Rate Of Fall Research Articles

A systematic review of fall prediction models for community-dwelling older adults: comparison between models based on research cohorts and models based on routinely collected data.

Prediction models can identify fall-prone individuals. Prediction models can be based on either data from research cohorts (cohort-based) or routinely collected data (RCD-based). We review and compare cohort-based and RCD-based studies describing the development and/or validation of fall prediction models for community-dwelling older adults. Medline and Embase were searched via Ovid until January 2023. We included studies describing the development or validation of multivariable prediction models of falls in older adults (60+). Both risk of bias and reporting quality were assessed using the PROBAST and TRIPOD, respectively. We included and reviewed 28 relevant studies, describing 30 prediction models (23 cohort-based and 7 RCD-based), and external validation of two existing models (one cohort-based and one RCD-based). The median sample sizes for cohort-based and RCD-based studies were 1365 [interquartile range (IQR) 426-2766] versus 90441 (IQR 56442-128157), and the ranges of fall rates were 5.4% to 60.4% versus 1.6% to 13.1%, respectively. Discrimination performance was comparable between cohort-based and RCD-based models, with the respective area under the receiver operating characteristic curves ranging from 0.65 to 0.88 versus 0.71 to 0.81. The median number of predictors in cohort-based final models was 6 (IQR 5-11); for RCD-based models, it was 16 (IQR 11-26). All but one cohort-based model had high bias risks, primarily due to deficiencies in statistical analysis and outcome determination. Cohort-based models to predict falls in older adults in the community are plentiful. RCD-based models are yet in their infancy but provide comparable predictive performance with no additional data collection efforts. Future studies should focus on methodological and reporting quality.

Incidence of Fall and its Associated Factor: A Single Centre Experience

INTRODUCTION: Patient falls during hospitalisation can cause catastrophic injuries and remain one of the major patient-safety issues faced by hospitals. This study was designed to determine the inpatient falls rate and the association between fall-related injury and sociodemographic variables. MATERIALS AND METHODS: A retrospective record review was conducted for a one-time inpatient fall in a single centre between January 2017 and December 2019. Pearson chi-square or Fisher's exact test were performed to assess association between the categorical variables. RESULTS: There were 44 inpatient falls who fell one time between January 2017 and December 2019. The inpatients fall rate was 3.0 per 10000 patient-days from 2017 to 2019. Overall, the patients who fell experienced an injury (n=24, 55%). There was no significant difference between age group, gender, time of fall, assisted type, history of fall, fall risk assessment, mental status, the department involved, and injurious fall outcome. CONCLUSION: Our study showed a low incidence of fall rate per 10000 patient-days for 2017-2019. More than half of the fallers experienced an injurious fall. The highest fall rate was noted in the surgical based departments. However, there was no significant difference between injurious fall outcomes and sociodemographic variables. Risk assessments and management strategies should focus on education, particularly bed safety.

River linear inversion to assess drainage base-level fall history in North-western Apennines and implications on the Alessandria Basin tectonic activity

Drainage network systems are responsive elements to recent active tectonics from among all the topographic features. In geodynamically active areas, fluvial landscapes can record different processes through the formation and current presence of features related to spatial-temporal variation in base-level fall and vertical incision of stream channels. This study focuses on the tectonic evolution of the Alessandria Basin, a synorogenic tectonic basin located at the junction between the Alps and the Apennines, that experienced progressive subsidence during the overthrusting of the Monferrato Thrust Front (the westernmost outer arc of the Apennine belt) onto the Po Foreland Basin. Even though several studies have assessed the Neogene tectonic evolution at a regional scale, rates and timing of the Quaternary activity are still poorly understood in terms of both Alps/Apennines uplift and activity of the compressive front of the Monferrato Arc. In this paper, we applied the method of the river profile linear inversions to reconstruct the base-level fall history of 6 catchments that drain into the Alessandria Basin. We used nine 10Be-derived basin-average denudation rates to constrain the erodibility parameter needed to infer base-level fall rates from χ-transformed river profiles. The results describe the tectonic history of the area in the last ∼5 Ma, documenting increases in base-level fall rate with an initial peak between 3 and 2.5 Ma, and a second between 2 and 1.5 Ma. While the first peak is coeval with the uplift phase that involved most of the northern-central Apennine, the second one suggests an acceleration in subsidence of the Alessandria Basin concurrently with the uplift of the Monferrato Thrust Front.

Investigation of The Incidence and Risk Factors of Falls, An Undesirable Incident in Hospitals: A Retrospective Study of Eight Years

Objective: Falls are undesirable incidents that must be reported in hospitals. Duration of hospital stay and cost of treatment may increase due to post-fall injuries. Therefore, it is very important to investigate the incidence and risk factors of falls to prevent them. The aim of the study was to investigate the incidence and risk factors of falls. Methods: The retrospective descriptive study was conducted in one of the largest medical faculty hospitals located in the western of Türkiye. The study data of 160,119 cases of falls between 2012 and 2019 were examined retrospectively using a “Socio-demographic Information Form” and “HARIZMI” and “ITAKI” Fall Risk Scales. Results: Statistically significant differences were found between fall rates by year (p < .05). It was detected that the risk of falls in adults was 2.3 times higher than in children (95% CI: 1.86-2.89); the risk of falls in men was 1.2 times higher than in women (95% CI: 1.04-1.43), and the risk of falls in internal medicine units was 4.2 times higher than in surgical units (95% CI: 3.57-5.06). Conclusion: The falls mostly occurred in internal medicine units. The risk of falls was higher in internal medicine units than in surgical units. The risk of falls was higher in adults than in children and men than in women. Necessary precautions should be taken for adult ve men patients who are at risk of falls. Institutional procedures and flowcharts should be established to rapidly evaluate cases of falls and make the necessary interventions. Warning signs should be placed in the rooms of patients who are at risk of falling.

The Effect of Energy Parameters of Power Sources on the Structure and Properties of Permanent Joints at Manual Arc Welding

The study presents the results of the research into the effect of the dynamic properties of inverter and diode power sources of welding arc power supply on the stability of melting and transfer of electrode metal into the weld pool. The principal energy parameters of the power source include the rates of rise and fall of short-circuit current, the ratio of arc burning current to short-circuit current, and other related factors. It has been demonstrated that an increase in the rate of change of these parameters within one welding mode microcycle alters the properties of heat and mass transfer, increases the frequency of electrode metal droplet transfer, reduces the size of transferred droplets in the weld pool and the duration of their stay on the electrode end under the influence of the high temperature of the welding arc, and the duration of short circuits. The increase in the mass fraction of alloying elements at their transition from the coated electrode to the weld metal is demonstrated to depend on the rate of change of the main energy parameters of one welding mode microcycle of the inverter power source in comparison with the diode rectifier. An enhancement in the structural integrity and properties of permanent joints during welding has been observed when using an inverter power source for the welding arc with high dynamic properties.

Screening for Risk of Fall-Related Inpatient Trauma in a US Acute Care Setting.

Introduction Falls during hospitalization are a leading cause of preventable trauma-related injuries. Factors associated with fall risk include an unfamiliar environment, changes in health status, and efficacy based on the home environment. Assessing fall efficacy with an individualized prevention plan can decrease falls. The primary aim of this study was to estimate the effect of implementing a fall efficacy screening and intervention on reducing patient falls. Methods The study utilized a quasi-experimental, cross-sectional design with a convenience sample of patients admitted to an in-patient adult medical unit within a community hospital over a twelve-month period. Sampling times included pre-implementation, immediately post-implementation, and a second post-implementation phase. The intervention consisted of an admission fall efficacy screening tool and an individualized educational initiative. Statistical analysis included descriptive statistics of central tendency and dispersion, along with inferential statistics using independent sample t-tests, chi-square tests, correlations, and binary logistic regression. Results Among the study participants (n=2,074), the total sample had an average age of 67.7 (+/- 17.4) years and had mean scores of 13.3 (6.9) on the Short Falls Efficacy Scale-International and 51.8 (20.3) on the Morse Fall Scale. Fifty-two percent of the study population were female; 16.2% of the patients were diagnosed with cerebrovascular accident (CVA) or CVA-like symptoms. Fall rates decreased with a rate of change of -4.15% after efficacy screening and intervention. Males demonstrated higher efficacy in avoiding falls compared to females (t(828) = 3.369, p <0.001). Patients with a CVA diagnosis demonstrated higher efficacy scores compared to non-CVA patients (t(2071) = -3.348, p <0.001). FES risk groups (ORof 5.632, 95% CI (2.171-7.892)) and age over 65 (OR 1.21, 95% CI (1.006-1.442)) were significant predictors of a fall when patients with a primary CVA diagnosis were omitted from the sample (p= 0.022 and 0.046 respectively). Conclusion The findings suggest that efficacy screening may be associated with decreased falls for acute care non-CVA inpatient populations over 65 years of age. Further research into the predictive utility of fall efficacy screening in acute care CVA and non-CVA hospitalized patient populations aged 65 years and above is recommended.

Late Holocene relative sea-level records from coral microatolls in Singapore

Late Holocene relative sea-level (RSL) data are important to understand the drivers of RSL change, but there is a lack of precise RSL records from the Sunda Shelf. Here, we produced a Late Holocene RSL reconstruction from coral microatolls in Singapore, demonstrating for the first time the utility of Diploastrea heliopora microatolls as sea-level indicators. We produced 12 sea-level index points and three marine limiting data with a precision of < ± 0.2 m (2σ) and < ± 26 years uncertainties (95% highest density region). The data show a RSL fall of 0.31 ± 0.18 m between 2.8 and 0.6 thousand years before present (kyr BP), at rates between − 0.1 ± 0.3 and − 0.2 ± 0.7 mm/year. Surface profiles of the fossil coral microatolls suggest fluctuations in the rate of RSL fall: (1) stable between 2.8 and 2.5 kyr BP; (2) rising at ~ 1.8 kyr BP; and (3) stable from 0.8 to 0.6 kyr BP. The microatoll record shows general agreement with published, high-quality RSL data within the Sunda Shelf. Comparison to a suite of glacial isostatic adjustment (GIA) models indicate preference for lower viscosities in the mantle. However, more high quality and precise Late Holocene RSL data are needed to further evaluate the drivers of RSL change in the region and better constrain GIA model parameters.

Design and application of high-precision calibration blackbody for space optical remote sensing sensor

Radiation calibration is a crucial step in producing high-quality images for spaceborne infrared cameras. Blackbody radiation sources, as the standard equipment for infrared thermometers, play an increasingly important role in radiation calibration. But as the camera aperture increases, blackbody faces challenges such as poor temperature uniformity, slow heating and cooling rates, large mass, and large volume. This article proposes a design scheme for spaceborne calibration blackbody based on a combination of rope pull fixation and limit block positioning. The temperature uniformity, temperature stability, temperature rise and fall rate, thermal stress characteristics, and anti-emission vibration characteristics of the blackbody under this scheme are analyzed and optimized in detail. The analysis results show that the conduction thermal resistance between the blackbody and the environment is nearly two orders of magnitude higher than that of the conventional scheme. The blackbody has excellent temperature uniformity, temperature stability, wide calibration temperature range, light weight, small volume, and fast temperature rise and fall speed. The blackbody scheme with a thickness of only 1.5 mm was implemented and applied on orbit.

Cost-effectiveness of lower limb prosthetic devices for mobility in older adults with dysvascular amputations

Background: There is limited consensus regarding the economic value of prosthetic devices with advancing age. We aimed to meet this knowledge gap by studying the cost-effectiveness of lower limb prostheses (LLPs) for older adults with dysvascular amputations. Methods Design: We constructed a decision analytic model nested with Markov models with a lifetime horizon to compare LLP recipients (LLP) with non-recipients (no-LLP) from a health care sector perspective. A 3% annual rate was applied to obtain the present value of the main outcome measures. One-way sensitivity analyses that modeled clinically extreme scenarios were conducted on LLP cost, change, abandonment rate, fall rate, mortality, and utility. Data sources: Model parameters were obtained from literature, with many source studies utilizing Medicare data and focusing on dysvascular amputations. Parameters included the “annual probability” of fall, LLP abandonment and mortality, costs associated with decreased physical inactivity or deconditioning, falls (rate and cost), abandonment (rate), mortality, and “utilities associated” with Markov model health states. All costs were adjusted to 2022 price levels. Intervention: Lower limb prosthesis. Main Outcome Measures: Lifetime cost, quality-adjusted life-years (QALYs), incremental cost-effectiveness ratio (ICER). Results: The LLP group incurred a lifetime cost of $36,789 and yielded 4.54 QALYs. The no-LLP group incurred a lifetime cost of $23,909 and yielded 2.58 QALYs. The ICER was $6588/QALY, which is below the most conservative willingness-to-pay threshold of $50,000/QALY and indicated that LLP was cost-effective compared with no-LLP. Sensitivity analyses for increasing LLP replacement to annual (ICER = $33,477/QALY), abandonment rate to 22% (ICER=$6367), fall rate to 70% (ICER = $7140/QALY), and increasing No-LLP EuroQol–five-dimension to 0.71 (ICER = $10,819/QALY) were all below the willingness-to-pay as well. Conclusions: LLP for older adults with dysvascular amputations was cost-effective for most clinically realistic scenarios.

The study of multi-discs hydraulic brake pressure dynamic characteristics

Abstract The pressure dynamic characteristics of hydraulic brakes directly impact the efficiency of the brake control system and aircraft stop distance. A simulation model of hydraulic brake is established with Simulink software. The simulation results are compared with the test results, which proves the reliability of the analysis model. The simulation results visually give the microscopic process of pressure rise and fall in the brake assembly. The study of dynamic characteristics is performed with the correlated simulation model to figure out the reasons for the slow rate of pressure rise and fall, for which suggestions are proposed for future system design improvements.

Ecohydrological indicators and environmental flow assessment in the middle and lower reaches of the Huai River, China

The vitality of river ecosystems is vital for the sustainable development of river basins, with the assessment of environmental flow (EF) playing a pivotal role in eco-informatics. This study delves into the middle and lower reaches (MLR) of the Huai River basin (HRB) in China, utilizing hydrological data spanning from 1950 to 2020. Its principal objective lies in the selection of ecohydrological indicators to refine the estimation of EF in the HRB. Employing principal component analysis (PCA), ecologically relevant hydrological indicators (ERHIs) were discerned and scrutinized for their hydrological characteristics. The analysis extended to evaluating hydrological shifts at different stations using ERHIs, determining suitable EF in the MLR, and delineating the trajectories of appropriate intra-annual flows in different hydrological years through HEC-RPT. Based on a variety of mutation test methods, the change point of runoff sequence was determined in 1991. The PCA analysis identified eight ERHIs, reflecting hydrological changes of 49.79 % and 56.26 % at Bengbu and Sanhezha, respectively, which indicate a moderate alteration. Based on ERHIs, the other stations in the HRB exhibited hydrological alterations ranging from 33 % to 47 %, notably highlighting substantial changes in maximal 30d flow and flow fall rate. The optimal flood pulse discharge in the middle reaches is 4150 m3/s, 3140 m3/s and 2150 m3/s in wet, dry and dry years, respectively. Downstream, flood pulse flow in wet, normal and dry years should exceed 4070 m3/s, 3110 m3/s and 1980 m3/s, respectively. The research contributes significantly to the management of rivers and the sustainable conservation of the ecological milieu.

Community Participation Transition After Stroke (COMPASS) Randomized Controlled Trial: Effect on Adverse Health Events

ObjectiveTo compare adverse health events in intervention versus control group participants in the Community Participation Transition After Stroke trial to reduce barriers to independent living for community-dwelling stroke survivors. DesignRandomized controlled trial. SettingInpatient rehabilitation (IR) to home and community transition. ParticipantsStroke survivors aged ≥50 years being discharged from IR who had been independent in activities of daily living prestroke (N=183). InterventionsParticipants randomized to intervention group (n=85) received home modifications and self-management training from an occupational therapist over 4 visits in the home. Participants randomized to control group (n=98) received the same number of visits consisting of stroke education. Main Outcome MeasuresDeath, skilled nursing facility (SNF) admission, 30-day rehospitalization, and fall rates after discharge from IR. ResultsTime-to-event analysis revealed that the intervention reduced SNF admission (cumulative survival, 87.8%; 95% confidence interval [CI], 78.6%-96.6%) and death (cumulative survival, 100%) compared with the control group (SNF cumulative survival, 78.9%; 95% CI, 70.4%-87.4%; P=.039; death cumulative survival, 87.3%; 95% CI, 79.9%-94.7%; P=.001). Thirty-day rehospitalization also appeared to be lower among intervention participants (cumulative survival, 95.1%; 95% CI, 90.5%-99.8%) than among control participants (cumulative survival, 86.3%; 95% CI, 79.4%-93.2%; P=.050) but was not statistically significant. Fall rates did not significantly differ between the intervention group (5.6 falls per 1000 participant-days; 95% CI, 4.7-6.5) and the control group (7.2 falls per 1000 participant-days; 95% CI, 6.2-8.3; incidence rate ratio, 0.78; 95% CI, 0.46-1.33; P=.361). ConclusionsA home-based occupational therapist–led intervention that helps stroke survivors transition to home by reducing barriers in the home and improving self-management could decrease the risk of mortality and SNF admission after discharge from rehabilitation.

Patient and family engagement in patient safety practices: A Making Healthcare Safer rapid response review

Background Patient and family engagement (PFE) is a developing area in reducing patient harm. This review addresses two questions: 1) What PFE patient safety practices (PSPs) have been used to prevent, report, or mitigate harms to patients and in what settings have they been used? 2) What evidence of effectiveness and unintended effects of PFE PSPs has been published since the Making Healthcare Safer (MHS) III report? Methods We searched PubMed and the Cochrane Library for studies published between January 2019 and April 2023. We included reviews of and primary studies on safety, quality, or utilization outcomes associated with any intervention focused on PFE in reporting and/or reducing patient safety events and harms. Results We retrieved 768 citations and found one systematic review and five studies meeting the inclusion criteria. The studies were either multi-component patient fall interventions or patient portals and information tools. Patient fall intervention PFE PSPs demonstrated significant decreases in overall rate of fall (15%–71% reductions) and fall with injury (34%–67% reductions) across three studies and a 17% decrease in the hospital length of stay in one study. Across three studies employing portals and information tools, PFE PSPs facilitated the identification of errors and significantly decreased the hospital length of stay and readmissions. Conclusions Research on PFE PSPs provides emerging evidence of the effectiveness of including PFE as a component of interventions targeting specific preventable harms. More research is needed to support the measurement of and better determine the overall effectiveness of a broader implementation of PFE PSPs.

Impact of reduced contrast sensitivity function in the elderly

ABSTRACT Contrast sensitivity is a visual function associated with recognizing objects in low light. Objective: to review the contrast sensitivity function (CSF) in the elderly, the changes related to it with aging and the impact of its decline on daily activities. Methods: Search in PubMed/MEDLINE and SciELO, using the descriptors “contrast sensitivity” AND “seniors” OR “Elder*” OR “older adults” OR aged. Inclusion criteria: age ≥ 60 years or “elderly” and reference to CSF assessment. Results: elderly people have reduced CSF, leading to the risk of falls. CSF is useful for balance, performance on digital tasks, movement processing and quality of life, as well as it is important in cognitive and neuropsychological tests. Impairment of CSF is associated with loss of driving performance of motor vehicles, especially at low luminance. Elderly people who have a decrease in CSF have less social interaction and a lower quality of life. Conclusion: the reduction in CSF occurs with aging and is associated with postural imbalance, in addition to an increase in fall rates and impact on the activities of daily living of the elderly, influencing mobility and social interaction.

Ladder Use Ability, Behavior and Exposure by Age and Gender.

This study aimed to quantify and compare ladder use ability and behavior in younger and older men and women from three ladder use behavior experiments. The experimental tasks comprised (1) changing a lightbulb on a household stepladder under two cognitive demands (single and dual task), (2) clearing a simulated roof gutter on a straight ladder and (3) querying ladder choice in different exigency scenarios. Ladder use ability and behavior data were captured from recorded time, performance, motion capture and user choice data. In addition, this study surveyed ladder use frequency and habitual behaviors. The experimental findings indicate that older adults require more time to complete ladder tasks; younger adults display riskier ladder use behaviors; men and women display similar ladder use ability; and men are more willing to climb riskier ladders. The survey found older adults to report more frequent ladder use than younger adults, and men use straight ladders more frequently than women. These results suggest that the reported higher ladder fall rates experienced by older adults and men are linked to increased ladder use exposure and riskier ladder choice. This knowledge can help guide population-specific interventions to reduce ladder falls in both young and older people.

Risk-adjusted trend in national inpatient fall rates observed from 2011 to 2019 in acute care hospitals in Switzerland: a repeated multicentre cross-sectional study

ObjectivesThis study aimed to investigate whether a significant trend regarding inpatient falls in Swiss acute care hospitals between 2011 and 2019 could be confirmed on a national level, and whether...

The Impact of Patient Education on Inpatient Fall Risk: A Review.

» Patient falls in the hospital are one of the leading sentinel events identified by the Joint Commission.» Hospital falls affect orthopaedic patients of older age at higher rates, and up to 34% of falls lead to injury such as fractures.» Patients often misperceive their fall risk, and modalities aimed at educating patients to address the incongruence between perceived and actual fall risk significantly reduce fall rate and injurious fall rate.» Adequate communication with patients and their families with the goal of educating them may diminish the physical, psychological, and emotional detriment to orthopaedic patients.

Intraoperative Performance and Early Postoperative Outcomes Following Phacoemulsification With Three Fluidic Systems: A Randomized Trial.

To compare intraoperative performance and early postoperative outcomes following phacoemulsification with two systems using active fluidics and one using gravity-based fluidics. In this prospective randomized trial, 200 eyes were randomized to the traditional and Active Sentry groups (n = 80 eyes each) where the Centurion Vision System was used with traditional or Active Sentry (Alcon Laboratories, Inc) hand-pieces, respectively, or the Infinit group (n = 40 eyes) where the Infiniti Vision System (Alcon Laboratories, Inc) was used. Within the traditional and Active Sentry groups, there were two subgroups with low (30 mm Hg) or high (55 mm Hg) intraocular pressure (IOP) used. Outcome measures compared were: cumulative dissipated energy (CDE), percentage change in central corneal thickness (CCT) at 1 day, 1 week, and 1 month, anterior chamber cells at 1 day and 1 week, rate of rise and fall of IOP following occlusion break, corneal endothelial cell density (ECD), and macular thickness 6 months postoperatively. CDE was significantly lower in group II compared to the traditional group (2.96 ± 1.4 vs 4.14 ± 2.2, P = .001). With 30 mm Hg IOP, the Active Sentry group had significantly less percentage change in CCT at 1 week postoperatively compared to the traditional handpiece group (0.01% vs 0.02%, P = .008). Incidence of anterior chamber cells less than grade 2 on day 1 was significantly higher in the Active Sentry group (82.9% vs 52%, P = .03). Percentage change in ECD was significantly lower in the Active Sentry group (-0.957 vs -0.98%, P = .005). Significantly faster rise of IOP to baseline following occlusion break was seen in the Active Sentry group. The use of Active Sentry handpiece was associated with lower CDE, less postoperative increase in CCT, fewer anterior chamber cells, and faster rise of IOP following occlusion break. [J Refract Surg. 2024;40(5):e304-e312.].

CAN PATIENTS WITH CARDIOVASCULAR RISK FACTORS AND DIFFERENCE BETWEEN OFFICE AND OUT-OF-OFFICE BP MEASUREMENTS BENEFIT FROM ABPM?

Objective: Blood pressure (BP) is a dynamic parameter characterized by fluctuations during the 24-hour period. During the nighttime hours, BP drops 10-20% in normotensive and untreated hypertensive patients - a dipping phenomenon, followed by a rapid and gradual increase during waking hours. The dipping phenomenon can be checked by Ambulatory Blood Pressure Measurement (ABPM). The main clinical indications for ABPM, suggested by the available studies, are white-coat phenomena, masked hypertension, and nocturnal hypertension. Design and method: Our study involved 45 patients with over 20% difference between office and out-of-office blood pressure measurements. We checked their medical history for other cardiovascular risk factors, such as Dyslipidemia, Diabetes Mellitus, Coronary Disease. Our patients were under 24 hour- ABPM and they were classified according to the rate of fall in systolic BP during 24-hour recording into four categories: the extreme-dippers drop &gt;20%, dippers drop &gt;10% and &lt;20%, non-dippers drop &lt;10% and &gt;0%, and reverse-dippers or risers drop &lt;0%. The purpose of our study is to consider the significance of ABPM in specific target groups of patients with cardiovascular risk factors. Results: In our study 44 patients participated (56,8% men) with mean age 55,9 and mean value of systolic BP 120,7mmHg. 40,9% of the patients had a history of hypertension, 36,4% dyslipidemia, 15,9% diabetes mellitus and 11,4% coronary disease. 77,3% of the patients were judged to be normotensive, but 35,3% of them had a history of hypertension and were under medication, only 11,4% were judged to be hypertensive, 6,8% with isolated diastolic hypertension and 4,5% with isolated systolic hypertension. According to ABPM, we changed medication in 29,5% of the patients. 76.9% of them had already history of hypertension and were under medication, 38,5% had dyslipidemia and 30,7% diabetes mellitus and coronary disease. Conclusions: In our study we were not able to demonstrate that patients with difference between office and out-of-office BP measurements and cardiovascular risk factors could benefit most from ABPM but we demonstrated that patients with a history of hypertension could benefit form ABPM, so that physician could choose the appropriate treatment.

Impact Of Walking And The OTAGO Exercise Program On Improving Balance Parameters In The Elderly

There will likely be a rise in fall rates as the population ages. This will impact our society and put more strain on healthcare systems by increasing the number of unintentional injuries and injury-related deaths. According to Zijlstra et al. (2007), falls have a significant psychological impact on individuals, frequently leading to diminished confidence, decreased functional activity, deconditioning, and an elevated risk of falls. Estimated costs of fall-related damage to older adults owing to demographic changes in Australia (2003) predict that by 2051, fall-related injuries, which currently account for 5% of the country's overall health budget, would triple and cost the Australian health system about $1,375 million annually. Exercise and other modifications in lifestyle can potentially reduce the risk of many physical falls (Gregg et al., 2000; Sherrington et al., 2011). The current recommendations for physical exercise among older persons, which include elements of aerobic, resistance, and balance training, are not met by many of them. According to Chodzko-Zajko et al. (2009), the American College of Sports Medicine (ASCM) advises older persons to engage in aerobic, muscle-strengthening, and flexibility exercises. People who have mobility issues or are at risk of falling should also engage in certain activities designed to enhance their balance. We determined that the study's subjects would be third-age individuals (over 65) who reside in assisted living facilities located in Tirana's district and city due to the issues that this demographic faces. Keywords: falls prevention, ageing, nursing home support services, quality of life, older people, walking, OTAGO exercise program, balance, preventive care.