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BMJ Open May 2024To report the prevalence and risk factors for the fear of falling (FOF) among older individuals living in residential care facilities in India.
Cross-sectional study of prevalence and correlates of fear of falling in the older people in residential care in India: the Hyderabad Ocular Morbidity in Elderly Study (HOMES).
OBJECTIVE
To report the prevalence and risk factors for the fear of falling (FOF) among older individuals living in residential care facilities in India.
DESIGN
Cross-sectional study.
SETTING
Homes for the aged centres in Hyderabad, India.
PARTICIPANTS
The study included individuals aged ≥60 years from homes for the aged centres. The participants underwent a comprehensive eye examination in make-shift clinics setup in homes. Trained investigators collected the personal and demographic information of the participants and administered the Patient Health Questionnaire-9 and Hearing Handicap Inventory for Elderly questionnaire in the vernacular language. FOF was assessed using the Short Falls Efficacy Scale. The presence of hearing and visual impairment in the same individual was considered dual sensory impairment (DSI). A multiple logistic regression analysis was done to assess the factors associated with FOF.
PRIMARY OUTCOME MEASURE
FOF.
RESULTS
In total, 867 participants were included from 41 homes for the aged centres in the analyses. The mean (±SD) age of the participants was 74.2 (±8.3) years (range 60-96 years). The prevalence of FOF was 56.1% (95% CI 52.7% to 59.4%; n=486). The multivariate analysis showed that those with DSI had eleven times higher odds of reporting FOF than those with no impairment (OR 11.14; 95% CI 3.15 to 41.4.) Similarly, those with moderate depression had seven times higher odds (OR 6.85; 95% CI 3.70 to 12.70), and those with severe depression had eight times higher odds (OR 8.13; 95% CI 3.50 to 18.90) of reporting FOF. A history of falls in the last year was also associated with increased odds for FOF (OR 1.52; 95% CI 1.03 to 2.26).
CONCLUSION
FOF is common among older individuals in residential care in India. Depression, falling in the previous year and DSI were strongly associated with FOF. A cross-disciplinary approach may be required to address FOF among the older people in residential care in India.
Topics: Humans; Cross-Sectional Studies; India; Accidental Falls; Aged; Male; Female; Fear; Aged, 80 and over; Prevalence; Middle Aged; Risk Factors; Homes for the Aged; Vision Disorders; Logistic Models; Surveys and Questionnaires
PubMed: 38806424
DOI: 10.1136/bmjopen-2023-080973 -
Clinical Interventions in Aging 2024Multiple sclerosis (MS) is a chronic inflammatory condition that causes demyelination of the central nervous system accompanied by a wide range of symptoms. The high... (Review)
Review
Multiple sclerosis (MS) is a chronic inflammatory condition that causes demyelination of the central nervous system accompanied by a wide range of symptoms. The high prevalence of falls among patients diagnosed with MS within the initial six months highlights the importance of this issue. The objective of this study is to identify factors associated with falls in MS patients in order to increase awareness and reduce the risk of falls. This scoping review used specific Mesh terms to formulate the literature search around falls and MS using Medline, Google Scholar, Scopus, and Embase search engines. English papers published between 2012 and 2022, studies with a clear definition of falls, McDonald's diagnostic criteria for MS, and those with Expanded Disability Status Scale (EDSS) or Patient Determined Disease Steps (PDDS) scores were included. Critical data from the selected articles were extracted and classified according to the different factors associated with falls in MS patients. Eighteen articles were included in this review. The most important factors associated with falls in MS patients identified were the severity and progression of the disease, mobility and balance problems, bladder dysfunction, fear of falling, fatigue, and cognitive dysfunction. In conclusion, this scoping review yielded the most common factors associated with falls in patients with MS. Study findings can be used to develop future interventions focusing on improving mobility, proprioception, and balance to decrease fall risk and injury amongst MS patients.
Topics: Humans; Accidental Falls; Multiple Sclerosis; Postural Balance; Risk Factors; Fear; Fatigue; Disease Progression; Cognitive Dysfunction; Severity of Illness Index
PubMed: 38803468
DOI: 10.2147/CIA.S460475 -
Journal of Bone and Mineral Metabolism May 2024Patients with multiple sclerosis (MS) commonly present musculoskeletal disorders characterized by lower bone mineral density (BMD) and muscle weakness. However, the...
INTRODUCTION
Patients with multiple sclerosis (MS) commonly present musculoskeletal disorders characterized by lower bone mineral density (BMD) and muscle weakness. However, the underlying etiology remains unclear. Our objective is to identify shared pleiotropic genetic effects and estimate the causal relationship between MS and musculoskeletal disorders.
MATERIALS AND METHODS
We conducted linkage disequilibrium score regression (LDSR), colocalization, and Mendelian randomization (MR) analyses using summary statistics from recent large-scale genome-wide association studies (GWAS), encompassing MS, falls, fractures, and frailty. Additional MR analyses explored the causal relationship with musculoskeletal risk factors, such as BMD, lean mass, grip strength, and vitamin D.
RESULTS
We observed a moderate genetic correlation between MS and falls (RG = 0.10, P-value = 0.01) but not between MS with fracture or frailty in the LDSR analyses. MR revealed MS had no causal association with fracture and frailty but a moderate association with falls (OR: 1.004, FDR q-value = 0.018). We further performed colocalization analyses using nine SNPs that exhibited significant associations with both MS and falls in MR. Two SNPs (rs7731626 on ANKRD55 and rs701006 on OS9 gene) showed higher posterior probability of colocalization (PP.H4 = 0.927), suggesting potential pleiotropic effects between MS and falls. The nine genes are associated with central nervous system development and inflammation signaling pathways.
CONCLUSION
We found potential pleiotropic genetic effects between MS and falls. However, our analysis did not reveal a causal relationship between MS and increased risks of falls, fractures, or frailty. This suggests that the musculoskeletal disorders frequently reported in MS patients in clinical studies are more likely attributed to secondary factors associated with disease progression and treatment, rather than being directly caused by MS itself.
Topics: Humans; Accidental Falls; Mendelian Randomization Analysis; Multiple Sclerosis; Frailty; Genome-Wide Association Study; Fractures, Bone; Polymorphism, Single Nucleotide; Risk Factors; Bone Density; Linkage Disequilibrium; Female
PubMed: 38801451
DOI: 10.1007/s00774-024-01504-8 -
Revista Medica de Chile Jun 2023Functional tests are a fundamental axis in assessing the risk of falls in older adults. However, many of them lack associative value with the actual functional status of...
BACKGROUND AND PURPOSE
Functional tests are a fundamental axis in assessing the risk of falls in older adults. However, many of them lack associative value with the actual functional status of the older adults, medical history, and comorbidities.
METHODS
Analytical study with cross-sectional design. Three functional tests were performed (Timed Up & Go, Five Times Sit to Stand Test, and Unipodal Station Test) in 148 independent older adults (mean = 74.8 SD = 7.2), 83 non-fallers, and 58 with self-reported accidental falls in the last year. Other factors, such as grip strength and abdominal circumference, were considered.
RESULTS AND DISCUSSION
The functional tests presented associative value in older adults with a history of falls (p < 0.05). The grip strength has a statistically significant correlation between both groups. Functional tests can discriminate the risk of falls in independent older adults and those with similar comorbidities.
CONCLUSION
The three functional tests applied show associative values in falling older adults. The grip strength presented associative value with the functional tests.
Topics: Humans; Accidental Falls; Cross-Sectional Studies; Aged; Male; Female; Hand Strength; Geriatric Assessment; Aged, 80 and over; Risk Factors; Risk Assessment; Reference Values
PubMed: 38801375
DOI: 10.4067/s0034-98872023000600677 -
Sensors (Basel, Switzerland) May 2024Payloads for light unmanned free balloons must meet several safety requirements such as being able to protect the inner electronics in order to extract scientific data...
Payloads for light unmanned free balloons must meet several safety requirements such as being able to protect the inner electronics in order to extract scientific data and to reduce the chance of inflicting personal injury in case of an accidental fall. This article proposes a novel payload structure, which exhibits the form of a dodecahedron. The actual form was determined by carrying out theoretical drop tests on different polyhedrons using the finite element method (FEM). From the simulations, it could be deduced that the dodecahedron was the optimal choice, since the duration of the impact was longer, while the impact force was slightly lower. The payload was produced by additive technologies; therefore, after performing tensile tests on probable materials, PLA was selected as the optimal candidate. The theoretical results about the dodecahedron's ability were validated by laboratory and real-life drop tests, where the new payload was subjected to 56% less impact force under a 78% longer collision time compared to a classic, rectangular cuboid design. Based on these tests, it was demonstrated that the new structure is safer and it is applicable.
PubMed: 38794037
DOI: 10.3390/s24103182 -
Medicine May 2024Horseback riding requires adapting to constant changes in balance conditions, maintaining equilibrium on the horse, and preventing falls. However, differences in balance...
Horseback riding requires adapting to constant changes in balance conditions, maintaining equilibrium on the horse, and preventing falls. However, differences in balance performance among horseback riders and non-rider-healthy young women in Saudi Arabia have not been explored. This study investigates whether horseback-rider women would perform better on static and dynamic balance tests than non-rider women. Also, the study examined the effect of years of horseback riding on balance performance in the rider group. Twenty healthy young females participated in the study using a convenience sampling method. Ten were riders, and ten were non-riders. Static and dynamic balance tests, including the Berg balance scale (BBS), timed up and go (TUG), and unipedal stance test (UPST), was obtained from all subjects. Descriptive and inferential statistics were used to compare balance performance between the horseback riders and non-riders groups. The horseback-rider group had statistically significantly higher scores on both the static and dynamic tests than non-riders: BBS test (Z = -2.537, P = .011), TUG (t = -3.889, P = .001), and unipedal stance test with the eyes open and closed (t = 14.048, t = 13.639, P = .000). Our rider sample did not show a statistically significant correlation between years of riding and balance scores. The horseback riders have greater static and dynamic balance abilities than non-riders. Further study is needed to compare the balance performance between experienced riders versus beginners among healthy adults in Saudi Arabia.
Topics: Female; Postural Balance; Humans; Saudi Arabia; Cross-Sectional Studies; Young Adult; Horses; Adult; Animals; Accidental Falls
PubMed: 38788034
DOI: 10.1097/MD.0000000000038291 -
PloS One 2024Falls in older individuals are a serious health issue in super-aged societies. The stepping reaction is an important postural strategy for preventing falls. This study...
Falls in older individuals are a serious health issue in super-aged societies. The stepping reaction is an important postural strategy for preventing falls. This study aimed to reveal the characteristics of lateral stepping in response to mechanical disturbance by means of an analysis of the hip joint kinematics in the stepping leg and head stability during crossover steps. The participants included 11 healthy older and 13 younger individuals. An electromagnet-controlled disturbance-loading device induced crossover steps due to lateral disturbance. Responses were measured using a motion capture system and force plates. The righting reaction of the head was quantified by lateral displacement (sway), neck joint kinematics (angle displacement, angular velocity), and neck joint moment during crossover stepping. Moreover, the relationship between the neck lateral bending moment and angular velocity of hip flexion/adduction of the stepping leg was examined. The lateral head sway was significantly larger in the older participants (1.13±0.7 m/s2) than in the younger individuals (0.54±0.3 m/s2); whereas, the angle displacement (older -14.1±7.1 degree, young -8.3±4.5 degree) and angular velocity (older 9.9±6.6 degree/s, 41.2±27.7 degree/s) of the head were significantly lower in the older than in the younger participants. In both groups, the moment of neck lateral bending exhibited a significant negative correlation with the hip flexion angular velocity of the stepping leg. Correlation analysis also showed a significant negative correlation between the neck lateral bending moment and hip adduction angular velocity only in the older group (r = 0.71, p<0.01). In conclusion, older individuals increased instability in the lateral direction of the head and decreased righting angle displacement and angular velocity of the head during crossover steps. The correlation between neck moment and hip flexion/adduction angular velocity suggested a decrease in step speed due to increased neck muscle tone, which could be influenced by vestibulospinal reflexes.
Topics: Humans; Biomechanical Phenomena; Hip Joint; Male; Aged; Female; Aging; Head; Adult; Postural Balance; Young Adult; Accidental Falls; Walking
PubMed: 38787885
DOI: 10.1371/journal.pone.0299850 -
PloS One 2024Falls are one of the leading causes of non-disease death and injury in the elderly, often due to delayed sensory neural feedback essential for balance. This delay,...
Delayed center of mass feedback in elderly humans leads to greater muscle co-contraction and altered balance strategy under perturbed balance: A predictive musculoskeletal simulation study.
Falls are one of the leading causes of non-disease death and injury in the elderly, often due to delayed sensory neural feedback essential for balance. This delay, challenging to measure or manipulate in human studies, necessitates exploration through neuromusculoskeletal modeling to reveal its intricate effects on balance. In this study, we developed a novel three-way muscle feedback control approach, including muscle length feedback, muscle force feedback, and enter of mass feedback, for balancing and investigated specifically the effects of center of mass feedback delay on elderly people's balance strategies. We conducted simulations of cyclic perturbed balance at different magnitudes ranging from 0 to 80 mm and with three center of mass feedback delays (100, 150 & 200 ms). The results reveal two key points: 1) Longer center of mass feedback delays resulted in increased muscle activations and co-contraction, 2) Prolonged center of mass feedback delays led to noticeable shifts in balance strategies during perturbed standing. Under low-amplitude perturbations, the ankle strategy was predominantly used, while higher amplitude disturbances saw more frequent employment of hip and knee strategies. Additionally, prolonged center of mass delays altered balance strategies across different phases of perturbation, with a noticeable increase in overall ankle strategy usage. These findings underline the adverse effects of prolonged feedback delays on an individual's stability, necessitating greater muscle co-contraction and balance strategy adjustment to maintain balance under perturbation. Our findings advocate for the development of training programs tailored to enhance balance reactions and mitigate muscle feedback delays within clinical or rehabilitation settings for fall prevention in elderly people.
Topics: Humans; Postural Balance; Aged; Muscle Contraction; Muscle, Skeletal; Accidental Falls; Male; Computer Simulation; Models, Biological; Female; Biomechanical Phenomena
PubMed: 38787871
DOI: 10.1371/journal.pone.0296548 -
Clinical and Experimental Emergency... May 2024This study aimed to investigate the characteristics and epidemiological trends of pediatric injuries among patients visiting emergency departments (EDs) on Jeju Island.
OBJECTIVE
This study aimed to investigate the characteristics and epidemiological trends of pediatric injuries among patients visiting emergency departments (EDs) on Jeju Island.
METHOD
Employing a community-level serial cross-sectional analysis, we targeted pediatric patients aged 18 years or younger who visited EDs for injuries over a ten-year period. The data, sourced from the Jeju Injury Surveillance System (JISS), facilitated a comprehensive examination of injury characteristics and epidemiological trends. This included an evaluation of the annual incidence and overall trends in pediatric injury cases.
RESULTS
The study found toddlers (42.5% of cases) to be the most frequently injured age group. Males were more prone to injuries, with a male-to-female ratio of 1.7:1. Injuries among visitors accounted for 17.3% of cases, with a seasonal spike in Summer, evenings and weekends. Most incidents occurred at home, predominantly accidental in nature, with adolescents more likely to require EMS services. The common mechanisms of injuries were blunt force (49.2%), slips/falls (22.0%), and motor vehicle collisions (13.2%), leading to bruises, cuts, and sprains. Over the decade, a general increase in pediatric injuries was observed. Accidental injuries initially surged but later stabilized, while self-harm/suicide and assault/violence injuries showed a concerning upward trend. Age-specific analysis revealed increasing trends in infants and adolescents.
CONCLUSION
The study underscores the crucial need for targeted injury prevention and resource allocation strategies, particularly for high-risk groups and times, to effectively mitigate pediatric trauma on Jeju Island.
PubMed: 38778491
DOI: 10.15441/ceem.24.203 -
Age and Ageing May 2024Fall prevention is a global health priority. Strength and balance exercise programmes are effective at reducing falls. Emerging literature suggests dance is an enjoyable... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Fall prevention is a global health priority. Strength and balance exercise programmes are effective at reducing falls. Emerging literature suggests dance is an enjoyable and sociable form of exercise. However, there is little evidence that dance reduces fall incidence.
METHODS
Systematic review and meta-analysis examining effectiveness and cost-effectiveness of dance for falls prevention in older adults. Five databases were searched with no restrictions on publication date or intervention settings. Risk of bias was assessed using variants of Cochrane Risk of bias tools, Mixed-Methods Appraisal and Drummond checklist as appropriate. Certainty of evidence was assessed using GRADE.
RESULTS
Forty-one studies were included (19 RCTs, 13 quasi-experimental, two mixed-method, seven observational studies, 2,451 participants). Five types of dance interventions were identified: ballroom and Latin dance, dance exercise, cultural dance, dance therapy, and low-impact dance. Meta-analysis was only possible for functional outcome measures: Timed-Up-and-Go (dance versus usual care, mean difference (MD) = 1.36; 95% CI -3.57 to 0.85), Sit-to-Stand (dance versus exercise MD = -0.85; 95% CI -2.64 to 0.93: dance versus education MD = -1.64; 95% CI -4.12 to 0.85), Berg Balance Scale (dance versus usual care MD = 0.61; 95% CI -4.26 to 5.47). There was unexplained variance in effects and no significant differences between intervention and control groups. Overall, certainty of evidence was very low; we are uncertain about the effect of dance interventions in reducing falls.
CONCLUSIONS
There is very low certainty evidence for dance as an alternative to strength and balance training if the aim is to prevent falls. No robust evidence on the cost-effectiveness of dance interventions for the prevention of falls was found.
PROSPERO REGISTRATION
CRD42022382908.
Topics: Humans; Accidental Falls; Aged; Dance Therapy; Dancing; Cost-Benefit Analysis; Male; Female; Postural Balance; Treatment Outcome; Risk Factors; Age Factors; Aged, 80 and over
PubMed: 38776214
DOI: 10.1093/ageing/afae104