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BMC Geriatrics May 2023This study systematically reviewed injury death and causes in the elderly population in China from 2000 to 2020, to prevent or reduce the occurrence of injuries and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
This study systematically reviewed injury death and causes in the elderly population in China from 2000 to 2020, to prevent or reduce the occurrence of injuries and death.
METHODS
The CNKI, VIP, Wan Fang, MEDLINE, Embase, SinoMed, and Web of Science databases were searched to collect epidemiological characteristics of injury death among elderly over 60 years old in China from January 2000 to December 2020. Random effects meta-analysis was performed to pool injury mortality rate and identify publication bias, with study quality assessed using the AHRQ risk of bias tool.
RESULTS
(1) A total of 41 studies with 187 488 subjects were included, covering 125 million elderly. The pooled injury mortality rate was 135.58/10 [95%CI: (113.36 to 162.14)/10], ranking second in the total death cause of the elderly. (2)Subgroup analysis showed that male injury death (146.00/10) was significantly higher than that of females (127.90/10), and overall injury mortality increased exponentially with age (R = 0.957), especially in those over 80 years old; the spatial distribution shows that the injury death rate in the central region is higher than that in the east and west and that in the countryside is higher than that in the city; the distribution of death time shows that after entering an aging society (2000-2020) is significantly higher than before (1990-2000). (3) There are more than 12 types of injury death, and the top three are falling, traffic accidents, and suicide.
CONCLUSIONS
China's elderly injury death rate is at a high level in the world, with more males than females, especially after the age of 80. There are regional differences. The main types of injury death are falling, traffic, and suicide. During the 14th Five-Year Plan period, for accidental injuries and death, a rectification list for aging and barrier-free environments was issued.
PROSPERO REGISTRATION
The systematic review was registered in PROSPERO under protocol number CRD42022359992.
Topics: Aged; Aged, 80 and over; Female; Humans; Male; Accidents, Traffic; Big Data; China; East Asian People; Prevalence; Accidental Falls; Suicide, Completed
PubMed: 37259039
DOI: 10.1186/s12877-023-04056-0 -
Age and Ageing May 2023The 16-item Falls Efficacy Scale International (FES-I) is widely used to assess concerns-about-falling. Variants include 7-item Short FES-I, 30-item Iconographical Falls... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The 16-item Falls Efficacy Scale International (FES-I) is widely used to assess concerns-about-falling. Variants include 7-item Short FES-I, 30-item Iconographical Falls Efficacy Scale (Icon FES) and 10-item short Icon FES. No comprehensive systematic review and meta-analysis has been conducted to synthesise evidence regarding the measurement properties of these tools.
OBJECTIVES
To conduct a systematic review and meta-analysis of the measurement properties of four FES-I variants.
METHODS
MEDLINE, Embase, CINAHL Plus, PsycINFO and Web of Science were searched systematically and articles were assessed for eligibility independently. The methodological quality of eligible studies was assessed using COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist. The quality of measurement properties was assessed using COSMIN criteria for good measurement properties. Where possible, meta-analysis was conducted; otherwise, narrative synthesis was performed. Overall certainty of evidence was rated using a modified Grading of Recommendations, Assessment, Development and Evaluation system approach.
RESULTS
The review included 58 studies investigating measurement properties of the four instruments. There was high-quality evidence to support internal consistency, reliability and construct validity of all instruments. Moderate- to high-certainty evidence suggests one-factor structure of FES-I with two underlying dimensions, one-factor structure of Short FES-I and two-factor structure of Icon FES. There was high-certainty evidence to support the responsiveness of FES-I, with further research needed for the other instruments.
CONCLUSION
There is evidence for excellent measurement properties of all four instruments. We recommend the use of these tools with healthy older people and people at a greater risk of falls due to conditions that might affect mobility and balance.
Topics: Humans; Aged; Accidental Falls; Psychometrics; Reproducibility of Results; Health Status; Checklist
PubMed: 37211363
DOI: 10.1093/ageing/afad055 -
BMC Primary Care May 2023With the ageing population worldwide, falls are becoming a severe and growing health problem. Interprofessional multifactorial fall prevention interventions (FPIs) have...
BACKGROUND
With the ageing population worldwide, falls are becoming a severe and growing health problem. Interprofessional multifactorial fall prevention interventions (FPIs) have effectively prevented falls in community-dwelling older adults. However, the implementation of FPIs often fails due to a lack of interprofessional collaboration. Therefore, gaining insight into the influencing factors of interprofessional collaboration in multifactorial FPI's for older adults living in the community is essential. Consequently, our aim was to provide an overview of factors influencing interprofessional collaboration in multifactorial FPIs for community-dwelling older adults.
METHODS
This qualitative systematic literature research was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Pubmed, CINAHL, and Embase electronic databases have been systematically searched for eligible articles, with a qualitative design. The quality was appraised using the Checklist for Qualitative Research by the Joann Briggs Institute. The findings were inductively synthesized using a meta-aggregative approach. Confidence in the synthesized findings was established using the ConQual methodology.
RESULTS
Five articles were included. Analysis of the included studies resulted in 31 influencing factors for interprofessional collaboration, which were labelled as findings. These findings were summarized in ten categories and combined into five synthesized findings. Results showed that communication, role clarity, information sharing, organization, and interprofessional aim influence interprofessional collaboration in multifactorial FPIs.
CONCLUSIONS
This review provides a comprehensive summary of findings on interprofessional collaboration, specifically in the context of multifactorial FPIs. Knowledge in this area is considerably relevant given the multifactorial nature of falls, which demands an integrated, multidomain approach, including both health and social care. The results can be utilized as a fundament for developing effective implementation strategies aiming to improve interprofessional collaboration between health and social care professionals working in multifactorial FPIs in the community.
Topics: Accidental Falls; Communication; Qualitative Research; Independent Living; Information Dissemination
PubMed: 37193995
DOI: 10.1186/s12875-023-02066-w -
JPMA. the Journal of the Pakistan... Feb 2023To explore the occupational safety and health of fishermen in coastal areas, and the causes and health problems experienced by them.
OBJECTIVES
To explore the occupational safety and health of fishermen in coastal areas, and the causes and health problems experienced by them.
METHOD
The systematic review was conducted in February 2021, and comprised search on Google Cendekia, ScienceDirect, ProQuest, PubMed and BioMed Central databases for relevant studies published in English or Indonesian from 2016 to February 2021. The key words used were fisheries, fishermen, occupational, safety and health. The studies identified were assessed using population-intervention-control-outcomes-study framework.
RESULTS
Of the 24,271 studies initially identified, 23(0.09%) were reviewed in detail. Findings showed that fishing accidents occurred every year, causing traumatic injuries. The cause of such accidents had both internal and external factors. Health problems experienced by the fishermen included physical and mental health disorders.
CONCLUSIONS
The occupational safety and health of fishermen need to be paid attention to.
Topics: Humans; Accidents, Occupational; Risk Factors; Fisheries; Safety; Occupational Health
PubMed: 37096729
DOI: 10.47391/JPMA.Ind-S2-40 -
Sensors (Basel, Switzerland) Mar 2023The Timed Up and Go (TUG) test is a widely used tool for assessing the risk of falls in older adults. However, to increase the test's predictive value, the instrumented... (Review)
Review
The Timed Up and Go (TUG) test is a widely used tool for assessing the risk of falls in older adults. However, to increase the test's predictive value, the instrumented Timed Up and Go (iTUG) test has been developed, incorporating different technological approaches. This systematic review aims to explore the evidence of the technological proposal for the segmentation and analysis of iTUG in elderlies with or without pathologies. A search was conducted in five major databases, following PRISMA guidelines. The review included 40 studies that met the eligibility criteria. The most used technology was inertial sensors (75% of the studies), with healthy elderlies (35%) and elderlies with Parkinson's disease (32.5%) being the most analyzed participants. In total, 97.5% of the studies applied automatic segmentation using rule-based algorithms. The iTUG test offers an economical and accessible alternative to increase the predictive value of TUG, identifying different variables, and can be used in clinical, community, and home settings.
Topics: Humans; Aged; Accidental Falls; Postural Balance; Time and Motion Studies; Parkinson Disease; Physical Therapy Modalities
PubMed: 37050485
DOI: 10.3390/s23073426 -
Journal of Neuroengineering and... Apr 2023This study aims to conduct a meta-analysis to assess the effect of virtual reality-based therapy (VRBT) on balance dimensions and fear of falling in patients with... (Meta-Analysis)
Meta-Analysis Review
Virtual reality-based therapy improves balance and reduces fear of falling in patients with multiple sclerosis. a systematic review and meta-analysis of randomized controlled trials.
OBJECTIVE
This study aims to conduct a meta-analysis to assess the effect of virtual reality-based therapy (VRBT) on balance dimensions and fear of falling in patients with multiple sclerosis (PwMS). Secondarily, to determine the most recommendable dose of VRBT to improve balance.
METHODS
PubMed Medline, Web of Science, Scopus, CINAHL and PEDro were screened, without publication date restrictions, until September 30th, 2021. Randomized controlled trials (RCTs) comparing the effectiveness of VRBT against other interventions in PwMS were included. Functional and dynamic balance, confidence of balance, postural control in posturography, fear of falling and gait speed were the variables assessed. A meta-analysis was performed by pooling the Cohen's standardized mean difference (SMD) with 95% confidence interval (95% CI) using Comprehensive Meta-Analysis 3.0.
RESULTS
Nineteen RCTs, reporting 858 PwMS, were included. Our findings reported that VRBT is effective in improving functional balance (SMD = 0.8; 95%CI 0.47 to 1.14; p < 0.001); dynamic balance (SMD = - 0.3; 95%CI - 0.48 to - 0.11; p = 0.002); postural control with posturography (SMD = - 0.54; 95%CI - 0.99 to - 0.1; p = 0.017); confidence of balance (SMD = 0.43; 95%CI 0.15 to 0.71; p = 0.003); and in reducing fear of falling (SMD = - 1.04; 95%CI - 2 to - 0.07; p = 0.035); but not on gait speed (SMD = - 0.11; 95%CI: - 0.35 to 0.14; p = 0.4). Besides, the most adequate dose of VRBT to achieve the greatest improvement in functional balance was at least 40 sessions, five sessions per week and 40-45 min per sessions; and for dynamic balance, it would be between 8 and 19 weeks, twice a week and 20-30 min per session.
CONCLUSION
VRBT may have a short-term beneficial role in improving balance and reducing fear of falling in PwMS.
Topics: Humans; Accidental Falls; Randomized Controlled Trials as Topic; Physical Therapy Modalities; Multiple Sclerosis; Virtual Reality
PubMed: 37041557
DOI: 10.1186/s12984-023-01174-z -
International Journal of Environmental... Feb 2023With the aging process, elderly people present changes in their bodies that can lead them to suffer several geriatric syndromes. The present study aimed to analyze and... (Meta-Analysis)
Meta-Analysis
With the aging process, elderly people present changes in their bodies that can lead them to suffer several geriatric syndromes. The present study aimed to analyze and synthesize the literature produced concerning the association of sarcopenia with falls in elderly people with cognitive impairment. This is a systematic review study on etiology and risk, conducted according to the JBI methodology using the Medline (Pubmed), Cinahl, Embase, Scopus, and Web of Science databases. The gray literature search was conducted in the CAPES Brazilian Digital Library of Theses and Dissertations, Google Scholar, Networked Digital Library of Theses and Dissertations (NDLTD), EBSCO Open Dissertations, DART-e, and ACS Guide to Scholarly Communication. The identification of the association between the variables was extracted from the articles themselves (Odds Ratio and the 95% Confidence Intervals). Four articles published between 2012 and 2021 were included in this review. A prevalence of falls was identified, ranging from 14.2% to 23.1%, of cognitive impairment ranging from 24.1% to 60.8%, and of sarcopenia ranging from 6.1 to 26.6%. The meta-analysis found that elderly people with cognitive impairment who suffer falls are at a 1.88 times greater risk of presenting sarcopenia ( = 0.01). There is evidence of an association between the variables, but it is necessary to conduct follow-up studies to support this association as well as other factors that may influence the senescence and senility process.
Topics: Aged; Humans; Accidental Falls; Brazil; Cognitive Dysfunction; Follow-Up Studies; Sarcopenia
PubMed: 36901167
DOI: 10.3390/ijerph20054156 -
Health and Quality of Life Outcomes Feb 2023In the field of neurorehabilitation, robot-assisted therapy (RAT) and virtual reality (VR) have so far shown promising evidence on multiple motor and functional... (Review)
Review
BACKGROUND
In the field of neurorehabilitation, robot-assisted therapy (RAT) and virtual reality (VR) have so far shown promising evidence on multiple motor and functional outcomes. The related effectiveness on patients' health-related quality of life (HRQoL) has been investigated across neurological populations but still remains unclear. The present study aimed to systematically review the studies investigating the effects of RAT alone and with VR on HRQoL in patients with different neurological diseases.
METHODS
A systematic review of the studies evaluating the impact of RAT alone and combined with VR on HRQoL in patients affected by neurological diseases (i.e., stroke, multiple sclerosis, spinal cord injury, Parkinson's Disease) was conducted according to PRISMA guidelines. Electronic searches of PubMed, Web of Science, Cochrane Library, CINAHL, Embase, and PsychINFO (2000-2022) were performed. Risk of bias was evaluated through the National Institute of Health Quality Assessment Tool. Descriptive data regarding the study design, participants, intervention, rehabilitation outcomes, robotic device typology, HRQoL measures, non-motor factors concurrently investigated, and main results were extracted and meta-synthetized.
RESULTS
The searches identified 3025 studies, of which 70 met the inclusion criteria. An overall heterogeneous configuration was found regarding the study design adopted, intervention procedures and technological devices implemented, rehabilitation outcomes (i.e., related to both upper and lower limb impairment), HRQoL measures administered, and main evidence. Most of the studies reported significant effects of both RAT and RAT plus VR on patients HRQoL, whether they adopted generic or disease-specific HRQoL measures. Significant post-intervention within-group changes were mainly found across neurological populations, while fewer studies reported significant between-group comparisons, and then, mostly in patients with stroke. Longitudinal investigations were also observed (up to 36 months), but significant longitudinal effects were exclusively found in patients with stroke or multiple sclerosis. Finally, concurrent evaluations on non-motor outcomes beside HRQoL included cognitive (i.e., memory, attention, executive functions) and psychological (i.e., mood, satisfaction with the treatment, device usability, fear of falling, motivation, self-efficacy, coping, and well-being) variables.
CONCLUSIONS
Despite the heterogeneity observed among the studies included, promising evidence was found on the effectiveness of RAT and RAT plus VR on HRQoL. However, further targeted short- and long-term investigations, are strongly recommended for specific HRQoL subcomponents and neurological populations, through the adoption of defined intervention procedures and disease-specific assessment methodology.
Topics: Humans; Quality of Life; Accidental Falls; Robotics; Fear; Stroke; Stroke Rehabilitation; Virtual Reality
PubMed: 36810124
DOI: 10.1186/s12955-023-02097-y -
International Journal of Environmental... Feb 2023In older people, dementia is a well-established risk factor for falls. However, the association and the causal relationship between falls and the earlier stages of... (Review)
Review
BACKGROUND
In older people, dementia is a well-established risk factor for falls. However, the association and the causal relationship between falls and the earlier stages of cognitive impairment remains unclear. The purpose of the study was to review the literature data on the association between falls and cognitive impairment, no dementia, including Mild Cognitive Impairment.
METHODS
According to PRISMA guidelines, we searched five electronic databases (EMBASE, Web of Science, Medline, CINAHL, and PsychINFO) for articles published between January 2011 and August 2022 on observational studies of older people with a cognitive assessment and/or cognitive impairment diagnosis and a recording of falls. Their quality was reviewed according to the STROBE checklist.
RESULTS
We selected 42 of the 4934 initially retrieved publications. In 24 retrospective studies, a statistically significant association between falls and cognitive status was found in only 15 of the 32 comparisons (47%). Of the 27 cross-sectional analyses in prospective studies, only eight (30%) were positive and significant. We counted four longitudinal analyses, half of which suggested a causal relationship between falls and cognitive impairment. The investigational methods varied markedly from one study to another.
CONCLUSION
It is still not clear whether falls are associated with cognitive impairment, no dementia. Data in favor of a causal relationship are scarce. Further studies are needed to clarify their relationship.
Topics: Humans; Aged; Accidental Falls; Prospective Studies; Retrospective Studies; Cross-Sectional Studies; Cognitive Dysfunction
PubMed: 36767992
DOI: 10.3390/ijerph20032628 -
Frontiers in Public Health 2022In recent years, traditional Chinese exercises have been passed down and reformed to play a significant role in the study of interventions for the treatment of falls in... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
In recent years, traditional Chinese exercises have been passed down and reformed to play a significant role in the study of interventions for the treatment of falls in older people. However, few studies have evaluated the efficacy of various Chinese traditional exercises in the intervention of falls behavior in the elderly. In this study, four Chinese traditional exercises commonly used in clinical practice were selected as subjects to systematically evaluate the effectiveness of Tai Chi, Ba Duan Jin, Yi Jin Jing and Wu Qin Xi in intervening in the treatment of fall behavior in the elderly.
METHODS
We conducted a systematic review in accordance with the PRISMA guidelines. Four published randomized controlled trials (RCTs) of traditional Chinese exercise interventions for the treatment of falls behavior in older adults were searched through authoritative databases such as CNKI, Web of Science, PubMed, EMbase and the Cochrane Library, all from the time of construction to November 2022.
RESULTS
A total of 45 studies with 4 traditional interventions were included. Ba Duan Jin was more effective in improving TUGT [SMD = -1.93 (-2.49, -1.38), < 0.05] and MFES [SMD = -33.45 (-63.93, -2.97), < 0.05], while Yi Jin Jing was more effective in enhancing ECLSB [SMD = -0.19 (-5.12, -4.74), < 0.05] and BBS [SMD = -5.79 (-10.80, -0.78), < 0.05], both of which showed better effects.
DISCUSSION
The present evidence suggests that all four traditional Chinese body-building exercise therapies have a preventive effect on fall behavior in older adults. In clinical treatment and daily physical exercise, two exercises, BaDuan Jin and Yi Jin Jing, may be preferred to reduce the risk of falls in the elderly, but the exercise regimen of Qigong should be selected scientifically and rationally according to their actual conditions.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/#myprospero.
Topics: Aged; Humans; Accidental Falls; Exercise Therapy; Network Meta-Analysis; Randomized Controlled Trials as Topic; Medicine, Chinese Traditional
PubMed: 36684937
DOI: 10.3389/fpubh.2022.1096599