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Fall risk assessment

Alexandra G Robinson, Amy M Dennett, David A Snowdon
BACKGROUND: Task-specific training is an effective form of rehabilitation for improving mobility in neurological conditions. However, it remains unclear if task-specific training is effective in people with progressive disease. OBJECTIVE: To establish the efficacy of task-specific training on the mobility of individuals with progressive neurological conditions. DATA SOURCES: Electronic databases MEDLINE, EMBASE, CINAHL and Cochrane Database of Systematic Reviews...
November 15, 2018: Physiotherapy
Veronica Miyasike-daSilva, Jonathan C Singer, William E McIlroy
BACKGROUND: Locomotion on stairs is challenging for balance control and relates to a significant number of injurious falls. The visual system provides relevant information to guide stair locomotion and there is evidence that peripheral vision is potentially important. RESEARCH QUESTION: This study investigated the role of the lower visual field information for the control of stair walking. It was hypothesized that restriction in the lower visual field (LVF) would significantly impact gaze and locomotor behaviour specifically during descent and during transition phases emphasizing the importance of the LVF information during online control...
February 27, 2019: Gait & Posture
Elisa Pelosin, Cecilia Cerulli, Carla Ogliastro, Giovanna Lagravinese, Laura Mori, Gaia Bonassi, Anat Mirelman, Jeffrey M Hausdorff, Giovanni Abbruzzese, Roberta Marchese, Laura Avanzino
BACKGROUND: Falls are frequent in Parkinson's disease and ageing. Impairments in the cholinergic-mediated attentional supervision of gait may contribute to increased fall risk, especially when obstacles challenge gait. Interventions combining motor-cognitive approaches have been shown to improve motor performance, cognitive skills and falls number. Here, we hypothesized that an intervention simulating an attention-demanding walking condition could impact not only complex gait performance and fall risk but also short-latency afferent inhibition (SAI), as a marker of cholinergic activity...
March 15, 2019: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
William Beedham, George Peck, Simon E Richardson, Kevin Tsang, Michael Fertleman, David Jh Shipway
Head injury is a common cause for hospital admission and additionally 250,000 UK inpatients fall during hospital admissions annually. Head injury most commonly occurs as a result of falls from standing height in older adults. Older adults are frequently frail and multi-morbid; many have indications for anticoagulation and antiplatelet agents. The haemorrhagic complications of head injury occur in up to 16% of anticoagulated patients sustaining a head injury. These patients suffer adverse outcomes from surgery as a result of medical complications...
March 2019: Clinical Medicine: Journal of the Royal College of Physicians of London
Grant R Williams, Lisette Dunham, YunKyung Chang, Allison M Deal, Mackenzi Pergolotti, Jennifer L Lund, Emily Guerard, Kelly Kenzik, Hyman B Muss, Hanna K Sanoff
PURPOSE: The association between geriatric assessment (GA)-identified impairments and long-term health care use in older cancer survivors remains unknown. Our objective was to evaluate whether a GA performed at cancer diagnosis was predictive of hospitalizations and long-term care (LTC) use in older adult cancer survivors. METHODS: Older adults with GA performed between 3 months before through 6 months after diagnosis were included (N = 125). Patients with Medicare Parts A and B coverage and no managed care were identified...
March 14, 2019: Journal of Oncology Practice
Peggy M Cawthon, Thomas G Travison, Todd M Manini, Sheena Patel, Karol M Pencina, Roger A Fielding, Jay M Magaziner, Anne B Newman, Todd Brown, Douglas P Kiel, Steve R Cummings, Michelle Shardel, Jack Guralnik, Linda J Woodhouse, Marco Pahor, Ellen Binder, Ralph B D'Agostino, Quian-Li Xue, Eric Orwoll, Francesco Landi, Denise Orwig, Laura Schaap, Nancy K Latham N, Vasant Hirani, Timothy Kwok, Suzette Pereira, Daniel Rooks, Makoto Kashiwa, Moises Torres-Gonzalez, Joseph P Menetski, Rosaly Correa-De-Araujo, Shalender Bhasin
BACKGROUND: Lack of consensus on how to diagnose sarcopenia has limited the ability to diagnose this condition and hindered drug development. The Sarcopenia Definitions and Outcomes Consortium (SDOC) was formed to develop evidence-based diagnostic cut-points for lean mass and/or muscle strength that identify people at increased risk of mobility disability. We describe here the proceedings of a meeting of SDOC and other experts to discuss strategic considerations in the development of evidence-based sarcopenia definition...
March 14, 2019: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Brett H Shaw, Dave Borrel, Kimiya Sabbaghan, Colton Kum, Yijian Yang, Stephen N Robinovitch, Victoria E Claydon
BACKGROUND: Orthostatic hypotension (OH; profound falls in blood pressure when upright) is a common deficit that increases in incidence with age, and may be associated with falling risk. Deficit accumulation results in frailty, regarded as enhanced vulnerability to adverse outcomes. We aimed to evaluate the relationships between OH, frailty, falling and mortality in elderly care home residents. METHODS: From the Minimum Data Set (MDS) document, a frailty index (FI-MDS) was generated from a list of 58 deficits, ranging from 0 (no deficits) to 1...
March 13, 2019: BMC Geriatrics
En Loong Soon, Adriel Zhijie Leong, Jean Chiew, Arun-Kumar Kaliya-Perumal, Chun Sing Yu, Jacob Yoong-Leong Oh
Study Design: Retrospective database analysis. Purpose: To identify risk factors that predict mortality following acute spine fractures in geriatric patients of Singapore. Overview of Literature: Acute geriatric spinal fractures contribute significantly to local healthcare costs and hospital admissions. However, geriatric mortality following acute spine fractures is scarcely assessed in the Asian population. Methods: Electronic records of 3,010 patients who presented to our hospital's emergency department and who were subsequently admitted during 2004-2015 with alleged history of traumatic spine fractures were retrospectively reviewed, and 613 patients (mean age, 85...
March 15, 2019: Asian Spine Journal
Ananda A Santana-Ribeiro, Giulliani A Moreira-Brasileiro, Manuel H Aguiar-Oliveira, Roberto Salvatori, Victor Carvalho, Claudia K Alvim-Pereira, Carlos R Araújo-Daniel, Julia G Reis-Costa, Alana L Andrade-Guimarães, Alecia Ao Santos, Edgard R Vieira, Miburge B Gois-Junior
OBJECTIVES: Walking and postural balance are extremely important to obtain food and to work. Both are critical for quality of life and ability to survive. While walking reflects musculoskeletal and cardiopulmonary systems, postural balance depends on body size, muscle tone, visual, vestibular, and nervous systems. Since GH and IGF-I act on all these systems, we decided to study those parameters in a cohort of individuals with severe short stature due to untreated isolated GH deficiency (IGHD) caused by a mutation in the GHRH receptor gene...
March 1, 2019: Endocrine Connections
Young-Shin Lee, Eun-Ju Choi, Yeon-Hee Kim, Hyeoun-Ae Park
OBJECTIVE: The purpose of this study was to explore the characteristics and predictors of falls in high- and low-risk inpatients in a tertiary hospital in Korea. METHODS: Fallers' data were extracted from quality improvement reports and electronic health records from June 1, 2014, to May 31, 2015. Data on nonfallers matched by the length of hospitalization and medical departments of fallers were extracted from electronic health records. Participants were classified into a high- or a low-risk group based on their Morse Fall Scale score, fall risk-related symptoms, and medications known to increase fall risk...
March 8, 2019: Journal of Patient Safety
Taklo Simeneh Yazie, Teferra Abula Orjino, Wondwossen Amogne Degu
Purpose: Tenofovir disoproxil fumarate (TDF), a drug broadly used in combination antiretroviral therapy, is associated with renal dysfunction but the prevalence varied from country to country and it is not known in Ethiopia. The objectives of this study were to assess the prevalence of renal dysfunction and risk factors associated with it and the mean change in estimated glomerular filtration rate in human immunodeficiency virus infected patients receiving TDF based antiretroviral regimen at Tikur Anbessa Specialized Hospital...
2019: International Journal of Nephrology
Scott D Cinel, Steven J Taylor
Predation risk induces broad behavioral and physiological responses that have traditionally been considered acute and transitory. However, prolonged or frequent exposure to predators and the sensory cues of their presence they broadcast to the environment impact long-term prey physiology and demographics. Though several studies have assessed acute and chronic stress responses in varied taxa, these attempts have often involved a priori expectations of the molecular pathways involved in physiological responses, such as glucocorticoid pathways and neurohormone production in vertebrates...
2019: Frontiers in Behavioral Neuroscience
Yolanda van Vugt, James Stinear, T Claire Davies, Yanxin Zhang
Individuals with hereditary spastic paraparesis (HSP) are often impaired in their ability to control posture as a result of the neurological and musculoskeletal implications of their condition. This research aimed to assess postural stability during gait in a group of adults with HSP. Ten individuals with HSP and 10 healthy controls underwent computerized gait analysis while walking barefoot along a 10-m track. Two biomechanics methods were used to assess stability: the center of pressure and center of mass separation (COP-COM) method, and the extrapolated center of mass (XCOM) method...
March 7, 2019: Journal of Biomechanics
Kimihiko Kimachi, Miho Kimachi, Misa Takegami, Rei Ono, Shin Yamazaki, Yoshihito Goto, Yoshihiro Onishi, Miho Sekiguchi, Koji Otani, Shin-Ichi Konno, Shin-Ichi Kikuchi, Shunichi Fukuhara, Yosuke Yamamoto
OBJECTIVES: To examine the longitudinal association between baseline disability due to low back pain (LBP) and future risk of falls, particularly significant falls requiring treatment, in a community-dwelling older population. METHODS: This was a prospective population-based cohort study using data from the Locomotive Syndrome and Health Outcomes in Aizu Cohort Study (LOHAS; 2008-2010). A total of 2,738 residents aged ≥60 years were enrolled. LBP was assessed using the Roland-Morris Disability Questionnaire (RMDQ), and the level of LBP-related disability was divided into three categories (none, low, and medium to high)...
March 11, 2019: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Woo-Chul Park, Miji Kim, Sunyoung Kim, Jinho Yoo, Byung Sung Kim, Jinmann Chon, Su Jin Jeong, Chang Won Won
OBJECTIVE: To predict the risk of falls, Fall Risk Assessment (FRA) system has been newly developed to measure multi-systemic balance control among community-dwelling older adults. The aim of this study was to examine the association between FRA and fall-related physical performance tests. METHODS: A total of 289 community-dwelling adults aged 65 years and older participated in this cross-sectional study. All participants underwent FRA test and physical performance tests such as Short Physical Performance Battery (SPPB), Berg Balance Scale (BBS), and Timed Up and Go Test (TUG)...
February 2019: Annals of Rehabilitation Medicine
Shannon T Lipscomb, Alicia J Miao, Jennifer K Finders, Bridget Hatfield, Brianne H Kothari, Katherine Pears
The current study examined links between social determinants across communities and school readiness of children attending kindergarten in each community, in literacy, math, self-regulation, and social skills. Four types of social determinants were explored: socioeconomic, crime/violence, health and well-being, and access to resources. Data came from the Oregon Kindergarten Assessment, with 40,652 entering kindergarteners attending 706 schools in the fall of 2014. The 706 schools were nested within 36 counties...
March 9, 2019: Prevention Science: the Official Journal of the Society for Prevention Research
William D Leslie, Yunhua Luo, Shuman Yang, Andrew L Goertzen, Sharif Ahmed, Isabelle Delubac, Lisa M Lix
OBJECTIVE: Finite element analysis (FEA) is a computational method to predict the behavior of materials under applied loading. We developed a software tool that automatically performs FEA on dual-energy X-ray absorptiometry hip scans to generate site-specific fracture risk indices (FRIs) that reflect the likelihood of hip fracture from a sideways fall. This longitudinal study examined associations between FRIs and incident fractures. METHODS: Using the Manitoba Bone Mineral Density (BMD) Registry, femoral neck (FN), intertrochanter (IT), and subtrochanter (ST) FRIs were automatically derived from 13,978 anonymized dual-energy X-ray absorptiometry scans (Prodigy, GE Healthcare) in women and men aged 50 yr or older (mean age 65 yr)...
February 8, 2019: Journal of Clinical Densitometry
Mavil May Cervo, Nitin Shivappa, James R Hebert, Wendy H Oddy, Tania Winzenberg, Saliu Balogun, Feitong Wu, Peter Ebeling, Dawn Aitken, Graeme Jones, David Scott
BACKGROUND & AIMS: Aging is characterized by progressive decline in physiologic reserves and functions as well as prolonged inflammation, increasing susceptibility to disease. Diet plays an important role in maintaining health, and reducing morbidity and mortality, especially in older populations. This study was designed to determine prospective associations between dietary inflammatory index (DII® ) scores and bone health, sarcopenia-related outcomes, falls risk and incident fractures in community-dwelling Australian older adults...
February 21, 2019: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Chamith S Rajapakse, Nishtha Gupta, Marissa Evans, Hamza Alizai, Malika Shukurova, Abigail L Hong, Nicholas J Cruickshank, Nirmal Tejwani, Kenneth Egol, Stephen Honig, Gregory Chang
Currently, clinical determination of pathologic fracture risk in the hip is conducted using measures of defect size and shape in the stance loading condition. However, these measures often do not consider how changing lesion locations or how various loading conditions impact bone strength. The goal of this study was to determine the impact of defect location on bone strength parameters in both the sideways fall and stance-loading conditions. We recruited 20 female subjects aged 48-77 years for this study and performed MRI of the proximal femur...
March 6, 2019: Bone
Mwenya Mubanga, Liisa Byberg, Agneta Egenvall, Johan Sundström, Patrik Karl Erik Magnusson, Erik Ingelsson, Tove Fall
OBJECTIVE: To study the association between dog ownership and cardiovascular risk factors. DESIGN: A nationwide register-based cohort study and a cross-sectional study in a subset. SETTING: A cohort of 2 026 865 participants was identified from the Register of the Total Population and linked to national registers for information on dog ownership, prescribed medication, hospital admissions, education level, income and country of birth. Participants were followed from 1 October, 2006, to the end of the study on 31 December, 2012, assessing medication for a cardiovascular risk factor, emigration and death...
March 7, 2019: BMJ Open
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