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González-Pisano AC, Company-Sancho MC, Abad-Corpa E, Solé-Agusti MC, Cidoncha-Moreno MÁ, González MMP. Relationship between Falls and the Use of Medications and Diseases in an Otago Exercise Programme in Old People Living in the Community in Spain. Healthcare (Basel) 2023; 11:healthcare11070998. [PMID: 37046925 PMCID: PMC10093805 DOI: 10.3390/healthcare11070998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 04/03/2023] Open
Abstract
(1) Background: Falls are a significant health problem among older adults, and can result in severe injuries, disability, and even death. In Spain, the prevalence of falls is lower if the person lives in the community than if they are institutionalized. Research has shown that exercise is an effective strategy for reducing the risk of falls among older adults. The objective of this study was to study the influence of a multicomponent exercise intervention on falls in people between 65 and 80 years of age despite the presence of diseases and drug use that are risk factors for falls; (2) Methods: This is a quasi-experimental study that focuses on people aged 65–80 who attended 21 primary healthcare centres. Target: Inclusion criteria were people between 65 and 80 years of age, living in the community with independent ambulation, and who were served by the healthcare centre of their region. Variables analysed: The number and characteristics of falls, sociodemographic, drug use, and previous diseases; (3) Results: The drugs associated with falls are benzodiazepines (OR 2.58), vasodilators (OR = 2.51), and psychotropics (OR = 1.61). For one of the years, a relationship was found between the consumption of antidepressants and falls (OR = 1.83). The associated diseases were mental and behavioural (OR = 2.53); (4) Discussion: The intervention has been related to the reduction in falls in people who consumed benzodiazepines, vasodilators, and psychotropics and in people with mental disorders; (5) Conclusion: This research concludes the importance of the implementation of the Otago Exercise Programme in the prevention of falls in the elderly.
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Affiliation(s)
- Ana Covadonga González-Pisano
- Research Group “Community Health and Active Aging”, Biosanitary Research Institute of the Principality of Asturias, Primary Care, Ministry of Health, Asturias, 33006 Oviedo, Spain
| | - Maria Consuelo Company-Sancho
- Health Promotion Service, Directorate General for Public Health, Canary Islands Health Service, 35003 Las Palmas de Gran Canaria, Spain
| | - Eva Abad-Corpa
- Nursing and Healthcare Research Unit (Investén-Isciii), CIBER of Frailty and Healthy Aging (CIBER-FES), 30011 Murcia, Spain
| | | | | | - Marta M Pisano González
- General Direction of Care, Humanization and Social and Health Care, Principado de Asturias, Biosanitary Research Institute of the Principality of Asturias, Ministry of Health, 33006 Oviedo, Spain
- Correspondence:
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Escosura Alegre I, Fernández Rodríguez EJ, Sánchez Gómez C, García Martín A, Rihuete Galve MI. Living Conditions and the Incidence and Risk of Falls in Community-Dwelling Older Adults: A Multifactorial Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4921. [PMID: 36981827 PMCID: PMC10048933 DOI: 10.3390/ijerph20064921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
Old age represents a social group that is undergoing continuous expansion. The aging population will be prone to chronic diseases and falls, which is a marker of frailty and a public health problem. This study aims to examine the relationship between living conditions and the prevalence of the risk of falls in older adults within the community. As an observational cross-sectional study, intentional sampling was carried out on residents of the metropolitan area over 75 years of age. The socio-demographic data of the subjects and their history of falls were collected. Additionally, the subjects were evaluated on the risk of falling, basic activities of daily living, such as walking and balance, fragility, and their fear of falling. The statistical analyses used were based on the Shapiro-Wilk test for normality, statistics of central tendency with description, mean (M) and dispersion, standard deviation (SD), bivariate contingency tables for studying the relationships between the variables, and the analysis of Pearson's relational statistics (χ2). The comparisons of means were resolved by parametric or non-parametric routes. We obtained the following results: 1. The socio-demographic profile of our sample consisted of adults over 75 years of age, the majority of whom were overweight or obese women living in an urban area, specifically in an apartment, and receiving care; 2. Older people in the studied community had mild dependency and frailty, and were also at severe risk of falls; 3. The prevalence of falls was higher in women than in men in this study. Through these results, we confirmed the relationship between living conditions and the prevalence of risk of falls in older adults within the community.
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Affiliation(s)
- Irene Escosura Alegre
- Nursing and Physiotherapy Department, University of Salamanca, 37007 Salamanca, Spain
| | - Eduardo José Fernández Rodríguez
- Nursing and Physiotherapy Department, University of Salamanca, 37007 Salamanca, Spain
- Institute of Biomedical Research of Salamanca, 37007 Salamanca, Spain
| | - Celia Sánchez Gómez
- Institute of Biomedical Research of Salamanca, 37007 Salamanca, Spain
- Department of Developmental and Educational Psychology, University of Salamanca, 37007 Salamanca, Spain
| | - Alberto García Martín
- Department of Labour Law and Social Work, University of Salamanca, 37007 Salamanca, Spain
| | - María Isabel Rihuete Galve
- Nursing and Physiotherapy Department, University of Salamanca, 37007 Salamanca, Spain
- Institute of Biomedical Research of Salamanca, 37007 Salamanca, Spain
- Medical Oncology Service, Salamanca University Hospital, 37007 Salamanca, Spain
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Bustamante-Troncoso C, Herrera-López LM, Sánchez H, Pérez JC, Márquez-Doren F, Leiva S. [Effect of a multidimensional intervention for prevention of falls in the eldery]. Aten Primaria 2020; 52:722-730. [PMID: 31740074 PMCID: PMC8054286 DOI: 10.1016/j.aprim.2019.07.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 05/30/2019] [Accepted: 07/29/2019] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To evaluate the effect of a multidimensional intervention on the perception and management of risk factors and frequency of falls in independent elderly people living in the community. DESIGN Randomised clinical trial. SETTING Family health centre, primary care. PARTICIPANTS Independent elderly people living in the community. INTERVENTION For intervention group (IG) a multidimensional intervention, consisting of home visits and telephone follow-up was carried out for 5 months (n=77), and those assigned to the control group (CG, n=77) received usual care in the family health centre. MAIN MEASUREMENTS Perception of risk of falls, number of risk factors and number of falls in the study period. RESULTS In both groups there were increases in the perception of risk factors for falling associated with walking (IG: P<.001 and CG: P<.001). Belonging to the IG was significantly associated with a decrease in the risk factors associated with surfaces (r=0.25) and shoes (r=0.24), as well as an increase in the perception of risk of falls associated with walking (r=0.21) and the presence of objects or furniture (r=0.36). In the IG, 5 participants (7.9%) suffered at least one fall in the 5-month period and 18 (27.7%) patients in the CG (P=.004). CONCLUSIONS The multidimensional intervention was effective in reducing the frequency of falls and in the management of extrinsic risk factors associated with surfaces, lighting, and support devices.
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Affiliation(s)
| | | | - Hugo Sánchez
- Servicio de Salud Metropolitano Sur, Santiago de Chile, Chile
| | - J Carola Pérez
- Facultad de Psicología, Universidad del Desarrollo, Santiago de Chile, Chile
| | | | - Sara Leiva
- Centro de Salud Familiar Félix de Amesti, Departamento de Salud Municipalidad de Macul, Santiago de Chile, Chile
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Machón M, Mosquera I, Larrañaga I, Martín U, Vergara I. [Socioeconomic inequalities in health among the elderly population in Spain]. GACETA SANITARIA 2020; 34:276-288. [PMID: 31563284 DOI: 10.1016/j.gaceta.2019.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/29/2019] [Accepted: 06/19/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To examine socioeconomic inequalities in health in the older population in Spain. METHOD A systematic search and review of the literature published between 2000 and 2017 in English and Spanish was conducted in Social Science Citation Index, Sociology Database, Scopus, PubMed and Embase. Primary and secondary studies analysing these inequalities in Spain were included. Two researchers were responsible for the selection of the studies and the extraction of the information (first author, year of publication, region, design, population/sample, socioeconomic and health indicators used, and main results). RESULTS A total of 89 articles were included, corresponding to 87 studies. Of the studies, 81.6% were cross-sectional, 88.5% included only non-institutionalised population and 35.6% were carried out at a national level. The studies analysed social inequalities in the following health indicators: functional status (n=29), morbidity (n=19), self-perceived health (n=18), mental and emotional health (n=10), cognitive status (n=7), quality of life (n=9), mortality (n=15) and life expectancy (n=2). Socioeconomic inequalities were detected in all of them, although the magnitude varied depending on the socioeconomic and health indicator used. The educational level and the ecological indexes were the indicators that detected more inequalities in health. The impact of inequalities by sex was different in functional status, morbidity, self-perceived health, mental and emotional health and mortality. CONCLUSION There are socioeconomic inequalities in health among the elderly population and their magnitude varies by sex in some of the health indicators. The increase in educational level and the maintenance of sufficient pensions can be key policies that contribute to the reduction of inequalities in this population group.
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Affiliation(s)
- Mónica Machón
- Unidad de Investigación de Atención Primaria-OSIs Gipuzkoa, San Sebastián (Guipúzcoa), España; Instituto de Investigación Sanitaria Biodonostia, San Sebastián (Guipúzcoa), España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), España; Kronikgune - Centro de Investigación en Cronicidad, Barakaldo (Vizcaya), España
| | - Isabel Mosquera
- Departamento de Sociología 2, Facultad de Ciencias Sociales y de la Comunicación, Universidad del País Vasco UPV/EHU, Leioa (Vizcaya), España; OPIK - Grupo de investigación en Determinantes Sociales de la Salud y Cambio Demográfico, Universidad del País Vasco UPV/EHU, Leioa (Vizcaya), España.
| | - Isabel Larrañaga
- Departamento de Salud, Delegación Territorial de Gipuzkoa, Gobierno Vasco, San Sebastián (Guipúzcoa), España
| | - Unai Martín
- Departamento de Sociología 2, Facultad de Ciencias Sociales y de la Comunicación, Universidad del País Vasco UPV/EHU, Leioa (Vizcaya), España; OPIK - Grupo de investigación en Determinantes Sociales de la Salud y Cambio Demográfico, Universidad del País Vasco UPV/EHU, Leioa (Vizcaya), España
| | - Itziar Vergara
- Unidad de Investigación de Atención Primaria-OSIs Gipuzkoa, San Sebastián (Guipúzcoa), España; Instituto de Investigación Sanitaria Biodonostia, San Sebastián (Guipúzcoa), España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), España; Kronikgune - Centro de Investigación en Cronicidad, Barakaldo (Vizcaya), España
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Rodrigues ARGDM, Assef JC, de Lima CB. Assessment of risk factors associated with falls among the elderly in a municipality in the state of Paraíba, Brazil. A cross-sectional study. SAO PAULO MED J 2019; 137:430-437. [PMID: 31939568 PMCID: PMC9745815 DOI: 10.1590/1516-3180.2018.0198120619] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 06/12/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Falls among the elderly are one of the main public health problems that have direct consequences for their health. They reduce these individuals' autonomy and functional independence. OBJECTIVE The objective of this study was to evaluate the risk factors associated with falls among elderly people enrolled within primary healthcare. DESIGN AND SETTING Cross-sectional study conducted at primary healthcare units in the municipality of Patos, state of Paraíba, Brazil. METHODS The Fall Risk Score and Timed Up and Go (TUG) test were used for evaluating the risk of falling among 316 elderly individuals. The independent variables used were sociodemographic and health conditions, while the dependent variable was the frequency of falls on the same level, over the course of previous years. The descriptive statistical tests used were the chi-square and Mann-Whitney tests. RESULTS Occurrence of falls was reported by 211 of the 316 participants, representing a prevalence of 66.8% with confidence interval 61.6-72.0. The logistic regression results showed, after adjusting for all variables included in the model, that only the variables of vestibular disorders, self-assessed health status and dizziness/vertigo (trend) were significant (P ≤ 0.05). Most of the elderly participants had two or more associated pathological conditions. The participants were predominantly female (68.4%). CONCLUSIONS Higher occurrence of falls was observed among female elderly individuals who suffered recurrent falls, had had low levels of schooling, presented comorbidities, had comorbidities and made use of drugs. These conditions predisposed these individuals to greater vulnerability to the risk of falls.
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Affiliation(s)
- Alba Rejane Gomes de Moura Rodrigues
- BSN. Nurse and Doctoral Student of Surgical Research, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo (SP); and Instructor, Unidade Acadêmica de Enfermagem (UAENF), Universidade Federal de Campina Grande (UFCG), Cajazeiras (PB), Brazil.
| | - José Cesar Assef
- MD. Associate Professor, Department of Surgery, and Director of Emergency Services, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo (SP), Brazil.
| | - Carlos Bezerra de Lima
- BSN, MD. Nurse, Nursing Department, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro (RJ); Teacher of Postgraduate Program, Faculdade Brasileira de Ensino Pesquisa e Extensão (FABEX), João Pessoa (PB), Brazil.
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Mental health in Parkinson's disease after receiving aquatic therapy: a clinical trial. Acta Neurol Belg 2019; 119:193-200. [PMID: 30413971 DOI: 10.1007/s13760-018-1034-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 10/23/2018] [Indexed: 10/27/2022]
Abstract
Depression is a major determinant of quality of life in individuals with Parkinson's disease. The aim of this study was to evaluate the effects of a program of Ai Chi aquatic therapy on pain, depression and quality of life in people with Parkinson's disease. Participants were randomized to receive dry land physiotherapy treatment (control group) or aquatic Ai Chi sessions in the pool (experimental group). The outcome measures used included the VAS pain scale, the Geriatric Depression Scale and the SF-36 quality of life scale. In the experimental group treated with aquatic therapy, significant differences were found in the pain, depression and quality of life variables post-treatment (p < 0.001). In the control group, improvements were only observed in the VAS pain scale, and these were less significant than the changes found in the experimental group (p = 0.006). The significant changes registered in the experimental group at the post-treatment assessment were maintained 1 month after completing the experimental intervention program. In conclusion, these findings indicate that physical exercise performed in water has positive effects on some of the factors that influence mood and quality of life in people with Parkinson's disease.
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Mosquera I, Machón M, Vergara I, Larrañaga I, Martín U. [Social inequalities in health among the elderly population: review of indicators used in Spain]. GACETA SANITARIA 2019; 34:297-304. [PMID: 30665691 DOI: 10.1016/j.gaceta.2018.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 11/13/2018] [Accepted: 11/14/2018] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To identify the indicators of social position used to evaluate inequalities in health among the population aged 65 and over in Spain. METHOD A systematic search of the literature published in English and Spanish since 2000 in health and social databases was carried out. Primary and secondary studies analyzing these inequalities in Spain were included. The indicators used were identified, as well as the advantages and limitations pointed out by the authors. The main findings were synthesized in a review of the literature. RESULTS We included 87 studies, described in 89 articles. The socioeconomic indicators employed were both individual and ecological. Among the former, educational level was the most analyzed socioeconomic variable (n=73). Other individual variables used were occupation (n=17), objective economic level (n=16), subjective economic level (n=4), housing and household material wealth (n=6), relationship with work activity (n=5), and mixed measures (n=5). Among the ecological indicators, simple (n=3) and complex indices (n=7) were identified. The latter had been constructed based on several indicators, such as educational level and unemployment. Inequalities in multiple health indicators were analyzed, self-perceived health being the only indicator assessed according to all the socioeconomic indicators described. CONCLUSIONS A wide variety of indicators is identified for the evaluation of social inequalities in health among the elderly population. There have not been sufficiently assessed from a gender perspective; this is a line of interest for future research.
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Affiliation(s)
- Isabel Mosquera
- Departamento de Sociología 2, Facultad de Ciencias Sociales y de la Comunicación, Universidad del País Vasco UPV/EHU, Leioa (Vizcaya), España; Opik-Grupo de investigación en Determinantes Sociales de la Salud y Cambio Demográfico, Universidad del País Vasco UPV-EHU, Leioa (Vizcaya), España
| | - Mónica Machón
- Unidad de Investigación de Atención Primaria - OSIs Gipuzkoa, Osakidetza, San Sebastián (Guipúzcoa), España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), España; Instituto de Investigación Sanitaria Biodonostia, San Sebastián (Guipúzcoa), España; Kronikgune - Centro de Investigación en Cronicidad, Barakaldo (Vizcaya), España.
| | - Itziar Vergara
- Unidad de Investigación de Atención Primaria - OSIs Gipuzkoa, Osakidetza, San Sebastián (Guipúzcoa), España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), España; Instituto de Investigación Sanitaria Biodonostia, San Sebastián (Guipúzcoa), España; Kronikgune - Centro de Investigación en Cronicidad, Barakaldo (Vizcaya), España
| | - Isabel Larrañaga
- Departamento de Salud, Gobierno Vasco, San Sebastián (Guipúzcoa), España
| | - Unai Martín
- Departamento de Sociología 2, Facultad de Ciencias Sociales y de la Comunicación, Universidad del País Vasco UPV/EHU, Leioa (Vizcaya), España; Opik-Grupo de investigación en Determinantes Sociales de la Salud y Cambio Demográfico, Universidad del País Vasco UPV-EHU, Leioa (Vizcaya), España
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Alex D, Khor HM, Chin AV, Hairi NN, Othman S, Khoo SPK, Bahyah Kamaruzzaman S, Tan MP. Cross-sectional analysis of ethnic differences in fall prevalence in urban dwellers aged 55 years and over in the Malaysian Elders Longitudinal Research study. BMJ Open 2018; 8:e019579. [PMID: 30018093 PMCID: PMC6059344 DOI: 10.1136/bmjopen-2017-019579] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Falls represent major health issues within the older population. In low/middle-income Asian countries, falls in older adults remain an area which has yet to be studied in detail. Using data from the Malaysian Elders Longitudinal Research (MELoR), we have estimated the prevalence of falls among older persons in an urban population, and performed ethnic comparisons in the prevalence of falls. DESIGN Cross-sectional analysis was carried out using the first wave data from MELoR which is a longitudinal study. SETTING Urban community dwellers in a middle-income South East Asian country. PARTICIPANTS 1565 participants aged ≥55 years were selected by simple random sampling from the electoral rolls of three parliamentary constituencies. OUTCOME MEASURES Consenting participants from the MELoR study were asked the question 'Have you fallen down in the past 12 months?' during their computer-assisted home-based interviews. Logistic regression analyses were conducted to compare the prevalence of falls among various ethnic groups. RESULTS The overall estimated prevalence of falls for individuals aged 55 years and over adjusted to the population of Kuala Lumpur was 18.9%. The estimated prevalence of falls for the three ethnic populations of Malays, Chinese and Indian aged 55 years and over was 16.2%, 19.4% and 23.8%, respectively. Following adjustment for ethnic discrepancies in age, gender, marital status and education attainment, the Indian ethnicity remained an independent predictor of falls in our population (relative risk=1.45, 95% CI 1.08 to 1.85). CONCLUSION The prevalence of falls in this study is comparable to other previous Asian studies, but appears lower than Western studies. The predisposition of the Indian ethnic group to falls has not been previously reported. Further studies may be needed to elucidate the causes for the ethnic differences in fall prevalence.
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Affiliation(s)
- Deepa Alex
- Division of Geriatric Medicine, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Hui Min Khor
- Division of Geriatric Medicine, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ai Vyrn Chin
- Division of Geriatric Medicine, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Noran Naqiah Hairi
- Julius Centre, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sajaratulnisah Othman
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Shahrul Bahyah Kamaruzzaman
- Division of Geriatric Medicine, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Maw Pin Tan
- Division of Geriatric Medicine, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
- Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Lavedán A, Viladrosa M, Jürschik P, Botigué T, Nuín C, Masot O, Lavedán R. Fear of falling in community-dwelling older adults: A cause of falls, a consequence, or both? PLoS One 2018; 13:e0194967. [PMID: 29596521 PMCID: PMC5875785 DOI: 10.1371/journal.pone.0194967] [Citation(s) in RCA: 120] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 03/14/2018] [Indexed: 11/19/2022] Open
Abstract
Background Despite the number of studies that have tried to demonstrate that there is an association between previous falls and the fear of falling, the relationship between these two variables remains a matter of controversy. Objectives Our objective was to investigate whether the fear of falling is a cause of falls, a consequence, or both in community-dwelling adults aged ≥ 75 years old. Methods A descriptive, longitudinal, prospective study was performed. A total of 640 individuals were interviewed between 2009 and 2011. Sociodemographic data, health status, history of falls and fear of falling were assessed at baseline and at 24 months. Results The prevalence of falls at baseline was 25% as opposed to 35.2% at 24 months. The prevalence of the fear of falling was 41.5% at baseline. Logistic regression analysis showed a significant association between a history of falls and the fear of falling. Other factors associated with the fear of falling were female gender, comorbidity, depressive symptoms, and disability. In total, 41.7% of the subjects who had reported a fear of falling at baseline had suffered at least one fall 24 months later. Unadjusted Cox regression analysis revealed that the fear of falling was a risk factor for falls. According to the final model adjusted for other covariates, the only reliable predictor was female gender. The Cox model stratified by gender failed to show a crude association between fear of falling and falls. Conclusion A previous history of falls in the previous year was a good predictor of the fear of falling; but the fear of falling was a predictor of falls during follow-up only in the unadjusted model, pointing to strong gender turns out as an effect modifier of the association of FOF and subsequent falls. Nursing staff working in elderly care should not only routinely assess patients’ previous history of falls, but also evaluate their fear of falling and its associated factors.
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Affiliation(s)
- Ana Lavedán
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
| | - Maria Viladrosa
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- University Hospital Arnau de Vilanova, Lleida, Spain
| | - Pilar Jürschik
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
| | - Teresa Botigué
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- * E-mail:
| | - Carmen Nuín
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
| | - Olga Masot
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
| | - Raquel Lavedán
- University Clinical Hospital Lozano Blesa, Zaragoza, Spain
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Millán-Calenti JC, Martínez-Isasi S, Lorenzo-López L, Maseda A. Morbidity and medication consumption among users of home telecare services. HEALTH & SOCIAL CARE IN THE COMMUNITY 2017; 25:888-900. [PMID: 27487761 DOI: 10.1111/hsc.12377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/24/2016] [Indexed: 06/06/2023]
Abstract
Telecare is a healthcare resource based on new technologies that, through the services offered, attempt to help elderly people to continue living in their homes. In this sense, first-generation telecare services have quickly developed in Europe. The aim of this work was to define the profile, pattern of medication consumption and disease frequencies of elderly users of a telecare service. The cross-sectional study involved 742 Spanish community-dwelling elders (85.3% of the total users aged 65 years and over who used a telecare service before the end of the data collection period). Data were collected between March and September 2012. Subjects' mean age was 83.3 (SD 6.6) years, and the majority lived alone (78.3%) and were female (85.8%). The mean Charlson comorbidity index score was 1.13 (SD 1.1), and the mean number of prescribed medications per day was 5.6 (SD 3.0). The most frequent diseases were hypertension (51.1%) and rheumatic disorders (44%); and the most consumed medications were those for the cardiovascular (75%) and nervous (65.2%) systems. For the total sample, the three main determinants of polymedication (five or more medications) were hypertension, anxiety-depressive symptoms and coronary heart disease. Regardless of the social elements contributing to the implementation of telecare services, specific health characteristics of potential users, such as morbidity and polypharmacy, should be carefully considered when implementing telecare services in the coming years.
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Affiliation(s)
- José C Millán-Calenti
- Gerontology Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña, A Coruña, Spain
| | - Santiago Martínez-Isasi
- Gerontology Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña, A Coruña, Spain
| | - Laura Lorenzo-López
- Gerontology Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña, A Coruña, Spain
| | - Ana Maseda
- Gerontology Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña, A Coruña, Spain
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Programa multifactorial para la prevención de caídas: un proyecto multifactorial en el ámbito rural. Semergen 2016; 42:506-507. [DOI: 10.1016/j.semerg.2015.09.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 09/15/2015] [Indexed: 11/21/2022]
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12
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Effects of an Ai Chi fall prevention programme for patients with Parkinson's disease. NEUROLOGÍA (ENGLISH EDITION) 2016. [DOI: 10.1016/j.nrleng.2015.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Pérez-de la Cruz S, García Luengo A, Lambeck J. Efectos de un programa de prevención de caídas con Ai Chi acuático en pacientes diagnosticados de parkinson. Neurologia 2016; 31:176-82. [DOI: 10.1016/j.nrl.2015.05.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Revised: 05/19/2015] [Accepted: 05/25/2015] [Indexed: 10/23/2022] Open
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Mazharizad F, Dadipoor S, Madani A, Moradabadi AS. Investigating the prevalence and causes of events leading to falls among the elderly hospitalized in Bandar Abbas hospitals. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2015; 4:11. [PMID: 25767822 PMCID: PMC4355833 DOI: 10.4103/2277-9531.151920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND AND PURPOSE OF STUDY Statistical indices show a growing increase in the elderly population around the world and our country. On the one hand, senior citizens are more exposed to tragic events than other age groups due to natural physiological changes. Falling down, accidents and scalds are among the most prevalent deadly events in this age group. Environmental security is vital in maintaining the elderly's health. Therefore, the present research was conducted seeking to determine the prevalence and causes of falls among the elderly hospitalized in Bandar Abbas hospitals. METHODS AND MATERIALS The present research is of a descriptive, cross-sectional type. Research population is comprised of all the elderly patients in Bandar Abbas hospitals. The sample included 300 individuals who were selected according to convenience sampling method till the sample was saturated. The instrument used was a questionnaire and the data were also gathered through interviews. The collected data were later analyzed by SPSS version 16. To analyze the data, descriptive statistics (frequency and percentage) were used along with the Chi-squared test. The significance level was set at P < 0.05. RESULTS From among the 300 subjects, 47.3% had experienced falls since the age of 60. In 22 of cases, it had led to injury and they were obliged to visit a doctor. The results of this research revealed that the causes of falls among the elderly were respectively: 43.33% of unbalance, 12.3% of poor eyesight, 11.66% of non-existing handles or fences, 12% of slippery ground, 2.66% of insufficient lightning, 8.66% of unbalance and poor eyesight and 9.33% of other reasons. As the results revealed, a correlation existed between falls and educational level (P < 0.025). Moreover, a significant correlation was found between sex and falls (P < 0.011). A similar significant correlation was also observed between the place of residence and falling down (P < 0.045). CONCLUSION According to the research results, planning to prevent events and traumas among the elderly and securing their residential environment is of an essential significance.
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Affiliation(s)
- Fereshteh Mazharizad
- Department of Nursing, School of Nursing, Bandar Abbas Branch, Islamic Azad University, Bandar Abbas, Iran
| | - Sakineh Dadipoor
- Hormozgan Fertility and Infertility Research Center, Bandar Abbas, Iran
| | - Abdoulhhossain Madani
- Department of Public Health, Social Determinants for Health Promotion Research Center, School of Health, Bandar Abbas, Iran
| | - Ali Safari Moradabadi
- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Lavedán Santamaría A, Jürschik Giménez P, Botigué Satorra T, Nuin Orrio C, Viladrosa Montoy M. [Prevalence and associated factors of falls in community-dwelling elderly]. Aten Primaria 2014; 47:367-75. [PMID: 25510489 PMCID: PMC6983699 DOI: 10.1016/j.aprim.2014.07.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 05/19/2014] [Accepted: 07/09/2014] [Indexed: 12/11/2022] Open
Abstract
Objetivo Estimar la prevalencia de caídas e identificar los factores asociados a ellas en la población mayor comunitaria. Diseño Estudio descriptivo, transversal. Emplazamiento Atención Primaria de Salud, Lleida. Participantes Se incluyó a 640 personas de 75 o más años de edad, que disponían de tarjeta sanitaria y residían en viviendas unifamiliares, a través de un muestreo aleatorizado. Mediciones principales La fuente de datos proviene de la encuesta de fragilidad en Lleida (Encuesta FRALLE). Las variables utilizadas fueron la presencia de caídas en el último año, factores sociodemográficos, estado de salud, calidad de vida relacionada con la salud y miedo a caer. Resultados La prevalencia de caídas fue del 25,0% (IC 95% 24,8-25,1). Tras el análisis multivariado, la discapacidad básica (OR = 2,17; IC 95% 1,32-3,58), los síntomas depresivos (OR = 1,67; IC 95% 1,07-2,59) y el miedo a caer (OR = 2,53; IC 95% 1,63-3,94) fueron los únicos factores asociados de forma independiente a las caídas en el último año. Conclusiones Una de cada 4 personas mayores presentaron al menos una caída en el último año. Este estudio demuestra que el miedo a caer, los síntomas depresivos y la discapacidad básica son variables independientes asociadas a caídas previas. Estos 3 factores pueden dar lugar a una espiral favorecedora de caídas, pudiendo ser posibles objetivos para la actuación eficaz en el contexto de caídas.
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Factors related to functional prognosis in elderly patients after accidental hip fractures: a prospective cohort study. BMC Geriatr 2014; 14:124. [PMID: 25425462 PMCID: PMC4280690 DOI: 10.1186/1471-2318-14-124] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 11/13/2014] [Indexed: 11/10/2022] Open
Abstract
Background A restriction in functional capacity occurs in all hip fractures and a variety of factors have been shown to influence patient functional outcome. This study sought to provide new and comprehensive insights into the role of factors influencing functional recovery six months after an accidental hip fracture. Methods A prospective cohort study was conducted of patients aged 65 years or more who attended the Emergency Room (ER) for a hip fracture due to a fall. The following were studied as independent factors: socio-demographic data (age, sex, instruction level, living condition, received help), comorbidities, characteristics of the fracture, treatment performed, destination at discharge, health-related quality of life (12-Item Short Form Health Survey) and hip function (Short Western Ontario and McMaster Universities Osteoarthritis Index). As main outcome functional status was measured (Barthel Index and Lawton Instrumental Activities of Daily Living Scale). Data were collected during the first week after fracture occurrence and after 6 months of follow-up. Patients were considered to have deteriorated if there was worsening in their functional status as measured by Barthel Index and Lawton IADL scores. Factors associated with the outcome were studied via logistic regression analysis. Results Six months after the fall, deterioration in function was notable, with mean reductions of 23.7 (25.2) and 1.6 (2.2) in the Barthel Index and Lawton IADL Scale scores respectively. Patients whose status deteriorated were older, had a higher degree of comorbidity and were less educated than those who remained stable or improved. The multivariate model assessing the simultaneous impact of various factors on the functional prognosis showed that older patients, living with a relative or receiving some kind of social support and those with limited hip function before the fall had the highest odds of having losses in function. Conclusion In our setting, the functional prognosis of patients is determined by clinical and social factors, already present before the occurrence of the fracture. This could make it necessary to perform comprehensive assessments for patients with hip fractures in order to identify those with a poor functional prognosis to tackle their specific needs and improve their recovery.
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Physical Function, Fear of Falling, Occupational Status and Falls in a Nigerian Older Adults Sample. AGEING INTERNATIONAL 2014. [DOI: 10.1007/s12126-014-9202-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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González N, Aguirre U, Orive M, Zabala J, García-Gutiérrez S, Las Hayas C, Navarro G, Quintana JM. Health-related quality of life and functionality in elderly men and women before and after a fall-related wrist fracture. Int J Clin Pract 2014; 68:919-28. [PMID: 24666925 DOI: 10.1111/ijcp.12410] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
AIMS To evaluate health-related quality of life (HRQoL) and functionality among older men and women who suffered a wrist fracture because of a fall and to identify postfracture consequences. METHODS Observational, prospective cohort study of patients recruited in the emergency departments (ED) of six public hospitals of the Basque Health Service and one of the Catalan Health Service. Two groups of adults aged 65 or older were recruited: 960 with wrist fractures because of falls (fracture cohort) and 119 without fall-related wrist fractures in the previous year (non-fracture cohort). We collected sociodemographical and clinical data; general and specific HRQoL data measured by the 12-Item Short Form Health Survey (SF-12) and a short version of the Disabilities of the Arm, Shoulder, and Hand instrument (QuickDASH); and data about basic (BADL) and instrumental (IADL) activities of daily living, measured by the Barthel Index and the Lawton and Brody Index (LBI). RESULTS Women with wrist fractures exhibited greater declines than men 6 months after the fall in all questionnaires except the LBI, and greater declines than those in the non-fracture cohort independent of gender. Patients aged 80 years and older presented with worse baseline scores in all the outcome measures and lost more HRQoL and functionality after wrist fractures. DISCUSSION Women and older individuals experienced the greatest reductions in HRQoL and functionality after a fall-related wrist facture, suggesting that they might merit special attention in clinical care and public health policy. CONCLUSIONS Specific prevention strategies may be needed to avoid or reduce the consequences of fall-related wrist fractures.
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Affiliation(s)
- N González
- Research Unit, Hospital Galdakao-Usansolo - Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Galdakao, Spain
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Rossi-Izquierdo M, Santos-Pérez S, Del-Río-Valeiras M, Lirola-Delgado A, Faraldo-García A, Vaamonde-Sánchez-Andrade I, Gayoso-Diz P, Soto-Varela A. Is there a relationship between objective and subjective assessment of balance in elderly patients with instability? Eur Arch Otorhinolaryngol 2014; 272:2201-6. [DOI: 10.1007/s00405-014-3122-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 05/22/2014] [Indexed: 11/30/2022]
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Sandoval RA, Sá ACAM, Menezes RLD, Nakatani AYK, Bachion MM. Ocorrência de quedas em idosos não institucionalizados: revisão sistemática da literatura. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2013. [DOI: 10.1590/s1809-98232013000400019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Revisão sistemática da literatura com o objetivo de identificar a ocorrência de quedas de idosos residentes na comunidade. Utilizando o portal CAPES, realizou-se busca nas bases de dados Academic Search (EBSCO), SciELO e Science Direct (ELSEVIER); e uma busca adicional na base de dados Lecturas Educación Física y Deportes, do site EFDEPORTES. Foram encontrados, com os descritores utilizados, 247 artigos publicados no período de 2000 a 2011. Foram excluídos 230 que não atenderam a um ou mais dos critérios de inclusão. Incluíram-se no estudo 17 artigos, sendo 12 transversais, dois de coorte prospectiva, dois de pesquisa de base populacional e um de coorte retrospectiva. A amostra total envolvida nos estudos foi de 114.911 sujeitos, com média de idade de aproximadamente 70 anos, distribuídos em sete países: Brasil, Estados Unidos, Espanha, Itália, Nigéria, Turquia e China. A ocorrência de quedas variou de 15,9 a 56,3%, com mediana de 28,50%. Embora apresente variação, a ocorrência de quedas na população idosa que reside na comunidade é alta.
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Terroso M, Rosa N, Torres Marques A, Simoes R. Physical consequences of falls in the elderly: a literature review from 1995 to 2010. Eur Rev Aging Phys Act 2013. [DOI: 10.1007/s11556-013-0134-8] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Analysis of extrinsic and intrinsic factors that predispose elderly individuals to fall. Rev Assoc Med Bras (1992) 2012. [DOI: 10.1016/s0104-4230(12)70224-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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de Almeida ST, Chaves Soldera CL, de Carli GA, Gomes I, Lima Resende TD. Análise de fatores extrínsecos e intrínsecos que predispõem a quedas em idosos. Rev Assoc Med Bras (1992) 2012. [DOI: 10.1590/s0104-42302012000400012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Pérula LA, Varas-Fabra F, Rodríguez V, Ruiz-Moral R, Fernández JA, González J, Pérula CJ, Roldán AM, de Dios C. Effectiveness of a multifactorial intervention program to reduce falls incidence among community-living older adults: a randomized controlled trial. Arch Phys Med Rehabil 2012; 93:1677-84. [PMID: 22609117 DOI: 10.1016/j.apmr.2012.03.035] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Revised: 03/05/2012] [Accepted: 03/25/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To determine the effectiveness of a multifactorial intervention program to prevent falls among older adults as compared with a brief intervention. DESIGN Randomized controlled trial. SETTING Eleven health centers located in Córdoba, Spain. PARTICIPANTS People over 70 years old (N=404), who are residents in the community. INTERVENTIONS The centers were randomized to either 1 of the 2 groups: intervention group (IG), of a multifactorial nature (individual advice, information leaflet, physical exercise workshop, and home visits), or control group (CG) (brief individual advice and information leaflet). MAIN OUTCOME MEASURES Fall rates and time until the fall; estimates of the relative and absolute risk of falls; and survival analysis and Cox regression. RESULTS Of the patients recruited, 133 were in the IG and 271 were in the CG. Around 33% in the IG and 30.25% in the CG had had a fall in the previous year (P=.56). After 12 months, the fall incidence rate was 17.29% in the IG and 23.61% in the CG (relative risk=0.73; 95% confidence interval [CI], 0.48-1.12; P=.146). Around 60% of the IG patients said they had increased the time spent on physical activity. In the IG, the incidence of falls at home was 27.5% compared with 49.3% in the CG (P=.04). Being a woman (odds ratio [OR]=1.62; 95% CI, 1.03-2.54), having a history of falls (OR=1.15; 95% CI, 1.05-1.26), suffering acute health problems (OR=2.19; 95% CI, 1.09-4.40), and doing moderate exercise (OR=1.91; 95% CI, 1.08-3.38) were found as factors associated with a higher risk of falls. CONCLUSIONS Although the reduction of falls in the IG was nearly halved, and after the intervention there was a significant reduction in the number of falls at these patients' homes, the multifactorial intervention program is no more effective than the brief intervention to reduce the overall risk of falls.
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Affiliation(s)
- Luis A Pérula
- Unidad Docente de Medicina Familiar y Comunitaria de Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía and University of Córdoba, Córdoba, Spain.
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Molina López T, Caraballo Camacho MDLO, Palma Morgado D, López Rubio S, Domínguez Camacho JC, Morales Serna JC. [Prevalence of multiple medication and cardiovascular risk in patients over 65 years]. Aten Primaria 2011; 44:216-22. [PMID: 21924797 DOI: 10.1016/j.aprim.2011.03.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2010] [Revised: 03/12/2011] [Accepted: 03/16/2011] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To describe the prevalence of multiple medication in patients over 65 years. DESIGN Cross-sectional study. SETTING Sevilla and Jerez-Costa North-West Primary Health Care Districts. PARTICIPANTS Patients older than 65 years randomly chosen from district databases. Patients in nursing homes, with major mental disease, or end-of- life situations were excluded. MAIN MEASUREMENTS Multiple medication was defined as a prescription of five or more drugs during the last six months. We assessed the medication used by clinical health records audit. Other characteristics were studied by interviewing a subsample of patients. RESULTS A total of 2,919 clinical health records from 14 centres were reviewed. The prevalence of multiple medication was 49.6% (95% CI: 47.7-51.4) with a range from 33% (95% CI: 26.8-39.3) to 82% (95% CI: 74,3-89,7) between centres. The large majority of patients (90.2% [95% CI: 88.7-91.8]) of patients showed criteria to be included in Cardiovascular Risk Health Care Process. Interviewed patients confirmed taking an average of 8.7 drugs (95% CI: 8.4-9.0). Among them, 83.2% (95% CI: 78.9-87.4) were high cardiovascular risk patients. CONCLUSIONS Prevalence of multiple medication in patients over 65 years is about 50% with wide variations between centres. The number of drugs per patient ratio was close to eight. A large majority of them were high risk cardiovascular patients.
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Affiliation(s)
- Teresa Molina López
- Servicio de Farmacia, Distrito de Atención Primaria Sevilla, Servicio Andaluz de Salud, Sevilla, España.
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Duaso E, Casas A, Formiga F, Lázaro Del Nogal M, Salvà A, Marcellán T, Navarro C. [Falls and osteoporotic fractures prevention units: proposed Osteoporosis, Falls and Fractures Group of the Spanish Society of Geriatrics and Gerontology]. Rev Esp Geriatr Gerontol 2011; 46:268-274. [PMID: 21945012 DOI: 10.1016/j.regg.2011.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Revised: 05/19/2011] [Accepted: 05/26/2011] [Indexed: 05/31/2023]
Abstract
Since forming the Osteoporosis, Falls and Fractures Group of the Spanish Society (GOCF) of Geriatrics and Gerontology (SEGG) a review was performed of the epidemiology of falls, along with a description of measures that have shown a degree of effectiveness in prevention. We also present the proposal of a common basic model of action in fall prevention units, mainly addressed to the community. Finally, a consensus model falls register is presented, common to community level and institutional areas, with the objective of being useful and easy to fill in at any care level.
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Affiliation(s)
- Enric Duaso
- Servicio de Geriatría, Consorcio Sanitario de Igualada, Barcelona, España.
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Maia BC, Viana PS, Arantes PMM, Alencar MA. Consequências das quedas em idosos vivendo na comunidade. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2011. [DOI: 10.1590/s1809-98232011000200017] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
As quedas em idosos são um problema frequente, com importantes consequências físicas, psicológicas e sociais. O objetivo deste estudo foi realizar uma revisão sistematizada da literatura sobre as consequências das quedas em idosos vivendo na comunidade. A busca foi realizada entre junho a outubro de 2008 nas bases de dados eletrônicas Medline, Lilacs, PEDro e SciELO. Apenas artigos em inglês, português e espanhol foram considerados para esta revisão. Foram identificados inicialmente 114 artigos potencialmente relevantes. Após análise do título e dos resumos, considerando-se critérios de inclusão e exclusão predeterminados, foram selecionados para esta revisão dez artigos. Foram identificadas as seguintes consequências: fraturas, imobilização, lesões de tecidos moles, contusões, entorses, feridas e abrasões, lesões musculares e neurológicas, surgimento de outras doenças, dor, declínio funcional e da atividade física, atendimento médico, hospitalização, reabilitação, medo de cair, abandono de atividades, tristeza, mudança na vida/comportamentos, sentimento de impotência, declínio em atividade social, perda de autonomia e da independência, mudança de domicílio/ ambiente, rearranjo familiar e morte. As fraturas e o medo de uma nova queda ficaram dentre as consequências mais citadas. O conhecimento das consequências físicas, psicológicas e sociais das quedas em idosos é de extrema importância, pois ele auxiliará no delineamento das estratégias preventivas e de reabilitação de tais repercussões.
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Jiménez-Sánchez MD, Córcoles-Jiménez MP, del Egido-Fernández MÁ, Villada-Munera A, Candel-Parra E, Moreno-Moreno M. [Analysis of hip-fracture falls in the elderly]. ENFERMERIA CLINICA 2011; 21:143-50. [PMID: 21493115 DOI: 10.1016/j.enfcli.2011.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2010] [Revised: 02/05/2011] [Accepted: 02/13/2011] [Indexed: 10/18/2022]
Abstract
AIMS To identify the circumstances associated with falls resulting in hip fracture in the elderly, and risk factors for this kind of fall. METHOD A 12 month observational study of patients over 65 years, admitted for hip fracture resulting from a fall to the General University Hospital of Albacete. VARIABLES demographic data, circumstances of fall, type of fracture, previous falls, associated diseases, regular drug treatment and mental status, collected from medical records and interviews. Descriptive statistical analyses were performed, which included, comparison of means (t test), comparison of proportions (χ(2)), odds ratio and corresponding 95% confidence intervals, and logistic regression models. RESULTS A total of 312 patients were included with a mean age 81.68 years (range, 65-99), of which 74.3% (232) were women. Only 35 patients (11,2%) lived in an institution, 212 (68%) had not had a fall during previous six months, and 116 patients (37.2%) had cognitive impairment. Falls occurred indoors (189 patients, 63.2%), with only 14% (41) during the night. Most of falls were related to extrinsic factors (31.5% tripping, slipping 24.1%; n=257). Patients had previous diseases in a 96% (300) of cases, with the most common being hypertension (177 patients, 59%) and diabetes (72, 24%). Drugs most frequently taken were anti-platelets (82, 31.9%), antihypertensives, diuretics (78, 30.4%), oral hypoglycaemic agents (41, 16%), anxiolytics (37, 14.4%) and antidepressants (35, 13.6%). The prior independence for walking on the street appears as a protective factor to fall indoors. CONCLUSIONS In this sample, falls resulting in hip fracture occurred commonly in elderly people without previous falls, while at home, at a time of increased activity, and by extrinsic factors.
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García-Casanova MC, Estevez-Pereda MI, Valverde-Quintairos MÁ, Barenys de Lacha M. Estado nutricional en individuos mayores de 65 años con diagnóstico de fractura de fémur. ENFERMERIA CLINICA 2011; 21:75-83. [DOI: 10.1016/j.enfcli.2011.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2010] [Revised: 01/02/2011] [Accepted: 01/11/2011] [Indexed: 11/15/2022]
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Valim-Rogatto PC, Candolo C, Brêtas ACP. Nível de atividade física e sua relação com quedas acidentais e fatores psicossociais em idosos de centro de convivência. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2011. [DOI: 10.1590/s1809-98232011000300012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Este estudo seccional teve por objetivo estimar o nível de atividade física (NAF) de idosos que frequentam centros de convivência (CCI), analisando a possível associação com quedas acidentais e outras variáveis relacionadas. Uma amostra de 291 idosos de três CCI da cidade de Cuiabá (MT, Brasil) respondeu ao Mini-Exame do Estado Mental (MEEM) e ao Questionário Internacional de Atividades Físicas (IPAQ). Foram utilizadas para a análise de dados, estatística descritiva e a regressão logística ordinal pelo Modelo de Odds Proporcional (MOP) (p<0,05). Cerca de 40% dos idosos disseram ter caído no ano anterior ao inquérito. Quanto ao NAF, 38,1% dos voluntários foram classificados no NAF "alto", 49,8% no "moderado" e 12,1% no "baixo". Os resultados do MOP para NAF indicaram que idosos mais velhos têm menos chance de estar no NAF alto (OR=0,78: IC=0,96-2,92) do que idosos nas faixas etárias mais jovens. O mesmo foi observado em idosos que não trabalham (OR=0,38: IC=0,22-0,67) e aqueles com baixo índice cognitivo (OR=0,31; IC=0,31-0,38). A ocorrência de quedas não mostrou associação com o NAF.
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Falls in the elderly of the Family Health Program. Arch Gerontol Geriatr 2010; 51:317-22. [DOI: 10.1016/j.archger.2010.01.010] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2009] [Revised: 01/18/2010] [Accepted: 01/20/2010] [Indexed: 11/19/2022]
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Miedo a las caídas en las personas mayores no institucionalizadas. GACETA SANITARIA 2010; 24:453-9. [DOI: 10.1016/j.gaceta.2010.09.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2010] [Revised: 07/30/2010] [Accepted: 09/08/2010] [Indexed: 11/20/2022]
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Gobierno Hernández J, Pérez de Las Casas MO, Madan Pérez MT, Baute Díaz D, Manzaneque Lara C, Domínguez Coello S. [Can we prevent falls in the elderly from primary care?]. Aten Primaria 2009; 42:284-91. [PMID: 19944493 DOI: 10.1016/j.aprim.2009.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2009] [Revised: 07/21/2009] [Accepted: 08/04/2009] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To determine the effectiveness of multifactorial intervention by Primary Care in the prevention of falls in the elderly who had fallen the year before. DESIGN Intervention study with a control group. SETTING Three clinics in a rural area. SUBJECTS 224 patients > or = 65 years, independent for mobility (113 in the intervention (IG) and 111 in the control (GC) group. INTERVENTIONS Intervention Group. INITIAL ASSESSMENT 1) Demographic data questionnaire, number, circumstances and consequences of falls, comorbidity and drugs. 2) Oriented examination. 3) Home risks assessment. INTERVENTIONS referred to cardiology if arrhythmia or bradycardia, referred for eye examination if changes in acute vision, recommendation for systems support if gait or balance problems, postural measures if orthostatic hypotension, behavioural measures in urinary incontinence and recommendations to modify home risks. CONTROL GROUP Questionnaire on: demographic data, number, circumstances and consequences of falls and medication use. They received normal medical care. RESULTS At one year 44% of the IG and 33% in the CG fell again (P=0.123). In the sub-group with more than one fall at the beginning of the study, 63% in the IG, and 56% in CG fell again (P=0.599). There were serious consequences in 6% of the IG compared to 14% in the CG (P=0.277). CONCLUSIONS Multifactorial intervention from primary care is not effective in reducing falls or for reducing the severity of their consequences.
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Fall incidence in a population of elderly persons in Nigeria. Gerontology 2009; 56:278-83. [PMID: 19738364 DOI: 10.1159/000236327] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2009] [Accepted: 05/19/2009] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Falls are a common public health problem amongst the elderly in many communities. There is a need for information on the causes as well as the impact of this preventable risk on health among the elderly in sub-Saharan Africa. OBJECTIVE To examine the prevalence and factors associated with falls among a population of elderly persons in Nigeria. METHODS A multi-stage stratified sampling of households was implemented to select persons aged 65 years and older in the south-western and north-central parts of Nigeria (n = 2,096). Respondents were asked about the occurrence, number, and consequences of falls in the previous 12 months. They were also assessed for the presence of vision impairment, chronic pain and medical conditions. RESULTS Falls were reported by 23% (n = 482) of the sample. Females (24.0%) were more likely than males (17.9%) to report falls. Respondents with chronic pain conditions, especially those with arthritis, and those with insomnia were at increased risk for falls. Among fallers, females were more likely than males to sustain injuries, including fractures (45.0 vs. 30.1%; p = 0.001). Persons with near vision impairment were less prone to serious falls with injuries than those with no visual impairment (p < 0.05). CONCLUSION Falls are an important health problem among elderly Nigerians. A fall prevention program must have a particular focus on females, those with chronic pain conditions and those experiencing insomnia.
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da Silva Gama Z, Gómez Conesa A. Morbilidad, factores de riesgo y consecuencias de las caídas en ancianos. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/s0211-5638(08)72972-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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