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Frontiers in Public Health 2022This study aims to clarify the risk factors for falls to prevent severe consequences in older adults. (Meta-Analysis)
Meta-Analysis
AIM
This study aims to clarify the risk factors for falls to prevent severe consequences in older adults.
METHODS
We searched the PubMed, Web of Science, Embase, and Google Scholar databases using the terms "risk factors" OR "predicting factors" OR "predictor" AND "fall" OR "drop" to identify all relevant studies and compare their results. The study participants were divided into two groups, the "fall group" and the "control group", and differences in demographic characteristics, lifestyles, and comorbidities were compared.
RESULTS
We included 34 articles in the analysis and analyzed 22 factors. Older age, lower education level, polypharmacy, malnutrition, living alone, living in an urban area, smoking, and alcohol consumption increased the risk of falls in the aging population. Additionally, comorbidities such as cardiac disease, hypertension, diabetes, stroke, frailty, previous history of falls, depression, Parkinson's disease, and pain increased the risk of falls.
CONCLUSION
Demographic characteristics, comorbidities, and lifestyle factors can influence the risk of falls and should be taken into consideration.
Topics: Aged; Humans; Accidental Falls; Aging; Frailty; Hypertension; Risk Factors
PubMed: 36324472
DOI: 10.3389/fpubh.2022.902599 -
JAMA Jun 2019Whether exercise reduces subsequent falls in high-risk older adults who have already experienced a fall is unknown. (Randomized Controlled Trial)
Randomized Controlled Trial
IMPORTANCE
Whether exercise reduces subsequent falls in high-risk older adults who have already experienced a fall is unknown.
OBJECTIVE
To assess the effect of a home-based exercise program as a fall prevention strategy in older adults who were referred to a fall prevention clinic after an index fall.
DESIGN, SETTING, AND PARTICIPANTS
A 12-month, single-blind, randomized clinical trial conducted from April 22, 2009, to June 5, 2018, among adults aged at least 70 years who had a fall within the past 12 months and were recruited from a fall prevention clinic.
INTERVENTIONS
Participants were randomized to receive usual care plus a home-based strength and balance retraining exercise program delivered by a physical therapist (intervention group; n = 173) or usual care, consisting of fall prevention care provided by a geriatrician (usual care group; n = 172). Both were provided for 12 months.
MAIN OUTCOMES AND MEASURES
The primary outcome was self-reported number of falls over 12 months. Adverse event data were collected in the exercise group only and consisted of falls, injuries, or muscle soreness related to the exercise intervention.
RESULTS
Among 345 randomized patients (mean age, 81.6 [SD, 6.1] years; 67% women), 296 (86%) completed the trial. During a mean follow-up of 338 (SD, 81) days, a total of 236 falls occurred among 172 participants in the exercise group vs 366 falls among 172 participants in the usual care group. Estimated incidence rates of falls per person-year were 1.4 (95% CI, 0.1-2.0) vs 2.1 (95% CI, 0.1-3.2), respectively. The absolute difference in fall incidence was 0.74 (95% CI, 0.04-1.78; P = .006) falls per person-year and the incident rate ratio was 0.64 (95% CI, 0.46-0.90; P = .009). No adverse events related to the intervention were reported.
CONCLUSIONS AND RELEVANCE
Among older adults receiving care at a fall prevention clinic after a fall, a home-based strength and balance retraining exercise program significantly reduced the rate of subsequent falls compared with usual care provided by a geriatrician. These findings support the use of this home-based exercise program for secondary fall prevention but require replication in other clinical settings.
TRIAL REGISTRATION
ClinicalTrials.gov Identifiers: NCT01029171; NCT00323596.
Topics: Accidental Falls; Aged; Aged, 80 and over; Exercise Therapy; Female; Follow-Up Studies; Humans; Independent Living; Male; Postural Balance; Resistance Training; Secondary Prevention; Single-Blind Method
PubMed: 31162569
DOI: 10.1001/jama.2019.5795 -
Singapore Medical Journal Mar 2020One in three community-dwelling elderly aged ≥ 65 years and one in two aged > 80 years will have at least one fall within a year. Many elderly people are 'silent...
One in three community-dwelling elderly aged ≥ 65 years and one in two aged > 80 years will have at least one fall within a year. Many elderly people are 'silent fallers' who do not report the fall nor seek medical assistance unless they are injured. In Singapore, falls account for 40% of injury-related deaths. Unaddressed risk factors for falls lead to recurrent falls and poor quality of life. Elderly people who have experienced falls and near falls can have a fear of falling, post-fall anxiety syndrome, depression and reduction in activities, with a negative impact on their well-being. Primary care doctors can screen and optimise modifiable risk factors such as poor vision, balance, poor gait, motor weakness, joint disorders, psychotropic drugs, sedatives, anti-hypertension medications, choice of footwear and environment factors. Timely referrals for cataract operations, balance and strengthening exercises, and osteoporosis treatment can reduce the risk of falls and injurious outcomes.
Topics: Accidental Falls; Aged; Aged, 80 and over; Female; Humans; Independent Living; Male; Primary Health Care; Referral and Consultation; Risk Factors; Singapore
PubMed: 32488276
DOI: 10.11622/smedj.2020029 -
Clinics in Geriatric Medicine May 2019Falls in hospitalized patients are a pressing patient safety concern, but there is a limited body of evidence demonstrating the effectiveness of commonly used fall... (Review)
Review
Falls in hospitalized patients are a pressing patient safety concern, but there is a limited body of evidence demonstrating the effectiveness of commonly used fall prevention interventions in hospitals. This article reviews common study designs and the evidence for various hospital fall prevention interventions. There is a need for more rigorous research on fall prevention in the hospital setting.
Topics: Accident Prevention; Accidental Falls; Aged; Aged, 80 and over; Geriatric Assessment; Hospitalization; Humans; Patient Safety; Risk Assessment
PubMed: 30929888
DOI: 10.1016/j.cger.2019.01.007 -
Journal of Nursing Management Nov 2021This review aims to identify types of the existing fall prevention education (FPE) and their effectiveness in promoting fall risk awareness, knowledge and preventive...
OBJECTIVES
This review aims to identify types of the existing fall prevention education (FPE) and their effectiveness in promoting fall risk awareness, knowledge and preventive fall behaviour change among community-dwelling older people.
BACKGROUND
FPE is a cost-effective and helpful tool for reducing fall occurrences.
EVALUATION
This is a systematic review study using electronic searches via EBSCOHost® platform, ScienceDirect, Scopus and Google Scholar in March 2021. The review protocol was registered with PROSPERO (CRD42021232102). The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement flow chart guided the search strategy. Articles published from January 2010 to March 2021 were included for quality appraisal using the 'Transparent Reporting of Evaluations with Non-randomised Designs' (TREND) and the 'Consolidated Standards of Reporting Trials' (CONSORT) statement for randomised controlled trial studies.
KEY ISSUES
Six FPE studies selected emphasised on personal health status, exercise and environmental risk factors. These studies reported an increase in fall risk awareness or knowledge and a positive change in fall preventive behaviours. Two studies included nurses as educators in FPE.
CONCLUSION
FPE evidently improved awareness or knowledge and preventive fall behaviour change among older adults. Nurses are in great potential in planning and providing FPE for older adults in community settings.
IMPLICATIONS FOR NURSING MANAGEMENT
Expand nurses' roles in fall prevention programmes in community settings by using high-quality and evidence-based educational tools. Highlight the nurse's role and collaborative management in FPE.
Topics: Aged; Humans; Accidental Falls; Independent Living; Nurse's Role; Controlled Clinical Trials as Topic
PubMed: 34331491
DOI: 10.1111/jonm.13434 -
Revista Gaucha de Enfermagem Feb 2017To identify the risk factors for falls of the community-dwelling elderly in order to update the Taxonomy II of NANDA International. (Review)
Review
OBJECTIVE
To identify the risk factors for falls of the community-dwelling elderly in order to update the Taxonomy II of NANDA International.
METHOD
A systematic literature review based on research using the following platforms: EBSCOHost®, CINAHL and MEDLINE, from December 2010 to December 2014. The descriptors used were (Fall* OR Accidental Fall) AND (Community Dwelling OR Community Health Services OR Primary health care) AND (Risk OR Risk Assessment OR Fall Risk Factors) AND (Fall* OR Accidental Fall) AND (Community Dwelling OR older) AND Nurs* AND Fall Risk Factors.
RESULTS
The sample comprised 62 studies and 50 risk factors have been identified. Of these risk factors, only 38 are already listed in the classification.
CONCLUSIONS
Two new categories of risk factors are proposed: psychological and socio-economical. New fall risk factors for the community-dwelling elderly have been identified, which can contribute to the updating of this nursing diagnosis of the Taxonomy II of NANDA International.
Topics: Accidental Falls; Aged; Humans; Independent Living; Risk Factors
PubMed: 28273251
DOI: 10.1590/1983-1447.2016.04.55030 -
International Journal of Environmental... Nov 2021Exercise intervention has a positive effect on reducing the fall risk in older adults. To investigate the effect of different factors of exercise intervention (type,... (Meta-Analysis)
Meta-Analysis Review
Exercise intervention has a positive effect on reducing the fall risk in older adults. To investigate the effect of different factors of exercise intervention (type, duration, and frequency) on reducing the fall risk in older adults, a meta-analysis was performed in this study. According to the PRISMA, two researchers independently searched PubMed, Web of Science, and the China National Knowledge Infrastructure databases to assess the quality of the studies using the PEDro scale. A total of 648 subjects in 10 randomized controlled trials were included in this study, and the exercise interventions included integrated training (resistance training, core training, and balance training), balance training, core training, Pilates, Ba Duan Jin, and Tai Chi. These studies show that exercise intervention has a huge and significant impact on reducing the risk of falls of the elderly. In conclusion, an integrated intervention with a frequency of more than five times a week and a duration of more than 32 weeks are more effective in reducing the fall risk.
Topics: Accidental Falls; Aged; Exercise; Exercise Therapy; Humans; Randomized Controlled Trials as Topic; Tai Ji
PubMed: 34886293
DOI: 10.3390/ijerph182312562 -
Revista Brasileira de Enfermagem 2021to identify scientific productions on nursing care related to fall risk prevention among hospitalized elderly people. (Review)
Review
OBJECTIVE
to identify scientific productions on nursing care related to fall risk prevention among hospitalized elderly people.
METHODS
an integrative literature review from 2015 to 2019 in the PubMed/MEDLINE, Scopus, Web of Science, LILACS, BDENF, SciELO and CINAHL databases, in Portuguese, English and Spanish. The keywords were elderly, hospitalization, accidents due to falls, nursing care.
RESULTS
thirty-three publications were analyzed. The synthesis of the studies resulted in the categories: Clinical nursing assessments to prevent falls among hospitalized elderly people; Fall risk factors for elderly people; Fall risk prevention strategies for elderly people.
FINAL CONSIDERATIONS
it was found that the scientific knowledge produced on nursing care related to fall risk prevention for hospitalized elderly people evidences the clinical assessment, risk factors and strategies such as nursing care, contributing to foster self-care behavior and promotion security for elderly people.
Topics: Accidental Falls; Aged; Hospitalization; Humans; Nursing Care; Risk Factors
PubMed: 34231780
DOI: 10.1590/0034-7167-2020-0904 -
Wounds : a Compendium of Clinical... Oct 2019Falls are the leading cause of injury, premature institutionalization, and long-term disability in elderly adults worldwide, with a fall-related fatality in the United... (Observational Study)
Observational Study
Falls are the leading cause of injury, premature institutionalization, and long-term disability in elderly adults worldwide, with a fall-related fatality in the United States every 19 minutes.1 According to the Centers for Disease Control and Prevention,2 3 million people over 65 years of age receive emergency room treatment for fall injuries at an average cost of $30 000. The annual cost of fall injuries was more than $50 billion in 2015.1,2 Community-based interventions effective in preventing falls include exercise, medication, and nutritional management as well as improving safety of the local environment.3 Evidence supporting interventions designed to reduce hospital inpatient falls is less clear despite considerable research aimed at reducing this growing problem. Those injured due to falling during a hospital stay incur higher costs, including a 6-day longer hospital stay, than non-fallers.4 Programs have worked to prevent other "never events," such as wound infections or pressure ulcers, but mixed results have been reported for preventing falls or fall-related injuries in hospitals. This month's Evidence Corner reviews a randomized controlled trial (RCT)5 and a prospective observational study6 that offer important clues on how to prevent hospital inpatient falls.
Topics: Accidental Falls; Accidents, Home; Aged; Aged, 80 and over; Cost-Benefit Analysis; Decision Trees; Environment Design; Exercise; Humans; Independent Living; Patient Education as Topic; Prospective Studies; Randomized Controlled Trials as Topic; United States
PubMed: 31730506
DOI: No ID Found -
Latest Research Trends in Fall Detection and Prevention Using Machine Learning: A Systematic Review.Sensors (Basel, Switzerland) Jul 2021Falls are unusual actions that cause a significant health risk among older people. The growing percentage of people of old age requires urgent development of fall... (Review)
Review
Falls are unusual actions that cause a significant health risk among older people. The growing percentage of people of old age requires urgent development of fall detection and prevention systems. The emerging technology focuses on developing such systems to improve quality of life, especially for the elderly. A fall prevention system tries to predict and reduce the risk of falls. In contrast, a fall detection system observes the fall and generates a help notification to minimize the consequences of falls. A plethora of technical and review papers exist in the literature with a primary focus on fall detection. Similarly, several studies are relatively old, with a focus on wearables only, and use statistical and threshold-based approaches with a high false alarm rate. Therefore, this paper presents the latest research trends in fall detection and prevention systems using Machine Learning (ML) algorithms. It uses recent studies and analyzes datasets, age groups, ML algorithms, sensors, and location. Additionally, it provides a detailed discussion of the current trends of fall detection and prevention systems with possible future directions. This overview can help researchers understand the current systems and propose new methodologies by improving the highlighted issues.
Topics: Accidental Falls; Aged; Algorithms; Humans; Machine Learning; Quality of Life; Seasons
PubMed: 34372371
DOI: 10.3390/s21155134