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Sebastiani C, Wong JYX, Litt A, Loewen J, Reece K, Conlin N, Dunand T, Montero Odasso M, D'Amore C, Saunders S, Beauchamp M. Mapping sex and gender differences in falls among older adults: A scoping review. J Am Geriatr Soc 2024; 72:903-915. [PMID: 38147460 DOI: 10.1111/jgs.18730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 11/02/2023] [Accepted: 11/19/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND There is growing recognition of the importance of sex and gender differences within falls literature, but the characterization of such literature is uncertain. The aim of this scoping review was to (1) map the nature and extent of falls literature examining sex or gender differences among older adults, and (2) identify gaps and opportunities for further research and practice. METHODS We used a scoping review methodology. Eligible studies included participants with a mean age of ≥ 60 years and study aims specifying falls and either sex or gender concepts. MEDLINE, Embase, CINAHL, Ageline, and Psychinfo databases were searched from inception to March 2, 2022. Records were screened and charted by six independent reviewers. Descriptive and narrative reports were generated. RESULTS A total of 15,266 records were screened and 74 studies were included. Most studies reported on sex and gender differences in fall risk factors (n = 52, 70%), incidence/prevalence (n = 26, 35%), fall consequences (n = 22, 30%), and fall characteristics (n = 15, 20%). The majority of studies (n = 70, 95%) found significant sex or gender differences in relation to falls, with 39 (53%) identifying significant sex differences and 31 (42%) identifying significant gender differences. However, only three (4%) studies defined sex or gender concepts and only nine (12%) studies used sex or gender terms appropriately. Fifty-six (76%) studies had more female participants than males. Four (5%) were intervention studies. Studies did not report falls in line with guidelines nor use common fall definitions. CONCLUSION Sex and gender differences are commonly reported in falls literature. It is critical for future research to use sex and gender terms appropriately and include similar sample sizes across all genders and sexes. In addition, there is a need to examine more gender-diverse populations and to develop interventions to prevent falls that address sex and gender differences among older adults.
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Affiliation(s)
- Crista Sebastiani
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Jamie Yee Xin Wong
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Amandeep Litt
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Julia Loewen
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Karly Reece
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Nicole Conlin
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Tessa Dunand
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Manuel Montero Odasso
- Schulich School of Medicine and Dentistry, Department of Medicine, Western University, London, Ontario, Canada
| | - Cassandra D'Amore
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Stephanie Saunders
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Marla Beauchamp
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
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Asamoto T, Osawa Y, Takegami Y, Okamoto M, Iida H, Imagama S. Fall risk in patient with dysplastic hip osteoarthritis. INTERNATIONAL ORTHOPAEDICS 2024; 48:221-227. [PMID: 37606767 DOI: 10.1007/s00264-023-05938-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/10/2023] [Indexed: 08/23/2023]
Abstract
PURPOSE Patients with dysplastic hip osteo arthritis (DHOA) often have a spinopelvic imbalance, and they are more likely to experience falls. This study aimed to evaluate the risk factors for falls in patients with DHOA, including spinopelvic parameters. METHODS In this cross-sectional study, a total of 103 patients with DHOA were included from 2019 to 2021. Fall risk was evaluated using the Fall Risk Index 5 items version (FRI-5). Demographics, functional outcomes, and spinopelvic parameters were compared between the high-risk group (FRI-5 ≥ 6) and the low-risk group (FRI-5 < 6). Multivariate analysis was performed using factors with significant differences in univariate analysis. RESULTS High-risk and low-risk groups comprised 54 and 49 patients, respectively. Females were significantly more common in the high-risk group than in the low-risk group. The Harris Hip Score was significantly lower in the high-risk group than in the low-risk group (p = 0.02). Pelvic incidence, tilt, and obliquity were significantly higher in the high-risk group than in the low-risk group (p < 0.01). In multivariate analysis, female sex (odds ratio [OR]: 3.76, 95% confidence interval [CI]: 1.11-12.64, p = 0.03), pelvic obliquity (OR: 1.36, 95% CI: 1.09-1.71, p < 0.01), and Harris hip score (OR: 0.96, 95% CI: 0.93-0.99, p = 0.02) were identified as risk factors. CONCLUSION Female sex, pelvic obliquity, and low Harris hip score were associated with an increased risk of falls among patients with DHOA.
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Affiliation(s)
- Takamune Asamoto
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Yusuke Osawa
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan.
| | - Yasuhiko Takegami
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Masanori Okamoto
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Hiroki Iida
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Shiro Imagama
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
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Alenazi AM, Alanazi MF, Elnaggar RK, Alshehri MM, Alqahtani BA, Alhowimel AS, Alhwoaimel NA, Alanazi AD, Alotaibi MA, Almutairi SM, Alghamdi MS, Bindawas SM. Prevalence and risk factors for falls among community-dwelling adults in Riyadh area. PeerJ 2023; 11:e16478. [PMID: 38077414 PMCID: PMC10710170 DOI: 10.7717/peerj.16478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/26/2023] [Indexed: 12/18/2023] Open
Abstract
Objectives This study aimed to assess fall prevalence, identify related risk factors, and establish cut-off scores for fall risk measures among community-dwelling adults in Riyadh region of Saudi Arabia. Methods A cross-sectional study was conducted in community, Riyadh city, Saudi Arabia. A sample of 276 Saudi citizens aged ≥40 years who were able to read and write in Arabic. Fall history and number of falls in the past 12 months were determined via self-reports. Variables assessed included demographic information, self-reported chronic diseases, depressive symptoms, and back pain severity. Results Participants were classified as either fallers (n = 28, 10.14%) or non-fallers. Fallers were more likely to have arthritis (odds ratio [OR]: 7.60, p = 0.001), back pain (OR: 5.22, p = 0.002), and higher depressive symptom scores (OR: 1.09, p = 0.013) than non-fallers. The number of reported falls was significantly associated with an elevated body mass index (incidence rate ratio [IRR]: 1.09, p = 0.045), arthritis (IRR: 8.74, p < 0.001), back pain (IRR: 4.08, p = 0.005), neurological diseases (IRR: 13.75, p < 0.007), and depressive symptoms (IRR: 1.08, p = 0.005). Cut-off scores predictive of falls associated with back pain and depressive symptoms were 1.5 (sensitivity: 0.61; specificity: 0.79; area under the curve [AUC]: 0.70) and 11.5 score (sensitivity: 0.57; specificity: 0.76; AUC: 0.66), respectively. Conclusions The prevalence of falls was relatively low among the individuals considered in this study. Chronic conditions, back pain severity, and depressive symptoms were determined to be associated with falls among community-dwelling individuals in Saudi Arabia.
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Affiliation(s)
- Aqeel M. Alenazi
- Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Riyadh, Saudi Arabia
| | - Maram F. Alanazi
- Occupational Therapy, Sydney University, Sydney, New South Wales, Australia
| | - Ragab K. Elnaggar
- Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Riyadh, Saudi Arabia
- Department of Physical Therapy for Pediatrics, Cairo University, Cairo, Giza, Egypt
| | | | - Bader A. Alqahtani
- Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Riyadh, Saudi Arabia
| | - Ahmed S. Alhowimel
- Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Riyadh, Saudi Arabia
| | - Norah A. Alhwoaimel
- Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Riyadh, Saudi Arabia
| | - Ahmad D. Alanazi
- Department of Rehabilitation Science, Majmaah University, Majmaah, Riyadh, Saudi Arabia
| | - Mazyad A. Alotaibi
- Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Riyadh, Saudi Arabia
| | - Sattam M. Almutairi
- Department of Physical Therapy, College of Medical Rehabilitation, Qassim University, Buraydah, Qassim, Saudi Arabia
| | - Mohammed S. Alghamdi
- Department of Medical Rehabilitation Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Saad M. Bindawas
- Department of Rehabilitation Sciences, King Saud University, Riyadh, Saudi Arabia
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Sakuma T, Iguchi M, Kimura K. Effects of simulated trunk flexion contracture on the margin of stability during obstacle crossing in elderly individuals. Gait Posture 2023; 102:139-145. [PMID: 37018888 DOI: 10.1016/j.gaitpost.2023.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 03/22/2023] [Accepted: 03/29/2023] [Indexed: 04/07/2023]
Abstract
BACKGROUND Trunk flexion contracture is an abnormal posture in elderly individuals with lumbar kyphosis. It is unclear whether this posture affects locomotor stability (margin of stability [MoS]) during obstacle crossing, which is a common trigger for falls in elderly people. RESEARCH QUESTION Does trunk flexion contracture negatively affect MoS during obstacle crossing in elderly people? METHODS Ten healthy elderly individuals performed five trials of obstacle crossing using a comfortable speed under two experimental conditions, namely, with (FLEX) or without (NORMAL) a hard lumbar brace to simulate trunk flexion contracture. The obstacle-crossing motion was captured using an optical motion analysis system in order to calculate the MoS in the anteroposterior direction. The MoS at initial contact (IC) and that when the swing foot was above the obstacle (Obs) was compared between FLEX and NORMAL. A greater MoS suggests greater risk of a forward fall. The trunk and lower limb joint angles were measured at Obs. RESULTS FLEX significantly increased the MoS at IC, whereas the MoS at Obs did not differ between the two conditions. FLEX demonstrated a crouch posture characterized by an increased flexion angle of stance-side hip and knee joints at the Obs instant. SIGNIFICANCE Forward fall chance might be increased at IC in obstacle crossing with trunk flexion contracture. Meanwhile, the MoS at Obs might be controlled by increasing the crouch posture to offset a forward shift in the CoM position due to the trunk flexion. Because the risk of a stumble on an obstacle and of forward falls should be higher at Obs than at IC, the crouch posture seems to be an effective adaptation that enables elderly people with trunk flexion contracture to safely cross obstacles.
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Affiliation(s)
- Toru Sakuma
- Faculty of Health Sciences, Tsukuba University of Technology, Tsukuba, Japan.
| | - Masaki Iguchi
- Faculty of Health Sciences, Tsukuba University of Technology, Tsukuba, Japan
| | - Kensaku Kimura
- Faculty of Health Sciences, Tsukuba University of Technology, Tsukuba, Japan
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Arai T, Fujita H, Maruya K, Morita Y, Asahi R, Ishibasi H. Loss of height predicts fall risk in elderly Japanese: a prospective cohort study. J Bone Miner Metab 2023; 41:88-94. [PMID: 36513883 DOI: 10.1007/s00774-022-01383-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 10/18/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The purpose of this study was to explore whether height loss is associated with future falls and whether the combination of height loss and fall experience is associated with future falls. MATERIALS AND METHODS In this prospective observational study, a total of 765 individuals (354 men, 411 women) agreed to join the study. Baseline data on demographics, comorbidities, physical performance, and previous falls were assessed. Height loss was calculated as the difference between the self-reported height at a younger age and the current height and was divided into two groups: < 2 cm and ≥ 2 cm. Approximately 15 months after the baseline evaluation, follow-up questionnaires were used to assess the fall history. Participants were classified as either "non-fallers" or "fallers." Multiple logistic regression was used to evaluate the association between falls and each factor and to obtain adjusted odds ratio estimates. RESULTS The follow-up questionnaire was returned by 668 participants, 74 of whom (11.1%) fell at least once during the observation period. Multiple logistic regression analysis found that height loss of > 2 cm was a significant predictor of future falls, even after adjusting for other factors. Additionally, the combination of height loss and previous falls was a risk factor for falls. CONCLUSIONS We suggest that height loss of ≥ 2 cm is a predictor of future falls in older adults, and the combination of height loss and fall experiences may be a useful screening tool for determining fall risk.
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Affiliation(s)
- Tomoyuki Arai
- Department of Physical Therapy Faculty of Health and Medical Care, Saitama Medical University, 981, Kawakado, Iruma, Saitama, 350-0436, Japan.
| | - Hiroaki Fujita
- Department of Physical Therapy Faculty of Health and Medical Care, Saitama Medical University, 981, Kawakado, Iruma, Saitama, 350-0436, Japan
| | - Kohei Maruya
- Department of Physical Therapy Faculty of Health and Medical Care, Saitama Medical University, 981, Kawakado, Iruma, Saitama, 350-0436, Japan
| | - Yasuhiro Morita
- Department of Physical Therapy Faculty of Health and Medical Care, Saitama Medical University, 981, Kawakado, Iruma, Saitama, 350-0436, Japan
| | - Ryoma Asahi
- Department of Physical Therapy, School of Health Sciences, Japan University of Health Science, 2-555, Suga, Satte, Saitama, Japan
| | - Hideaki Ishibasi
- Ina Hospital Orthopedics, 9419, Ina, Kitaadati, Saitama, 362-0806, Japan
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Hata T, Shima H, Nitta M, Ueda E, Nishihara M, Uchiyama K, Katsumata T, Neo M. The Relationship Between Duration of General Anesthesia and Postoperative Fall Risk During Hospital Stay in Orthopedic Patients. J Patient Saf 2022; 18:e922-e927. [PMID: 35532998 DOI: 10.1097/pts.0000000000001021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES We performed a retrospective observational study to investigate the relationship between general anesthesia duration and postoperative falls of hospitalized patients who underwent orthopedic surgery. METHODS We used electronic medical record data and incident report data from the Osaka Medical and Pharmaceutical University Hospital. The study included 4,042 patients admitted to the Department of Orthopedic Surgery from 2014 to 2018, and the following exclusion criteria were applied: no surgery, less than 18 years of age, and fall between admission and surgery. This study only considered falls that occurred within 21 days of surgery. The multivariate logistic regression model adjusted for patient background was used to determine the risk of falling according to the duration of general anesthesia. RESULTS After exclusions, 3,398 patients were included in the analysis. Among them, 45 patients (1.32%) had fallen, of whom 7 (15.6%) were injured and 2 (4.4%) experienced fractures. Multivariate logistic regression analysis to determine the adjusted odds ratio showed that longer general anesthesia duration was an independent risk factor for postoperative falls. In addition, cardiovascular disease had significantly higher associations with postoperative falls. CONCLUSIONS In the postoperative care of orthopedic patients, the risk of falling should be assessed by considering the duration of general anesthesia in addition to the traditional fall risk factors. Furthermore, falls could be prevented by educating patients and their caregivers about the risk and mobilizing staff to support postoperative patients at a higher risk of falls when they walk in the hospital.
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Duan H, Wang H, Bai Y, Lu Y, Xu X, Wu J, Wu X. Health-Related Physical Fitness as a Risk Factor for Falls in Elderly People Living in the Community: A Prospective Study in China. Front Public Health 2022; 10:874993. [PMID: 35910877 PMCID: PMC9326063 DOI: 10.3389/fpubh.2022.874993] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesHealth-related physical-fitness (HRPF) involves multi-components of physical functional tests and is reported to be associated with the risk of fall. The study sought to determine whether specific physical fitness components were stronger predictors of falls among elderly people.MethodsThis prospective cohort study involved 299 community residents age ≥60 years from Shanghai, China. The baseline data included comprehensive assessment of sociodemographic, clinical, and HRPF test. Subjects were followed for 1 year and were contacted by telephone to report falls. LASSO regression and Multivariate regression analysis were used to identify risk predictors of fall. In addition, we used receiver operating characteristic (ROC) curve analyses to determine whether the predictors have diagnostic.ResultsDuring the 1-year prospective fall assessment, 11.7% of these subjects experienced one or frequent falls. LASSO models revealed that age (=0.01) and 8-ft up-and-go test score (=0.06) were positively associated with falls, while activity-specific balance confidence (ABC; = −0.007) and 2-min step test score (= −0.005) were inversely related. The Area Under roc Curve (AUC) for a linear combination of age, ABC scale score, 2-min step test and 8-ft up-and-go test was 0.778 (95% confidence interval: 0. 700–0.857), which was superior to any of the variables taken alone.ConclusionAge, activity-specific balance confidence and fitness abnormalities were determined to contribute to the incident of falls. The value of 2-min step test score, and 8-ft up-and-go test score were the key HRPF components in predicting falls among elderly people.
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Affiliation(s)
- Hongxia Duan
- Department of Rehabilitation, Shanghai Seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hao Wang
- School of Nursing, Shanghai Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yiwen Bai
- Department of Rehabilitation, Shanghai Seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yan Lu
- Department of Rehabilitation, Shanghai Seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xueping Xu
- Department of Rehabilitation, Shanghai Seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jing Wu
- School of Nursing, Shanghai Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Jing Wu
| | - Xubo Wu
- Department of Rehabilitation, Shanghai Seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Medicine, Shanghai Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Xubo Wu
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Marín-Jiménez N, Cruz-León C, Perez-Bey A, Conde-Caveda J, Grao-Cruces A, Aparicio VA, Castro-Piñero J, Cuenca-García M. Predictive Validity of Motor Fitness and Flexibility Tests in Adults and Older Adults: A Systematic Review. J Clin Med 2022; 11:jcm11020328. [PMID: 35054020 PMCID: PMC8779466 DOI: 10.3390/jcm11020328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/17/2021] [Accepted: 01/05/2022] [Indexed: 02/04/2023] Open
Abstract
Motor fitness and flexibility have been linked to several health issues. We aimed to investigate the predictive validity of motor fitness and flexibility tests in relation to health outcomes in adults and older adults. Web of Science and PubMed databases were screened for studies published from inception to November 2020. Two authors systematically searched, evaluated, and extracted data from identified original studies and systematic reviews/meta-analysis. Three levels of evidence were constructed: strong, moderate, and limited/inconclusive evidence. In total, 1182 studies were identified, and 70 studies and 6 systematic reviews/meta-analysis were summarized. Strong evidence indicated that (i) slower gait speed predicts falls and institutionalization/hospitalization in adults over 60 years old, cognitive decline/impairment over 55 years old, mobility disability over 50 years old, disability in instrumental activities of daily living (IADL) over 54 years old, cardiovascular disease risk over 45 years old, and all-cause mortality over 35 years old; (ii) impaired balance predicts falls and disability in IADL/mobility disability in adults over 40 years old and all-cause mortality over 53 years old; (iii) worse timed up&go test (TUG) predicts falls and fear of falling over 40 years old. Evidence supports that slower gait speed, impaired balance, and worse TUG performance are significantly associated with an increased risk of adverse health outcomes in adults.
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Affiliation(s)
- Nuria Marín-Jiménez
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
| | - Carolina Cruz-León
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
| | - Alejandro Perez-Bey
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
- Correspondence: ; Tel.: +34-65-7588624
| | - Julio Conde-Caveda
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
| | - Alberto Grao-Cruces
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
| | - Virginia A. Aparicio
- Department of Physiology, Institute of Nutrition and Food Technology “José Mataix Verdú”, University of Granada, 18071 Granada, Spain;
- Sport and Health University Research Centre, University of Granada, 18007 Granada, Spain
| | - José Castro-Piñero
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
| | - Magdalena Cuenca-García
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, 11519 Cádiz, Spain; (N.M.-J.); (C.C.-L.); (J.C.-C.); (A.G.-C.); (J.C.-P.); (M.C.-G.)
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), University of Cádiz, 11009 Cádiz, Spain
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Deng ZH, Xu J, Long LJ, Chen F, Chen K, Lu W, Wang DP, Peng LQ. Association between hip and knee osteoarthritis with falls: A systematic review and meta-analysis. Int J Clin Pract 2021; 75:e14537. [PMID: 34132007 DOI: 10.1111/ijcp.14537] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 06/13/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To examine the association between hip and knee osteoarthritis (OA) and falls. Potentially relevant articles that examine the association between hip, knee, radiological, and self-reported OA and falls were retrieved from PubMed, EMBASE, Scopus, and Web of Science up until March of 2020. METHODS The pooled risk ratios (RRs) as well as their related 95% confidence intervals (CIs) were calculated. Statistic and subgroup analyses were performed. A total of 21 studies involving 146 965 participants were included. RESULTS No association was found between hip OA and falls. The pooled RRs value suggested a higher prevalence of falls in knee OA patients (RR = 1.35, 95% CI: 1.20 to 1.51, P < .00001) and self-reported OA (RR = 1.33, 95% CI: 1.23 to 1.45, P < .00001) than in non-OA subjects. The pooled RR value suggested no difference between prevalence of falls in radiological OA patients compared to non-OA subjects (RR = 1.82, 95% CI: 0.89 to 3.73, P = .10). Both radiological and self-reported knee OA seem to be positively associated with falls, while no obvious association was found between hip OA and falls. CONCLUSIONS Therefore, knee OA is a risk factor for falls which should be closely monitored.
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Affiliation(s)
- Zhen-Han Deng
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
- School of Medicine, Shenzhen University, Shenzhen, China
- Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Tissue Engineering of Shenzhen, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
- Clinical College of Anhui Medical University Affiliated Shenzhen Second People's Hospital, Shenzhen, China
| | - Jian Xu
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
- School of Medicine, Shenzhen University, Shenzhen, China
| | - Lu-Jue Long
- Xiangya Stomatological Hospital & School of Stomatology, Central South University, Changsha, China
| | - Fei Chen
- Key Laboratory of Tissue Engineering of Shenzhen, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
| | - Kang Chen
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
| | - Wei Lu
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
| | - Da-Ping Wang
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
- School of Medicine, Shenzhen University, Shenzhen, China
- Guangzhou Medical University, Guangzhou, China
- Key Laboratory of Tissue Engineering of Shenzhen, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
- Clinical College of Anhui Medical University Affiliated Shenzhen Second People's Hospital, Shenzhen, China
| | - Liang-Quan Peng
- Department of Sports Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
- School of Medicine, Shenzhen University, Shenzhen, China
- Key Laboratory of Tissue Engineering of Shenzhen, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China
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10
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Muhammad T, Maurya P, Sharma P. Prevalence and correlates of bone and joint diseases and its association with falls among older adults in India: Evidence from LASI, 2017-18. Geriatr Nurs 2021; 42:1143-1150. [PMID: 34404017 DOI: 10.1016/j.gerinurse.2021.07.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 12/13/2022]
Abstract
This study explores the prevalence and correlates of bone and joint diseases and its association with falls among older adults in India. Data from the Longitudinal Aging Study in India (2017-18) were utilized for analysis (n = 31,464). Bivariate and logistic regression was used to fulfill the study objectives. The findings revealed that 19.71% of older adults had bone and joint disease, which was higher among women (22.79%) than men (16.25%). The strongest predictors of such diseases included being currently employed, physically inactive, having difficulties in performing functional activities and higher economic status. The fall in the last two years was reported by 12.63% of older adults, and bone and joints diseases were significantly associated with falls (AOR = 1.287; 95% CI: 1.117-1.483) after adjusting for several socio-demographic and health covariates. These findings imply that policymakers and providers must implement interventions designed to reduce the risk of those diseases and associated falls.
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Affiliation(s)
- T Muhammad
- Department of Population Policies and Programmes, International Institute for Population Sciences, Mumbai, Maharashtra 400088, India.
| | - Priya Maurya
- Department of Development Studies, International Institute for Population Sciences, Mumbai, Maharashtra 400088, India.
| | - Palak Sharma
- Department of Mathematical Demography and Statistics, International Institute for Population Sciences, Mumbai, Maharashtra 400088, India.
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11
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Identifying Activity Limitation and Decline in Quality of Life in Patients with Knee Osteoarthritis Who Are Scheduled to Undergo Total Knee Arthroplasty. J UOEH 2021; 43:33-39. [PMID: 33678784 DOI: 10.7888/juoeh.43.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
This study examines factors associated with activity limitation and the decline in quality of life in patients with knee osteoarthritis (OA), and to determine standard values that would be useful for understanding the disease state. We assessed individual factors, the modified version of the Self-Rating Frenchay Activities Index (SR-FAI), and the Japanese Knee Osteoarthritis Measure (JKOM) of 661 participants. Multiple regression analyses were used to examine the relationship between dependent and explanatory variables. Standard values were calculated after stratifying based on factors related to each dependent variable through multiple regression analyses. Among the participants aged 60-74/75-89 years, the standard values for the modified SR-FAI were 23/19 and 20/18 points for K-L grades III and IV in the males, and 29/23 and 26/21 points in the females, respectively. The standard values for the JKOM were 35/49 and 45/59 points for K-L grades III and IV in the males and 41/52 and 47/60 points in the females, respectively. These standard values are a useful index for interpreting the degree of activity limitation and satisfaction reduction in patients with knee OA, and could help in clinical decision making for healthcare providers.
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12
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Correlation between clinical tests for gait and stability using biomechanical variables in the gait of institutionalized elderly subjects. BIOMEDICAL HUMAN KINETICS 2021. [DOI: 10.2478/bhk-2021-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Study aim: This study aims to identify biomechanical gait variables explaining clinical test results in institutionalized elderly people.
Material and methods: Twenty-nine elderly (82.0 ± 6.3 years) residents in a nursing home were assessed. They were able to walk 10 meters without walking aids. First, the spontaneous gait was assessed using inertial measurement units in a 10-meter long corridor. Fifteen biomechanical gait variables were analyzed. Then, three clinical tests usually used in elderly subjects were applied: the Timed Up and Go (TUG) test, the Tinetti Scale and the Sit to Stand (STS) test. A correlation matrix using Pearson’s correlation coefficient between clinical and biomechanical variables was performed, obtaining a total of 45 potential correlations. A stepwise multiple linear regression analysis was then performed to determine the influence of each variable.
Results: TUG, Tinetti and STS were significantly correlated with similar biomechanical variables, including temporal, temporo-spatial and kinematic variables. Adults over 80 years old and women showed stronger correlations. Single support and ankle angle at takeoff were the two most important variables in stepwise regression analysis.
Conclusions: In institutionalized elderly subjects, clinical variables for gait and postural stability are correlated with the biomechanical gait variables, especially in women and adults aged over 80 years.
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13
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Kimachi K, Kimachi M, Takegami M, Ono R, Yamazaki S, Goto Y, Onishi Y, Sekiguchi M, Otani K, Konno SI, Kikuchi SI, Fukuhara S, Yamamoto Y. Level of Low Back Pain-Related Disability Is Associated with Risk of Subsequent Falls in an Older Population: Locomotive Syndrome and Health Outcomes in Aizu Cohort Study (LOHAS). PAIN MEDICINE 2020; 20:2377-2384. [PMID: 30856262 DOI: 10.1093/pm/pny313] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES To examine the longitudinal association between baseline disability due to low back pain (LBP) and future risk of falls, particularly significant falls requiring treatment, in a community-dwelling older population. METHODS This was a prospective population-based cohort study using data from the Locomotive Syndrome and Health Outcomes in Aizu Cohort Study (LOHAS; 2008-2010). A total of 2,738 residents aged ≥60 years were enrolled. LBP was assessed using the Roland-Morris Disability Questionnaire (RMDQ), and the level of LBP-related disability was divided into three categories (none, low, and medium to high). Incidence of falls over the following year was determined using a self-reported questionnaire after the one-year follow-up period. The risk ratio (RR) for LBP-related disability associated with any fall and any fall requiring treatment was estimated using log binomial regression models. RESULTS Data were analyzed for 1,358 subjects. The prevalence of LBP at baseline was 16.4%, whereas 122 (8.9%) participants reported a low level of LBP-related disability and 101 (7.4%) reported medium to high levels of LBP-related disability. Incidence of any fall and falls requiring treatment was reported by 22.1% and 4.6% of participants, respectively. Subjects with medium to high levels of disability were more likely to experience subsequent falls (adjusted RR = 1.53, 95% confidence interval [CI] = 1.21-1.95) and falls requiring treatment (adjusted RR = 2.55, 95% CI = 1.41-4.60) than those with no LBP-related disability. CONCLUSIONS Level of LBP-related disability was associated with an increased risk of serious falls in a general population of community-living older adults. These findings can alert health care providers involved in fall prevention efforts to the important issue of activity-related disability due to LBP.
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Affiliation(s)
- Kimihiko Kimachi
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Miho Kimachi
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Misa Takegami
- Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Rei Ono
- Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Shin Yamazaki
- Department of Environmental Epidemiology, National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan
| | - Yoshihito Goto
- Department of Community Medicine Supporting System, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yoshihiro Onishi
- Institute for Health Outcomes and Process Evaluation Research (iHope International), Kyoto, Japan
| | | | | | | | | | - Shunichi Fukuhara
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Center for Innovation in Clinical Research, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yosuke Yamamoto
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Arai T, Fujita H, Maruya K, Morita Y, Asahi R, Ishibashi H. The one-leg portion of the Stand-Up Test predicts fall risk in aged individuals: A prospective cohort study. J Orthop Sci 2020; 25:688-692. [PMID: 31337578 DOI: 10.1016/j.jos.2019.06.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 05/27/2019] [Accepted: 06/19/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Falls are a primary cause of physical disability in older adults, making them a major public health problem. Locomotive syndrome risk assessments have proven to be simple to administer, practical, and useful as screening tools in detecting decreased mobility in middle-aged and elderly adults. The current prospective study investigated whether these tests were associated with future falls among elderly Japanese. METHODS This study was a two-year prospective observational study. A total of 1800 individuals (aged 65-79 years) who were without certification of long-term care or physical disability were initially invited through letters to participate in the study. Of these, 499 individuals (225 men, 274 women) agreed to participate and underwent baseline assessments. Demographic information, body function physical performance measurements, and locomotive syndrome risk tests [Stand-Up Test (SUT), Two-Step Test (TST), and the 25-question Geriatric Locomotive Function Scale (GLFS-25)] were assessed. Following baseline evaluation, we sent a follow-up questionnaire to assess fall history in the past two years. Participants were classified as either "non-fallers" or "fallers" (denoted by one or more falls). Multiple logistic regression was used to evaluate the association between falls and each factor by providing adjusted odds ratio estimates. RESULTS The follow-up questionnaire was returned by 399 participants, 54 of whom (13.5%) fell at least once during the two-year observation period. The multiple logistic regression analysis revealed that difficulty with standing on one leg from a 40-cm-high seat (a portion of the SUT) was a significant predictor of future falls (odds ratio = 2.20, 95%CI = 1.04-4.69, p = 0.04). A history of falling was also a risk factor of falls. CONCLUSION Our results suggest that standing on one leg from a 40-cm-high seat is predictive of falling in older adults, even after adjustment for previous falls and other confounding variables.
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Affiliation(s)
- Tomoyuki Arai
- Department of Physical Therapy Faculty of Health and Medical Care, Saitama Medical University, 981, Kawakado, Iruma, Saitama, 350-0436, Japan.
| | - Hiroaki Fujita
- Department of Physical Therapy Faculty of Health and Medical Care, Saitama Medical University, 981, Kawakado, Iruma, Saitama, 350-0436, Japan
| | - Kohei Maruya
- Department of Physical Therapy Faculty of Health and Medical Care, Saitama Medical University, 981, Kawakado, Iruma, Saitama, 350-0436, Japan
| | - Yasuhiro Morita
- Department of Rehabilitation, JCHO Tokyo Shinjuku Medical Center, 5-1, Tukudotyo, Shinjyuku, Tokyo 162-8543, Japan
| | - Ryoma Asahi
- Department of Physical Therapy, School of Health Sciences, Japan University of Health Science, 2-555, Suga, Satte, Saitama, 340-0145, Japan
| | - Hideaki Ishibashi
- Ina Hospital Orthopedics, 9419, Ina, Kitaadati, Saitama, 362-0806, Japan
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15
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Kato S, Murakami H, Demura S, Yoshioka K, Shinmura K, Yokogawa N, Igarashi T, Yonezawa N, Shimizu T, Tsuchiya H. Abdominal trunk muscle weakness and its association with chronic low back pain and risk of falling in older women. BMC Musculoskelet Disord 2019; 20:273. [PMID: 31159812 PMCID: PMC6547466 DOI: 10.1186/s12891-019-2655-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 05/24/2019] [Indexed: 11/10/2022] Open
Abstract
Background Previous studies have indicated that trunk muscle strength decreases with chronic low back pain, and is associated with poor balance, poor functional performance, and falls in older adults. Strengthening exercises for chronic low back pain are considered the most effective intervention to improve functional outcomes. We developed an innovative exercise device for abdominal trunk muscles that also measures muscle strength. The correlation between muscle weakness, as measured by our device, the presence of chronic low back pain, and decreased physical ability associated with a risk of falling were evaluated in older women. Methods Thirty-eight elderly women, who could walk without support during daily activities and attended our outpatient clinic for treatment of chronic low back pain, knee or hip arthritis, or osteoporosis, were included in this study. Anthropometric measurements were performed. Grip power and one-leg standing time with eyes open were measured, and abdominal trunk muscle strength was measured using our device. History of falling in the previous 12 months was noted. Subjects with chronic low back pain (visual analog scale score ≥ 20 mm) for over 3 months were assigned to the low back pain group (n = 21). The remaining subjects formed the non-low back pain group (n = 17). Results Abdominal muscle strength of subjects in the low back pain group, and with history of falling, was significantly lower compared with that of subjects in the non-low back pain group, and in subjects without a history of falling, respectively. There was a moderate positive correlation between abdominal trunk muscle strength and one-leg standing time with eyes open. Conclusion We measured abdominal muscle strength in older women with chronic low back pain using our device, and it was significantly lower than that of those without chronic low back pain. Muscle weakness was associated with a history and risk of falling.
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Affiliation(s)
- Satoshi Kato
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan.
| | - Hideki Murakami
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Satoru Demura
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Katsuhito Yoshioka
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Kazuya Shinmura
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Noriaki Yokogawa
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Takashi Igarashi
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Noritaka Yonezawa
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Takaki Shimizu
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan
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16
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Kudo D, Miyakoshi N, Hongo M, Kasukawa Y, Ishikawa Y, Ishikawa N, Shimada Y. An epidemiological study of traumatic spinal cord injuries in the fastest aging area in Japan. Spinal Cord 2019; 57:509-515. [PMID: 30733575 DOI: 10.1038/s41393-019-0255-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 01/19/2019] [Accepted: 01/21/2019] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Retrospective epidemiological study. OBJECTIVE To investigate the epidemiology of traumatic spinal cord injury (TSCI) in the fastest aging area in Japan. SETTING Hospitals in Akita Prefecture, Japan. Akita Prefecture has the highest ratio of people aged 65 or older in Japan (30.4% in 2012 and 34.6% in 2016). METHODS Patients with acute TSCI who required hospital treatment between 2012 and 2016 were included. The incidence of TSCI, cause, level, skeletal injury, and Frankel grade were investigated. RESULTS The mean annual incidence of TSCI excluding Frankel E was 86 per million (range 86-104 per million) during the 5-year study period, with a mean age of 65.9 years (male, 75.1%) and patients in their 60s as the largest age group. Cervical injury was seen in 89.8%, and cervical TSCI without skeletal injury was seen in 65.5%. Frankel D was the most common neurological deficit (53.5%). The most common cause was falls on level surfaces (32.1%), followed by low falls (21.6%) and road traffic accidents (15.6%). CONCLUSIONS Recent incidence and characteristics of TSCI in the fastest aging society in Japan are presented. The incidence of incomplete cervical TSCI and falls on level surfaces appear to be increasing.
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Affiliation(s)
- Daisuke Kudo
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan.
| | | | | | | | | | - Noriyuki Ishikawa
- Department of Orthopedic Surgery, Akita Red Cross Hospital, Akita, Japan
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17
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Kim HJ, Lee SJ, Hyun JK, Kim SY, Kim TU. Influence of Hip Fracture on Knee Pain During Postoperative Rehabilitation. Ann Rehabil Med 2018; 42:682-689. [PMID: 30404417 PMCID: PMC6246861 DOI: 10.5535/arm.2018.42.5.682] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 06/12/2018] [Indexed: 11/28/2022] Open
Abstract
Objective To investigate whether fracture type, surgical procedure, or fracture grade affect knee pain during postoperative rehabilitation after a hip fracture. Methods We conducted a retrospective case-controlled study of 139 patients during postoperative rehabilitation after surgery for hip fractures. Patients were divided into two groups: patients experiencing knee pain during the first week of postoperative rehabilitation, and patients without knee pain. We compared the types of fracture, surgical procedure, and fracture grade between the two groups. Results We enrolled 52 patients (37.4%) with knee pain during the first weeks of postoperative rehabilitation. For type of fracture, knee pain was more common with intertrochanteric fracture than with femur neck fracture (48.8% vs. 21.1%, respectively; p=0.001). For the surgical procedure, there was no significant difference between the groups. For the fracture grade, the grades classified as unstable fractures were more common in the group of intertrochanteric fracture patients with knee pain than in those without knee pain (74.1% vs. 36.4%, respectively; p=0.002). Conclusion Intertrochanteric fracture affected knee pain after hip fracture surgery more than did femur neck fracture, particularly in unstable fractures. Furthermore, there was no difference in each fracture type according to the surgical procedure. Careful examination and management for knee pain is needed in patients with hip fracture surgery.
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Affiliation(s)
- Hee-Ju Kim
- Department of Rehabilitation Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Seong Jae Lee
- Department of Rehabilitation Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Jung Keun Hyun
- Department of Rehabilitation Medicine, Dankook University College of Medicine, Cheonan, Korea.,Department of Nanobiomedical Science & WCU Research Center, Dankook University, Cheonan, Korea.,Institute of Tissue Regeneration Engineering, Dankook University, Cheonan, Korea
| | - Seo-Young Kim
- Department of Rehabilitation Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Tae Uk Kim
- Department of Rehabilitation Medicine, Dankook University College of Medicine, Cheonan, Korea
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18
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Ciliz M, Sartor J, Lindig T, Pilotto A, Schäffer E, Weiss M, Scheltens P, Becker S, Hobert MA, Berg D, Liepelt-Scarfone I, Maetzler W. Brain-Area Specific White Matter Hyperintensities: Associations to Falls in Parkinson’s Disease. JOURNAL OF PARKINSONS DISEASE 2018; 8:455-462. [DOI: 10.3233/jpd-181351] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Meltem Ciliz
- Department of Neurodegeneration, Center for Neurology and Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany
| | - Jennifer Sartor
- Department of Neurodegeneration, Center for Neurology and Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany
| | - Tobias Lindig
- Department of Diagnostic and Interventional Neuroradiology, University of Tuebingen, Tuebingen, Germany
| | - Andrea Pilotto
- Department of Neurodegeneration, Center for Neurology and Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany
| | - Eva Schäffer
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Michael Weiss
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Philip Scheltens
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Sara Becker
- Department of Neurodegeneration, Center for Neurology and Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany
| | - Markus A. Hobert
- Department of Neurodegeneration, Center for Neurology and Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Daniela Berg
- Department of Neurodegeneration, Center for Neurology and Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Inga Liepelt-Scarfone
- Department of Neurodegeneration, Center for Neurology and Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany
| | - Walter Maetzler
- Department of Neurodegeneration, Center for Neurology and Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- DZNE, German Center for Neurodegenerative Diseases, Tuebingen, Germany
- Department of Neurology, Christian-Albrechts-University of Kiel, Kiel, Germany
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Marshall LM, Litwack-Harrison S, Makris UE, Kado DM, Cawthon PM, Deyo RA, Carlson NL, Nevitt MC. A Prospective Study of Back Pain and Risk of Falls Among Older Community-dwelling Men. J Gerontol A Biol Sci Med Sci 2017; 72:1264-1269. [PMID: 27852636 DOI: 10.1093/gerona/glw227] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 10/25/2016] [Indexed: 01/23/2023] Open
Abstract
Background Musculoskeletal pain is associated with increased fall risk among older men. However, the association of back pain, the most prevalent type of pain in this population, and fall risk is unknown. Methods We conducted a prospective investigation among 5,568 community-dwelling U.S. men at least 65 years of age from the Osteoporotic Fractures in Men Study (MrOS). Baseline questionnaires inquired about back pain and its location (such as low back), severity, and frequency in the past year. During 1 year of follow-up, falls were summed from self-reports obtained every 4 months. Outcomes were recurrent falls (≥2 falls) and any fall (≥1 fall). Associations of back pain and fall risk were estimated with risk ratios (RRs) and 95% confidence intervals (CIs) from multivariable log-binomial regression models adjusted for age, dizziness, arthritis, knee pain, urinary symptoms, self-rated health, central nervous system medication use, and instrumental activities of daily living. Results Most (67%) reported any back pain in the past year. During follow-up, 11% had recurrent falls and 25% fell at least once. Compared with no back pain, any back pain was associated with elevated recurrent fall risk (multivariable RR = 1.3, 95% CI: 1.1, 1.5). Multivariable RRs for 1, 2, and 3+ back pain locations were, respectively, 1.2 (95% CI: 1.0, 1.5), 1.4 (1.1, 1.8), and 1.7 (95% CI: 1.3, 2.2). RRs were also elevated for back pain severity and frequency. Back pain was also associated with risk of any fall. Conclusions Among older men, back pain is independently associated with increased fall risk.
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Affiliation(s)
- Lynn M Marshall
- Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland
| | | | - Una E Makris
- Department of Internal Medicine, VA North Texas Health Care System.,Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas
| | - Deborah M Kado
- Department of Family Medicine and Public Health.,Department of Internal Medicine, University of California, San Diego
| | - Peggy M Cawthon
- California Pacific Medical Center Research Institute, San Francisco
| | - Richard A Deyo
- Department of Family Medicine, Oregon Health and Science University, Portland
| | - Nels L Carlson
- Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland
| | - Michael C Nevitt
- Department of Epidemiology and Biostatistics, University of California, San Francisco
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20
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Response to the Editor. Osteoporos Sarcopenia 2016; 2:257-258. [PMID: 30775496 PMCID: PMC6372773 DOI: 10.1016/j.afos.2016.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 10/20/2016] [Indexed: 11/21/2022] Open
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21
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Are people following hip and knee arthroplasty at greater risk of experiencing a fall and fracture? Data from the Osteoarthritis Initiative. Arch Orthop Trauma Surg 2016; 136:865-72. [PMID: 26994762 DOI: 10.1007/s00402-016-2445-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Falls are a major challenge for older people and are a significant source of mortality and morbidity. There has been uncertainty as to whether people with total hip (THA) or knee (TKA) arthroplasty have a greater risk of falls and associated fractures. This analysis was to explore this question with a large community dataset. MATERIALS AND METHODS Data from all people enroled onto the US Osteoarthritis Initiative programme who had undergone a THA (n = 104) or TKA (n = 165), within a 12-month period, were compared to those who had not undergone an arthroplasty (n = 4631). Data were collected on: the number of participants who reported a fall within a 12-month period; the frequency of falls in this period; and whether a fracture was sustained during this period. Odd ratios were calculated for the probability of experiencing a fall or fracture between the groups. RESULTS There was no statistical difference in falls between people following THA (OR 0.90; 95 % CI 0.58-1.41) or TKA (OR 0.95; 0.67-1.35) compared to a non-arthroplasty cohort. Whilst there was no statistical difference in fracture risk between people following TKA compared to non-arthroplasty individuals (OR 1.25; 95 % CI 0.57-2.70), those who underwent THA had a 65 % lower chance of experiencing a fracture in the initial 12 post-operative months compared to the non-THA cohort (OR 0.35; 95 % CI 0.19-0.65; p < 0.01). CONCLUSIONS There appears a lower chance of experiencing a fracture for people following THA compared to those who have not.
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Gait variability analysed using an accelerometer is associated with locomotive syndrome among the general elderly population: The GAINA study. J Orthop Sci 2016; 21:354-60. [PMID: 27020175 DOI: 10.1016/j.jos.2016.02.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Revised: 11/15/2015] [Accepted: 02/03/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND Gait variability analysed using an accelerometer provides a unique measurement of locomotive dysfunction in patients with musculoskeletal disease or in frail elderly subjects. Therefore, assessing gait variability may become a clinical screening method for the locomotive syndrome. The purpose of this study was to investigate whether gait variability analysed using an accelerometer was associated with locomotive syndrome in the general elderly population. METHODS A total of 273 residents were screened after a yearly medical check-up, and of these, 223 subjects (mean age, 73.6 ± 8.3 years) met the eligibility criteria. Demographic information, body function and structure measurements (bone mass, grip strength, muscle mass, and postural alignment), and gait parameters were assessed. Gait variability analysis was based on acceleration using a wireless tri-axial accelerometer attached to the 3rd lumbar vertebra process by a trunk belt. Autocorrelation coefficients were used to represent gait variability in three directions: vertical, mediolateral, and anteroposterior. The subjects were classified as either having or not having the locomotive syndrome based on the 5-question Geriatric Locomotive Function Scale. RESULTS Of the 223 subjects, 41 (18.3%) had the locomotive syndrome. Autocorrelation coefficients in three directions were lower in the subjects with locomotive syndrome. Using multivariate logistic regression analysis with adjustment factors, of the autocorrelation coefficients only gait variability in the vertical axis remained a significant independent associated with the locomotive syndrome. CONCLUSION This finding suggested that gait variability based on evaluation of autocorrelation coefficients in the vertical axis measured using an accelerometer has the potential to become a screening method for the locomotive syndrome in the general elderly population.
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Identification of Clinical and Functional Falls Risk Factors Among Low Bone Density Older Women. TOPICS IN GERIATRIC REHABILITATION 2016. [DOI: 10.1097/tgr.0000000000000100] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Marshall LM, Litwack-Harrison S, Cawthon PM, Kado DM, Deyo RA, Makris UE, Carlson HL, Nevitt MC. A Prospective Study of Back Pain and Risk of Falls Among Older Community-dwelling Women. J Gerontol A Biol Sci Med Sci 2016; 71:1177-83. [PMID: 26757988 DOI: 10.1093/gerona/glv225] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 11/30/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Back pain and falls are common health conditions among older U.S. women. The extent to which back pain is an independent risk factor for falls has not been established. METHODS We conducted a prospective study among 6,841 community-dwelling U.S. women at least 65 years of age from the Study of Osteoporotic Fractures (SOF). Baseline questionnaires inquired about any back pain, pain severity, and frequency in the past year. During 1 year of follow-up, falls were summed from self-reports obtained every 4 months. Two outcomes were studied: recurrent falls (≥2 falls) and any fall (≥1 fall). Associations of back pain and each fall outcome were estimated with risk ratios (RRs) and 95% confidence intervals (CIs) from multivariable log-binomial regression. Adjustments were made for age, education, smoking status, fainting history, hip pain, stroke history, vertebral fracture, and Geriatric Depression Scale. RESULTS Most (61%) women reported any back pain. During follow-up, 10% had recurrent falls and 26% fell at least once. Any back pain relative to no back pain was associated with a 50% increased risk of recurrent falls (multivariable RR = 1.5, 95% CI: 1.3, 1.8). Multivariable RRs for recurrent falls were significantly elevated for all back pain symptoms, ranging from 1.4 (95% CI: 1.1, 1.8) for mild back pain to 1.8 (95% CI: 1.4, 2.3) for activity-limiting back pain. RRs of any fall were also significantly increased albeit smaller than those for recurrent falls. CONCLUSIONS Older community-dwelling women with a recent history of back pain are at increased risk for falls.
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Affiliation(s)
- Lynn M Marshall
- Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland.
| | | | - Peggy M Cawthon
- California Pacific Medical Center Research Institute, San Francisco
| | - Deborah M Kado
- Department of Family and Preventive Medicine and Department of Internal Medicine, University of California, San Diego
| | - Richard A Deyo
- Department of Family Medicine, Oregon Health and Science University, Portland
| | - Una E Makris
- Department of Internal Medicine and Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas
| | - Hans L Carlson
- Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland
| | - Michael C Nevitt
- Department of Epidemiology and Biostatistics, University of California, San Francisco
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Mat S, Tan PJ, Ng CT, Fadzli F, Rozalli FI, Khoo EM, Hill KD, Tan MP. Mild Joint Symptoms Are Associated with Lower Risk of Falls than Asymptomatic Individuals with Radiological Evidence of Osteoarthritis. PLoS One 2015; 10:e0141368. [PMID: 26491868 PMCID: PMC4619628 DOI: 10.1371/journal.pone.0141368] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 10/03/2015] [Indexed: 11/19/2022] Open
Abstract
Osteoarthritis (OA) exacerbates skeletal muscle functioning, leading to postural instability and increased falls risk. However, the link between impaired physical function, OA and falls have not been elucidated. We investigated the role of impaired physical function as a potential mediator in the association between OA and falls. This study included 389 participants [229 fallers (≥2 falls or one injurious fall in the past 12 months), 160 non-fallers (no history of falls)], age (≥65 years) from a randomized controlled trial, the Malaysian Falls Assessment and Intervention Trial (MyFAIT). Physical function was assessed using Timed Up and Go (TUG) and Functional Reach (FR) tests. Knee and hip OA were diagnosed using three methods: Clinical, Radiological and Self-report. OA symptom severity was assessed using the Western Ontario and McMaster Universities Arthritis Index (WOMAC). The total WOMAC score was categorized to asymptomatic, mild, moderate and severe symptoms. Individuals with radiological OA and ‘mild’ overall symptoms on the WOMAC score had reduced risk of falls compared to asymptomatic OA [OR: 0.402(0.172–0.940), p = 0.042]. Individuals with clinical OA and ‘severe’ overall symptoms had increased risk of falls compared to those with ‘mild’ OA [OR: 4.487(1.883–10.693), p = 0.005]. In individuals with radiological OA, mild symptoms appear protective of falls while those with clinical OA and severe symptoms have increased falls risk compared to those with mild symptoms. Both relationships between OA and falls were not mediated by physical limitations. Larger prospective studies are needed for further evaluation.
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Affiliation(s)
- Sumaiyah Mat
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Pey June Tan
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chin Teck Ng
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Department of Rheumatology & Immunology, Singapore General Hospital, Singapore, Singapare
| | - Farhana Fadzli
- Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Faizatul I. Rozalli
- Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ee Ming Khoo
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Keith D. Hill
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Maw Pin Tan
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- * E-mail:
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Measurement of gait speed in older adults to identify complications associated with frailty: A systematic review. J Geriatr Oncol 2015; 6:484-96. [PMID: 26362356 DOI: 10.1016/j.jgo.2015.08.006] [Citation(s) in RCA: 122] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 07/24/2015] [Accepted: 08/17/2015] [Indexed: 11/22/2022]
Abstract
Several frailty screening tests in older cancer patients were developed but their statistical performance is low. We aimed to assess whether measurement of usual gait speed (GS) alone could be used as a frailty screening test in older cancer patients. This systematic review was conducted on "pub med" between 1984 and 2014 and included reviews and original studies. Eligibility criteria were: GS over a short distance, alone or included in composite walking tests (Timed Get Up and Go test: TGUG, Short Physical Performance Battery: SPPB) in older people (aged 65 and over) living in a community setting and predictive value of GS on medical complications associated with frailty. 46 articles were finally selected. GS alone is consensual and recommended for screening sarcopenia in elderly. A slow GS is predictive of early death, disability, falls and hospitalization/institutionalization in older people living in a community setting. GS alone is comparable to composite walking tests that do not provide additional information on the medical complications associated with frailty. Despite few studies in geriatric oncology, GS seems to predict overall survival and disability. We suggest GS over 4m (at a threshold of 1m/s) as a new frailty screening test in older cancer patients (65 and over) to guide the implementation of a comprehensive geriatric assessment during the initial management phase or during follow-up. Prospective cohort studies are needed to validate this algorithm and compare it with other screening tool.
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Ding Z, Wang Q, Pan X, Zhu Q, Lu H, Wang K, Ni X, Lu Y, Gu J. Expression of receptor activator of nuclear factor-κB ligand is related to sex differences in collagen-induced arthritis. Int Immunopharmacol 2015; 28:892-6. [PMID: 25863233 DOI: 10.1016/j.intimp.2015.03.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 03/28/2015] [Indexed: 01/06/2023]
Abstract
Osteoclasts are responsible for bone destruction in rheumatoid arthritis, and women show greater disease activity and functional disability than men. This study aimed to examine differences in the pathogenesis of collagen-induced arthritis and osteoclastogenesis between female and male mice in vivo and in vitro. Female mice exhibited worse disease progression and increased osteoclastogenesis, as measured by tartrate-resistant acid phosphatase (TRAP) staining than male mice. Significantly higher levels of CD11b(+) cells were detected in the bone marrow of female mice than that of male mice. Furthermore, the mRNA expression of receptor activator of nuclear factor-κB ligand was higher in female mice that were immunized with or without collagen II. These findings highlighted sex differences in arthritis morbidity and suggested that female mice are more likely to develop arthritis than male mice. Further studies are needed to investigate the mechanisms of sex differences in collagen-induced arthritis.
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Affiliation(s)
- Zheng Ding
- Translational Medicine Research Center of Jiangning Hospital, Nanjing Medical University and Liver Transplantation Center of First Affiliated Hospital, Nanjing, China
| | - Qi Wang
- Translational Medicine Research Center of Jiangning Hospital, Nanjing Medical University and Liver Transplantation Center of First Affiliated Hospital, Nanjing, China
| | - Xiongxiong Pan
- Department of Anesthesiology, First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Qin Zhu
- Translational Medicine Research Center of Jiangning Hospital, Nanjing Medical University and Liver Transplantation Center of First Affiliated Hospital, Nanjing, China
| | - Hao Lu
- Translational Medicine Research Center of Jiangning Hospital, Nanjing Medical University and Liver Transplantation Center of First Affiliated Hospital, Nanjing, China
| | - Kunpeng Wang
- Translational Medicine Research Center of Jiangning Hospital, Nanjing Medical University and Liver Transplantation Center of First Affiliated Hospital, Nanjing, China
| | - Xuhao Ni
- Translational Medicine Research Center of Jiangning Hospital, Nanjing Medical University and Liver Transplantation Center of First Affiliated Hospital, Nanjing, China
| | - Yunjie Lu
- Translational Medicine Research Center of Jiangning Hospital, Nanjing Medical University and Liver Transplantation Center of First Affiliated Hospital, Nanjing, China.
| | - Jian Gu
- Translational Medicine Research Center of Jiangning Hospital, Nanjing Medical University and Liver Transplantation Center of First Affiliated Hospital, Nanjing, China.
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Harato K, Yoshida H. Pseudogout at the knee joint will frequently occur after hip fracture and lead to the knee pain in the early postoperative period. J Orthop Surg Res 2015; 10:4. [PMID: 25585622 PMCID: PMC4298053 DOI: 10.1186/s13018-014-0145-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 12/23/2014] [Indexed: 01/02/2023] Open
Abstract
Background Symptomatic knee joint effusion is frequently observed after hip fracture, which may lead to postoperative knee pain during rehabilitation after hip fracture surgery. However, unfortunately, very little has been reported on this phenomenon in the literature. The purpose of the current study was to investigate the relationship between symptomatic knee effusion and postoperative knee pain and to clarify the reason of the effusion accompanied by hip fracture. Methods A total of 100 patients over 65 years of age with an acute hip fracture after fall were prospectively followed up. Knee effusion was assessed on admission and at the operating room before the surgery. If knee effusion was observed at the time of the surgery, synovial fluid was collected into syringes to investigate the cause of the effusion using a compensated polarized light microscope. Furthermore, for each patient, we evaluated age, sex, radiographic knee osteoarthritis (OA), type of the fracture, laterality, severity of the fracture, and postoperative knee pain during rehabilitation. These factors were compared between patients with and without knee effusion at the time of the surgery. As a statistical analysis, we used Mann–Whitney U-test for patients’ age and categorical variables were analyzed by chi-square test or Fisher’s exact test. Results A total of 30 patients presented symptomatic knee effusion at the time of the surgery. In patients with knee effusion, numbers of intertrochanteric fracture, radiographic knee OA, and postoperative knee pain were significantly large compared to those without effusion. In terms of synovial fluid analysis, calcium pyrophosphate dihydrate crystals were observed in 80% of patients with knee effusion. Conclusion From our study, approximately 63% of patients with knee effusion at the time of the surgery had postoperative knee pain. In addition, this effusion was basically related to pseudogout.
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Affiliation(s)
- Kengo Harato
- Department of Orthopedic Surgery, Kawasaki Municipal Kawasaki Hospital, 12-1, Shinkawadouri, Kawasaki-ku, Kawasaki City, Kanagawa, 210-0013, Japan. .,Department of Orthopedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan.
| | - Hiroki Yoshida
- Department of Orthopedic Surgery, National Hospital Organization, Tochigi National Hospital, 1-10-37, Nakatomatsuri, Utsunomiya City, Tochigi, 320-8580, Japan.
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Abstract
Bone fragility is a major health concern, as the increased risk of bone fractures has devastating outcomes in terms of mortality, decreased autonomy, and healthcare costs. Efforts made to address this problem have considerably increased our knowledge about the mechanisms that regulate bone formation and resorption. In particular, we now have a much better understanding of the cellular events that are triggered when bones are mechanically stimulated and how these events can lead to improvements in bone mass. Despite these findings at the molecular level, most exercise intervention studies reveal either no effects or only minor benefits of exercise programs in improving bone mineral density (BMD) in osteoporotic patients. Nevertheless, and despite that BMD is the gold standard for diagnosing osteoporosis, this measure is only able to provide insights regarding the quantity of bone tissue. In this article, we review the complex structure of bone tissue and highlight the concept that its mechanical strength stems from the interaction of several different features. We revisited the available data showing that bone mineralization degree, hydroxyapatite crystal size and heterogeneity, collagen properties, osteocyte density, trabecular and cortical microarchitecture, as well as whole bone geometry, are determinants of bone strength and that each one of these properties may independently contribute to the increased or decreased risk of fracture, even without meaningful changes in aBMD. Based on these findings, we emphasize that while osteoporosis (almost) always causes bone fragility, bone fragility is not always caused just by osteoporosis, as other important variables also play a major role in this etiology. Furthermore, the results of several studies showing compelling data that physical exercise has the potential to improve bone quality and to decrease fracture risk by influencing each one of these determinants are also reviewed. These findings have meaningful clinical repercussions as they emphasize the fact that, even without leading to improvements in BMD, exercise interventions in patients with osteoporosis may be beneficial by improving other determinants of bone strength.
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Heckenbach K, Ostermann T, Schad F, Kröz M, Matthes H. Medication and falls in elderly outpatients: an epidemiological study from a German Pharmacovigilance Network. SPRINGERPLUS 2014; 3:483. [PMID: 25207204 PMCID: PMC4158008 DOI: 10.1186/2193-1801-3-483] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 08/12/2014] [Indexed: 01/07/2023]
Abstract
The aim of this study was to investigate the relationship between fall risk increasing drugs (FRIDS) and the risk of falls in regard to fall-related chronic diseases. In total, 39 primary care physicians in Germany participated in the EvaMed Pharmacovigilance Network. Antihypertensives, non-steroidal anti-inflammatory drugs, hypnotics and sedatives, antidepressants and psycholeptics were labelled as FRIDS. A fall was defined according to a diagnosis in the chapter Injury or poisoning (S00-T14 in International Statistical Classification of Diseases 10th Revision (ICD-10)). Patients older than or equal to 65 years with at least two doctor’s visits were included. FRIDS were prescribed for 1768 patients from a total of 5124 patients included in the analysis. FRIDS and seven chronic diseases were statistically significant associated with a higher risk of experiencing a fall. The risk was highest for patients with a diagnosis abnormalities of gait and mobility, vertigo, visual -impairment and weight loss, and increased by 50-90% with arthritis, diseases of arteries, arterioles and capillaries and heart failure. From patients (N = 425) with at least one diagnosis of fall, 219 patients were prescribed FRIDS. In 100 (45.7%) of cases the diagnoses for fall were made before and in 105 (47.9%) of cases at least a month after the prescription of FRIDS. 14 (6.4%) patients had a prescription of FRIDS and a diagnosis of fall within one month. Perceptual disorders, low walking speed and pain are prominent predictors for falls in the elderly. A prescription of FRIDS selects more vulnerable patients having a higher risk of falls. However, experiencing a fall is mainly due to the disease followed by treatment. Thus, not prescribing FRIDS will avoid only a small number of falls.
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Affiliation(s)
| | - Thomas Ostermann
- Institute of Integrated medicine, University of Witten/Herdecke, Gerhard-Kienle-Weg 4, D-58313 Herdecke, Germany
| | - Friedemann Schad
- Havelhoehe Research Institute, Kladower Damm 221, 14089 Berlin, Germany
| | - Matthias Kröz
- Havelhoehe Research Institute, Kladower Damm 221, 14089 Berlin, Germany
| | - Harald Matthes
- Havelhoehe Research Institute, Kladower Damm 221, 14089 Berlin, Germany
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Oppewal A, Hilgenkamp TIM, van Wijck R, Schoufour JD, Evenhuis HM. The predictive value of physical fitness for falls in older adults with intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:1317-1325. [PMID: 24691357 DOI: 10.1016/j.ridd.2014.03.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 03/09/2014] [Indexed: 06/03/2023]
Abstract
A high incidence of falls is seen in people with intellectual disabilities (ID), along with poor balance, strength, muscular endurance, and slow gait speed, which are well-established risk factors for falls in the general population. The aim of this study was to assess the predictive value of these physical fitness components for falls in 724 older adults with borderline to profound ID (≥ 50 years). Physical fitness was assessed at baseline and data on falls was collected at baseline and after three years. Gait speed was lowest in participants who fell three times or more at follow-up. Gait speed was the only physical fitness component that significantly predicted falls, but did not remain significant after correcting for confounders. Falls at baseline and not having Down syndrome were significant predictors for falls. Extremely low physical fitness levels of older adults with ID, possible strategies to compensate for these low levels, and the finding that falls did not increase with age may explain the limited predictive value of physical fitness found in this study.
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Affiliation(s)
- Alyt Oppewal
- Intellectual Disability Medicine, Department of General Practice, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Thessa I M Hilgenkamp
- Intellectual Disability Medicine, Department of General Practice, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands; Abrona, Amersfoortseweg 56, 3712 BE Huis ter Heide, The Netherlands
| | - Ruud van Wijck
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, A. Deusinglaan 1, 9713 AV Groningen, The Netherlands
| | - Josje D Schoufour
- Intellectual Disability Medicine, Department of General Practice, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Heleen M Evenhuis
- Intellectual Disability Medicine, Department of General Practice, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
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Grenier S, Payette MC, Langlois F, Vu TTM, Bherer L. Depressive symptoms are independently associated with recurrent falls in community-dwelling older adults. Int Psychogeriatr 2014; 26:1-9. [PMID: 24758735 DOI: 10.1017/s104161021400074x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
ABSTRACT Background: Falls and depression are two major public health problems that affect millions of older people each year. Several factors associated with falls are also related to depressive symptoms such as medical conditions, sleep quality, use of medications, cognitive functioning, and physical capacities. To date, studies that investigated the association between falls and depressive symptoms did not control for all these shared factors. The current study addresses this issue by examining the relationship between falls and depression symptoms after controlling for several confounders. Methods: Eighty-two community-dwelling older adults were enrolled in this study. The Geriatric Depression Scale (GDS-30) was used to evaluate the presence of depressive symptoms, and the following question was used to assess falls: "Did you fall in the last 12 months, and if so, how many times?" Results: Univariate analyses indicated that the number of falls was significantly correlated with gender (women), fractures, asthma, physical inactivity, presence of depressive symptoms, complaints about quality of sleep, use of antidepressant drugs, and low functional capacities. Multivariate analyses revealed that depressive symptoms were significantly and independently linked to recurrent falls after controlling for confounders. Conclusions: Results of the present study highlight the importance of assessing depressive symptoms during a fall risk assessment.
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Affiliation(s)
- Sébastien Grenier
- Centre de recherche, Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, Québec, Canada
| | - Marie-Christine Payette
- Centre de recherche, Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, Québec, Canada
| | - Francis Langlois
- Institut universitaire de gériatrie de Sherbrooke (IUGS), Montréal, Québec, Canada
| | - Thien Tuong Minh Vu
- Institut universitaire de gériatrie de Montréal (IUGM), Montréal, Québec, Canada
| | - Louis Bherer
- Centre de recherche, Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, Québec, Canada
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Chang SF, Yang RS, Lin TC, Chiu SC, Chen ML, Lee HC. The Discrimination of Using the Short Physical Performance Battery to Screen Frailty for Community-Dwelling Elderly People. J Nurs Scholarsh 2014; 46:207-15. [DOI: 10.1111/jnu.12068] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2013] [Indexed: 12/13/2022]
Affiliation(s)
- Shu-Fang Chang
- Associate Professor, Department of Nursing, College of Nursing; National Taipei University of Nursing and Health Sciences; Taiwan
| | - Rong-Sen Yang
- Professor, Department of Orthopedic Surgery; National Taiwan University Hospital; Taipei Taiwan
| | - Tsung-Ching Lin
- Instructor, Department of Physical Medicine and Rehabilitation; Far Eastern Memorial Hospital; Taipei Taiwan
| | - Shu-Ching Chiu
- Instructor, General Education Center; Central Taiwan University of Science and Technology; Taichung Taiwan
| | - Mei-Li Chen
- Instructor, Department of Nursing, College of Nursing; National Taipei University of Nursing and Health Sciences; Taiwan
| | - Hui-Chen Lee
- Instructor, Department of Nursing, College of Nursing; National Taipei University of Nursing and Health Sciences; Taiwan
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Relationship between patient-based outcome score and conventional objective outcome scales in post-operative total knee arthroplasty patients. INTERNATIONAL ORTHOPAEDICS 2013; 38:373-8. [PMID: 23974838 DOI: 10.1007/s00264-013-2064-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Accepted: 07/31/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE Evaluations for knee osteoarthritis (OA) or post-operative total knee arthroplasty (TKA) have mainly been assessed by objective scales. Though the Knee injury and Osteoarthritis Outcome Score (KOOS) is attracting attention as a patient-based outcome score, the relationship with conventional objective scales after TKA remains controversial. The purpose of this study was to investigate the relationship between KOOS and conventional objective scales and evaluate the features of patient-based outcome scores. METHODS Subjects were 130 post-operative patients involving 186 knees treated with TKA. Their mean age was 74.0 ± 8.0 years, and the follow-up period was 43 months. Japanese Orthopaedic Association (JOA) score, original Knee Society Score (KSS) and surgeon's satisfaction score were scored as conventional objective scales besides KOOS. Spearman's correlation coefficient was estimated between these scales. Comparisons between OA and rheumatoid arthritis (RA) as well as primary and revision surgery were performed by the Mann-Whitney U test. RESULTS There were strong correlations between KOOS activities of daily living (ADL) and JOA score (r = 0.806), KSS function score (r = 0.803) and between KOOS pain and KSS knee score (r = 0.689). However, there was a poor correlation between KOOS and surgeon's satisfaction score (r = 0.188-0.321). TKA for RA showed poorer results only in KOOS pain (p = 0.003), and revision surgery showed poorer results in KSS function, KOOS symptoms and KOOS quality of life (QOL). CONCLUSIONS This study suggested that conventional objective scales reflected mainly ADL disturbances in post-operative TKA patients. Furthermore, patient-based outcome scores made it possible to evaluate and detect a minute change of knee pain and QOL in TKA patients. The Japanese KOOS was a useful tool to evaluate conditions after TKA.
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Stenhagen M, Ekström H, Nordell E, Elmståhl S. Falls in the general elderly population: a 3- and 6- year prospective study of risk factors using data from the longitudinal population study 'Good ageing in Skane'. BMC Geriatr 2013; 13:81. [PMID: 23919320 PMCID: PMC3750524 DOI: 10.1186/1471-2318-13-81] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Accepted: 07/31/2013] [Indexed: 11/13/2022] Open
Abstract
Background Accidental falls in the elderly are a major health problem, despite extensive research on risk factors and prevention. Only a limited number of multifactorial, long-term prospective studies have been performed on risk factors for falls in the general elderly population. The aim of this study was to identify risk factors predicting falls in a general elderly population after three and six years, using a prospective design. Methods The prevalence of 38 risk factors was recorded at a baseline assessment of 1763 subjects (aged 60–93 years). The incidence of one or more falls was recorded after three and six years. The predicted risk of falling, after exposure to the various risk factors, was analysed in a multiple logistic regression model, adjusted for age and sex, and presented as odds ratios (OR). A principal component analysis (PCA), including the statistical significant factors, was also performed to identify thematic, uncorrelated components associated with falls. Results The use of neuroleptics (OR 3.30, 95% CI: 1.15–9.43), heart failure with symptoms (OR 1.88, 95% CI: 1.17–3.04) and low walking speed (OR 1.77, 95% CI: 1.28–2.46) were prominent individual risk factors for falls. In the PCA, three main components predicting falls were identified: reduced mobility, OR 2.12 (95% CI 1.54–2.91), heart dysfunction, OR 1.66 (95% CI 1.26–2.20) and functional impairment including nocturia, OR 1.38 (95% CI 1.01-1.88). Conclusions Three main components predicting falls were identified in a general elderly population after three and six years: reduced mobility, heart dysfunction and functional impairment including nocturia. The use of neuroleptic drugs was also a prominent individual risk factor, although the prevalence was low. Heart failure with symptoms was a significant risk factor for falls and may be of clinical importance as the prevalence of this condition in the elderly is increasing worldwide. There is need for further research on the relation between heart failure and falls in the elderly, as the treatment for this condition is poorly documented in this demographic. The findings of this study may be valuable in the development of intervention programmes aimed at sustainable, long-term reduction of falls in the elderly.
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Affiliation(s)
- Magnus Stenhagen
- Department of Health Sciences, Division of Geriatric Medicine, Lund University, Skåne University Hospital, Malmö SE-205 02, Sweden.
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