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BMC Public Health Jun 2024Falls are common in the elderly and can lead to adverse consequences, like injuries, hospitalization, disability even mortality. Successful ageing emerged in sight to...
BACKGROUND
Falls are common in the elderly and can lead to adverse consequences, like injuries, hospitalization, disability even mortality. Successful ageing emerged in sight to assess physical, psychological and social status of older adults. This study is conducted to explore the association between them in a large Indian community-dwelling population.
METHODS
Data were based on the wave 1 survey of the Longitudinal Ageing Study in India (LASI). People aged 60 and above with complete information were included. The elderly met five standards including absence of chronic diseases, freedom from disability, high cognitive ability, free from depressive symptoms and active social engagement, were classified into successful agers. The assessment of falls, fall-related injuries and multiple falls depended on interview. Multivariate logistic regression was conducted to find the associations between falls, fall-injury, multiple falls and successful ageing after adjusting both socio-demographic and biological covariates. The log-likelihood ratio test was calculated interactions in subgroups.
RESULTS
31,345 participants in LASI were finally included in our study. Of them, 20.25% reported fall, and 25% were classified into successful agers. After full adjustment, successful ageing was negatively associated with falls (OR 0.70; 95%CI 0.65-0.76) and multiple falls (OR 0.70; 95%CI 0.63-0.78). And the association did not show the significance in older adults with fall-related injuries (OR 0.86; 95%CI 0.72-1.04).
CONCLUSIONS
Successful ageing was negatively associated with falls and multiple falls, but not fall-related injuries in older people in India. Future studies are demanded to explore the causal relationship and to reveal the underlying mechanism.
Topics: Humans; Accidental Falls; India; Male; Female; Aged; Middle Aged; Cross-Sectional Studies; Longitudinal Studies; Aged, 80 and over; Aging; Risk Factors
PubMed: 38914970
DOI: 10.1186/s12889-024-19181-7 -
PloS One 2024Environmental factors resulting from climate change and air pollution are risk factors for many chronic conditions including dementia. Although research has shown the... (Review)
Review
Environmental factors resulting from climate change and air pollution are risk factors for many chronic conditions including dementia. Although research has shown the impacts of air pollution in terms of cognitive status, less is known about the association between climate change and specific health-related outcomes of older people living with dementia. In response, we outline a scoping review protocol to systematically review the published literature regarding the evidence of climate change, including temperature and weather variability, on health-related quality of life, morbidity, mobility, falls, the utilization of health resources, and mortality among older adults living with dementia. This scoping review will be guided by the framework proposed by Arksey and O'Malley. Electronic search (Medline, Embase, PsycINFO, CINAHL, Scopus, Web of Science) using relevant subject headings and synonyms for two concepts (older people with dementia, weather/ climate change). No publication date or other restrictions will be applied to the search strategy. No language restriction will be applied in order to understand the impact of non-English studies in the literature. Eligible studies must include older adults (65+years) with dementia living in the community and investigate the impacts of climate change and/or weather on their health-related quality of life, morbidity, mobility, falls, use of health resources and mortality. Two independent reviewers will screen abstracts and select those for a full-text review, perform these reviews, select articles for retention, and extract data from them in a standardized manner. This data will then be synthesized and interpreted. OSF registration: DOI: 10.17605/OSF.IO/YRFM8.
Topics: Humans; Climate Change; Dementia; Weather; Quality of Life; Aged; Accidental Falls
PubMed: 38913693
DOI: 10.1371/journal.pone.0304181 -
Disability and Rehabilitation Jun 2024To identify the factors associated with the fear of falling (FOF) and fall-related injuries (FRI) among full-time wheelchair and motorized mobility scooter (WC/S) users...
PURPOSE
To identify the factors associated with the fear of falling (FOF) and fall-related injuries (FRI) among full-time wheelchair and motorized mobility scooter (WC/S) users with various health conditions.
METHODS
This cross-sectional study included participants (≥18 years old) who used WC/S for at least one year for ≥ 75% of mobility and had a history of ≥ 1 fall in the past three years. Logistic regression models identified factors associated with FOF (yes/no) and FRI (yes/no) during the past year. Data on demographics, prior falls, mental health, environmental accessibility, and WC/S usage were used as independent variables.
RESULTS
Among 156 participants, 96% reported at least one fall within the past year, among whom 94.6% reported FOF, and 74% reported FRI within the same period. FOF was associated with fall incidence in the past year (OR = 17.75, = 0.001). FRI was associated with higher levels of anxiety (OR = 1.15, = 0.003) and fewer hours of WC/S use per week (OR = 0.98, = 0.012).
CONCLUSION
This study highlights the high prevalence of FOF and FRI among WC/S users who had falls. The findings emphasized the relation between prior fall experiences and FOF and underscored the significance of addressing anxiety symptoms and WC/S usage in relation to FRI.
PubMed: 38910322
DOI: 10.1080/09638288.2024.2365984 -
The National Medical Journal of India 2023Numerous studies have investigated the causes of falls in the elderly. However, there is little information about metabolic syndrome (MS) as a risk factor for falls in... (Review)
Review
Numerous studies have investigated the causes of falls in the elderly. However, there is little information about metabolic syndrome (MS) as a risk factor for falls in older adults. No evaluations have given a qualitative overview of studies examining the relationship between MS and falls in the elderly. We did a literature search in electronic databases to look for studies that assessed a link between MS and falls among people over the age of 55 years. We found three studies of high quality. These included 2774 people with an average age of 72 years. Even after controlling for other risk factors, two studies found that MS was significantly associated with an older adult's 1.3-2.5-fold increased risk of falling. We found that MS and its independent components were strongly linked with falls among the elderly, even after correcting for numerous variables.
Topics: Humans; Accidental Falls; Metabolic Syndrome; Aged; Risk Factors; Middle Aged; Female; Male
PubMed: 38909297
DOI: 10.25259/NMJI_944_2021 -
Journal of Neuroengineering and... Jun 2024Falls are common in a range of clinical cohorts, where routine risk assessment often comprises subjective visual observation only. Typically, observational assessment...
BACKGROUND
Falls are common in a range of clinical cohorts, where routine risk assessment often comprises subjective visual observation only. Typically, observational assessment involves evaluation of an individual's gait during scripted walking protocols within a lab to identify deficits that potentially increase fall risk, but subtle deficits may not be (readily) observable. Therefore, objective approaches (e.g., inertial measurement units, IMUs) are useful for quantifying high resolution gait characteristics, enabling more informed fall risk assessment by capturing subtle deficits. However, IMU-based gait instrumentation alone is limited, failing to consider participant behaviour and details within the environment (e.g., obstacles). Video-based eye-tracking glasses may provide additional insight to fall risk, clarifying how people traverse environments based on head and eye movements. Recording head and eye movements can provide insights into how the allocation of visual attention to environmental stimuli influences successful navigation around obstacles. Yet, manual review of video data to evaluate head and eye movements is time-consuming and subjective. An automated approach is needed but none currently exists. This paper proposes a deep learning-based object detection algorithm (VARFA) to instrument vision and video data during walks, complementing instrumented gait.
METHOD
The approach automatically labels video data captured in a gait lab to assess visual attention and details of the environment. The proposed algorithm uses a YoloV8 model trained on with a novel lab-based dataset.
RESULTS
VARFA achieved excellent evaluation metrics (0.93 mAP50), identifying, and localizing static objects (e.g., obstacles in the walking path) with an average accuracy of 93%. Similarly, a U-NET based track/path segmentation model achieved good metrics (IoU 0.82), suggesting that the predicted tracks (i.e., walking paths) align closely with the actual track, with an overlap of 82%. Notably, both models achieved these metrics while processing at real-time speeds, demonstrating efficiency and effectiveness for pragmatic applications.
CONCLUSION
The instrumented approach improves the efficiency and accuracy of fall risk assessment by evaluating the visual allocation of attention (i.e., information about when and where a person is attending) during navigation, improving the breadth of instrumentation in this area. Use of VARFA to instrument vision could be used to better inform fall risk assessment by providing behaviour and context data to complement instrumented e.g., IMU data during gait tasks. That may have notable (e.g., personalized) rehabilitation implications across a wide range of clinical cohorts where poor gait and increased fall risk are common.
Topics: Deep Learning; Accidental Falls; Humans; Risk Assessment; Walking; Male; Female; Adult; Eye-Tracking Technology; Eye Movements; Gait; Video Recording; Young Adult
PubMed: 38909239
DOI: 10.1186/s12984-024-01400-2 -
Annals of the Academy of Medicine,... Jun 2023
Topics: Humans; Accidental Falls; Osteoporosis; Frail Elderly; Emergency Service, Hospital; Aged; Female; Male; Aged, 80 and over; Singapore; Osteoporotic Fractures
PubMed: 38904515
DOI: 10.47102/annals-acadmedsg.2022400 -
Current Aging Science 2024The incidence of elderly people experiencing falls is currently increasing, which results in serious medical issues, such as fear of falling, limited physical activity,...
BACKGROUND
The incidence of elderly people experiencing falls is currently increasing, which results in serious medical issues, such as fear of falling, limited physical activity, disability, and bone fractures, especially hip fractures. This study aimed to investigate balancing ability using a multi-directional reach test (MDRT) in older adults with and without diabetes mellitus.
METHODS
72 older adults with and without diabetes mellitus were recruited, and divided into two groups, including older adults without diabetes mellitus (n = 36) and older adults with diabetes mellitus (n = 36). All subjects completed all directions of the MDRT.
RESULTS
There were no significant differences in MDRT scores in all directions between the two groups (p>0.05). Both groups achieved the highest MDRT scores in the forward direction. In contrast, the two groups had the lowest scores of MDRT in a backward direction. Furthermore, older adults with diabetes mellitus had lower MDRT scores in all directions than older adults without diabetes mellitus.
CONCLUSION
The current study indicated that MDRT could be used to investigate the ability of balance in individuals with diabetes mellitus.
Topics: Humans; Aged; Male; Female; Diabetes Mellitus; Postural Balance; Geriatric Assessment; Accidental Falls; Aged, 80 and over; Age Factors; Aging; Case-Control Studies; Predictive Value of Tests
PubMed: 38904153
DOI: 10.2174/0118746098253144231024052312 -
International Journal of Medical... 2024Predicting fall injuries can mitigate the sequelae of falls and potentially utilize medical resources effectively. This study aimed to externally validate the accuracy... (Observational Study)
Observational Study
Predicting fall injuries can mitigate the sequelae of falls and potentially utilize medical resources effectively. This study aimed to externally validate the accuracy of the Saga Fall Injury Risk Model (SFIRM), consisting of six factors including age, sex, emergency transport, medical referral letter, Bedriddenness Rank, and history of falls, assessed upon admission. This was a two-center, prospective, observational study. We included inpatients aged 20 years or older in two hospitals, an acute and a chronic care hospital, from October 2018 to September 2019. The predictive performance of the model was evaluated by calculating the area under the curve (AUC), 95% confidence interval (CI), and shrinkage coefficient of the entire study population. The minimum sample size of this study was 2,235 cases. A total of 3,549 patients, with a median age of 78 years, were included in the analysis, and men accounted for 47.9% of all the patients. Among these, 35 (0.99%) had fall injuries. The performance of the SFIRM, as measured by the AUC, was 0.721 (95% CI: 0.662-0.781). The observed fall incidence closely aligned with the predicted incidence calculated using the SFIRM, with a shrinkage coefficient of 0.867. The external validation of the SFIRM in this two-center, prospective study showed good discrimination and calibration. This model can be easily applied upon admission and is valuable for fall injury prediction.
Topics: Humans; Accidental Falls; Male; Female; Aged; Prospective Studies; Middle Aged; Risk Assessment; Aged, 80 and over; Adult; Risk Factors; Wounds and Injuries; Incidence; Young Adult
PubMed: 38903917
DOI: 10.7150/ijms.92837 -
Disability and Rehabilitation Jun 2024To translate the Berg Balance Scale (BBS) to Hungarian and to evaluate the psychometric characteristics of the Hungarian version (HU-BBS).
PURPOSE
To translate the Berg Balance Scale (BBS) to Hungarian and to evaluate the psychometric characteristics of the Hungarian version (HU-BBS).
METHODS
In total, 150 institutionalised older adults were recruited for the study. Eighty-one participants completed the retesting. Internal consistency, intra- and inter-rater reliability, and 95% limits of agreement of the HU-BBS were examined. Construct validity was assessed through convergent, discriminant, and known-group validity.
RESULTS
The overall Cronbach's alpha was 0.943. The intra- and inter-rater reliability was excellent (intraclass correlation coefficient > 0.92). The Bland-Altman analysis revealed a mean inter-rater difference of 0.284 [-2.193-2.744] and a mean intra-rater difference of 0.259 [-2.657-3.162]. Regarding convergent validity, the HU-BBS was correlated with the functional status ( = 0.833), Timed Up and Go test (r= -0.824), and age (r= -0.606). The HU-BBS scores of women were similar to those of men ( = 0.104), showing discriminant validity. Additionally, the HU-BBS scores were lower among faller than among non-faller participants ( ˂ 0.0001), establishing known-group validity.
CONCLUSIONS
Translation and cultural adaptation of the original scale was successful. The HU-BBS proved to be a reliable, valid tool confirming that it can be used in future clinical and scientific work on Hungarian older adults.Implications for rehabilitationInstitutionalised older adults are vulnerable and at a high risk of developing further decline in postural control, contributing to an increase in limited functional mobility and risk for falls.The Berg Balance Scale is a widely used tool originally developed to measure postural control in older adults.The Hungarian version of the Berg Balance Scale tested on institutionalised older adults shows excellent test-retest reliability, good internal consistency, and acceptable convergent construct validity.The Hungarian version of the Berg Balance Scale is a valid and reliable tool for measuring postural control among Hungarian-speaking institutionalised older adults both in clinical practice and scientific studies.
Topics: Humans; Female; Male; Postural Balance; Hungary; Aged; Reproducibility of Results; Psychometrics; Aged, 80 and over; Geriatric Assessment; Cross-Cultural Comparison; Translations; Translating; Accidental Falls; Institutionalization
PubMed: 38896556
DOI: 10.1080/09638288.2023.2232717 -
International Journal of Older People... Jul 2024Fall hazards in bathroom spaces constitute one of the most critical issues in the daily lives of older adults. Bathroom falls are somewhat different and constrained in...
BACKGROUND
Fall hazards in bathroom spaces constitute one of the most critical issues in the daily lives of older adults. Bathroom falls are somewhat different and constrained in nature than those in other parts of a home environment.
OBJECTIVES
This study aimed to adopt a user-centred approach to explore older adults' general bathroom needs, with a specific focus on showers and bathtubs as the designated activity area.
METHODS
The authors employed an extended importance-performance analysis (IPA) with a mixed-method research design. Three hundred and eleven older adults participated in a face-to-face IPA questionnaire for the quantitative phase of the study. The authors gathered the qualitative data through open-ended questions from 59 older adults.
RESULTS
The authors found positive correlation between older adults' attitudes towards an older-friendly bathroom and the potential for their bathrooms to be fall-free. The IPA calculations identify three key items with higher ratings in both importance and performance: The presence of appropriate artificial lighting, efficient mechanical ventilation and an accessible inside towel rail. Thematic analysis yields four themes: comfort, ease of access, error-proof design and emergency management.
CONCLUSIONS
The IPA calculations and thematic analysis confirm that older adults' rankings of importance and performance and their corresponding priority levels within the overarching themes indicate the need for these aspects to perform well and justify ongoing investments. The study concludes that addressing fall prevention requires not only designing specific solutions but also utilising appropriate technology in bathing and toileting activities.
IMPLICATIONS FOR PRACTICE
Practitioners in geriatric and gerontological nursing, design, architecture and health care can use the importance and performance priority levels of older adults to guide the development and implementation of fall-free bathroom design. Policymakers can leverage the insights from this research to inform guidelines and regulations related to building codes, accessibility standards and healthcare policies.
Topics: Humans; Aged; Accidental Falls; Male; Female; Toilet Facilities; Aged, 80 and over; Surveys and Questionnaires; User-Centered Design
PubMed: 38895910
DOI: 10.1111/opn.12623