with Full Text, PubMed and COCHRANE databases as well as a manual search. Inclusion and exclusion criteria were determined for the literature searches and the methodology followed the PRISMA guidelines.ResultsFifty-four articles were eligible to be included in the review and malnutrition risk varied from 0% to 83%. This large range was influenced by the different tools used and heterogeneity of study samples. Most of the studies were cross sectional and without a subsequent nutrition intervention component. Types of nutrition intervention that were identified included dietetics care, nutrition education, and referral to Meals on Wheels services and community services. These interventions helped to improve the’ nutritional status of older adults.ConclusionsTimely nutrition screening of older adults living in the community, if followed up with appropriate intervention and monitoring improves the nutritional status of older adults. This indicates that nutrition intervention should be considered a priority following nutrition screening for malnourished and at risk older adults. Further evaluation of outcomes of nutrition screening and associated interventions, using structured pathways of care, is warranted.  相似文献   

15.
BackgroundAs one of the leading causes of death around the world, suicide is a global public health threat. Due to the paucity of systematic studies, there exist vast variations in suicide ideation, attempts and suicide rates between various regions of Chinese aging communities.ObjectivesOur systematic study aims to (1) identify studies describing the epidemiology of suicidal ideation, suicide attempts and behaviors among global Chinese communities; (2) conduct systematic review of suicide prevalence; (3) provide cross-cultural insights on this public health issue in the diverse Chinese elderly in China, Hong Kong, Taiwan, Asian societies and Western countries. Data sources: Using the PRISMA statement, we performed systematic review including studies describing suicidal ideation, attempts, and behavior among Chinese older adults in different communities. Literature searches were conducted by using both medical and social science data bases in English and Chinese.ResultsForty-nine studies met inclusion criteria. Whereas suicide in Chinese aging population is a multifaceted issue, culturally appropriate and inter-disciplinary approach to improve the quality of life for the Chinese older adults is critical.ConclusionsFuture research is needed to explore the risk and protective factors associated with suicidal thoughts, attempts and behaviors in representative Chinese aging populations.  相似文献   

16.
Background:Falls in the elderly have become a serious social problem worldwide. Approximately a third of persons fall at least once in the year after total joint arthroplasty (TJA), but preventing and treating falls is still challenging in clinical practice. Until now, no formal systematic review or meta-analysis was performed to summarize the risk factors of falls after TJA. The present study aimed to quantitatively and comprehensively conclude the risk factors of falls after TJA in elderly patients.Methods:The electronic databases to be searched include CNKI, Embase, Medline, and Cochrane central database (all up to November 2018). All studies on the risk factors of falls after TJA in elderly patients without language restriction were reviewed. Process of evaluation of identified studies and extraction of data were independently conducted by 2 reviewers, qualities of included studies were assessed using the Newcastle–Ottawa Scale. Data were pooled and a meta-analysis completed. All analyses were performed by the software Stata 11.0.Results:A total of 14 studies were included, which altogether included 1284456 patients with TJA, of them 12879 cases of falls occurred after surgery, suggesting the accumulated incidence of 13.1% and the prevalence of in-hospital falls was 1.0%. This study has provided evidence for the preventing of falls in the elderly patients who were underwent TJA. Outcome measures include advanced age, female, Overweight (BMI≥25 kg/m2), falls history, use of walking aid, diabetes, cardiac disease, hypertension, COPD and depressive symptoms. The ABC Scale was significantly negatively correlated with falls after lower extremity joint replacement.Conclusions:Related prophylaxis strategies should be implemented in elderly patients involved with above-mentioned risk factors to prevent falls after TJA.  相似文献   

17.
PurposeTo examine the experiences and needs of Asian older adults who are socially isolated and lonely living in Asian and western countries.Materials and methodsSix databases were searched for qualitative studies from each database’s inception to December 2019. Qualitative data were meta-summarized and then meta-synthesized.ResultsFourteen studies were included in this review. Five themes emerged: (1) association with older adults’ well-being, (2) loss of social support, (3) dealing with social isolation and loneliness (4) unique experiences of Asian older adults in western countries, and (5) wish list of older adults. The older adults felt psychologically down and experienced a lack of social support from their family members. They coped using strategies such as religious reliance and social engagement with peers. Asian older adults in western countries faced cultural barriers and tried to form ethnic communities. The older adults wished for more community resources and care.ConclusionThere were multiple associations of social isolation and loneliness on the Asian older adults’ well-being and social support. Coping mechanisms such as acceptance and social engagement were adopted. They expressed support needs such as social programs and healthcare services. More geographically distributed studies are needed to gather a more comprehensive and causality-related perspectives of socially isolated and lonely older adults. Lay-led programs, technology, and active coping strategies are proposed and can be incorporated in healthcare services and social programs to assist these older adults.  相似文献   

18.

Aim

The present study examined whether ethnicity independently predicted future falls among community‐dwelling older Singaporeans, and whether ethnicity moderated the relationships between falls risk factors at baseline and falls at follow up.

Methods

Data from a longitudinal survey of older Singaporeans were used. Baseline assessment included handgrip strength, global cognitive function, mobility difficulties, health and psychosocial status. One‐year retrospective falls information at follow up was the primary outcome.

Results

Final analysis included 1975 participants (mean age 73.6 ± 6.2 years, 53% women). Indians, followed by Malays, had a higher risk of falling compared with Chinese at follow up. This association remained after controlling for falls risk factors. Self‐reported pain and poor global cognitive function imposed a substantial increment in the risk of falling among Malays compared with Chinese, but not Indians.

Conclusion

Ethnicity was a significant predictor of future falls among older Singaporeans. Falls screening and intervention should take ethnicity into account to reach and support the appropriate target population. Geriatr Gerontol Int 2018; 18: 72–79 .  相似文献   

19.
BackgroundPain catastrophizing has been associated with pain intensity and mobility limitations in adults, and may be associated with mobility problems among older adults with chronic pain. This study examined the associations between pain catastrophizing and pain characteristics, and physical performance in older people.MethodsThe MOBILIZE Boston Study II (MBS) included 354 adults aged ≥70 years, living in the Boston area, originally enrolled in the MBS I from 2005−2008. Pain catastrophizing was measured using the 13-item Pain Catastrophizing Scale (PCS), with scores ranging from 13−65. Pain severity and pain interference were assessed by subscales of the Brief Pain Inventory. Pain distribution was classified as none, single site, and multisite. Mobility performance was assessed using the Short Physical Performance Battery (SPPB). Falls were assessed prospectively using monthly fall calendar postcards.ResultsOne-fourth of all participants (24 %) had high scores on the PCS (score>30). PCS was inversely associated with age and was greater among those with osteoarthritis, depression, or anxiety (p-value<0.05). PCS score was associated with global measures of pain including pain severity (p-value = 0.01), pain interference (p-value = 0.004) and multisite pain compared to no pain (p-value = 0.006). After adjusting for confounders, PCS was not associated with mobility and fall in this older population.ConclusionAlthough pain catastrophizing is prevalent in older adults with chronic pain, it was not associated with mobility or falls in older people. Further research is needed to determine possible long-term effects of pain catastrophizing on chronic pain and functioning in older adults.  相似文献   

20.
ObjectiveTo identify the evidence about the usefulness of the Functional Reach Test to evaluate balance and falls risk; to verify the Functional Reach Test assessment method and other variables that could interfere in its results; and to establish normative data for older adults.Data sourcesManual and electronic searches (MEDLINE, Embase, Web of Science, LILACS, CINAHL, AgeLine and PsycINFO) were conducted with no language restrictions and published since 1990.Study selectionObservational studies about the Functional Reach Test in older adults with no specific health condition were selected.Data extractionTwo independent reviewers extracted data from studies and a third reviewer provided consensus. The studies methodological quality was appraised using the Newcastle-Ottawa Scale. Studies were submitted to critical analysis and meta-analysis.Results40 studies were selected (8 prospective and 32 cross-sectional). 33 studies used the Functional Reach to assess balance and 21 studies the falls risk. The meta-analysis of Functional Reach normative data was 26.6 cm [95%CI: 25.14; 28.06] for community-dwelling older adults (n = 21 studies) and was 15.4 cm [95%CI: 13.47; 17.42] for non-community older adults (n = 5 studies), with statistics differences between settings. Functional Reach Test performance was found to decrease with age. Sex and prospective history of falls did not influence the test results. Methodological quality analysis determined high to low risk of bias of the studies.ConclusionThis review revealed that the method of assessment and data of the Functional Reach Test varied greatly. Different values should be used for community- and non-community-dwelling older adults.  相似文献   

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