Assessment and prevention of falls in older people – concise guidance

Swift, Cameron; Iliffe, Steve

doi:10.7861/clinmedicine.14-6-658

Cited by 35 publications

(33 citation statements)

References 17 publications

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“…23 A recent systematic review concluded there was insufficient evidence to determine how walking affects fall risk. 24,25 Most fall prevention trials tested multi-component exercise programs and many did not include MVPA as a component. 2 These trials were not designed to evaluate dose-response relationships relating MVPA to risk of falls.…”

Section: Discussionmentioning

confidence: 99%

Accelerometer‐Measured Moderate to Vigorous Physical Activity and Incidence Rates of Falls in Older Women

Buchner

Rillamas‐Sun

et al. 2017

J American Geriatrics Society

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Objectives To examine whether moderate/vigorous physical activity (MVPA) measured by accelerometry is associated with incident falls, and whether associations differ by physical function or history of falls. Design Prospective study with baseline data collection in 2012-2014 and one year of follow-up. Setting Women's Health Initiative particip ants living in the U.S. Participants 5545 ambulatory women aged 63-99 Measurements Minutes of MVPA per day measured by Actigraph GT3X+ accelerometer; functional status measured by the Short Physical Performance Battery (SPPB); fall risk factors assessed by questionnaire; fall injuries assessed by phone interview; incident falls ascertained from fall calendars. Results Incident rate ratios (IRR) revealed increased fall risk among women in the lowest compared to highest quartiles of MVPA (IRR=1.26; 95% CI 1.08-1.48) adjusted for age, race/ethnicity, and fall risk factors. Fall rates were not significantly associated with MVPA among women with high SPPB (9-12) or 0-1 falls in the previous year. However, among women with low SPPB (≤8) or history of frequent falls, fall rates were increased among women with low vs. higher MVPA levels (interaction P -values <0.03 and <0.00001, respectively). Falls among women with MVPA above the median were less likely to involve injuries requiring medical treatment (9.9%), than falls among women with lower MVPA levels (13.0%; P <0.001). Conclusion These findings indicate that falls are not more common or injurious among older women who engage in higher levels of MVPA. These findings support encouraging women to engage in the amounts and types of MVPA that they prefer. Older women with low physical function or frequent falls who choose low MVPA represent a high risk group for whom vigilance about falls prevention is warranted.

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Section: Discussionmentioning

confidence: 99%

Accelerometer‐Measured Moderate to Vigorous Physical Activity and Incidence Rates of Falls in Older Women

Buchner

Rillamas‐Sun

et al. 2017

J American Geriatrics Society

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“…Falling is a major problem in older adults. 30-40% of people over the age of 65, who live in the community, fall at least once a year [1]. About half of them fall again in the following year and need long-term care [2].…”

Section: Introductionmentioning

confidence: 99%

The Relationships Between Fall Risk, Depression, Executive Dysfunctions and Daily Life of Older Adults

Engel‐Yeger

Zilbershlag

2020

Preprint

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Background: Falling is a major problem in older adults that may significantly reduce health and quality of life (QOL). Body dysfunctions that include depression, cognitive decline and executive dysfunctions may elevate fall risk and impair daily activities and QOL. Yet, most studies evaluate these body dysfunctions using laboratory measures in clinical settings. The present study aimed to: (1) compare these body dysfunctions between high/low risk fallers (2) examine the relationship between these body dysfunctions among the high risk fallers (3) explore the specific contribution of fall risk as a mediator between depression, executive dysfunctions and daily life. Methods: Participants were 123 older adults who live in the community. Depression and cognitive status were measured by the GDS-15 and the MoCA. Fall risk was determined by a questionnaire supported by the Time Up and Go test (TUG). Executive functions (EF) were assessed by the BRIEF-A and the aEFPT medication management assessment. Daily activity performance was measured by the Barthel Index of ADL and the Instrumental ADL Scale. QOL was measured by the World Health Organization Quality of Life Brief Questionnaire. Results: High fall risk was prevalent among 32% of the sample. High risk fallers had significantly lower cognitive level, higher depression, lower EF, lower daily activity performance and lower QOL. Among the high risk group, lower EF as measured in BRIEF-A scales correlated with lower performance of daily activities and lower QOL. SEM model revealed that fall risk mediated between depression, executive dysfunctions and daily life. Conclusions: Depression and executive dysfunctions are more prevalent in older adults with high fall risk and are significantly related to their daily activity performance and to their QOL. Community fall-prevention and rehabilitation programs should screen for fall risk and related body dysfunctions as expressed during daily activity performance and understand their impacts on people’s QOL.

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“…This geriatric syndrome reflects the reduction of functional reserve capacity, which results in vulnerability coupled with accident, impairment, active disease process, adverse pharmacological stimulus or any combination of these. It is estimated that 30% of people over 65, and 50% of people over 80 experience a fall at least once a year [1]. Falls in long-term care facilities (LTC) are three times more common than in the community of seniors, with roughly 50% of older adults in LTC falling every year, and 40% of these falling multiple times.…”

Section: Introductionmentioning

confidence: 99%

“…Significant injuries occur in 4-15% of falls. Mortal injuries as a result of a fall occur in 23-40% [1,[4][5][6].…”

Section: Introductionmentioning

confidence: 99%

The risk of falling among older adults in long-term care: screening by the Morse Fall Scale

Bóriková¹,

Žiaková²,

Tomagová³

et al. 2018

Kontakt

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To identify the incidence of key fall risk factors in groups of older adults in longterm care facilities and to find out which factors can be identified by the Morse Fall Scale (MFS) as significant in relation to high fall risks. Fall risk screening is the basis for efficient intervention planning. MFS is often recommended for fall risk detection even in long-term care settings. No tool for the prediction of fall risks has been tested in Slovakia so far. Methods: The design of this study is descriptive and correlated. Fall risk factors and fall risk screening (according to MFS) were assessed in 89 older adults in two longterm care facilities. The data were collected from July to October 2016. Results: The majority of monitored risk factors had a high incidence in the sample. The authors identified that a strong predictor of a fall is mainly the presence of a fall in the patient's clinical history. Statistically significant correlations were found between a history of falling, disorder of the gait and balance, use of ambulatory aids, mental disorder, falling during the study and a high fall risk according to MFS. Conclusion: This tool provides nurses with the information on the level of fall risk and specific risk factors. It also enables targeted planning of preventive and protective interventions. Despite the clinical efficiency of the tool it is still important to continue testing the prediction value of the tool in different areas of nursing practice in Slovakia.

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Assessment and prevention of falls in older people – concise guidance

Cited by 35 publications

References 17 publications

Accelerometer‐Measured Moderate to Vigorous Physical Activity and Incidence Rates of Falls in Older Women

Accelerometer‐Measured Moderate to Vigorous Physical Activity and Incidence Rates of Falls in Older Women

The Relationships Between Fall Risk, Depression, Executive Dysfunctions and Daily Life of Older Adults

The risk of falling among older adults in long-term care: screening by the Morse Fall Scale

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