Risk Factors For Falls Research Articles

Demographic Comparisons of Self-Reported Fall Risk Factors Among Older Adults Attending Outpatient Rehabilitation.

Identify the prevalence and prevalence differences of fall risk factors by sex, clinic rurality, and race/ethnicity among older adults (≥65 years old) receiving outpatient rehabilitation. Our secondary analysis used Electronic Health Record data of 108,751 older adults attending outpatient rehabilitation (2018-2022) within a large health system across 7 states and completed the Stay Independent Questionnaire. The mean age was 73.3 (±6.36), 58.1% were female, 84.3% were non-Hispanic White, and 88.8% attended an urban clinic. Fall risks were identified via the Centers for Disease Control and Prevention's Stay Independent Questionnaire. Older adults had a high prevalence of fall risks (44.3%), including history of falls (34.9%). The most prevalent fall-risk factors were impaired strength, gait, and balance. Compared to males, females had a higher prevalence of reporting a fall (4.3%), a fall with injury (9.9%), worrying about falling 9.1%), rushing to the toilet (8.5%), trouble stepping onto a curb (8.4%), taking medicine for sleep or mood (6.0%), feeling sad or depressed (5.3%), and feeling unsteady (4.6%). Males reported a higher prevalence of losing feeling in feet (9.4%), ≥1 fall in the past year (8.1%), and using hands to stand up (4.4%). Compared to White older adults, Native American/Alaska Natives had the highest prevalence of fall history (43.8%), Hispanics had the highest prevalence of falls with injury (56.1%), and Hispanics and Blacks had a higher prevalence of reporting 11/12 Stay Independent Questionnaire risk factors. Older adults receiving outpatient rehabilitation have a high prevalence of fall risks, including falls and difficulties with strength, balance, or gait. Findings indicate that rehabilitation providers should perform screenings for these impairments, including incontinence and medication among females, loss of feeling in the feet among males, and all Stay Independent Questionnaire -related fall risk factors among Native American/Alaska Natives, Hispanics, and Blacks.

Risk Factors of Falls according to Living Arrangements in Older Adults: Comparison between Living with Others and Living Alone

Risk Factors of Falls according to Living Arrangements in Older Adults: Comparison between Living with Others and Living Alone

Falls experienced by adult cancer survivors: a scoping review

Purpose Accidental falls among adult cancer survivors are a health concern. Falls impose economic burdens and detrimental consequences to cancer survivors. This review aimed to synthesize findings from published research to explore the relationship between falls and cancer diagnosis and treatment among cancer survivors. Materials and methods A scoping review was conducted using four databases (Medline, EMBASE, CINAHL, and Scopus) for the years 2001–2021. A total of 425 abstracts were identified after removing duplicates. A second search for the years 2022–2023 was completed where 80 abstracts were identified. screening, full-text review, and data extraction were conducted. Study characteristics and key findings were extracted from full texts. Descriptive numerical summaries were presented, and narrative analyses were performed. Results and conclusions A total of 42 articles were included in the scoping review which demonstrated (1) an increased prevalence of falls among cancer survivors, (2) the presence of cancer-specific fall risk factors, (3) a lack of cancer-specific fall prediction tools, and (4) few fall prevention interventions as part of usual care among cancer survivors. Younger cancer survivors were underrepresented. Cancer survivors should be aware of their risk of falls, and health professionals should ensure that fall prevention is part of usual care.

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.

Risk factors for respiratory syncytial virus-associated acute lower respiratory infection in children under 5 years: An updated systematic review and meta-analysis

ObjectivesRespiratory syncytial virus (RSV) is a leading cause of acute lower respiratory infection (ALRI) in young children. With substantial advances in RSV research, we aimed to conduct an updated systematic review of risk factors for RSV-ALRI in children under 5 years. MethodsWe updated our previously published literature search to November 2022 among three English databases and additionally searched three Chinese databases (from January 1995) to identify all relevant publications. We performed random-effects meta-analyses to estimate the pooled odds ratio (OR) and 95% confidence interval (CI) for each risk factor and each outcome (RSV-ALRI in the community and RSV-ALRI hospitalization). ResultsA total of 47 studies were included (26 from the updated search). Indoor air pollution was identified as a possible risk factor for RSV-ALRI in the community (OR 1.45, 95% CI: 1.10-1.90). The identified risk factors for RSV-ALRI hospitalization fall into four categories: demographic (male sex, Māori and Pacific ethnicities vs European or other ethnicities), pre- and post-neonatal (prematurity, low birth weight, small for gestational age, maternal smoking during pregnancy or lactation, maternal age <30 years vs 30-34 years, multiparity, caesarean section vs vaginal), household and environmental (having siblings, passive smoking, maternal asthma, daycare centre attendance) and health and medical conditions (any chronic diseases, bronchopulmonary dysplasia, HIV infections, congenital heart disease, Down syndrome, cystic fibrosis, previous asthma). The pooled ORs ranged from 1.14 to 4.55. ConclusionOur findings on the risk factors for RSV-ALRI help identify RSV high-risk groups, which has important implications for RSV prevention at both individual and population levels.

Relationship Between Unit Characteristics and Fall Incidence: A Cross-Sectional Survey Using Administrative Data in Japan.

Falls are the most frequent accident experienced by inpatients in hospitals. As falls affect patient outcomes, high fall risk factors should be studied to prevent falls and improve patient safety. However, the relationship between hospital unit characteristics and fall risk has never been assessed. This study was designed to identify the unit characteristics significantly related to fall risk. A cross-sectional study was conducted on the medical records of patients hospitalized in a Japanese academic hospital between 2018 and 2019. This study quantified unit activities and utilized Diagnosis Procedure Combination data to examine unit characteristics related to falls based on unit day. Data on 16,307 patients were included in the analysis, and 355 unit days were certified as fall events. Based on patient condition and medical treatment, the results identified antineoplastic injections, radiation therapy, aseptic treatment room, and functional status of partly assisted transfers, meals, and oral care as unit characteristics associated with increased fall events. Decreased nursing time per patient at night (odds ratio [OR] = 0.75, p = .04) and higher numbers of partially assisted transfer patients were also identified as unit characteristics associated with higher fall incidence rates (OR = 5.56, p = .01). The results of this study are expected to assist nurses to predict falls based on unit characteristics; reducing nursing time in the units was found to be a factor associated with higher fall risk. Nurse managers must understand the unit-related fall risk factors, appropriately assign nurse staffing numbers, and demonstrate nursing leadership to prevent falls in their units.

무동력 트레드밀과 탄성밴드를 이용한 운동이 뇌병변 장애 노인의 하지근력, 낙상위험요인 및 보행능력에 미치는 영향

무동력 트레드밀과 탄성밴드를 이용한 운동이 뇌병변 장애 노인의 하지근력, 낙상위험요인 및 보행능력에 미치는 영향

Factors Associated with Falls in Community-Dwelling Older Adults: A Subgroup Analysis from a Telemergency Service.

According to the number of falls, fallers can be single (only one fall) or recurrent (two or more falls), with different risk profiles for loss of independence and frailty. The presence of risk factors in community-dwelling single- and recurrent fallers using a wearable fall-detection device, such as the Personal Emergency Response System (PERS), as part of a telemergency service, is still unknown. This article evaluates how using a PERS, within a telemergency service, helps identify risk profiles and assessment of any differences between non-fallers and fallers in community-dwelling older adults. A sub-group analysis was performed, dividing users into non-fallers (n = 226) and fallers (≥1 fall; n = 89); single-fallers (n = 66) and recurrent fallers (n = 23). Median age was higher in fallers (87.7 years vs. 86), whereas recurrent fallers were less independent, had fewer comorbidities, and had more low-extremity disabilities. The use of the PERS for medical problems (Adjusted OR = 0.31), excluding falls, support calls (Adjusted OR = 0.26), and service demands (Adjusted OR = 0.30), was significantly associated with a fall risk reduction. The findings suggest that the integration within a telemergency service may impact on fall-risk factors.

How Could We Prevent the Threatening of Falls to the Elderly?

Falls among the elderly population can have serious and potentially life-threatening consequences. To prevent such incidents, a multi-faceted approach must be implemented within the healthcare system. Firstly, healthcare providers should conduct routine screenings for fall risk factors, such as muscle weakness and balance issues, during regular check-ups. Additionally, implementing regular exercise programs that focus on improving strength and balance can help reduce the likelihood of falls. Assessing and modifying the home environment to remove potential hazards, such as uneven flooring or inadequate lighting, is also crucial in preventing falls. Furthermore, educating both the elderly individuals and their caregivers about fall prevention strategies is essential. By combining these efforts with proper medication management and regular vision checks, we can effectively decrease the threat of falls among the elderly population and improve their overall quality of life.

Hamstrings-quadriceps strength ratio could be related to falls in community-living older adults

A prior study reported that the concentric strength imbalance between hamstrings and quadriceps is associated with falls in older adults. Given that the concentric strength may not be measured as conveniently as the isometric strength, it is meaningful to test whether the isometric hamstring-quadricep strength imbalance is related to falls among older adults. This study sought to explore whether the hamstrings-quadriceps ratio could differentiate fallers from non-fallers in community-dwelling older adults. One hundred and eleven older adults were included in this cross-sectional study. Their isometric knee joint strength capacity (extensors and flexors) was measured. Based on their fall history in the past year, they were classified as fallers (at least one fall) or non-fallers (no fall). The hamstrings-quadriceps ratio was compared between the faller and non-faller groups. The receiver operating characteristic analysis was used to determine the cutoff value of the hamstrings-quadriceps ratio able to best classify fallers and non-fallers. Fallers showed a significantly lower hamstrings-quadriceps ratio than non-fallers (p = 0.008). The receiver operating characteristic analysis identified 0.733 as the best ratio to differentiate fallers from non-fallers with an accuracy of 64.0 %. A 0.1-unit reduction in the hamstrings-quadriceps ratio increases the probability of falling by a factor of 1.30. The hamstrings-quadriceps ratio could be used as an additional fall risk factor when assessing the risk of falls among older adults. A smaller than 0.733 hamstring-quadriceps ratio may indicate a high risk of falls.

Apolipoprotein ɛ4 Is Associated With Increased Risk of Fall- and Fracture-Related Hospitalization: The Perth Longitudinal Study of Ageing Women.

Apolipoprotein ɛ4 (APOE ɛ4) may be a genetic risk factor for reduced bone mineral density (BMD) and muscle function, which could have implications for fall and fracture risk. We examined the association between APOE ɛ4 status and long-term fall- and fracture-related hospitalization risk in older women. A total of 1276 community-dwelling women from the Perth Longitudinal Study of Aging Women (mean age ± SD = 75.2 ± 2.7 years) were included. At baseline, women underwent APOE genotyping and detailed phenotyping for covariates including prevalent falls and fractures, as well as health and lifestyle factors. The association between APOE ɛ4 and fall-, any fracture-, and hip fracture-related hospitalizations, obtained over 14.5 years from linked health records, was examined using multivariable-adjusted Cox-proportional hazard models. Over 14.5 years, 507 (39.7%) women experienced a fall-related hospitalization and 360 (28.2%) women experienced a fracture-related hospitalization, including 143 (11.2%) attributed to a hip fracture. In multivariable-adjusted models, compared to noncarriers, APOE ɛ4 carriers (n = 297, 23.3%) had greater risk for a fall- (hazard ratio [HR] 1.48, 95% CI: 1.22-1.81), fracture- (HR 1.28, 95% CI: 1.01-1.63), or hip fracture-related hospitalization (HR 1.83, 95% CI: 1.29-2.61). The estimates remained similar when specific fall and fracture risk factors (fear of falling, plasma 25-hydroxyvitamin D, grip strength, timed up-and-go, hip BMD, vitamin K status, prevalent diabetes, HbA1c, cholesterol, and abbreviated mental test score) were added to the multivariable model. In conclusion, APOE ɛ4 is a potential risk factor for fall- and fracture-related hospitalization in community-dwelling older women. Screening for APOE ɛ4 could provide clinicians an opportunity to direct higher-risk individuals to appropriate intervention strategies.

Application of Research on Risk Assessment of Roadway Roof Falls Based on Combined Weight Matter Element Extension Model

Roof falls in coal mine roadways are the main causes of many casualties, shutdowns and production plan delays. To understand the relationship between the influencing factors of roadway roof fall accidents and the importance ranking of the accidents, we will reduce safety accidents in coal mines. To enable the timely prediction and control of roadway roof fall risks, based on the investigation of many roadway roof fall risk factors, 12 evaluation indexes such as the roadway roof rock thickness, geological conditions and roadway section shape were selected. An evaluation index system of roadway roof fall risks is constructed. A risk degree standard of roadway roof falls is proposed. The risk evaluation model of roadway roof falls was established by using the combination weight of the analytic hierarchy process (AHP), entropy weight method (EW) and matter element extension theory. According to the principle of the maximum membership degree, the risk degree of roadway roof falls is determined. Based on Java Web, a risk assessment system for roadway roof falls was developed. We name the system Multiple Weight-Material Element Web (MW-MEW). The MW-MEW system was used to evaluate the risk degree of roof falls in the C9 return airway of the Xingu Coal Mine. Compared with the evaluation results of the AHP matter element extension model, it is found that the evaluation results of the MW-MEW system are more in line with the actual engineering conditions. The successful application of the MW-MEW system will provide new avenues for the quantitative evaluation of roof fall risks in coal mine roadways.

Shoe sole impedes leg muscle activation and impairs dynamic balance responding to a standing-slip

The shoe sole is identified as a fall risk factor since it may impede the afferent information about the outside world collected by the plantar sensory units. However, no study has directly quantified how the shoe sole compromises body balance and increases fall risk. This study aimed to inspect how the sole affects human balance after an unexpected standing-slip. It was hypothesized that individuals wearing the sole, relative to their barefoot counterparts, would exhibit 1) more impaired stability and 2) disrupted lower limb muscle activation following a standing-slip. Twenty young adults were evenly randomized into two groups: soled and barefoot. The soled group wore a pair of customized 10-mm thick soles, while the other group was bare-footed. Full-body kinematics and leg muscle electromyography (EMG) were collected during a standardized and unexpected standing-slip. The EMG electrodes were placed on the tibialis anterior, gastrocnemius, rectus femoris, and biceps femoris bilaterally. Dynamic stability, spatiotemporal gait parameters, and the EMG latency of the leg muscles were compared between groups. The sole impeded the initiation of the recovery step possibly because it interfered with the accurate detection of the external perturbation and subsequently activated the leg muscles later in the soled group than in the barefoot group. As a result, individuals in the soled group experienced a longer slip distance and were more unstable than the barefoot group at the recovery foot liftoff. The findings of this study could augment our understanding of how the shoe sole impairs body balance and increases the fall risk.

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...

Evidence-Based Strategies for Injury Prevention and Exercise Prescription in Elderly Communities: The Physical Therapist's Perspective

Injury prevention and exercise prescription are critical components of healthcare for older adults. Physical therapists play a critical role in fall risk screening, assessment, and prevention in elderly communities. By incorporating STEADI (Stopping Elderly Accidents, Deaths, and Injuries) and other evidence-based tools and resources, physical therapists can help identify and address fall risk factors, link older adults with community-based programs and resources, and reduce the incidence of falls and related injuries in this population. Evidence-based interventions for fall prevention include exercise interventions that are tailored and include a combination of exercise types, considering individual abilities and preferences. Exercise programs can reduce falls in older people living in residential aged care facilities, but exercise has little or no lasting effect on falls after the end of a program. Physical therapists should consider the patient's fall risk, functional limitations, and comorbidities when prescribing exercises for balance and falls prevention. Physical therapists can help elderly communities implement evidence-based strategies for injury prevention and exercise prescription by adopting a person-centered approach, challenging ageist stereotypes, using sound outcome measures, prioritizing physical activity, and collaborating with other healthcare professionals. By doing so, physical therapists can promote the health, independence, and well-being of older adults, and help them lead active, fulfilling lives. A combination of strength, balance, and functional training exercises, as well as other evidence-based strategies, can significantly reduce the risk of falls in elderly communities. Physical therapists and healthcare providers should consider these interventions when developing fall prevention programs for older adults. Exercise interventions for preventing falls in elderly communities should be implemented regularly, with a frequency of at least three sessions per week, and for a duration of up to 12 months. Keywords: Elderly communities, injury prevention, exercise prescription in elderly, falls prevention, aging

Combining real data and expert knowledge to build a Bayesian Network — Application to assess multiple risk factors for fall among elderly people

Building a prediction model based on both real data and expert knowledge can be challenging. We experienced this difficulty in our context of predicting fall risk factors in the elderly, where two sources of data were available: hand-reported information from medical consultations and expert information from human specialists. As is often the case, the real data were incomplete and imbalanced, and the participation of medical experts required the selection of a kind of model they can understand. This article describes the steps followed in the construction and evaluation of the model, structured as a new framework. The proposed model is a Bayesian network (BN) built from expert knowledge and learning from a real data set, guided by both the understandability of the BN graph and the performance of the model to predict risk factors. The resulting Bayesian network model includes 90 variables to evaluate 10 actionable target risk factors. It demonstrated its potential compared to other classifiers in terms of prediction performance, whilst offering a higher degree of interpretability.

ASSESSMENT OF FALL RISK IN CANCER PATIENTS RECEIVING PALLIATIVE CARE

Aim: This study aims to evaluate fall risk factors in cancer patients receiving palliative care units. Method: This cross-sectional descriptive study was performed on 122 cancer patients served the palliative care unit between 01 October and 20 November 2020. The patient’s functional status was evaluated with the Katz Index of Independence in Activities of Daily Living. The data were collected using the Itaki Fall Risk Scale. Results: The mean age of patients was 57.32±12.10 years. The fall risk score of the patients was found to be 17.25±6.20. The risk of falling was higher in the elderly, those with chronic disease, diagnosed with lung cancer, and a history of falling variables. The most common minor risk factor was the presence of chronic disease, and the most common major risk factor was dizziness. Conclusions and Suggestions: Fall risk is high in cancer patients receiving palliative care. Cancer patients receiving palliative care treatment should be evaluated in terms of fall risk.

Unveiling Fall Triggers in Older Adults: A Machine Learning Graphical Model Analysis.

While existing research has identified diverse fall risk factors in adults aged 60 and older across various areas, comprehensively examining the interrelationships between all factors can enhance our knowledge of complex mechanisms and ultimately prevent falls. This study employs a novel approach-a mixed undirected graphical model (MUGM)-to unravel the interplay between sociodemographics, mental well-being, body composition, self-assessed and performance-based fall risk assessments, and physical activity patterns. Using a parameterized joint probability density, MUGMs specify the higher-order dependence structure and reveals the underlying graphical structure of heterogeneous variables. The MUGM consisting of mixed types of variables (continuous and categorical) has versatile applications that provide innovative and practical insights, as it is equipped to transcend the limitations of traditional correlation analysis and uncover sophisticated interactions within a high-dimensional data set. Our study included 120 elders from central Florida whose 37 fall risk factors were analyzed using an MUGM. Among the identified features, 34 exhibited pairwise relationships, while COVID-19-related factors and housing composition remained conditionally independent from all others. The results from our study serve as a foundational exploration, and future research investigating the longitudinal aspects of these features plays a pivotal role in enhancing our knowledge of the dynamics contributing to fall prevention in this population.

Fall risk factors among poly-medicated older Lebanese patients in primary care settings: a secondary cross-sectional analysis of the “MGPIDP-L project”

BackgroundFalling is a major concern for the health of older adults and significantly affects their quality of life. Identifying the various risk factors and the differences between older patients can be challenging. The objective of this study was to identify the risk factors for falls among polymedicated community-dwelling older Lebanese patients following a medication review.MethodsIn this analytical cross-sectional study, we examined the risk factors for falls in 850 patients aged ≥ 65 years who were taking ≥ 5 medications daily. The study involved conducting a medication review over the course of a year in primary care settings and using multivariate logistic regression analysis to analyze the data.ResultsOur results showed that 106 (19.5%) of the 850 included patients had fallen at least once in the three months prior to the medication review. Loss of appetite and functional dependence were identified as the most significant predictors of falls ORa = 3.020, CI [2.074–4.397] and ORa = 2.877, CI [1.787–4.632], respectively. Other risk factors for falls included drowsiness ORa = 2.172, CI [1.499–3.145], and the use of beta-blockers ORa = 1.943, CI [1.339–2.820].ConclusionOur study highlights the importance of addressing multiple risk factors for falls among Lebanese older adults and emphasizes the need for customized interventions and ongoing monitoring to prevent falls and improve health outcomes. This study sheds light on a critical issue in the Lebanese older population and provides valuable insight into the complex nature of falls among poly-medicated Lebanese community-dwelling older adults.Trial registration2021REC-001- INSPECT -09–04.

Risk Factors of Falling among Elderly People in Suez Canal University Hospitals

Risk Factors of Falling among Elderly People in Suez Canal University Hospitals