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Takekawa T, Obuchi K, Watanabe S, Yamada N, Abo M. A 10-Year Study of the Trend of Accidental Falls in the Elderly in a Japanese Hospital. Z Orthop Unfall 2024. [PMID: 38604232 DOI: 10.1055/a-2276-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Elderly people are prone to falls. We established the Falls Prevention Working Group (FPWG) at our hospital in 2015 to reduce the number of falls during hospitalization. This study compared the trend of in-hospital falls in the elderly in two time periods (2008/9 and 2018/9) and determined the effects of FPWG-implemented measures. Using medical records, we counted the monthly number of falls suffered by patients during hospitalization in April 2008-March 2009 and April 2018-March 2019. We also categorized the falls according to the severity of fall-related complications.A total of 3609 hospital falls were recorded during the 2008-2019 period (2008/9: n = 433, 2018/9: n = 324). Falls were more common in patients aged 70-79 in 2008/9 but were noted in those aged ≥ 80 in 2018/9. The mean number of falls/month (27.3 ± 6.4, range: 12-45) was stable throughout the year. The incidence of falls in 2018/9 (1.90/1000 per persons per day) was significantly lower than in 2008/9 (2.30/1000, p = 0.006). Level ≥ 3b accidents, reflecting serious accidents with complications, were encountered in 12 of 433 accidents in 2008/9 compared with significantly fewer accidents (2 of the same severity among 324 accidents) in 2018/9 (p = 0.030).Our results showed a decrease in in-hospital falls in 2018/9 and that the sufferers were older relative to 10 years earlier. A multidisciplinary team should recommend measures to prevent falls and an environment "resilient" to falls, and encourage patients to be aware of possible falls.
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Affiliation(s)
- Toru Takekawa
- Department of Rehabilitation Medicine, The Jikei University School of Medicine, Minato-ku, Japan
- Chiba Prefectural University of Health Sciences, Chiba, Japan
| | - Kei Obuchi
- Department of Rehabilitation Medicine, The Jikei University School of Medicine, Minato-ku, Japan
| | - Shu Watanabe
- Department of Rehabilitation Medicine, The Jikei University School of Medicine, Minato-ku, Japan
| | - Naoki Yamada
- Department of Rehabilitation Medicine, The Jikei University School of Medicine, Minato-ku, Japan
| | - Masahiro Abo
- Department of Rehabilitation Medicine, The Jikei University School of Medicine, Minato-ku, Japan
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Savvakis I, Adamakidou T, Kleisiaris C. Physical-activity interventions to reduce fear of falling in frail and pre-frail older adults: a systematic review of randomized controlled trials. Eur Geriatr Med 2024; 15:333-344. [PMID: 38411771 PMCID: PMC10997712 DOI: 10.1007/s41999-024-00944-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/15/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND Frailty in older adults leads to progressive deterioration of their physical condition and makes them prone to develop Fear of Falling (FoF). Physical-activity interventions appear to be effective in managing the components of frailty but there is no clear evidence to determine whether physical-activity may affect FoF in frail and pre-frail older adults. OBJECTIVE Τhis systematic literature review aims to synthesize evidence on the relationship between the physical interventions to ameliorate balance, strength, and mobility and FoF reduction in frail and pre-frail older adults. METHODS Studies assessing physical-activity interventions for frail and pre-frail older adults aged 60 years and older were identified in English through searches in PubMed, ScienceDirect, and Cochrane Central Register of Controlled Trials databases till February 2023. Study quality was assessed, and a qualitative synthesis of results was performed. RESULTS A total of 13 studies published were included. All of them were Randomized Control Trials and the most frequent assessment tool used to assess FoF (10 of 13 studies) was the Fall Efficacy Scale-International (FES-I). Six studies were assessed as having a low risk of bias. Cumulatively, the findings of this review indicate that physical-activity interventions are effective in reducing the FoF of frail and pre-frail older adults. CONCLUSION The results are encouraging and recapitulate the positive role of physical interventions in FoF reduction. However, future research would benefit from longer follow-up periods, longer intervention duration, and participation of interdisciplinary teams.
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Affiliation(s)
- Ioannis Savvakis
- Department of Nursing, Faculty of Health Sciences, Hellenic Mediterranean University, Heraklion, Greece.
| | - Theodoula Adamakidou
- Department of Nursing, Faculty of Health Sciences, University of West Attica, Athens, Greece
| | - Christos Kleisiaris
- Department of Nursing, Faculty of Health Sciences, Hellenic Mediterranean University, Heraklion, Greece
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Lin ME, Gallagher TJ, Straughan A, Marmor S, Adams ME, Choi JS. Association of Symptomatic Dizziness With All-Cause and Cause-Specific Mortality. JAMA Otolaryngol Head Neck Surg 2024; 150:257-264. [PMID: 38329761 PMCID: PMC10853869 DOI: 10.1001/jamaoto.2023.4554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 12/10/2023] [Indexed: 02/09/2024]
Abstract
Importance Dizziness is a highly prevalent complaint with wide-ranging causes and resultant morbidity. Whether symptomatic dizziness and its various manifestations are associated with all-cause and cause-specific mortality is unknown. Objective To examine the associations of symptomatic dizziness and its manifestations with all-cause and cause-specific mortality. Design, Setting, and Participants This cohort study is a mortality follow-up study based on the 1999-2004 National Health and Nutrition Examination Survey. The study cohort included adults 40 years and older who completed questions about symptomatic dizziness, including problems with dizziness, balance, falling, and positional dizziness, within the past 12 months. Respondents were linked to mortality data through December 31, 2019. Data were analyzed from February to August 2023. Exposure Self-reported symptomatic dizziness. Main Outcomes and Measures All-cause and cause-specific (cardiovascular disease, diabetes, cancer, and unintentional injuries) mortality. Cox proportional hazard regression models were used to examine associations between symptomatic dizziness and all-cause and cause-specific mortality while adjusting for demographics and medical history. Results In this nationally representative cohort of 9000 middle-aged and older US adults (mean [SD] age, 61.8 [13.8] years; 4570 [50.8%] female), prevalence of symptomatic dizziness was 23.8%. Specifically, 18.3% reported problems with dizziness, 14.5% reported problems with balance, 5.7% reported problems with falling, and 3.8% reported dizziness when turning in bed (positional dizziness). At a median (range) of 16.2 (0.1-20.6) years of follow-up, all-cause mortality for adults with symptomatic dizziness was higher than for those without (45.6% vs 27.1%). Symptomatic dizziness was associated with elevated risk for cause-specific mortality from diabetes (hazard ratio [HR], 1.66; 95% CI, 1.23-2.25), cardiovascular disease (HR, 1.33; 95% CI, 1.12-1.55), and cancer (HR, 1.21; 95% CI, 0.99-1.47) but not unintentional injuries (HR, 0.98; 95% CI, 0.51-1.88). Reporting problems with balance or falling was associated with increased all-cause mortality (balance: HR, 1.27; 95% CI, 1.17-1.39; and falling: HR, 1.52; 95% CI, 1.33-1.73), cardiovascular disease-specific mortality (balance: HR, 1.41; 95% CI, 1.20-1.66; and falling: HR, 1.49; 95% CI, 1.15-1.94), and diabetes-specific mortality risks (balance: HR, 1.74; 95% CI, 1.26-2.39; and falling: HR, 2.01; 95% CI, 1.26-3.18). There was no association between positional dizziness and mortality (HR, 0.98; 95% CI, 0.82-1.19). Conclusions and Relevance In this cohort study, symptomatic dizziness was associated with increased risk for all-cause and diabetes-, cardiovascular disease-, and cancer-specific mortality. The imprecision of the effect size estimate for cancer-specific mortality prevents making a definitive conclusion. Future studies are needed to determine whether symptomatic dizziness indicates underlying health conditions contributing to mortality or if early intervention for imbalance and falls can reduce mortality risk.
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Affiliation(s)
- Matthew E. Lin
- Keck School of Medicine of the University of Southern California, Los Angeles
| | - Tyler J. Gallagher
- Keck School of Medicine of the University of Southern California, Los Angeles
| | - Alexander Straughan
- Department of Otolaryngology–Head & Neck Surgery, University of Minnesota Medical School, Minneapolis
| | - Schelomo Marmor
- Department of Surgery, University of Minnesota Medical School, Minneapolis
| | - Meredith E. Adams
- Department of Otolaryngology–Head & Neck Surgery, University of Minnesota Medical School, Minneapolis
| | - Janet S. Choi
- Department of Otolaryngology–Head & Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles
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Kanemitsu M, Nakasa T, Ikuta Y, Adachi N. Decreased Joint Position Sense of the Ankle Joint Is a Risk Factor for Falls in the Elderly. Cureus 2023; 15:e51084. [PMID: 38283510 PMCID: PMC10810735 DOI: 10.7759/cureus.51084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2023] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND Falls in the elderly are common causes of morbidity, mortality, loss of independence, and poor quality of life. We hypothesized that decreased ankle position sense is one among several risk factors that might lead to falls. METHODS A total of 54 feet from 28 patients over 65 years of age and 10 feet from five healthy volunteers were included. Measurements of ankle position sense, medical history, and fall history within a year were obtained, which were compared between the groups. RESULTS The mean replication error angle of internal and external rotation was significantly higher in the elderly, and the mean replication error angle of internal rotation was significantly higher in the group with a history of falls. CONCLUSION The mean replication error angle of internal rotation and a history of fractures were significant risk factors for falls. Hence, an increase in the mean replication error angle of internal rotation may increase the risk of falls in the elderly population.
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Affiliation(s)
| | - Tomoyuki Nakasa
- Department of Artificial Joints and Biomaterials, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN
| | - Yasunari Ikuta
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN
| | - Nobuo Adachi
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JPN
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Nagata CDA, Garcia PA, Hamu TCDDS, Caetano MBD, Costa RR, Leal JC, Bastos JAI, Cadore EL, Durigan JLQ. Are dose-response relationships of resistance training reliable to improve functional performance in frail and pre-frail older adults? A systematic review with meta-analysis and meta-regression of randomized controlled trials. Ageing Res Rev 2023; 91:102079. [PMID: 37774931 DOI: 10.1016/j.arr.2023.102079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/11/2023] [Accepted: 09/25/2023] [Indexed: 10/01/2023]
Abstract
This systematic review with meta-analyses investigates the impact of resistance training (RT), using meta-regressions, on functional performance in frail and pre-frail adults aged ≥ 65 years to determine the key variables of RT. Ten randomized controlled trials involving 1303 participants were analyzed. Five studies assessed habitual walking speed (HWS), three studies evaluated performance in the timed-up-and-go test (TUG), three studies evaluated performance in the Short Physical Performance Battery (SPPB), and three studies assessed performance in the sit-to-stand test (STS). RT alone improved STS time and SPPB scores in frail and pre-frail older adults. RT improved STS performance (Effect Size (ES):- 0.536; 95% CI - 0.874 to - 0.199; p = .002) and led to a 2.261-point increase in SPPB performance (ES:1.682; 95% CI 0.579-2.786; p = .003). At least two weekly training sessions are required to increase SPPB scores, and three sessions seem to optimize the improvements. Higher training volume per exercise and volume per session reduce the gains in SPPB performance. We did not observe any association between different doses of RT and STS time improvements. RT alone positively influenced TUG performance only in community-dwelling older frail and pre-frail adults but not in institutionalized older individuals. RT alone did not improve the HWS compared to the non-active control group.
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Affiliation(s)
| | - Patrícia Azevedo Garcia
- Universidade de Brasília, Programa de Pós-Graduação em Ciências da Reabilitação, Brasília, DF, Brazil.
| | | | | | | | - Josevan Cerqueira Leal
- Universidade de Brasília, Programa de Pós-Graduação em Ciências da Reabilitação, Brasília, DF, Brazil.
| | - Júlia Aguillar Ivo Bastos
- Universidade de Brasília, Programa de Pós-Graduação em Ciências da Reabilitação, Brasília, DF, Brazil.
| | - Eduardo Lusa Cadore
- Exercise Research Laboratory (LAPEX), School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - João Luiz Quagliotti Durigan
- Universidade de Brasília, Laboratory of Muscle and Tendon Plasticity, Programa de Pós-Graduação em Educação Física, Brasília, DF, Brazil.
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Kanamori Y, Ide-Okochi A. Meaning of community activity participation for older adults in couple households. Int J Nurs Sci 2023; 10:468-475. [PMID: 38020833 PMCID: PMC10667302 DOI: 10.1016/j.ijnss.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 08/09/2023] [Accepted: 09/12/2023] [Indexed: 12/01/2023] Open
Abstract
Objective Currently, 65.3% of older adults in Japan live in couple households. If one partner dies, the other may be unable to reconstruct their lifestyles, have health problems, or become isolated. Participation in community activities helps them maintain physical, mental, and social health. This study aimed to clarify the meaning of participation in community activities among older adults in couple households. Methods Semi-structured individual interviews were used to collect data. In February 2019, six adults aged 65 and above who had lived with their spouses for at least one year and continuously participated in community activities were interviewed in Miyazaki City, Japan. Data were analyzed using the KJ method (a qualitative method that organizes ideas in a bottom-up fashion developed by Kawakita Jiro), supervised by a professional instructor. Results The results revealed seven symbols using this method: 1) building a cooperative relationship with a spouse: respect the willingness to work hard for members; 2) consideration for relationships with other organizations: pay attention to every detail; 3) proactive attitude: don't leave everything to others, 4) attitude of questioning one's way of being: myself in connection to others, 5) connection among participants: increased awareness directed toward others, 6) spiritual fulfillment: time, place, and opportunity for outings, 7) physical and mental self-control for continued community activities: growing awareness of health care. Conclusions For older adults in couple households, it is found that participation in community activities helps them receive support from their spouses and gain a proactive attitude, and the connection between participants contributes to physical and mental control and also improves their health.
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Affiliation(s)
- Yumie Kanamori
- School of Health Sciences, Kumamoto University, Kumamoto City, Japan
| | - Ayako Ide-Okochi
- School of Health Sciences, Kumamoto University, Kumamoto City, Japan
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Zaskey M, Seely KD, Hansen M, Collins HE, Burns A, Burns B. Outcomes after stairway falls in a rural Appalachian trauma center. Surgery 2023; 174:626-630. [PMID: 37380572 DOI: 10.1016/j.surg.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 05/09/2023] [Accepted: 05/22/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Injuries due to falls represent one of the most common etiologies of traumatic injury in the United States. Stairway-related falls in particular can lead to significant morbidity, mortality, and concomitant long-term disability and economic costs. Our study aims to evaluate the outcomes of patients presenting to a rural academic trauma center after experiencing a fall down stairs. METHODS This was a single institution retrospective analysis of data extracted from our trauma registry. The study was considered exempt by Ballad Health Institutional Review Board. The data included patients aged 18 years or older who presented to the emergency department after a fall down stairs between January 1, 2017, and June 17, 2022. Patients who experienced falls other than those involving stairs were excluded. RESULTS Of the 439 patients evaluated for falls down stairs, 259 (58.9%) were aged ≥65 years. Compared with younger patients, older patients required significantly longer hospital admissions (4.8 vs 3.6 days, P < .003), had significantly higher injury severity scores (9.1 vs 6.8, P < .05), and were more likely to be discharged to a posthospital care facility (51% vs 14.9%, P < .05). There was no difference in length of intensive care unit stay (3.8 vs 3.6 days, P < .72), ventilator days (3.3 vs 3.3 days, P < .97), or mortality (7% vs 3%, P < .08). When considering sex, male patients had significantly worse outcomes in injury severity score (9.0 vs 7.6, P < .02) and mortality (10% vs 2%, P < .0002) but no difference in hospital (4.5 vs 4.0 days, P < .20), intensive care unit (3.8 vs 3.5 days, P < .59) or ventilator days (2.8 vs 4.3 days, P < .27) when compared with female patients. CONCLUSION Patients aged 65 years or older who experience a fall down stairs are more severely injured and require more posthospital care. Our findings demonstrate that males have an elevated risk of mortality and increased injury severity compared to female patients. Previous findings from our institution examining injuries from falls, including a sub-analysis on ground-level falls, have shown similar sex disparity. This study shows the necessity of preventing stair-related falls, especially in the older population.
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Affiliation(s)
- Michael Zaskey
- Quillen College of Medicine, East Tennessee State University, Johnson City, TN
| | - Kevin D Seely
- College of Osteopathic Medicine, Rocky Vista University, Parker, CO.
| | | | | | | | - Bracken Burns
- Quillen College of Medicine, East Tennessee State University, Johnson City, TN
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Zhao IY, Montayre J, Leung AYM, Foster J, Kong A, Neville S, Ludolph R, Mikton C, Officer A, Molassiotis A. Interventions addressing functional abilities of older people in rural and remote areas: a scoping review of available evidence based on WHO functional ability domains. BMC Geriatr 2022; 22:827. [PMID: 36307764 PMCID: PMC9615260 DOI: 10.1186/s12877-022-03460-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 09/14/2022] [Indexed: 12/02/2022] Open
Abstract
Background The World Health Organization (WHO) encourages healthy ageing strategies to help develop and maintain older people’s functional abilities in five domains: their ability to meet basic needs; learn, grow, and make decisions; be mobile; build and maintain relationships, and contribute to society. This scoping review reports the available evidence-based interventions that have been undertaken with people ≥ 50 years of age in rural and remote areas and the outcomes of those interventions relevant to enhancing functional ability. Methods The scoping review was undertaken following the JBI methodology. A literature search was carried out to identify published intervention studies for enhancing functional ability in older people living in rural and remote settings. The databases searched included CINAHL, Scopus, ProQuest Central, PubMed, EBSCOHost, APA PsycInfo, Carin.info, and the European Network for Rural Development Projects and Practice database. Gray literature sources included government reports, websites, policy papers, online newsletters, and studies from a bibliographic hand search of included studies. Results Literature published from January 2010 to March 9, 2021 were included for review. A total of 67 studies were identified, including quasi-experimental studies (n = 44), randomized controlled trials (n = 22), and a descriptive study. Five main types of interventions were conducted in rural and remote areas with older people: Community Services, Education and Training, Exercise and Physical Activity, Health Promotion Programmes, and Telehealth. Health Promotion Programmes (n = 28, 41.8%) were the most frequently reported interventions. These focused primarily on improving the ability to meet basic needs. About half (n = 35, 52.2%) of the included studies were linked to the ability to learn, grow, and make decisions, and 40% of studies (n = 27) were relevant to the ability to be mobile. Only a very limited number of intervention studies were geared towards outcomes such as maintaining relationships (n = 6) and contributing to society (n = 3). Conclusion Interventions for enhancing functional ability focused primarily on the ability to meet basic needs. We identified the need for health-related interventions in rural and remote areas to consider all five functional ability domains as outcomes, particularly to strengthen the psychosocial wellbeing of older people and enhance their sense of purpose through their contributions to society. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03460-2.
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Montayre J, Foster J, Zhao IY, Kong A, Leung AYM, Molassiotis A, Officer A, Mikton C, Neville S. Age-friendly interventions in rural and remote areas: A scoping review. Australas J Ageing 2022; 41:490-500. [PMID: 35796240 PMCID: PMC10083949 DOI: 10.1111/ajag.13101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 04/27/2022] [Accepted: 05/03/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES In 2007, the World Health Organization published a guide on age-friendly cities. However, little is known about interventions that have been implemented to promote age-friendly communities in rural and remote areas. This paper presents the findings from a scoping review undertaken to locate available evidence of interventions, strategies, and programs that have been implemented in rural and remote areas to create age-friendly communities. METHODS This scoping review used the Joanna Briggs Institute (JBI) methodology. RESULTS A total of 219 articles were included in this review. No intervention studies were referred to as 'age-friendly'. However, there were interventions (mostly healthcare-related) that have been implemented in rural and remote areas with older people as participants. There were also non-evaluated community programs that were published in the grey literature. This review identified the common health interventions in older people and the indirect relevance to the WHO age-friendly framework domains in rural and remote contexts. CONCLUSIONS The eight age-friendly domains were not explicitly utilised as a guide in the development of interventions for older people in rural and remote settings. Implementation of age-friendly interventions in rural and remote areas requires a multisectoral approach that is tailored to address the specific needs of individual communities. Age-friendly interventions also need to consider socio-ecological factors to adequately and holistically address community needs and ensure long-term sustainability.
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Affiliation(s)
- Jed Montayre
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
| | - Jann Foster
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
| | - Ivy Yan Zhao
- World Health Organization Collaborating Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR
| | - Ariana Kong
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
| | - Angela Y M Leung
- World Health Organization Collaborating Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR
| | - Alex Molassiotis
- World Health Organization Collaborating Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR
| | - Alana Officer
- Department of Social Determinants of Health, Division of Healthier Populations, World Health Organization, Geneva, Switzerland
| | - Christopher Mikton
- Department of Social Determinants of Health, Division of Healthier Populations, World Health Organization, Geneva, Switzerland
| | - Stephen Neville
- Nursing Department, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
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Philippe AG, Goncalves A, Martinez C, Deshayes M, Charbonnier E. Can an Eight-Session Multicomponent Physical Exercise Program Reduce Fall Risk and Fear of Falling among the Elderly? Int J Environ Res Public Health 2022; 19. [PMID: 35886109 DOI: 10.3390/ijerph19148262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/01/2022] [Accepted: 07/05/2022] [Indexed: 11/17/2022]
Abstract
In older populations, falls are responsible for decrease autonomy and increased pain and injuries. With aging, fall risk is multifactorial and associated with sarcopenia, impaired balance, falls themselves and psychological factors such as fear of falling. The objectives of the present study were: (a) to test the effects of a short multicomponent physical exercise program on fall risk and fear of falling; and (b) to analyze the relationship between fall risk and fear of falling. The participants were thirty-five older persons who were engaged in an eight-session physical exercise program. Balance (i.e., One-leg Balance Test, and Functional Reach Test), lower-limb endurance (i.e., Wall-sit Test) and fear of falling were measured before and after the multicomponent physical exercise program. Results indicated an increase in balance and a diminution of fear of falling after the end of the physical exercise program (p < 0.05). The program has an effect on lower limb endurance (p > 0.05). Gains in balance were correlated to the diminution of fear of falling (p < 0.05). An 8-week multicomponent physical exercise program based on balance is efficient to reduce fall risk and fear of falling among the elderly.
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Arias-Casais N, Amuthavalli Thiyagarajan J, Rodrigues Perracini M, Park E, Van den Block L, Sumi Y, Sadana R, Banerjee A, Han ZA. What long-term care interventions have been published between 2010 and 2020? Results of a WHO scoping review identifying long-term care interventions for older people around the world. BMJ Open 2022; 12:e054492. [PMID: 35105637 PMCID: PMC8808408 DOI: 10.1136/bmjopen-2021-054492] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 12/20/2021] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE The global population is rapidly ageing. To tackle the increasing prevalence of older adults' chronic conditions, loss of intrinsic capacity and functional ability, long-term care interventions are required. The study aim was to identify long-term care interventions reported in scientific literature from 2010 to 2020 and categorise them in relation to WHO's public health framework of healthy ageing. DESIGN Scoping review conducted on PubMed, CINHAL, Cochrane and Google Advanced targeting studies reporting on long-term care interventions for older and frail adults. An internal validated Excel matrix was used for charting.Setting nursing homes, assisted care homes, long-term care facilities, home, residential houses for the elderly and at the community. INCLUSION CRITERIA Studies published in peer-reviewed journals between 1 January 2010 to 1 February 2020 on implemented interventions with outcome measures provided in the settings mentioned above for subjects older than 60 years old in English, Spanish, German, Portuguese or French. RESULTS 305 studies were included. Fifty clustered interventions were identified and organised into four WHO Healthy Ageing domains and 20 subdomains. All interventions delved from high-income settings; no interventions from low-resource settings were identified. The most frequently reported interventions were multimodal exercise (n=68 reports, person-centred assessment and care plan development (n=22), case management for continuum care (n=16), multicomponent interventions (n=15), psychoeducational interventions for caregivers (n=13) and interventions mitigating cognitive decline (n=13). CONCLUSION The identified interventions are diverse overarching multiple settings and areas seeking to prevent, treat and improve loss of functional ability and intrinsic capacity. Interventions from low-resource settings were not identified.
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Affiliation(s)
- Natalia Arias-Casais
- ATLANTES Global Observatory for Palliative Care, University of Navarra, Pamplona, Spain
| | | | | | - Eunok Park
- College of Nursing, Jeju National University, Jeju, Republic of Korea
| | - Lieve Van den Block
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium
- End-of-Life Care Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Yuka Sumi
- Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Ritu Sadana
- Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Anshu Banerjee
- Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Zee-A Han
- Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
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Feng C, Adebero T, DePaul VG, Vafaei A, Norman KE, Auais M. A Systematic Review and Meta-Analysis of Exercise Interventions and Use of Exercise Principles to Reduce Fear of Falling in Community-Dwelling Older Adults. Phys Ther 2022; 102:6383647. [PMID: 34636923 DOI: 10.1093/ptj/pzab236] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 06/14/2021] [Accepted: 08/30/2021] [Indexed: 11/14/2022]
Abstract
OBJECTIVE Fear of falling (FOF) contributes to activity restriction and institutionalization among older adults, and exercise interventions are linked to reduction in FOF. Adhering to exercise principles and adapting optimal exercise parameters are fundamental to optimizing the effectiveness of exercise interventions. The purpose of this review was to describe FOF exercise interventions in community-dwelling older adults, evaluate the extent to which these interventions followed the exercise principles and reported exercise parameters, and quantify the effect of these interventions on reducing FOF. METHODS Randomized controlled trials (RCTs) of FOF exercise interventions in older adults (≥65 years) were identified from 4 databases. The methodological quality of RCTs was assessed using the Physiotherapy Evidence Database scale. A random-effect model was used in the meta-analysis. RESULTS Seventy-five RCTs were included in this review. With regard to reporting exercise principles, specificity was reported in 92% of trials, progression in 72%, reversibility in 32%, overload in 31%, diminished return in 21%, and initial value in 8%. For exercise parameters, 97% of RCTs reported exercise type; 89%, frequency; and 85%, time. Only 25% reported the intensity. The pooled effect of exercise interventions on FOF among all included studies was a standard mean difference of -0.34 (95% CI = -0.44 to -0.23). CONCLUSION This study showed a significant small to moderate effect size of exercise interventions in reducing FOF among community-dwelling older adults. Most exercise principles and intensity of exercises were not adequately reported in included trials. IMPACT These inadequate reports could undermine efforts to examine the optimal dosage for exercise prescription. More attention must be given to designing and reporting components of therapeutic exercise programs to facilitate evidence-based practice.
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Affiliation(s)
- Chengying Feng
- School of Rehabilitation Therapy, Queen's University, Faculty of Health Sciences, Kingston, Ontario, Canada
| | - Tony Adebero
- Department of Health and Rehabilitation Sciences, University of Western Ontario, London, Ontario, Canada
| | - Vincent G DePaul
- School of Rehabilitation Therapy, Queen's University, Faculty of Health Sciences, Kingston, Ontario, Canada
| | - Afshin Vafaei
- Department of Health Sciences, Lakehead University, Thunder Bay, Ontario, Canada
| | - Kathleen E Norman
- School of Rehabilitation Therapy, Queen's University, Faculty of Health Sciences, Kingston, Ontario, Canada
| | - Mohammad Auais
- School of Rehabilitation Therapy, Queen's University, Faculty of Health Sciences, Kingston, Ontario, Canada
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Mello ABD, Izquierdo M, Teodoro JL, Cadore EL. Effects of multicomponent exercise training on the intrinsic capacity in frail older adults: review of clinical trials. Motriz: rev educ fis 2022. [DOI: 10.1590/s1980-657420220008022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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Zhang H, Zhao Y, Wei F, Han M, Chen J, Peng S, Du Y. Prevalence and Risk Factors for Fall among Rural Elderly: A County-Based Cross-Sectional Survey. Int J Clin Pract 2022; 2022:8042915. [PMID: 35832801 PMCID: PMC9252676 DOI: 10.1155/2022/8042915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 04/20/2022] [Accepted: 06/03/2022] [Indexed: 11/17/2022] Open
Abstract
AIM The aim of the study was to provide evidence for the prevention and reduction of falls in the elderly living in rural areas by analyzing epidemiological data of falls among the rural older people (>65 years old) and identifying the risk and protective factors. METHODS This study analyzed the sociodemographic characteristics, living environment, lifestyle, chronic disease condition, mental health, activities of daily living (ADL), and detailed information of falls of 3752 rural elderly. Rank tests, chi-square tests, and binary logistic regression were used for data analysis. RESULTS The prevalence of falls was 30.0%, and the 75-84-years age group had the highest fall rate (18.8%). According to the binary logistic regression analysis, six variables, including roughage intake frequency, age, gender, cane use, floor tiles, and IADL, were involved in the fall patterns. Low roughage intake (OR = 2.48, 95% CI 1.24-4.97), female gender (OR = 2.12, 95% CI 1.48-3.05), the use of a cane (OR = 2.11, 95% CI 1.08-4.10), and medium IADL (OR = 2.02, 95% CI 1.89-2.32) were the top four risk factors. CONCLUSION The fall in the rural elderly was mainly due to the poor living and working conditions. Routine fall assessment could address several preventable risk factors to reduce the prevalence and mitigate the harm of falls.
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Affiliation(s)
- Hongping Zhang
- College of Medicine and Health Science, Wuhan Polytechnic University, Wuhan 430023, China
| | - Yinshaung Zhao
- College of Medicine and Health Science, Wuhan Polytechnic University, Wuhan 430023, China
| | - Feng Wei
- Centers for Disease Prevention & Control of Huangpi District of Wuhan, Wuhan 430300, China
| | - Mo Han
- Centers for Disease Prevention & Control of Huangpi District of Wuhan, Wuhan 430300, China
| | - Jianquan Chen
- Department of Disease Control, Health and Family Planning Commission of Huangpi District of Wuhan, Wuhan 430300, China
| | - Songxu Peng
- Department of Maternal and Child Health, Xiangya School of Public Health, Xiangya School of Medicine, Central South University, Changsha 410008, China
| | - Yukai Du
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China
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Sun M, Min L, Xu N, Huang L, Li X. The Effect of Exercise Intervention on Reducing the Fall Risk in Older Adults: A Meta-Analysis of Randomized Controlled Trials. Int J Environ Res Public Health 2021; 18:12562. [PMID: 34886293 DOI: 10.3390/ijerph182312562] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 11/16/2022]
Abstract
Exercise intervention has a positive effect on reducing the fall risk in older adults. To investigate the effect of different factors of exercise intervention (type, duration, and frequency) on reducing the fall risk in older adults, a meta-analysis was performed in this study. According to the PRISMA®, two researchers independently searched PubMed, Web of Science, and the China National Knowledge Infrastructure databases to assess the quality of the studies using the PEDro scale. A total of 648 subjects in 10 randomized controlled trials were included in this study, and the exercise interventions included integrated training (resistance training, core training, and balance training), balance training, core training, Pilates, Ba Duan Jin, and Tai Chi. These studies show that exercise intervention has a huge and significant impact on reducing the risk of falls of the elderly. In conclusion, an integrated intervention with a frequency of more than five times a week and a duration of more than 32 weeks are more effective in reducing the fall risk.
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Agredano RS, Masclans JG, Guix-Comellas EM, Fraile VM, Sarria-Guerrero JA, Pola MS, Fabrellas N. Older Adults With Complex Chronic Conditions Who Receive Care at Home: The Importance of Primary Care Assessment. J Gerontol Nurs 2021; 47:31-38. [PMID: 34704867 DOI: 10.3928/00989134-20211013-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The current study aimed to describe the characteristics of older adults with complex chronic conditions cared for at home. One hundred thirty-eight participants were recruited. Participants' average age was 85.9 years and 69.6% were female. Poly-pharmacy was present in 89.9% of participants. Participants who presented with polypharmacy had a worse self-perception of health (p = 0.002), and the worst fall rate. A total of 22.5% had experienced a fall during the past 6 months. Approximately one half of participants rated their self-perceived quality of life as bad or very bad. The percentage who used emergency services (54.3%) was greater than the percentage who needed to be admitted (43.5%). A worse self-perception of physical health was significantly associated with hospital admissions (p = 0.01). Geriatric assessment by nurses can provide information to improve care in situations in which frailty, dependency, and chronic conditions occur together. Obtaining information on the needs of individuals with frailty is important in designing successful nursing interventions. [Journal of Gerontological Nursing, 47(11), 31-38.].
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Babiuch AS, Oestervemb K, Lipińska A, Stańczak ML, Cholewa M, Makulec K, Nowakowska K, Derengowska MH. Differences in the level of physical fitness and mobility among older women with osteoporosis and healthy women-cross-sectional study. Sci Rep 2021; 11:14179. [PMID: 34244566 DOI: 10.1038/s41598-021-93483-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 06/09/2021] [Indexed: 11/27/2022] Open
Abstract
The main aim of the study was to assess the risk of falls, and physical fitness in the group of women aged 60 to 65 years of age suffering from an identified osteoporosis in comparison to a similar group of healthy women. The main question was: What is the level of physical fitness and risk of fall among women with osteoporosis compared to healthy women? The research included 262 women aged 60 to 65 of age: 135 with osteoporosis and 127 healthy ones, living in the Małopolskie and the Świętokrzyskie Provinces of Poland. To assess the level of physical fitness, the Senior Fitness Test (SFT) was used, while the Tinetti POMA (Performance Oriented Mobility Assessment) and Timed Up&Go test (TUG) were used to asses the risk of fall. Significant statistical differences in average results of physical fitness assessment were noticed as regards the following aspects: flexibility of the lower body part p < 0.001; flexibility of the upper body part p < 0.001. Essential differences were demonstrated in assessing the risk of falling with p < 0.01. Women with osteoporosis are marked by a lower physical fitness than healthy women. A higher percentage of great and serious risk of fall was demonstrated among women with osteoporosis.
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Abraham PJ, Abraham MN, Griffin RL, Tanner L, Jansen JO. Evaluation of Injury Recidivism Using the Electronic Medical Record. J Surg Res 2021; 267:217-223. [PMID: 34153565 DOI: 10.1016/j.jss.2021.05.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 04/07/2021] [Accepted: 05/02/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Traumatic injuries remain one of the leading causes of death in the United States. Patients who survive traumatic injuries but return to the emergency department with repeat injuries are said to suffer from injury recidivism. Numerous studies have described trends in injury recidivism using trauma registry and survey data. To our knowledge, no prior study has leveraged electronic medical record (EMR) data to characterize injury recidivism. The EMR is potentially more comprehensive as it contains details of patients who visited the emergency department after injury but did not meet the criteria for inclusion in the trauma registry. Such injuries could be predictive of future recidivism. We therefore aimed to describe patterns of injury recidivism seen at a Level 1 trauma center using the EMR. METHODS A retrospective review was conducted of all injury-related encounters between January 2016 and December 2019. Manual review was conducted of all recidivistic encounters with < 11 months between encounters to ensure the recidivistic encounter was not a sequela of the index visit. A general estimating equation logistic regression adjusted for age, race, sex, and insurance payor, estimated odds ratios (ORs) and 95% confidence intervals (CIs) for the association between injury mechanism and odds of recidivistic encounter. RESULTS A total of 20,566 index encounters was included during the study period. Of the 20,566 encounters, 7.6% (n = 1570) had a recidivistic encounter during the study period, half of which (n = 781) occurred within the first year of the index encounter. An over two-fold increased odds of recidivism was observed for blunt assault encounters (OR 2.53, 95% CI 2.03-3.15) and unintentional falls (OR 2.10, 95% CI 1.76-2.52). For both mechanisms, this increase was observed across the three years following the index encounter. CONCLUSIONS Our study found that patients with assault injuries have the highest odds of injury recidivism and assault-related recidivistic encounters. These results demonstrate the feasibility and utility of incorporating EMR data, and suggest that the development of targeted interventions focused on mitigating assault injuries, such as hospital-based violence intervention programs, should be considered in our region.
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Affiliation(s)
- Peter J Abraham
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL
| | | | - Russell L Griffin
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Lauren Tanner
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Jan O Jansen
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL.
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García-Giménez JL, Mena-Molla S, Tarazona-Santabalbina FJ, Viña J, Gomez-Cabrera MC, Pallardó FV. Implementing Precision Medicine in Human Frailty through Epigenetic Biomarkers. Int J Environ Res Public Health 2021; 18:1883. [PMID: 33672064 PMCID: PMC7919465 DOI: 10.3390/ijerph18041883] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 12/15/2022]
Abstract
The main epigenetic features in aging are: reduced bulk levels of core histones, altered pattern of histone post-translational modifications, changes in the pattern of DNA methylation, replacement of canonical histones with histone variants, and altered expression of non-coding RNA. The identification of epigenetic mechanisms may contribute to the early detection of age-associated subclinical changes or deficits at the molecular and/or cellular level, to predict the development of frailty, or even more interestingly, to improve health trajectories in older adults. Frailty reflects a state of increased vulnerability to stressors as a result of decreased physiologic reserves, and even dysregulation of multiple physiologic systems leading to adverse health outcomes for individuals of the same chronological age. A key approach to overcome the challenges of frailty is the development of biomarkers to improve early diagnostic accuracy and to predict trajectories in older individuals. The identification of epigenetic biomarkers of frailty could provide important support for the clinical diagnosis of frailty, or more specifically, to the evaluation of its associated risks. Interventional studies aimed at delaying the onset of frailty and the functional alterations associated with it, would also undoubtedly benefit from the identification of frailty biomarkers. Specific to the article yet reasonably common within the subject discipline.
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Affiliation(s)
- José Luis García-Giménez
- U733, Centre for Biomedical Network Research on Rare Diseases (CIBERER-ISCIII), 28029 Madrid, Spain; (J.L.G.-G.); (F.V.P.)
- Mixed Unit for Rare Diseases INCLIVA-CIPF, INCLIVA Health Research Institute, 46010 Valencia, Spain
- Department of Physiology, Faculty of Medicine, University of Valencia, 46003 Valencia, Spain;
- EpiDisease S.L., Parc Cientific de la Universitat de València, 46980 Paterna, Spain
| | - Salvador Mena-Molla
- Department of Physiology, Faculty of Medicine, University of Valencia, 46003 Valencia, Spain;
- EpiDisease S.L., Parc Cientific de la Universitat de València, 46980 Paterna, Spain
| | | | - Jose Viña
- Freshage Research Group, Department of Physiology, Faculty of Medicine, Institute of Health Research-INCLIVA, University of Valencia and CIBERFES, 46010 Valencia, Spain;
| | - Mari Carmen Gomez-Cabrera
- Freshage Research Group, Department of Physiology, Faculty of Medicine, Institute of Health Research-INCLIVA, University of Valencia and CIBERFES, 46010 Valencia, Spain;
| | - Federico V. Pallardó
- U733, Centre for Biomedical Network Research on Rare Diseases (CIBERER-ISCIII), 28029 Madrid, Spain; (J.L.G.-G.); (F.V.P.)
- Mixed Unit for Rare Diseases INCLIVA-CIPF, INCLIVA Health Research Institute, 46010 Valencia, Spain
- Department of Physiology, Faculty of Medicine, University of Valencia, 46003 Valencia, Spain;
- EpiDisease S.L., Parc Cientific de la Universitat de València, 46980 Paterna, Spain
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Abstract
Significance: Free radicals although originally thought of as damaging molecules, inevitable side effects of the utilization of oxygen by cells, are now considered as signals that by modifying, among others, the thiol-disulfide balance regulate many cell processes from metabolism to cell cycle. Recent Advances: This review discusses the importance of the modulation of the oxidant levels through physiological strategies such as physical exercise or genetic manipulations such as the overexpression of antioxidant enzymes, in the promotion of healthy aging. Critical Issues: We have divided the review into five different sections. In the first two sections of the article "Oxidants are signals" and "Exercise training is an antioxidant," we discuss the main sources of free radicals during muscle contraction and their role, as hormetic substances, in the regulation of two main muscle adaptations to exercise in skeletal muscle; that is, mitochondrial biogenesis and the endogenous antioxidant defense. In the third section of the review, we deal with "the energy collapse in aging." The increased rate of reactive oxygen species (ROS) production and the low rate of mitochondria biosynthesis in the old cells are examined. Finally, in the fourth and fifth sections entitled "Overexpression of antioxidants enzymes in healthy aging" and "Exercise, longevity, and frailty," we consider the importance of the potentiation of the cellular defenses in health span and in life span. Future Directions: A correct manipulation of the ROS generation, directing these species to their physiological signaling role and preventing their deleterious effects, would allow the promotion of healthy aging. Antioxid. Redox Signal. 33, 570-579.
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Affiliation(s)
- Jose Viña
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and CIBERFES, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
| | - Gloria Olaso-Gonzalez
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and CIBERFES, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
| | - Coralie Arc-Chagnaud
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and CIBERFES, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain.,Université de Montpellier, INRA, UMR866 Dynamique Musculaire et Métabolisme, Montpellier, France
| | - Adrián De la Rosa
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and CIBERFES, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
| | - Mari Carmen Gomez-Cabrera
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and CIBERFES, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
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21
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Arc-Chagnaud C, Millan F, Salvador-Pascual A, Correas A, Olaso-Gonzalez G, De la Rosa A, Carretero A, Gomez-Cabrera M, Viña J. Reversal of age-associated frailty by controlled physical exercise: The pre-clinical and clinical evidences. Sports Medicine and Health Science 2019; 1:33-39. [PMID: 35782461 PMCID: PMC9219339 DOI: 10.1016/j.smhs.2019.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Demographic aging is one of the most serious challenges facing our society. Although we live longer, we do not live better because it is considered that approximately 16–20% of our life is spent in late-life morbidity. Older people have the greatest risk of developing frailty increasing the risk of presenting various adverse health events such as low quality of life, disability, hospitalization and even death. Frail men and women over 65 years old have lower muscle quality and muscle mass and higher percentage of body fat than non-frail people of the same age. In this review we will address the main physiological changes in the muscular and nervous system associated to aging. More specifically we will review the changes in muscle mass, quality, and strength relating them with the decrease in capillarization and muscular oxidative capacity as well as with the alterations in protein synthesis in the muscle with aging. The last section of the manuscript will be devoted to the animal models of frailty and the indexes developed to measure frailty in these models. We will finally address the importance of exercise training as an intervention to delay or even reverse frailty.
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Affiliation(s)
- C. Arc-Chagnaud
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and CIBERFES, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
- INRA, UMR866 Dynamique Musculaire et Métabolisme, Université de Montpellier, F-34060, Montpellier, France
| | - F. Millan
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and CIBERFES, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
| | - A. Salvador-Pascual
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and CIBERFES, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
| | - A.G. Correas
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and CIBERFES, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
| | - G. Olaso-Gonzalez
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and CIBERFES, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
| | - A. De la Rosa
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and CIBERFES, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
| | - A. Carretero
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and CIBERFES, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
| | - M.C. Gomez-Cabrera
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and CIBERFES, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
- Corresponding author. Av. Blasco Ibañez 15, 46010, Valencia, Spain.
| | - J. Viña
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia and CIBERFES, Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain
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Ortega-Bastidas P, Aqueveque P, Gómez B, Saavedra F, Cano-de-la-Cuerda R. Use of a Single Wireless IMU for the Segmentation and Automatic Analysis of Activities Performed in the 3-m Timed Up & Go Test. Sensors (Basel) 2019; 19:E1647. [PMID: 30959897 DOI: 10.3390/s19071647] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 03/12/2019] [Accepted: 03/19/2019] [Indexed: 12/15/2022]
Abstract
Falls represent a major public health problem in the elderly population. The Timed Up & Go test (TU & Go) is the most used tool to measure this risk of falling, which offers a unique parameter in seconds that represents the dynamic balance. However, it is not determined in which activity the subject presents greater difficulties. For this, a feature-based segmentation method using a single wireless Inertial Measurement Unit (IMU) is proposed in order to analyze data of the inertial sensors to provide a complete report on risks of falls. Twenty-five young subjects and 12 older adults were measured to validate the method proposed with an IMU in the back and with video recording. The measurement system showed similar data compared to the conventional test video recorded, with a Pearson correlation coefficient of 0.9884 and a mean error of 0.17 ± 0.13 s for young subjects, as well as a correlation coefficient of 0.9878 and a mean error of 0.2 ± 0.22 s for older adults. Our methodology allows for identifying all the TU & Go sub–tasks with a single IMU automatically providing information about variables such as: duration of sub–tasks, standing and sitting accelerations, rotation velocity of turning, number of steps during walking and turns, and the inclination degrees of the trunk during standing and sitting.
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Hosseini L, Kargozar E, Sharifi F, Negarandeh R, Memari AH, Navab E. Tai Chi Chuan can improve balance and reduce fear of falling in community dwelling older adults: a randomized control trial. J Exerc Rehabil 2018; 14:1024-1031. [PMID: 30656165 PMCID: PMC6323335 DOI: 10.12965/jer.1836488.244] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 11/10/2018] [Indexed: 12/14/2022] Open
Abstract
Fear of falling and balance impairment are prevalent in older adults and cause major morbidities for this population. The aim of this study was to evaluate the effect of Tai Chi Chuan on balance and fear of falling in community-dwelling older adults. This study was a single-blind randomized control trial. Sixty older adults were randomly allocated into two groups using a 4-cell random block design. The participants of intervention group were trained in Tai Chi Chuan for eight weeks, twice a week, and 55 min in each session. Balance and fear of falling were assessed by Timed Up and Go (TUG) test, Tinetti test and Falls Efficacy Scale International in baseline and after 8 weeks. After eight weeks of intervention, the mean scores of the TUG and Tinetti scales in the intervention group were improved significantly compared to the baseline and the control group (P<0.001). Moreover, the intervention group showed a significant reduction in fear of falling scores (P<0.001), while those in the control group remained unchanged. Tai Chi Chuan effectively improves the balance and fear of falling and could be considered as a practical and useful method for fall prevention in community-dwelling older adults.
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Affiliation(s)
- Lida Hosseini
- School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Kargozar
- Physical Medicine and Rehabilitation Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Negarandeh
- Nursing & Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir-Hossein Memari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Navab
- Critical care and Geriatric Nursing Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Smith ML, Towne SD, Herrera-Venson A, Cameron K, Horel SA, Ory MG, Gilchrist CL, Schneider EC, DiCocco C, Skowronski S. Delivery of Fall Prevention Interventions for At-Risk Older Adults in Rural Areas: Findings from a National Dissemination. Int J Environ Res Public Health 2018; 15:E2798. [PMID: 30544658 DOI: 10.3390/ijerph15122798] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 11/10/2018] [Accepted: 12/04/2018] [Indexed: 12/17/2022]
Abstract
Falls incidence rates and associated injuries are projected to increase among rural-dwelling older adults, which highlights the need for effective interventions to prevent falls and manage fall-related risks. The purpose of this descriptive study was to identify the geospatial dissemination of eight evidence-based fall prevention programs (e.g., A Matter of Balance, Stepping On, Tai Chi, Otago Exercise Program) across the United States (U.S.) in terms of participants enrolled, workshops delivered, and geospatial reach. These dissemination characteristics were compared across three rurality designations (i.e., metro areas; non-metro areas adjacent to metro areas; and, non-metro areas not adjacent to metro areas). Data were analyzed from a national repository of 39 Administration for Community Living (ACL) grantees from 2014–2017 (spanning 22 states). Descriptive statistics were used to assess program reach, delivery-site type, and completion rate by rurality. Geographic information systems (GIS) geospatially represented the collective reach of the eight interventions. Of the 45,812 participants who attended a fall prevention program, 12.7% attended workshops in non-metro adjacent areas and 6.6% attended workshops in non-metro non-adjacent areas. Of the 3755 workshops delivered (in over 550 unique counties), most were delivered in senior centers (26%), residential facilities (20%), healthcare organizations (13%), and faith-based organizations (9%). On average, the workshop attendance/retention rates were consistent across rurality (~70%). Findings highlight the need to diversify the delivery infrastructure for fall prevention programs to adequately serve older adults in rural areas. Ongoing efforts are needed to offer sustainable technical assistance and to develop scalable clinical-community referral systems to increase fall prevention program participation among rural-dwelling older adults.
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Lopez P, Pinto RS, Radaelli R, Rech A, Grazioli R, Izquierdo M, Cadore EL. Benefits of resistance training in physically frail elderly: a systematic review. Aging Clin Exp Res 2018; 30:889-99. [PMID: 29188577 DOI: 10.1007/s40520-017-0863-z] [Citation(s) in RCA: 158] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 11/17/2017] [Indexed: 12/14/2022]
Abstract
AIM Exercise is one of the most important components in frailty prevention and treatment. Therefore, we systematically reviewed the effect of resistance training (RT) alone or combined with multimodal exercise intervention on muscle hypertrophy, maximal strength, power output, functional performance, and falls incidence in physically frail elderly. METHODS MEDLINE, Cochrane CENTRAL, PEDro, and SPORTDiscus databases were searched from 2005 to 2017. Studies must have mentioned the effects of RT (i.e., included or not in multimodal training) on at least one of the following parameters: muscle mass, muscle strength, muscle power, functional capacity, and risk of falls in frail elderly. RESULTS The initial search identified 371 studies and 16 were used for qualitative analysis for describing the effect of strength training performed alone or in a multimodal exercise intervention. We observed that RT alone or in a multimodal training may induce increases of 6.6-37% in maximal strength; 3.4-7.5% in muscle mass, 8.2% in muscle power, 4.7-58.1% in functional capacity and risk of falls, although some studies did not show enhancements. CONCLUSION Frequency of 1-6 sessions per week, training volume of 1-3 sets of 6-15 repetitions and intensity of 30-70%1-RM promoted significant enhancements on muscle strength, muscle power, and functional outcomes. Therefore, in agreement with previous studies, we suggest that supervised and controlled RT represents an effective intervention in frailty treatment.
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Abstract
BACKGROUND Injury is a major public health problem and accounts for 10% of the global burden of disease. This study intends to present the temporal trend in the injury burden in Korea and to compare the burden size by injury mechanism and age group. METHODS This study was a nationwide population-based observational study. We used two data sets, the death certificates statistics and the Korean National Hospital Discharge Survey data (2004-2012). We calculated age-standardized disability-adjusted life year (DALY) from years of life lost (YLL) and years lived with disability (YLD) and trend analysis. RESULTS The DALYs of road injury decreased (P = 0.002), falls did not exhibit a trend (P = 0.108), and self-harm increased overall (P = 0.045). In the road injury, the YLLs decreased across all 4 age groups (0-14, 15-49, 50-79, ≥ 80) and the YLDs decreased in the 0-14-year-old group. In total, the DALYs of road injuries decreased in the 0-14-year-old group. In the fall injury, although the YLLs decreased in the over 80-year-old group, the YLDs increased in the 50-79-year-old group and the over 80-year-old group. The burden of self-harm injury was high in the age group 15 years and over, especially in the 15-49-year-old group. CONCLUSION The leading causes of the injury burden were road injuries, falls, and self-harm. The burden of road injury and self-harm have recently shown a gradual decreasing tendency. On the other hands, that of fall injuries are continually high in the age group over 50 years of age.
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Affiliation(s)
- Yoonjic Kim
- Department of Emergency Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Yu Jin Kim
- Department of Emergency Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- Laboratory of Emergency Medical Service, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
| | - Sang Do Shin
- Laboratory of Emergency Medical Service, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
- Department of Emergency Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kyoung Jun Song
- Laboratory of Emergency Medical Service, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
- Department of Emergency Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jungeun Kim
- Laboratory of Emergency Medical Service, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
| | - Jeong Ho Park
- Laboratory of Emergency Medical Service, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
- Department of Emergency Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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Lopez P, Izquierdo M, Radaelli R, Sbruzzi G, Grazioli R, Pinto RS, Cadore EL. Effectiveness of Multimodal Training on Functional Capacity in Frail Older People: A Meta-Analysis of Randomized Controlled Trials. J Aging Phys Act 2018; 26:407-18. [PMID: 28952861 DOI: 10.1123/japa.2017-0188] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In this meta-analysis, we investigated the effect of resistance training (RT) alone or included in a multimodal training on physical frailty outcomes, and whether different variables of RT prescription affect these outcomes. We identified 15 relevant studies searching through MEDLINE, Cochrane Central Register of Controlled Trials, SPORTDiscus, and PEDro database. Postintervention standardized mean difference scores were computed and combined using fixed effects meta-analysis. Analyses have shown positive effects of interventions on maximum strength, gait speed, and Timed Up and Go test. Further analyses have shown significant greater effect of shorter periods on maximum strength. Regarding RT prescription, percentage of one-repetition maximum showed significant effect on physical variables, whereas RT based on rate of perceived effort presented lower effect in the Timed Up and Go test. Although multimodal training is an effective intervention to increase physical capacity, caution should be taken regarding the period and the method to control RT intensity to optimize enhancements in frail older people.
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Whipple MO, Hamel AV, Talley KMC. Fear of falling among community-dwelling older adults: A scoping review to identify effective evidence-based interventions. Geriatr Nurs 2018; 39:170-177. [PMID: 28941942 PMCID: PMC5862787 DOI: 10.1016/j.gerinurse.2017.08.005] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 08/16/2017] [Accepted: 08/21/2017] [Indexed: 10/18/2022]
Abstract
Fear of falling presents a significant problem for many older adults by reducing physical function and increasing the risk of future falls. Several different types of interventions have improved fear of falling and a summary of efficacious interventions will help clinicians recommend treatment options. Using the Arksey and O'Malley Framework for scoping reviews, the purpose of this review was to identify efficacious interventions for treating fear of falling among community-dwelling older adults in order to provide a list of potential treatment options for care providers. A total of 45 publications were identified for inclusion in this review.
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Affiliation(s)
- Mary O Whipple
- School of Nursing, University of Minnesota, 5-140 Weaver Densford Hall, 308 Harvard St SE, Minneapolis, MN, 55455, USA.
| | - Aimee V Hamel
- School of Nursing, University of Minnesota, 5-140 Weaver Densford Hall, 308 Harvard St SE, Minneapolis, MN, 55455, USA
| | - Kristine M C Talley
- School of Nursing, University of Minnesota, 5-140 Weaver Densford Hall, 308 Harvard St SE, Minneapolis, MN, 55455, USA
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Omote S, Watanabe A, Hiramatsu T, Saito E, Yokogawa M, Okamoto R, Sakakibara C, Ichimori A, Kyota K, Tsukasaki K. A foot-care program to facilitate self-care by the elderly: a non-randomized intervention study. BMC Res Notes 2017; 10:586. [PMID: 29122000 PMCID: PMC5679143 DOI: 10.1186/s13104-017-2898-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 11/01/2017] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE We aimed to evaluate a foot-care awareness program designed to improve foot morphology, physical functioning, and fall prevention among the community-dwelling elderly. Eleven independent community-dwelling elderly women (aged 61-83 years) were provided with foot-care advice and shown effective foot-care techniques to perform regularly for 6 months, and compared with a control group of 10 elderly women who did not receive any intervention. Measurements of foot form, functional capacity, subjective foot movement, and physical function were taken at baseline and 6-month follow-up. RESULTS At follow-up, improvements were seen in the intervention group in foot morphology, subjective foot movement, foot pressure, and balance. In the intervention group, 90% of women had maintained or improved foot form and none of them had fallen during the post-intervention period, compared to the control group where 30% improved foot form (p = 0.0075) and four (40%) of them had fallen. Therefore, a foot-care program may have the potential to prevent falls and improve mobility among the elderly. Trial Registration UMIN-CTR No. UMIN000029632. Date of Registration: October 19, 2017.
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Affiliation(s)
- Shizuko Omote
- Faculty of Health Science, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan.
| | - Arisu Watanabe
- Division of Health Science, Graduate School of Medical Science, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan
| | - Tomoko Hiramatsu
- School of Nursing, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa, 920-0293, Japan
| | - Emiko Saito
- Graduate School of Human Health Sciences, Tokyo Metropolitan University, 7-2-10 Higashiogu, Arakawa, Tokyo, 116-8551, Japan
| | - Masami Yokogawa
- Faculty of Health Science, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan
| | - Rie Okamoto
- Faculty of Health Science, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan
| | - Chiaki Sakakibara
- Faculty of Health Science, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan
| | - Akie Ichimori
- Faculty of Health Science, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan
| | - Kaoru Kyota
- Faculty of Health Science, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan
| | - Keiko Tsukasaki
- Faculty of Health Science, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan
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Schoberer D, Leino-Kilpi H, Breimaier HE, Halfens RJ, Lohrmann C. Educational interventions to empower nursing home residents: a systematic literature review. Clin Interv Aging 2016; 11:1351-1363. [PMID: 27729778 PMCID: PMC5047743 DOI: 10.2147/cia.s114068] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose of the study Health education is essential to improve health care behavior and self-management. However, educating frail, older nursing home residents about their health is challenging. Focusing on empowerment may be the key to educating nursing home residents effectively. This paper examines educational interventions that can be used to empower nursing home residents. Methods A systematic literature search was performed of the databases PubMed, CINAHL, CENTRAL, PsycINFO, and Embase, screening for clinical trials that dealt with resident education and outcomes in terms of their ability to empower residents. An additional, manual search of the reference lists and searches with SIGLE and Google Scholar were conducted to identify gray literature. Two authors independently appraised the quality of the studies found and assigned levels to the evidence reported. The results of the studies were grouped according to their main empowering outcomes and described narratively. Results Out of 427 identified articles, ten intervention studies that addressed the research question were identified. The main educational interventions used were group education sessions, motivational and encouragement strategies, goal setting with residents, and the development of plans to meet defined goals. Significant effects on self-efficacy and self-care behavior were reported as a result of the interventions, which included group education and individual counseling based on resident needs and preferences. In addition, self-care behavior was observed to significantly increase in response to function-focused care and reasoning exercises. Perceptions and expectations were not improved by using educational interventions with older nursing home residents. Conclusion Individually tailored, interactive, continuously applied, and structured educational strategies, including motivational and encouraging techniques, are promising interventions that can help nursing home residents become more empowered. Empowering strategies used by nurses can support residents in their growth and facilitate their self-determination. Further research on the empowerment of residents using empowerment scales is needed.
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Affiliation(s)
- Daniela Schoberer
- Institute of Nursing Science, Medical University of Graz, Graz, Austria
| | | | - Helga E Breimaier
- Institute of Nursing Science, Medical University of Graz, Graz, Austria
| | - Ruud Jg Halfens
- Department of Health Services Research, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Christa Lohrmann
- Institute of Nursing Science, Medical University of Graz, Graz, Austria
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