Depressive symptoms in addition to visual impairment, reduced strength and poor balance predict falls in older Taiwanese people

Kwan, Marcella; Lin, Sang-I; Close, Jacqueline C.T.; Lord, Stephen R.

doi:10.1093/ageing/afs065

Cited by 36 publications

(44 citation statements)

References 24 publications

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“…LRs of several individual studies yielded PoTP of 50% or more. These included difficulty with activities of daily living (ADL),33,34 assistive device use,30,35,42 fear of falling,35,51 and previous fall history,33,37,43,48,49,52,54,55,57,59 The combined summary calculations, however, demonstrated small to moderate LRs and small change in PoTP. The medical history questions providing the largest increase in PoTP above PrTP of 30% included previous falls (PoTP= 44%), use of psychoactive medications (PoTP = 38%), requiring assistance for any ADL (PoTP = 38%), being fearful of falling (PoTP = 38%), and use of an ambulatory assistive device (PoTP = 36%).…”

Section: Resultsmentioning

confidence: 99%

“…Although data about the Falls Risk Assessment Questionnaire36 (>8 of 16 points; PoTP = 63%), the Balance Self-Perception Test44 (<50 of 60 points; PoTP = 63%), and the Activities Specific Balance Confidence Test41 (<90 of 100%; PoTP = 59%) look promising, results were based on a single study with small sample sizes. The Falls Efficacy Scale International (≥24; PoTP = 42%) is supported by 2 Level I prospective studies with moderate sample sizes,30,68 and may be more trustworthy.…”

Section: Resultsmentioning

confidence: 99%

“…Although less powerful, self-reported difficulty with walking might indicate possibility of future falls (PoTP = 41%) 40,50. Although the literature suggests that advancing age (>80 years),37–41 poor self-reported health,30,31,52 and frequent alcohol consumption39,40,41,43,46,48,49 are risk factors for falls, these conclusions were not supported by summary PoTP values for either positive or negative test results. Evidence about polypharmacy was inconsistent across studies.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Determining Risk of Falls in Community Dwelling Older Adults: A Systematic Review and Meta-analysis Using Posttest Probability

Lusardi

Fritz

Middleton³

et al. 2017

Journal of Geriatric Physical Therapy

423

308

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Background:Falls and their consequences are significant concerns for older adults, caregivers, and health care providers. Identification of fall risk is crucial for appropriate referral to preventive interventions. Falls are multifactorial; no single measure is an accurate diagnostic tool. There is limited information on which history question, self-report measure, or performance-based measure, or combination of measures, best predicts future falls.Purpose:First, to evaluate the predictive ability of history questions, self-report measures, and performance-based measures for assessing fall risk of community-dwelling older adults by calculating and comparing posttest probability (PoTP) values for individual test/measures. Second, to evaluate usefulness of cumulative PoTP for measures in combination.Data Sources:To be included, a study must have used fall status as an outcome or classification variable, have a sample size of at least 30 ambulatory community-living older adults (≥65 years), and track falls occurrence for a minimum of 6 months. Studies in acute or long-term care settings, as well as those including participants with significant cognitive or neuromuscular conditions related to increased fall risk, were excluded. Searches of Medline/PubMED and Cumulative Index of Nursing and Allied Health (CINAHL) from January 1990 through September 2013 identified 2294 abstracts concerned with fall risk assessment in community-dwelling older adults.Study Selection:Because the number of prospective studies of fall risk assessment was limited, retrospective studies that classified participants (faller/nonfallers) were also included. Ninety-five full-text articles met inclusion criteria; 59 contained necessary data for calculation of PoTP. The Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS) was used to assess each study's methodological quality.Data Extraction:Study design and QUADAS score determined the level of evidence. Data for calculation of sensitivity (Sn), specificity (Sp), likelihood ratios (LR), and PoTP values were available for 21 of 46 measures used as search terms. An additional 73 history questions, self-report measures, and performance-based measures were used in included articles; PoTP values could be calculated for 35.Data Synthesis:Evidence tables including PoTP values were constructed for 15 history questions, 15 self-report measures, and 26 performance-based measures. Recommendations for clinical practice were based on consensus.Limitations:Variations in study quality, procedures, and statistical analyses challenged data extraction, interpretation, and synthesis. There was insufficient data for calculation of PoTP values for 63 of 119 tests.Conclusions:No single test/measure demonstrated strong PoTP values. Five history questions, 2 self-report measures, and 5 performance-based measures may have clinical usefulness in assessing risk of falling on the basis of cumulative PoTP. Berg Balance Scale score (≤50 points), Timed Up and Go times (≥12 seconds), and 5 times sit-to-stand times (≥...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Determining Risk of Falls in Community Dwelling Older Adults: A Systematic Review and Meta-analysis Using Posttest Probability

Lusardi

Fritz

Middleton³

et al. 2017

Journal of Geriatric Physical Therapy

423

308

View full text Add to dashboard Cite

show abstract

“…Women' psychological status was also important in the incidence of falls. Pain and depression were deeply explored in previous studies by other researchers (Kvelde et al, 2013;Kwan, Lin, Close, & Lord, 2012;Spoelstra, Given, von Eye, & Given, 2010;van den Berg et al, 2011). But these factors are consequently excluded in our study because of the difficulty of diagnosis in a large sample.…”

Section: Discussionmentioning

confidence: 99%

Risk factors of indoor fall injuries in community-dwelling older women: A prospective cohort study

Xia

Jiang

et al. 2015

Archives of Gerontology and Geriatrics

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“…22,23 Kwan e outros 22 acreditam que um dos motivos para isto seria o fato de as pessoas depressivas serem mais sedentárias, o que reduz a força muscular dos membros inferiores e favorece a diminuição do equilíbrio do corpo. Por outro lado, idosos com depressão ou em uso de medicação antidepressiva provavelmente apresentam mobilidade reduzida, expondose menos aos riscos, o que poderia explicar os achados do presente estudo.…”

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Análise dos fatores associados a quedas com fratura de fêmur em idosos: um estudo caso-controle

Soares

Mello

Silva

et al. 2015

Rev. bras. geriatr. gerontol.

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ResumoObjetivo: Identificar os principais fatores associados a quedas e fraturas de fêmur em idosos. Métodos: Trata-se de estudo caso-controle (um grupo de casos e dois grupos controle) na proporção de 1:1:1, em que foram estudados 135 indivíduos com idade ≥60 anos, pareados por sexo, no período de 2005 a 2012. Os dados foram coletados por meio de entrevistas nos domicílios dos participantes, e realizou-se levantamento de informações em prontuários. Para análise das diferenças entre proporções e médias entre os grupos, empregaram-se o teste qui-quadrado e o teste t Student, respectivamente. Para o estudo da associação entre variáveis, foram realizadas análises univariadas e multivariadas empregando-se regressão logística. Como medida de efeito, foram empregados odds ratio (OR) e seu intervalo de confiança a 95% (IC95%). Em todas as análises, considerou-se um nível de significância de 5%. Resultados: Após análise multivariada, os fatores de proteção contra fratura de fêmur foram: ouvir bem e possuir corrimão nas escadas de suas residências. Os fatores de risco para fratura de fêmur foram: hipertensão arterial sistêmica, sedentarismo e possuir superfície escorregadia na residência. Os fatores de proteção para queda foram: possuir corrimão nas escadas de suas residências, ser portador de osteoporose e depressão. O fator de risco de queda foi o sedentarismo. Conclusão: As fraturas de fêmur representam importante fator de morbidade em idosos. Conhecer os fatores de risco para fraturas pós-queda em idosos é essencial para o planejamento de ações individuais e coletivas voltadas à prevenção deste agravo e suas consequências. Atividades físicas, planos terapêuticos mais adequados e correção de inadequações nos domicílios desses indivíduos devem ser orientados e incentivados. Palavras

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Depressive symptoms in addition to visual impairment, reduced strength and poor balance predict falls in older Taiwanese people

Cited by 36 publications

References 24 publications

Determining Risk of Falls in Community Dwelling Older Adults: A Systematic Review and Meta-analysis Using Posttest Probability

Determining Risk of Falls in Community Dwelling Older Adults: A Systematic Review and Meta-analysis Using Posttest Probability

Risk factors of indoor fall injuries in community-dwelling older women: A prospective cohort study

Análise dos fatores associados a quedas com fratura de fêmur em idosos: um estudo caso-controle

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