what type of fall risk factor is advanced age?

Woolf AD, Pfleger B. Elderly patients with the history of fall may experience diminished level of activity and function as well as distressing signs of depression. For example, in the United States of America, 20-30% of older people who fall suffer moderate to severe injuries such as bruises, hip fractures, or head trauma. Saf. We estimated odds ratios (OR) and 95% confidence intervals (CIs) to investigate the association between clinical factors and inpatient falls using conditional logistic regression analysis. Beta blockers, calcium channel blockers, angiotensin II receptor antagonists, angiotensin-converting enzyme inhibitors, digoxin, loop diuretics, other diuretics (thiazides or spironolactone), alpha blockers, anticholinergics, antihistamines, weak opioids, opioids, antipsychotics, anticonvulsants, benzodiazepine, hypnotics, anti-dementia drugs, antiparkinsonians, selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants, other antidepressants, vasodilating agents, and muscle relaxants were included in FRIDs. Osteoporos. PubMed Of these, the MFS is the most popular because of its ease of use; nurses can perform the rating in under three minutes. Women's Health and Aging Study. The following fall risk factors were examined for differences between groups (fallers vs. non-fallers): age, body mass index, depression, fear of falling, neuropathy, number of medications, sedentary behavior, and visual co-morbidities. Many different conditions can increase your risk of falling, such as: In addition, certain treatments, lifestyle habits and other factors can raise your risk as well: A fall risk assessment may include several steps. In conclusion, we identified that several clinical factors were associated with higher risks of falls among older adults hospitalized for acute care. Targeting a High-Risk Group for Fall Prevention: Strategies for - AJMC Many risk factors can be changed or modified to help prevent falls. Int. [17]. Am. Moreland JD, Richardson JA, Goldsmith CH, et al. Res. A fall risk assessment is important because knowing which factors increase your chances of falling helps you: All adults 65 years and older should have an initial fall risk screening. Sci. Ann Rheum Dis 2001;60:6128. Provided by the Springer Nature SharedIt content-sharing initiative, Archives of Gynecology and Obstetrics (2021). Agency for Healthcare Research and Quality. Even if youre low risk, your healthcare provider may still make preventive recommendations. Pepe, M. S., Fan, J. Age Ageing 39, 592597 (2010). Assessment and Management of Fall Risk in Primary Care Settings If youre 65 or older, talk to your healthcare provider about having a comprehensive fall risk assessment. Exercise to prevent. If you would like to reproduce some or all of this content, see Reuse of NCI Information for guidance about copyright and permissions. [20]. Your healthcare provider might ask you whether you: If you answer yes to any of these questions, your healthcare provider will recommend an additional, more thorough evaluation. . Too little blood reaches the brain. We also noted that many of the older adults in our study used anticonvulsants for treating epilepsy, mood disorders, and neuropathic pain29. Fall Risk Assessment Scales: A Systematic Literature Review What is a risk factor? In French community-dwelling older adults, poor nutritional status, as assessed by the Mini Nutritional Assessment, was associated with falls and fractures34. & Sundararajan, V. A. Switch medication or reduce the dose of any medications that increase fall risk. Falls occur more often with advancing age. ORs also indicated that among older adults prescribed FRIDs, those taking calcium channel blockers, diuretics (thiazides or spironolactone), anticonvulsants, and benzodiazepines had higher fall risks by 1.71 times (95% CI 1.012.88), 2.24 times (95% CI 1.024.90), 3.04 times (95% CI 1.735.32), and 2.26 times (95% CI 1.054.85), respectively. PubMedGoogle Scholar. Evaluating patients for fall risk - Mayo Clinic However, our study also had some limitations. 38, 7388 (2006). Results of a prospective, matched study. Laboratory tests included complete blood count, blood urea nitrogen, creatinine, serum electrolytes, glucose, hemoglobin A1c, aspartate aminotransferase (AST), alanine aminotransferase (ALT), protein, and albumin. The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request. Soc. All were published in English with publication time from 2012 to 2018. There were no significant differences in age, sex, number of comorbidities, and visual or hearing impairment between the two groups. After inclusion and exclusion criteria were applied, 14 full text articles were chosen for this meta-analysis. If the assessment shows you are at an increased risk, your health care provider and/or caregiver may recommend strategies to prevent falls and reduce the chance of injury. M1 was MFS only. Anti-hypertensive medication and COPD were both associated with increased fall risk. Scientific Reports Socioeconomic status of the . Advanced age Previous falls Muscle weakness Gait & balance problems Poor vision Postural hypotension Chronic conditions including arthritis, stroke, incontinence, diabetes, Parkinson's, dementia Fear of falling EXTRINSIC |Factors Lack of stair handrails Poor stair design Lack of bathroom grab bars Dim lighting or glare Using a fixed-effects model, we observed a significant difference of this factor (OR 1.39; 95% CI 1.101.77; Table 2; Fig. Oncol. This study was approved by the Institutional Review Board of Cangzhou Integrated Traditional Chinese and Western Medicine Hospital. Eight studies reported the BMI of 26.88 kg/m2 in fallers falls after lower extremity joint replacement, which is 0.11 kg/m2 higher than that in non-fallers groups, and the pooled results for meta-analysis suggested no difference (SMD -0.01; 95% CI 0.130.11). . J Public Health 2004;32:35660. Our results also indicate that the prevalence of leukocytosis, hypoalbuminemia, and hyponatremia was higher in fallers than controls. This indicates that adding factors such as comorbidities, fall risk-increasing drugs (FRID), and laboratory results to previous tools may improve their ability to predict inpatient falls. Diabetes and risk of hospitalized fall injury among older adults. Patients with diabetes mellitus or MFS scores45 had the highest risk of falls. Department of Family Medicine, College of Medicine, Hallym University Sacred Heart Hospital, Hallym University, Anyang, 14068, Republic of Korea, Department of Family Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, 24253, Republic of Korea, Department of Statistics and Institute of Statistics, Hallym University, Chuncheon, 24252, Republic of Korea, Department of Family Medicine, Kangnam Sacred Heart Hospital, 1, Singil-ro, Yeongdeungpo-gu, Seoul, 07441, Republic of Korea, You can also search for this author in Levinger P, Wee E, Margelis S, et al. Age-related changes in human postural control of prolonged standing. [3]. to maintaining your privacy and will not share your personal information without [13]. Many people assume that falls are a common or inevitable part of aging. Both number of total medications and FRID were higher in fallers than controls (all P<0.001). Fall-risk-increasing drugs: a systematic review and meta-analysis: II. The authors have no conflicts of interests to disclose. After adjusting for the MFS, diabetes mellitus and FRID, including calcium channel blockers, diuretics (thiazides or spironolactone), anticonvulsants, and benzodiazepines, were significantly associated with higher fall risk. For older adults, falls can be dangerous: 1 in 5 falls causes a serious injury, such as broken bones or a head injury. For more information, please refer to our Privacy Policy. Cite this article. 17, 260 (2017). 67, 10691075 (2011). J. Frailty Sarcopenia Falls 2, 5357 (2017). Soc. The main key words were as follows: factor or predictor or risk AND falls AND knee arthroplasty or hip arthroplasty or knee replacement or hip replacement AND elderly. CAS [16]. . Predictors of, [47]. Hazardous environmental exposures are recognized risk factors for falls among older adults. To obtain First, we were able to identify various fall-related clinical factors before fall events using the CDW. Research Article: Systematic Review and Meta-Analysis. The work cannot be used commercially without permission from the journal. J. If necessary, a sensitive analysis by excluding outlier study one by one was conducted to investigate the sources for heterogeneity. Medicine99(50):e23664, December 11, 2020. Tai chi is an ancient Chinese practice focused on flexibility and whole-body coordination, this practice concentrating on movement, meditation and breathing, and paying attention to exteroceptive and proprioceptive cues to promote harmonized motion in space. In-hospital patient, [32]. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. [5154] Prevalence of fall increases with increased number of chronic diseases, and chronic diseases are an important predictor in the elderly. Extrinsic factors include medications, environment and other factors. Finally, although we considered comprehensive factors, the AUC of the final model was 0.726, which is not very high, indicating that there is a need for further research to identify other possible fall-related factors. BMC geriatrics 2011;11:47. B. Table 2 shows the comparison of fall risk assessment and laboratory results between the groups. BMJ Open 7, e017045 (2017). Examining clinical factors led to significant improvements in fall prediction beyond that of the MFS in hospitalized older adults. Fall Prevention: Patient-Centered Outcomes - @ASHA bDepartment of Orthopaedic Surgery, the Second Hospital of Zhangjiakou City, Zhangjiakou, Hebei, PR China. Results of meta-analysis showed that females were more likely to fall, and the combinable OR was 1.62 (95% CI 1.361.09; Fig. 138, 98104 (2017). A previous study based on data from the longitudinal Health, Aging, and Body Composition Study reported that older adults with diabetes mellitus had higher risks of injurious falls19. Use of the CDW allowed relatively short data collection times and ensured high data quality35. Risk factors and characteristics of falls among hospitalized adult patients with hematologic diseases. The Students t-test or MannWhitney U test was used to compare continuous variables, and either the chi-square test or Fishers exact test was used to compare categorical variables. 3D). In patients, the percentage of Chronic Obstructive Pulmonary Disease (COPD) was significantly higher in fallers than non-fallers (OR 1.11; 95% CI 1.011.23; Table 2; Fig. We extracted comprehensive clinical data from a clinical data warehouse (CDW) of electronic health records and evaluated the risk-discriminative performance between MFS alone and MFS plus clinical factors. Med. the characteristics of the patient for a fall risk tool are varied: age, cognitive state, state of health in . [36]. 3I), with no heterogeneity (P = .183, I2 = 41.0%; Table 2). Try group exercise classes geared toward older adults, such as Tai Chi. Gribbin, J., Hubbard, R., Gladman, J. R., Smith, C. & Lewis, S. Risk of falls associated with antihypertensive medication: population-based case-control study. Policy. Doctors prescribe anti-hypertensive medications to keep blood pressure under control and decrease the risk of stroke and heart failure. J. [12]. Determinants of satisfaction with community reintegration in older adults with chronic stroke: role of balance self-efficacy. Google Scholar. Clinical comorbidity in patients with osteoarthritis: a case-control study of general practice consulters in England and Wales. Type of psychotropic medications might contribute to increased risk of falling in people following TJA; however, this requires further investigations with a larger sample size. PDF Fact Sheet Risk Factors for Falls - Centers for Disease Control and Advanced age, obesity and continuous femoral nerve blockade are independent, [29]. Although hazards within the homeoften contribute to a fall, more often than not falls are caused by personal risk factors. Your healthcare provider might recommend that you: Your provider may also recommend working with other healthcare professionals to keep you as healthy as possible, such as: Falls can be serious for any older adult. Only full-text articles without language restriction were included in this meta-analysis. The role of pain and function in determining patient satisfaction after total knee replacement Data from the National Joint Registry for England and Wales. Elderly patients and falls: a systematic review and meta-analysis Age, gender, historical falls, physical or cognitive impairments, medication, and environmental hazards have been reported as significant risk factors for falls [2,6-10]. The present study aimed to quantitatively and comprehensively conclude the risk factors of falls after TJA in elderly patients. [21]. Nurs. Riddle DL, Golladay GJ. Fall predictors beyond fall risk assessment tool items for acute hospitalized older adults: a matched casecontrol study. . In this matched casecontrol study, we demonstrated that several clinical factors also identified in other recent studies were associated with inpatient falls. [59]. Welmerink, D. B., Longstreth, W. T. Jr., Lyles, M. F. & Fitzpatrick, A. L. Cognition and the risk of hospitalization for serious falls in the elderly: results from the Cardiovascular Health Study. [16,21] Compared to TJA, majority of the presented studies focused on falls in patients following TKA. 3E). Correspondence: Yang Liu, Department of Orthopaedics and Traumatology, Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine , No. Some error has occurred while processing your request. [57,58] Older diabetic patients are characterized by a number of comorbidities and functional impairments predisposing to gait abnormalities and lower-extremity weakness,[59] therefore, compared to their counterparts without diabetes, diabetic patients might be less able to buffer and compensate for the psychological and pathophysiological factors associated with chronic pain including reflex inhibition, fear of falling, joint instability, and reduced attention. Outcome measures include advanced age, female, Overweight (BMI25 kg/m2), falls history, use of walking aid, diabetes, cardiac disease, hypertension, COPD and depressive symptoms. [28]. Thus, suggested that age-related factors such as impaired reflexes, reduced motor strength, proprioceptive loss, and balance may play a role. [4749] This would allow health care professionals to screen those with a substantial risk of falling and enroll them in a fall prevention training program. Identified risk factors for falls Intrinsic factors include blood pressure, orthostatics; cognition; vision; spasticity, rigidity; strength; sensory deficit, cerebellar, parkinsonism; and musculoskeletal issues, antalgia. PubMed Among FRID, calcium channel blockers, diuretics (thiazides or spironolactone), antipsychotics, anticonvulsants, benzodiazepine, and antiparkinsonians were more commonly taken by fallers than controls (21.9% and 12.0%, P=0.001; 10% and 4.4%, P=0.006; 17.1% and 11.0%, P=0.031; 26.2% and 12.0%, P<0.001; 10.0% and 4.1%, P=0.004; 8.6% and 4.4%, P=0.004; and 3.9% and 0.7%, P=0.009; respectively). Physiological. From the CDW, we extracted data on patients demographics, medical histories, fall risk assessments, medications, and laboratory results. Morse, J. M., Black, C., Oberle, K. & Donahue, P. A prospective study to identify the fall-prone patient. Eur. Obesity may impair the early outcome of total knee arthroplasty. A similar pattern is seen for many common cancer types. Choi, Y. et al. A qualitative and systematic review of the literature. Theander E, Jarnlo GB, Ornstein E, et al. These are called risk factors. BackgroundAccording to epidemiological evidence, people with type 2 diabetes mellitus have a higher risk of developing colorectal cancer.ObjectiveTo examine the relationship between colorectal cancer (CRC) and serum levels of IGF-1, IGF-1R, AGEs,RAGE and sRAGE in patients with type 2 diabetes.MethodsBy using RNASeq data of CRC patients from The Cancer Genome Atlas (TCGA) database, we . However, there was no significant difference between the groups based on medication changes on the day before falls (P=0.099). Matsumoto H, Okuno M, Nakamura T, et al. Injury 46, 119123 (2015). Activities of daily living decrease similarly in hospital-treated patients with a hip fracture or a vertebral fracture: a one-year prospective study in 151 patients. [3,4], Falls in the elderly have become a serious social problem,[5,6] and lower limb OA is also a major risk for falls with up to 50% reporting falling each year, which almost double the 33% reported in dwelling ageing people. Roelofs, E. et al. your express consent. Assoc. The AUC of the three models was 0.615, 0.646, and 0.725, respectively (M1 vs. M2, P=0.042 and M2 vs. M3, P<.001). Meta-analysis of these studies showed that overweight patients appeared more prone to falling (OR 1.18, 95% CI 1.081.29; Table 2; Fig. This study was a cross-sectional analysis of 64 participants at a primary care facility in the western United States of America. 26, 21572164 (2015). From choosing baby's name to helping a teenager choose a college, you'll make . Assessment and Management of Fall Risk in Primary Care Settings. National Joint Registry for England and Wales. Instruments for assessing the risk of falls in acute hospitalized patients: a systematic review and meta-analysis. The hospital has 13 ward units and 710 inpatient acute care beds. Reduction of, [19]. These and the list of comorbidities are shown in Table 1. 8, 363367 (2017). How to cite this article: Liu Y, Yang Y, Liu H, Wu W, Wu X, Wang T. A systematic review and meta-analysis of fall incidence and risk factors in elderly patients after total joint arthroplasty. J Bone Joint Surg Br 2007;89:893900. Gribbin J, Hubbard R, Gladman JR, et al. Yong Kyun Roh. Prevention of. [42]. Fehlberg, E. A. et al. Baker PN, van der Meulen JH, Lewsey J, et al. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. Furthermore, in older adults with dementia, the decline of motor and executive function, neuropsychiatric symptoms, and related medication use were associated with fall risk23,24. Smoking and dementia are strongly related to increased mortality . This risk level may be . Volpato S, Blaum C, Resnick H, et al. Oncol. Stang A. Qual. 3B), with no heterogeneity (P = .510, I2 = 0; Table 2). Risk factors and injury associated with falls in elderly hospitalized patients in a community hospital.
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