Fall Risk Factors In People Research Articles

Extrinsic and Behavioral Fall Risk Factors in People With Parkinson's Disease: An Integrative Review

Extrinsic and Behavioral Fall Risk Factors in People With Parkinson's Disease: An Integrative Review

Extrinsic and Behavioral Fall Risk Factors in People With Parkinson's Disease: An Integrative Review.

The aim of the study was to explore extrinsic and behavioral risks for falls in older adults with Parkinson's disease (PD). Falls that cause injury and disability in people with PD are common. Understanding the role of extrinsic and behavioral factors is important for fall prevention. Integrative literature review with search of CINAHL, MEDLINE, and SCOPUS and ancestry searching was performed. The methodology of Whittemore and Knafl guided the review; ten studies were included. Falls occur indoors and outdoors, commonly during daily activities in familiar home environments, but also when out in the community. Common challenges include uneven and unfamiliar environments and risky behavior like hurrying. Extrinsic risk factors combined with behavioral and intrinsic factors contribute to falls in people with PD both at home and in the community. Rehabilitation of people with PD should include assessment of falls, function, extrinsic risk factors, and fit with their environment to develop fall prevention plans.

Risk Factors for Falls in Older Adults With Mild Cognitive Impairment and Mild Alzheimer Disease.

Understanding fall risk factors in people with mild cognitive impairment (MCI) and Alzheimer disease (AD) can help to establish specific plans for prevention of falls. The purpose of this study was to identify fall risk factors in older adults with MCI and mild AD. A prospective study was conducted with community-dwelling older adults (40 MCI; 38 mild AD). The assessments consisted of sociodemographic and health variables, caloric expenditure, functional status, functional mobility (10-m walk test, dual-task test, and transition Timed Up and Go phases), cognitive domains, and depressive symptoms. Falls were recorded for 6 months by a falls calendar and monthly telephone calls. Falls were reported in 52.6% and 51.4% of people with MCI and mild AD, respectively. Among people with MCI, lower functional status, higher time spent on walk and dual task tests, and higher depressive symptom scores were associated with falls. Higher time spent on the dual-task test was independently associated with falls. Among people with mild AD, falls were associated with lower time spent on the walk test and turn-to-sit phase, and a higher visuospatial domain score. Lower time spent on the turn-to-sit phase was identified as an independent predictor of falls. Careful attention should be given to dual-task and turn-to-sit activities when detecting risk of falls among older people with MCI and mild AD.

The Relative Contribution of Physical and Cognitive Fall Risk Factors in People With Parkinson’s Disease

Background. In order to develop multifaceted fall prevention strategies for people with Parkinson’s disease (PD), greater understanding of the impact of physical and cognitive performance on falls is required. Objective. We aimed to identify the relative contribution of a comprehensive range of physical and cognitive risk factors to prospectively-measured falls in a large sample of people with PD and develop an explanatory multivariate fall risk model in this group. Methods. Measures of PD signs and symptoms, freezing of gait, balance, mobility, proprioception, leg muscle strength, and cognition were collected on 205 community-dwelling people with PD. Falls were monitored prospectively for 6 months using falls diaries. Results. A total of 120 participants (59%) fell during follow-up. Freezing of gait (P < .001), dyskinesia (P = .02), impaired anticipatory and reactive balance (P < .001), impaired cognition (P = .002), reduced leg muscle strength (P = .006), and reduced proprioception (P = .04) were significantly associated with future falls in univariate analyses. Freezing of gait (risk ratio [RR] = 1.03, 95% confidence interval [CI] = 1.00-1.05, P = .02), impaired anticipatory (RR = 1.01, 95% CI = 1.00-1.02, P = .03) and reactive (RR = 1.26, 95% CI = 1.01-1.58, P = .04) balance, and impaired orientation (RR = 1.28, 95% CI = 1.01-1.62, P = .04) maintained significant associations with falls in multivariate analysis. Conclusion. The study findings elucidate important physical and cognitive determinants of falls in people with PD and may assist in developing efficacious fall prevention strategies for this high-risk group.

OP0230-HPR Falls, Fear of Falling and Risk Factors in Adults with Rheumatoid Arthritis: A Prospective Study

BackgroundThe risk of falls may be higher in people with RA due to muscle weakness, impaired mobility and balance, pain and joint abnormalities however there are few studies that have...

The effects of an exercise program on fall risk factors in people with Parkinson's disease: A randomized controlled trial

This randomized controlled trial with blinded assessment aimed to determine the effect of a 6-month minimally supervised exercise program on fall risk factors in people with Parkinson's disease (PD). Forty-eight participants with PD who had fallen or were at risk of falling were randomized into exercise or control groups. The exercise group attended a monthly exercise class and exercised at home three times weekly. The intervention targeted leg muscle strength, balance, and freezing. The primary outcome measure was a PD falls risk score. The exercise group had no major adverse events and showed a greater improvement than the control group in the falls risk score, which was not statistically significant (between group mean difference = -7%, 95% CI -20 to 5, P = 0.26). There were statistically significant improvements in the exercise group compared with the control group for two secondary outcomes: Freezing of Gait Questionnaire (P = 0.03) and timed sit-to-stand (P = 0.03). There were statistically nonsignificant trends toward greater improvements in the exercise group for measures of muscle strength, walking, and fear of falling, but not for the measures of standing balance. Further investigation of the impact of exercise on falls in people with PD is warranted.