Falls In Elderly People Research Articles

Elderly People Fall Detection System Using Skeleton Tracking and Recognition

The fall detection systems use a variety of technologies like sensors, wearable devices, color camera, thermal camera etc. With the use of Microsoft Kinect camera for non-gaming purposes, depth images have started being utilized for fall detection. Various authors have made an attempt at using Kinect for fall detection in combination with a variety of techniques like ellipse analysis, bounding box analysis etc. However, most of these attempts fail to differentiate between human subjects and other inanimate objects and fail to identify the person who has fallen while assuming that there is only one person who needs to be monitored. This paper proposes a new system that is based on the depth images captured by Microsoft Kinect, skeleton tracking and bounding box analysis. The key novelty of this system is that it wraps the moving object into the bounding box and determines the change of size of the moving object by analysis the motion over the time to distinguish the human moving object and non-human moving object. The system stores the joint measurements of the known people in a database and compares the joint measurements of the detected person with the values in the database to identify the person. The proposed solution provides a significantly higher accuracy rate as compared to the current best solution and especially when the person carrying an object, sweeping the floor, dropping an object and picking an object from the floor.

IoT based fall detection and ambient assisted system for the elderly

Falls are considered as risky for the elderly people because it may affect the health of the people. So, in the recent years many elderly fall detection methods has been developed. In the present years many fall detection method had been developed but it uses only accelerometer sensor to detect the fall. It may fail in finding in the difference between actual fall and fall like activities such as sitting fast and jumping. In the proposed approach I have suggested a fall detection algorithm to detect the fall of elderly people. Daily human activities are divided into two parts such as static position and dynamic position. With the help of tri-axis accelerometer proposed fall detection can detect four kinds of positions such as falling front, front backward, jumping and sitting fastly. Acceleration and velocity is used to determine kind of fall. Our algorithm uses accelerometer and gyroscope sensor to predict the fall correctly and reduce the false positives and false negatives and increase the accuracy. In addition to that our method is made out of low cost and it can be used in real-time.

Randomized control study of toe exercise for prevention from fall in elderly people

Randomized control study of toe exercise for prevention from fall in elderly people

Falls in elderly people

Die Vorfahren des Homo sapiens lernten die Grundbegriffe des Gehens auf zwei Beinen in den Baumkronen der prahistorischen Urwalder. Als die Walder sich vor 5 Millionen Jahren lichteten, standen sie auf zwei Beinen in den Savannen und hatten uberlebenswichtige Vorteile: den Uberblick uber die Umgebung und freie Vorderbeine, die den Gebrauch von Werkzeugen ermoglichten. Neben diesem unbestreitbaren Nutzen gibt es aber auch Risiken der Bipedie. Aus Sicht der Altersmedizin sind dies vor allem Sturze.

PHYSIOTHERAPY METHODS IN PREVENTION OF FALLS IN ELDERLY PEOPLE

The process of population ageing is observed not only in Poland but also in other European countries. Physiological processes of ageing reduces the functional capacity. In particular, associated diseases, progressive weakness and failure of the motor system increases the risk of collapse in seniors. Dangerous consequences of falls, inter alia, injuries, can often cause death, what justifies its classification as a so-called geriatric giant. Health and psychosocial consequences of falls should be noted. Therefore, there is a great need for induction of preventive measures. Many results of studies constantly show, that an effective intervention in preventing falls in seniors should include, first and foremost, multidirectional rehabilitation, which aims to improve balance and increase postural strength muscle. In addition, prevention should include: patient education, pharmacotherapy prescribed by a medical specialist, eyesight improvement, elimination of potential risks surrounding the patient. The introduction of multi-directional prevention of falls can reduce the risk of their occurrence up to 50%

The Influence of Applying Torque in the Pre-swing Phase on the Minimum Toe Clearance for Prevention of Falls in Elderly People

The Influence of Applying Torque in the Pre-swing Phase on the Minimum Toe Clearance for Prevention of Falls in Elderly People

A Wearable EMG-based System Pre-fall Detector

The paper presents a wearable system able to evaluate real time the risk of fall in elderly people, promoting the fast adoption of properly intervention strategies for reducing injuries (e.g. by activating an impact reduction system). A wireless and minimally invasive surface Electromyography-based system (EMG) has been used to measure four lower limb muscles activities. This work deals with the identification of highly discriminative features extracted from the EMG signals for the automatic detection of people instability. The framework prototype uses a threshold-based approach assuring real time functioning and permitting the detection of a typical imbalance condition about 200ms after the stimulus perturbation, in simulated and controlled fall conditions.

Comparative analysis of time spent by the fire department on call of elderly victims fall in collective transport.

Introduction: The public transport is a major form of transportation in the cities and the increasing elderly population became many users this means of transport. Objective: The objective of the research was to compare the time spent by the fire department in the care of elderly fall victims in mass transportation between two cities. Method: Data were collected by analyzing the database record of the overall occurrences of the fire department on the fall of elderly people in public transport in the cities of Curitiba and Maringá between the years 2005-2012. Collected were the region the city where the event occurred; hospitals for referral of victims and the time spent in attending these events by teams of firemen from the cities. Results: Increased occurrence of falls in the elderly collective transport four times in Maringá was observed. The frequency of these occurrences happened mainly in the central region in both cities and time attendance differed significantly and in Maringa most visits took place within an hour and Curitiba with over an hour. Conclusion: We conclude that further studies should be conducted and management strategies of public transportation employees so they can improve the time spent on mobile medical care.

Physical performance and risk of fall in elderly people with severe osteoporosis

Searchable abstracts of presentations at key conferences on calcified tissues ISSN 2052-1219 (online)

CPC-068 Impact of Optimising Prescriptions to Reduce the Risk of Falls in Elderly People

BackgroundThe increase in life expectancy increases the risk of falls, leading to dependence and death. Some studies have shown a link between inappropriate prescriptions and falls.Purpose The main objective of...

Falls in elderly people: a multifactorial analysis of risk markers using data from the Swedish general population study ‘Good Ageing in Skåne’

The aim of this study was to describe the prevalence of falls in a general older population, especially among the most elderly, and the risk markers associated with falls. This is a cross-sectional study in which 38 fall risk markers were analysed in non-, occasional- and frequent-fallers. The population was 2,865 individuals (aged 60-93), randomly selected from the general population register. The risk of falling was calculated as age-adjusted odds ratios. The relation between the number of risk markers for an individual and falls was also analysed. About one in ten reported falling during the past 6 months, 35% of which were over 90 years old. Twenty-one risk markers were significantly related to falls confirming falling as a multifactorial problem. These included a variety of diseases, symptoms, medical and physical functions, life-style factors and the taking of certain drugs. The five risk markers with the highest odds ratio in frequent fallers were 'tendency to fall' (37.9), 'low walking speed' (12.8), consumption of 'neuroleptics' (10.9), 'impaired mobility' (10.0) and 'dementia' (5.4). Subjects with more than four and seven risk markers showed a 9- respectively 28-fold increase in the risk of falling, especially among frequent fallers and those aged over 90 years. Falls are common in the elderly population and the risk is multifactorial. The results imply that there is an overrepresentation of fallers in a distinct subgroup of the very elderly and those with multiple risk markers. The self-perceived clinical sign 'tendency to fall' seems highly sensitive as indicator of individuals at risk. Several risk markers may be treatable. Fall risk seems to increase in a non-linear, almost exponential way with increasing number of risk markers.

Intensive Exercise Reduces the Fear of Additional Falls in Elderly People: Findings from the Korea Falls Prevention Study

Background/AimsFalls among older people are a major public health problem and may result in fracture, medical complications that require hospitalization, and fear of additional falls. Given the prevalence and impact of the fear of falling again, reducing the incidence of falls is important to prevent additional falls. This study analyzed whether exercise programs decrease the fear of future falls in elderly patients who have fallen previously.MethodsA randomized controlled study was performed that included 65 elderly community-dwelling subjects who had fallen in the previous year. Subjects were randomized into two groups: an exercise group (EG, n = 36) and a control group (CG, n = 29). The EG participated in three exercise sessions per week for 12 weeks. Muscle strength, balance, agility, flexibility, and muscular endurance were measured at baseline and after 12 weeks.ResultsAfter the 12-week exercise program, the subjects in the EG demonstrated remarkable improvement in their walking speed, balance (p = 0.003), back strength (p = 0.08), lower extremity strength (p = 0.004), and flexibility (p < 0.001). When asked whether they were afraid of falling, more participants in the EG than in the CG responded "not at all" or "a little."ConclusionsThe 12-week exercise program described here reduced the fear of falling (p = 0.02). It also improved the balance, flexibility, and muscle strength of the participants and was associated with improved quality of life.

Atrial Fibrillation Boosted Fall Risk in Elderly Patients

SAN FRANCISCO – A history of atrial fibrillation more than tripled the risk of a nonaccidental fall in elderly people, an emergency department study showed.Of 459 consecutive elderly patients who presented to a large emergency department with a chief complaint of a fall, 225 had a fall deemed to be nonaccidental – that is, a fall not explained by mitigating circumstances such as being knocked over by another person.A history of atrial fibrillation (AF) was present in 20.4% of those with a nonaccidental fall, compared with 10.6% of the 234 elderly patients who presented with an accidental fall, Joya A. Ganguly, MD, reported at the annual meeting of the Heart Rhythm Society.The study population had a median age of 81 years. Patients younger than 81 who had nonaccidental falls were 3.36 times as likely to have a history of AF, compared with those who had accidental falls. However, among patients older than 81 years, AF was only 1.3 times as prevalent in nonaccidental fallers as in accidental fallers, an insignificant difference, according to Dr. Ganguly of the University of Utah, Salt Lake City.Patients with a nonaccidental fall were an average of 4 years older than those who presented with an accidental fall. Patients with a nonaccidental fall were also more likely to have a neurologic disorder and to be on three or more medications.In contrast, there was no difference between patients in the nonaccidental and accidental fall groups in blood pressure, heart rate, orthostatic hypotension, prior pacemaker placement, a history of heart failure, or the prevalence of AF at presentation, which was about 8% in both groups.Dr. Ganguly concluded that these study findings suggest elderly patients with a history of AF might be good candidates for fall-prevention education programs along the lines of the national program recently proposed by investigators at the University of Southern California as a cost-effective intervention (Clin. Geriatr. Med. 2010;26:751–66).She disclosed no conflict of interest.Bruce Jancin is with the Denver bureau of Elsevier Global Medical News. SAN FRANCISCO – A history of atrial fibrillation more than tripled the risk of a nonaccidental fall in elderly people, an emergency department study showed. Of 459 consecutive elderly patients who presented to a large emergency department with a chief complaint of a fall, 225 had a fall deemed to be nonaccidental – that is, a fall not explained by mitigating circumstances such as being knocked over by another person. A history of atrial fibrillation (AF) was present in 20.4% of those with a nonaccidental fall, compared with 10.6% of the 234 elderly patients who presented with an accidental fall, Joya A. Ganguly, MD, reported at the annual meeting of the Heart Rhythm Society. The study population had a median age of 81 years. Patients younger than 81 who had nonaccidental falls were 3.36 times as likely to have a history of AF, compared with those who had accidental falls. However, among patients older than 81 years, AF was only 1.3 times as prevalent in nonaccidental fallers as in accidental fallers, an insignificant difference, according to Dr. Ganguly of the University of Utah, Salt Lake City. Patients with a nonaccidental fall were an average of 4 years older than those who presented with an accidental fall. Patients with a nonaccidental fall were also more likely to have a neurologic disorder and to be on three or more medications. In contrast, there was no difference between patients in the nonaccidental and accidental fall groups in blood pressure, heart rate, orthostatic hypotension, prior pacemaker placement, a history of heart failure, or the prevalence of AF at presentation, which was about 8% in both groups. Dr. Ganguly concluded that these study findings suggest elderly patients with a history of AF might be good candidates for fall-prevention education programs along the lines of the national program recently proposed by investigators at the University of Southern California as a cost-effective intervention (Clin. Geriatr. Med. 2010;26:751–66). She disclosed no conflict of interest. Bruce Jancin is with the Denver bureau of Elsevier Global Medical News.

Effectiveness and Implementation Aspects of Interventions for Preventing Falls in Elderly People in Long-Term Care Facilities: A Systematic Review of RCTs

There is extensive literature on interventions to prevent or reduce falls in elderly people. These findings, however, were based mainly on studies of community-living persons. The primary aim of the present study was to report the effectiveness and implementation aspects of interventions aimed at reducing falls in elderly residents in long-term care facilities: a systematic review of randomized controlled trials (RCTs). MEDLINE, EMBASE, CINAHL, and hand searching of reference lists of included RCTs. RCTs that assessed fall incidents (falls, fallers, recurrent fallers, fall-related injuries) among elderly residents in long-term care facilities were included in this narrative review. Two independent reviewers abstracted data: general program characteristics (setting, population, intervention program) and outcomes, detailed program characteristics (assessment, intervention content, individually tailored, multidisciplinary), and implementation aspects (feasibility, implications for practice). The CONSORT Statement 2001 Checklist was used regarding the quality of reporting RCTs. Twenty trials met the inclusion criteria. Seven trials, 4 multifactorial and 3 monofactorial, showed a significant reduction in the fall rate, the percentage of recurrent fallers, or both the fall rate and the percentage of persons sustaining femoral fractures. The positive effective programs were as follows: a comprehensive structured individual assessment with specific safety recommendations; a multidisciplinary program including general strategies tailored to the setting and strategies tailored specifically to residents; a multifaceted intervention including education, environmental adaptation, balance, resistance training, and hip protector; calcium plus vitamin D supplementation; vitamin D supplementation; a clinical medication review; and a multifactorial intervention (fall risk evaluation, specific and general interventions). In general, because of the limited number of included trials, the evidence is inconclusive for multifaceted and single interventions in long-term care facilities. Most of the reviewed studies did not find a significant positive effect on fall incidents. However, our data support the conclusions of Gillespie et al. that multifactorial interventions in long-term care populations seem more likely to be beneficial. However, single interventions (eg, targeting vitamin D insufficiency) can be effective. Furthermore, a careful approach is needed as programs to prevent falls in these settings may be ineffective or even may have adverse effects. This may occur especially when a program is not feasible for the setting in which it is implemented.

GELASTIC PRESYNCOPE: AN UNUSUAL MANIFESTATION IN AN ELDERLY PATIENT

To the Editor: Laughter (gelastic) resulting in presyncope or syncope is a recognized, although rarely reported, cause of situational syncope. Characterized by an index event, laughter-induced presyncope or syncope persists and is amenable to behavioral modification. A case of recurrent presyncope precipitated by laughter in an elderly man and corrected using behavioral modification is presented. A 67-year-old man was seen in consultation for the complaint of near blackout spells with laughter. The first episode occurred while listening to a radio program while driving, when his laughing heavily resulted in blurring vision, darkening of visual field, feeling faint, and sensation of imminent loss of consciousness. He slowed his vehicle and pulled off the road, and the symptoms soon resolved. He denied complete loss of consciousness, uncontrolled movement of limbs, bowel or bladder incontinence, headache, or other associated symptoms. Since this index episode, patient reports recurrent episodes of near loss of consciousness associated with vigorous laughing. Episodes last only a few seconds. He had similar symptoms, but of lesser severity, in relation to straining during defecation and micturition. The patient denied any palpitations, irregular heartbeat, chronic cough, chest pain, shortness of breath, nausea or vomiting, diarrhea, other systemic or constitutional symptoms, having had stroke in the past, any history of seizures, or any sleep disturbances, including any symptoms suggestive of narcolepsy or cataplexy. His medical history was significant for diabetes mellitus, hypertension, and prolonged posttraumatic disorder, which were stable. The patient was evaluated using magnetic resonance imaging and a magnetic resonance angiogram of the brain, which showed only mild periventricular white matter changes that were nonspecific. Carotid Doppler studies were unremarkable. Chest X-rays were normal. No further diagnostic investigation was pursued because behavioral modification of avoiding vigorous prolonged laughter resolved his symptoms completely. Gelastic presyncope or syncope is a relatively uncommon type of neurally mediated event with a drop in systemic vascular resistance due to arterial dilation in the setting of a relative or absolute bradycardia. During prolonged laughter, there is repetitive Valsalva effect with reduced venous return secondary to increased intrathoracic pressure with associated systemic arterial dilatation and bradycardia resulting in reduced cardiac output and cerebral hypoperfusion. If the Valsalva effort is not aborted during the presyncopal phase, it is likely that it will culminate in a syncopal episode. This mechanism is similar to that seen with cough syncope. In addition, emotional factors and cerebral vasoconstriction secondary to systemic hypocapnia could be contributing to the syncope in this situation.1 This patient also had presyncopal sensations to straining from defecation and urination, suggesting Valsalva effect as the most likely mechanism. Laughter or gelastic syncope can potentially be misdiagnosed as cataplexy related to laughter. There have been only a few case reports of laughter syncope previously reported, mostly in the elderly population, in healthy adults and people predisposed to dysautonomia.1–4 Possible contribution of dysautonomic neuropathy secondary to diabetes mellitus can not be excluded in the current patient. A more-serious underlying mechanism of severe vascular disease involving the brachiocephalic trunk was noted to be the mechanism in the first reported case of laughter syncope.3 Syncope resolved after percutaneous angioplasty. Falls in elderly people can lead to devastating consequences, and hence it is essential to diagnose and prevent syncope in this age group. Beta-blockers and midodrine were noted to have beneficial effects in controlling symptoms in one described case of neurally mediated syncope.4 Behavioral modification may be the best initial approach before exposing the patients to medications. Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this letter. Author Contributions: All authors contributed equally to the letter in its concept, design, and preparation. Sponsor's Role: No sponsor.

Role of physical activity in the prevention of falls and their consequences in the elderly

Abstract This work aims to provide an inventory of the risk factors and consequences of falling in the elderly, namely fractures, and to identify strategies to prevent falls and minimise their effects. Falls in elderly people are a major cause of injuries, leading to a general fear of falling, poorer quality of life and even death. The increase in life expectancy brought by developments in the medical and health sciences has not always brought enhanced quality of life. More elderly people live with reduced functional capacities resulting in a higher prevalence of falls and associated problems for themselves and for society. Risk factors for falling, commonly resulting from normal aging processes, have already been identified through multiple studies. Exercise may play an important role in fall prevention and their consequences. Although, effective strategies are usually multi-disciplinary and focus simultaneously on several risk factors. However, only large-scale prevention programmes can have significant effective social impact. To minimise occurrence and consequences of falls, policies to systematically implement prevention programmes should be established.

FALLS IN ELDERLY PEOPLE

FALLS IN ELDERLY PEOPLE

3B2-03 空気圧制御による立ち上がり補助/下肢トレーニング補助機器の開発(OS ヒューマンロボットインタラクション)

In these years, low birthrate and longevity are rapidly progressing in advanced countries. It's important to reduce the number of elderly people who need care. And so this research paid its attention to the fall of elderly people's leg motor function. If leg motor functions, such as elderly people, are falling, operation by single-handed efforts, such as excretion, a walk, and standing-up and sitting-down operation, cannot be performed easily. Then, we developed the auxiliary apparatus for improving a leg motor function. The manufactured auxiliary apparatus assists standing-up and sitting down operation by an air cylinder. And the evaluation test was done using the manufactured auxiliary apparatus. By developing auxiliary apparatus, we aim at an improvement of elderly people's leg motor function and improvement in the quality of life. And we aim at spreading the auxiliary apparatus manufactured by this research, and finally we aims at decreasing a care burden.

Falls in elderly people that result in facial injuries

Falls in elderly people that result in facial injuries

Risk factors of fall in elderly people

Falls are the leading accidental cause of death among elderly people in their homes. Falls and their consequences are the primary reason in 40% of admissions to hospitals for people older than 65 years. The study population consisted of 77 randomly selected patients of both genders older then 65 years. Each patient was tested in his/her home and was completely informed about the methodology and the goals of investigation. Based on the exclusion criteria, three patients were excluded from the study, which means the investigation was conducted on 27 males (35.06%) and 50 females (64.94%) with the average age being 71.23 +/- 5.63 years. For each patient, a specially prepared questionnaire about risk factors was filled in. The sum of affirmative answers represented a relative index of fall risk. All patients were evaluated through Folstein's Mini-Mental State Examination Test that is suitable for on-sight use in patient's home. The score value over 20 excludes dementias, delirium, schizophrenia and affective disorders. Considering the values of the risk factor, scores obtained by the questionnaire and MMSE test scores, statistically significant differences were found between males and females (p < 0.005, respectively p < 0.01), "fallers" and "non-fallers" (p < 0.001, respectively p < 0.01), while considering the relation to the way of living (alone or with family), there were no statistically significant differences (p > 0.05).