Clinical history and biologic age predicted falls better than objective functional tests

Gerdhem, Paul; Ringsberg, Karin; Åkesson, Kristina; Obrant, Karl

doi:10.1016/j.jclinepi.2004.06.013

Cited by 74 publications

(49 citation statements)

References 31 publications

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“…The Romberg test has been frequently used since it is a simple measure of balance function. It has been shown to predict falls in the OPRA cohort 19 and injurious falls in another cohort 20 .…”

Section: Discussionmentioning

confidence: 99%

“…10 balance plate 19 . However, other sway tests have been able to discriminate between subjects with and without a recent fracture 10,11 and also have a prospective fall- 23 and fracturepredicting ability 3 .…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, our study clearly demonstrates that impaired balance is associated with previous fracture. Impaired balance is a risk factor for future fractures 1,19,26 . An improvement of balance may therefore be of outmost importance in patients with several previous fractures.…”

Section: Discussionmentioning

confidence: 99%

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The Relation Between Previous Fractures and Physical Performance in Elderly Women

Gerdhem

Ringsberg

Åkesson

2006

Archives of Physical Medicine and Rehabilitation

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Relation Between Previous Fractures and Physical Performance in Elderly Women

Gerdhem

Ringsberg

Åkesson

2006

Archives of Physical Medicine and Rehabilitation

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“…At the 1-year follow-up, the participants were asked to recall whether they had fallen in the last year. (25) …”

Section: Questionnairementioning

confidence: 99%

Associations Between Homocysteine, Bone Turnover, BMD, Mortality, and Fracture Risk in Elderly Women

Gerdhem

Ivaska

Isaksson

et al. 2007

Journal of Bone and Mineral Research

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107

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Homocysteine has been suggested to be a risk factor for fracture, but the causal relationship is not clear. In 996 women from the OPRA study, high homocysteine level was associated with high bone marker levels and low BMD at baseline. During a mean 7-year follow-up, high homocysteine level was associated with mortality, but no clear association to fracture risk existed.Introduction: Recently, the association between high serum homocysteine (Hcy) levels and an increased risk of fracture has been described. Materials and Methods: Hcy levels were measured at baseline in 996 women, all 75 years old. Vitamin B 12 , folate, serum cross-linking telopeptide of type I collagen (CTX), serum TRACP5b, serum osteocalcin, urine deoxypyridinoline, PTH, areal BMD (aBMD), calcaneal quantitative ultrasound (QUS), and physical performance were assessed at baseline. Fractures and mortality were recorded during a mean follow-up of 7.0 years. Results: Bone marker levels were higher in women with Hcy in the highest quartile compared with all other women (p < 0.05). The most evident correlation between Hcy and a bone marker was seen with CTX (r ‫ס‬ 0.19, p < 0.001). aBMD (hip) was 4% lower, QUS was up to 2% lower, and gait speed was 11% slower among women with Hcy in the highest quartile compared with the other women (p < 0.05). During the follow-up, 267 women sustained at least one low-energy fracture (including 69 hip fractures). When women in the highest Hcy quartile were compared with all other women, the hazard ratios (HRs) for sustaining any type of fracture was 1.18 (95% CI, 0.89-1.36) and for hip fracture was 1.50 (95% CI, 0.91-1.94). For the same group of women, the mortality risk was 2.16 (95% CI, 1.58-2.55). Adjustments for confounders did not substantially change these associations. Adjustment for PTH increased the HR for hip fracture to 1.67 (95% CI, 1.01-2.17). Low vitamin B 12 or folate was not associated with increased fracture risk or mortality. Conclusions: High Hcy levels were associated with higher bone turnover, poor physical performance, and lower BMD. There was no clear association to fracture risk. The increased mortality among women with high Hcy levels indicates that a high Hcy level may be a marker of frailty.

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“…1 Falls can result in physical and psychological harm to patients. [1][2][3] Although many successful fall prevention interventions have been conducted in community and nursing home settings, [4][5][6][7][8][9] fewer studies have been conducted in hospitals. Many of the fall prevention programs in hospitals are multifaceted and have had varying results.…”

mentioning

confidence: 99%

Intervention to Prevent Falls on the Medical Service in a Teaching Hospital

Krauss

Tutlam

Costantinou

et al. 2008

Infect. Control Hosp. Epidemiol.

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Objective.To evaluate an intervention to prevent falls at a hospital.Design.A quasi-experimental intervention with historical and contemporaneous control groups.Setting and Participants.Nursing staff and patients in the medicine service (comprising 2 intervention floors and 2 control floors) at an academic hospital.Intervention.Nursing staff were educated regarding fall prevention during the period from April through December 2005. Data on implemented prevention strategies were collected on control and intervention floors. Mean monthly fall rates were compared over time and between intervention and control floors, using repeated-measures analysis of variance.Results.Postintervention fall knowledge test scores for the nursing staff were greater than preintervention test scores (mean postintervention test score, 91%; mean preintervention test score, 72%;P< .001). Use of prevention strategies was greater on intervention floors than it was on control floors, including patient education via pamphlets (46% vs 15%;P< .001), use of toileting schedules (36% vs 25%;P= .016), and discussion of high-risk medications (51% vs 30%;P< .001). The mean fall rate for the first 5 months of the intervention was 43% less than that for the 9-month preintervention period for intervention floors (3.81 falls per 1,000 patient-days vs 6.64 falls per 1,000 patient-days;P= .043). Comparisons of mean rates for the overall 9-month intervention period versus the 9-month preintervention period showed a 23% difference in the fall rate for intervention floors, but this did not reach statistical significance (5.09 falls per 1,000 patient-days vs 6.64 falls per 1,000 patient-days;P= .182).Conclusion.The nursing staffs knowledge and use of prevention strategies increased. Fall rates decreased for 5 months after the educational intervention, but the reduction was not sustained.

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Clinical history and biologic age predicted falls better than objective functional tests

Cited by 74 publications

References 31 publications

The Relation Between Previous Fractures and Physical Performance in Elderly Women

The Relation Between Previous Fractures and Physical Performance in Elderly Women

Associations Between Homocysteine, Bone Turnover, BMD, Mortality, and Fracture Risk in Elderly Women

Intervention to Prevent Falls on the Medical Service in a Teaching Hospital

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