Risk Of Elderly People Research Articles

The Impact of a Health Education Program on Fear of Falling and Fall Risk in Elderly People from UATI: A Clinical Trial

The Impact of a Health Education Program on Fear of Falling and Fall Risk in Elderly People from UATI: A Clinical Trial

Avaliação do risco de queda em idosos com Alzheimer

Avaliação do risco de queda em idosos com Alzheimer

The Influences of Macronutrients on Bone Mineral Density, Bone Turnover Markers, and Fracture Risk in Elderly People: A Review of Human Studies.

Osteoporosis is a health condition that involves weak bone mass and a deteriorated microstructure, which consequently lead to an increased risk of bone fractures with age. In elderly people, a fracture attributable to osteoporosis elevates mortality. The objective of this review was to examine the effects of macronutrients on bone mineral density (BMD), bone turnover markers (BTMs), and bone fracture in elderly people based on human studies. A systematic search was conducted in the PubMed®/MEDLINE® database. We included human studies published up to April 2023 that investigated the association between macronutrient intake and bone health outcomes. A total of 11 meta-analyses and 127 individual human studies were included after screening the records. Carbohydrate consumption seemed to have neutral effects on bone fracture in limited studies, but human studies on carbohydrates' effects on BMD or/and BTMs are needed. The human studies analyzed herein did not clearly show whether the intake of animal, vegetable, soy, or milk basic proteins has beneficial effects on bone health due to inconsistent results. Moreover, several individual human studies indicated an association between eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and osteocalcin. Further studies are required to draw a clear association between macronutrients and bone health in elderly people.

Quantitative Ultrasound and Bone Health in Elderly People, a Systematic Review.

Reduced bone mineral density (BMD), osteoporosis, and their associated fractures are one of the main musculoskeletal disorders of the elderly. Quickness in diagnosis could prevent associated complications in these people. This study aimed to perform a systematic review (SR) to analyze and synthesize current research on whether a calcaneal quantitative ultrasound (QUS) can estimate BMD and predict fracture risk in elderly people compared to dual-energy x-ray absorptiometry (DXA), following the PRISMA guidelines. A search was conducted in the main open-access health science databases: PubMed and Web of Science (WOS). DXA is the gold standard for the diagnosis of osteoporosis. Despite controversial results, it can be concluded that the calcaneal QUS tool may be a promising method to evaluate BMD in elderly people, facilitating its prevention and diagnosis. However, further studies are needed to validate the use of calcaneal QUS.

Analysing the Psychological Impact of the COVID-19 Pandemic among Turkish Immigrants

COVID-19 Pandemic has already triggered a variety of psychological problems including fear, depression, anxiety, and suicidal attempts. This study aimed to investigate Turkish immigrants' psychological conditions and top concerns in Germany during the COVID-19 Pandemic. Demographics and current psychological conditions of participants were collected and analysed by means of a structured survey. A questionnaire was completed by 170 Turkish immigrants in Munich, Germany. The results demonstrated that Turkish immigrants with low income and education level as well as an unemployment status were worried more during the Pandemic. Moreover, the risk of elderly people getting infected by COVID-19 was one of the top concerns of participants. Therefore, main concerns of participants in our study were the deterioration of their economic situation and the possibility of older adults getting infected by COVID-19.

EFFECTS OF PHYSICAL THERAPY ON THE LEVEL OF KINESIOPHOBIA, SOMATIC MARKERS OF SARCOPENIA AND INDICATORS OF FALL RISK IN ELDERLY PERSONS WITH PARKINSON'S DISEASE

Objective: to assess the effectiveness of the impact of physical therapy on the level of kinesiophobia, somatic markers of sarcopenia and indicators of the of fall risk in elderly people with Parkinson's disease.
 Methods. The study involved 57 elderly people diagnosed with Parkinson's disease in combination with sarcopenia. They were divided into two groups: 1 (they were engaged according to the principles of polyclinic rehabilitation) and 2 (they were engaged according to the developed program of physical therapy for 6 months, rehabilitation training was carried out three times a week).
 The aim of the program was to decrease the level of kinesiophobia and increase the compliance of patients with the implementation of active methods of physical therapy (kinesitherapy) and, thus, to maintain general physical activity; increasing muscle strength and flexibility; facilitating the initiation of movements; improving joint mobility; maintaining correct posture; improving walking and maintaining balance; prevention of pain syndromes and contractures; prevention of respiratory disorders; adaptation to the changed conditions of daily activity. The physical therapy program was created taking into account the specifics of each comorbid condition using functional training on the Prosedos platform, therapeutic exercises, massage, elements of occupational therapy, nutrition correction, patient education. We consistently achieved individual short- and long-term goals of rehabilitation in the SMART-format within the patient-centered rehabilitation model. This increased compliance and helped to select such elements of functional training, which made it possible to individually adjust the most affected movements in each patient, and interfere with normal functioning. The control group consisted of 24 people without signs of sarcopenia and Parkinson's disease. The effectiveness of the program was assessed by the dynamics of the Tampa Kinesiophobia Scale, Fall efficacy scale, grip strength, The Short Physical Performance Battery, Timed Up and Go test, Berg Balance Scale. Patients were examined twice - before and after rehabilitation measures (with an interval of 6 months).
 Results. Elderly patients with Parkinson's disease and sarcopenia were found to have a high level of kinesiophobia, muscle weakness, impaired static and dynamic balance and, as a consequence, a high fall risk. The developed program of physical therapy caused a statistically significant better effect on the state of kinesiophobia, markers of sarcopenia and the fall risk in comparison with the general outpatient program for all the studied parameters (p <0.05). Persons of group 1 found a statistically significant improvement in their repeated results on the parameters of the balance subscale SPPB, TUG-test, Berg Balance Scale (p <0.05), without reaching the corresponding levels of the control group (p> 0.05). For all the studied parameters, during the repeated examination, the persons of group 2 showed a statistically significant improvement relative to the initial indicator (p <0.05) and repeated parameters of the OG1 (p <0.05), without reaching any level of the control group (p> 0.05).
 Conclusions. Elderly patients with comorbidity Parkinson's disease and sarcopenia require the development of physical therapy programs taking into account and correcting the specificity of each disease, the presence of kinesiophobia and a high fall risk, which will increase the overall efficiency of recovery processes.

Utilization of Micro-Doppler Radar to Classify Gait Patterns of Young and Elderly Adults: An Approach Using a Long Short-Term Memory Network.

To develop a daily monitoring system for early detection of fall risk of elderly people during walking, this study presents a highly accurate micro-Doppler radar (MDR)-based gait classification method for the young and elderly adults. Our method utilizes a time-series of velocity corresponding to leg motion during walking extracted from the MDR spectrogram (time-velocity distribution) in an experimental study involving 300 participants. The extracted time-series was inputted to a long short-term memory recurrent neural network to classify the gaits of young and elderly participant groups. We achieved a classification accuracy of 94.9%, which is significantly higher than that of a previously presented velocity-parameter-based classification method.

Death risk and the importance of clinical features in elderly people with COVID-19 using the Random Forest Algorithm

Abstract Objectives: train a Random Forest (RF) classifier to estimate death risk in elderly people (over 60 years old) diagnosed with COVID-19 in Pernambuco. A "feature" of this classifier, called feature importance, was used to identify the attributes (main risk factors) related to the outcome (cure or death) through gaining information. Methods: data from confirmed cases of COVID-19 was obtained between February 13 and June 19, 2020, in Pernambuco, Brazil. The K-fold Cross Validation algorithm (K=10) assessed RF performance and the importance of clinical features. Results: the RF algorithm correctly classified 78.33% of the elderly people, with AUC of 0.839. Advanced age was the factor representing the highest risk of death. The main comorbidity and symptom were cardiovascular disease and oxygen saturation ≤ 95%, respectively. Conclusion: this study applied the RF classifier to predict risk of death and identified the main clinical features related to this outcome in elderly people with COVID-19 in the state of Pernambuco.

치매노인의 낙상예방 운동프로그램이 체중분포지수와 낙상위험도에 미치는 영향

The purpose of this study was to investigate the effects of fall prevention exercise program on weight distribution index and fall risk in elderly people with dementia.,The subjects of this study were 20 people who had experience of falling in a public health center in Gyeonggi-do. The group A was conducted a muscle strength and co-ordinated exercise program, and the group B was conducted a frequency vibration exercise program.,The data of the study were analyzed using SPSS(Version 20.0) statistical program, and the comparison of the difference between before and after each group was analyzed through paired T-test to find out the degree of weight distribution index and fall risk improvement of the exercise program.,The relationship between each variable was analyzed by Pearsons Correlation, and the significance level=.05 for all statistical analysis was set as follows.,The results of the pre- and post-test of the muscle strength and coherence exercise program in Group A were not statistically significant in both weight distribution index (t=.399, p=.699) and fall risk (t= -2.193, p=.056).,The results of the B group frequency vibration exercise program were statistically significant in both the weight distribution index (t=4.492, p=.002*) and the fall risk (t= -3.939, p=.003*).

Faktor-Faktor Yang Berpengaruh Terhadap Perilaku Pengelolaan Dagusibu Obat Pada Masyarakat dengan Home Pharmacy Care di Wilayah Kecamatan Jakarta Pusat


 The household drug management is common practice worldwide especially Ethical drugs and OTC Drugs that indicated are acute and chronic condition. The beside higher costs, accumulation medicines at home can be attributed to the lack of knowledge and behavior in patient, patient's family and environmental. Negative relationships in household drug management more likely risk for elderly people have many illnesses and polypharmacy, drug interactions and adverse drug reactions. The objective of this study to analyze the factors Associated to behavior Dagusibu drug management in Community Jakarta Pusat With Home Pharmacy Care. This research used observational research by using cross-sectional design. this research type probability sampling with technique is cluster random sampling. The data analysis used bivariate analysis , especially chisquare test. The result of multivariate analysis showed the variable were significantly related to behavior dagusibu drug management, namely variables were medicine dispossal box (p=0.019;OR 3.009); medicine safety box (p=0.025;OR 2.974) and influence efect of family support (p=0.001;OR=5.092).

Estimating Postural Stability Using Improved Permutation Entropy via TUG Accelerometer Data for Community-Dwelling Elderly People.

To develop an effective fall prevention program, clinicians must first identify the elderly people at risk of falling and then take the most appropriate interventions to reduce or eliminate preventable falls. Employing feature selection to establish effective decision making can thus assist in the identification of a patient’s fall risk from limited data. This work therefore aims to supplement professional timed up and go assessment methods using sensor technology, entropy analysis, and statistical analysis. The results showed the different approach of applying logistic regression analysis to the inertial data on a fall-risk scale to allow medical practitioners to predict for high-risk patients. Logistic regression was also used to automatically select feature values and clinical judgment methods to explore the differences in decision making. We also calculate the area under the receiver-operating characteristic curve (AUC). Results indicated that permutation entropy and statistical features provided the best AUC values (all above 0.9), and false positives were avoided. Additionally, the weighted-permutation entropy/statistical features test has a relatively good agreement rate with the short-form Berg balance scale when classifying patients as being at risk. Therefore, the proposed methodology can provide decision-makers with a more accurate way to classify fall risk in elderly people.

Relationship between postural stability and fall risk in elderly people with lumbar spondylosis during local vibratory stimulation for proprioception: a retrospective study

Purpose: Reduced proprioception affects fall risks in elderly people with lumbar spondylosis. The decrease in proprioception in the trunk or lower legs may contribute to a decline in postural stability. We aimed to investigate the association between proprioceptive postural stability and fall risks in elderly individuals with lumbar spondylosis.Materials and Methods: In this retrospective study, the centre-of-pressure displacement was determined in elderly individuals with lumbar spondylosis during upright stance while standing on a Wii Balance Board with their eyes closed (fall-risk group, n = 55; non-fall-risk group, n = 60). Vibratory stimulations at 30 Hz were applied to the lumbar multifidus and gastrocnemius to evaluate the relative contributions of proprioceptive signals used in postural control (relative proprioceptive weighting ratio).Results: Compared with the non-fall-risk group, the fall-risk group displayed a high relative proprioceptive weighting ratio (p = 0.024). Relative proprioceptive weighting ratio (odds ratio, 1.1; 95% confidence interval: 1.004–1.109) was independently associated with fall risks after adjusting for confounding factors. Among variables related to fall risk, the relative proprioceptive weighting ratio was a significant factor (p < 0.035).Conclusion: The fall-risk group of elderly individuals with lumbar spondylosis was dependent on the ankle strategy. The fall risk in elderly people with lumbar spondylosis could be due to over-dependence on the input from muscle spindles in the gastrocnemius.

An Internet-of-Things Solution to Assist Independent Living and Social Connectedness in Elderly

Social isolation has been identified as a major risk in elderly people living alone because of their association with cognitive decline, depression, and other mental health-related issues. Ambient Assisted Living (AAL) is identified as a key technology to facilitate independent living and maintain social connnectedness between elderly, their families, and caregivers. AAL combines Internet of Things, Smart Homes, and machine learning to produce a smart solution that encourages independent, safe, and socially active life for elderly people within their own home. In this article, we propose, develop, implement, and validate a novel Internet-of-Things-based solution that uses passive (i.e., non-obstructive methods) sensing for real-time monitoring of elderly in their homes. The significance of the proposed solution is in the use of machine learning and statistical models to automatically build a personalised model by learning the normal behavioural pattern for the person from deployed sensors in the house. It then uses this model to detect significant changes in the behavioural pattern, should they occur, that could be a consequence of possible health deterioration. We evaluate the performance of the proposed solution via real-world in-home trials installed in six elderly people’s home for a period from 1.5 to 4 months. A discussion and analysis of the in-home trial outcomes and feedback from elderly who participated in the trials conclude the article.

Intracellular Water Content in Lean Mass is Associated with Muscle Strength, Functional Capacity, and Frailty in Community-Dwelling Elderly Individuals. A Cross-Sectional Study.

High intracellular water (ICW) content has been associated with better functional performance and a lower frailty risk in elderly people. However, it is not clear if the protective effect of high ICW is due to greater muscle mass or better muscle quality and cell hydration. We aimed to assess the relationship between ICW content in lean mass (LM) and muscle strength, functional performance, frailty, and other clinical characteristics in elderly people. In an observational cross-sectional study of community-dwelling subjects aged ≥75 years, ICW and LM were estimated by bioelectrical impedance, and the ICW/LM ratio (mL/kg) calculated. Muscle strength was measured as hand grip, frailty status was assessed according to Fried criteria, and functional status was assessed by Barthel score. For 324 recruited subjects (mean age 80 years), mean (SD) ICW/LM ratio was 408 (29.3) mL/kg. The ICW/LM ratio was negatively correlated with age (rs = −0.249; p < 0.001). A higher ICW/LM ratio was associated with greater muscle strength, better functional capacity, and a lower frailty risk, even when adjusted by age, sex, nº of co-morbidities, and LM. ICW content in LM (including the muscle) may influence muscle strength, functional capacity and frailty. However, further studies are needed to confirm this hypothesis.

Myiasis of Mandible Due to Lucilia sericata, in Diabetic Woman Patient: A Case Report

Introduction: Myiasis can be defined as the infestation of living tissues of humans and animals by dipterous eggs or larval stages that can penetrate the skin and soft tissues. Case Presentation: The aim of the study was to report an uncommon case of insect infestation in human tissues, called myiasis. The patient was a 62-year-old woman, with the larval presence in the jaw, who suffered from diabetes and anemia. She was originally from the rural areas of Khuzestan province, the southwest of Iran. She had a wound on her mandible with a foul-smelling mouth before preparing for coronary artery bypass grafting (CABG) surgery. Her mandible and mouth were infested by 50 live larvae after three days of CABG. The larvae were examined in the pathology and parasitology department of the laboratory and definitely identified as Lucilia sericata. Conclusions: Myiasis can be a risk for elderly people, especially old patients. The primary control method is the prevention and repulsion of adult flies before they can cause any damage.

Towards an Automated Unsupervised Mobility Assessment for Older People Based on Inertial TUG Measurements.

One of the most common assessments for the mobility of older people is the Timed Up and Go test (TUG). Due to its sensitivity regarding the indication of Parkinson’s disease (PD) or increased fall risk in elderly people, this assessment test becomes increasingly relevant, should be automated and should become applicable for unsupervised self-assessments to enable regular examinations of the functional status. With Inertial Measurement Units (IMU) being well suited for automated analyses, we evaluate an IMU-based analysis-system, which automatically detects the TUG execution via machine learning and calculates the test duration. as well as the duration of its single components. The complete TUG was classified with an accuracy of 96% via a rule-based model in a study with 157 participants aged over 70 years. A comparison between the TUG durations determined by IMU and criterion standard measurements (stopwatch and automated/ambient TUG (aTUG) system) showed significant correlations of 0.97 and 0.99, respectively. The classification of the instrumented TUG (iTUG)-components achieved accuracies over 96%, as well. Additionally, the system’s suitability for self-assessments was investigated within a semi-unsupervised situation where a similar movement sequence to the TUG was executed. This preliminary analysis confirmed that the self-selected speed correlates moderately with the speed in the test situation, but differed significantly from each other.

RELATIONSHIP BETWEEN PHYSICAL ACTIVITY, COGNITION AND ALZHEIMER PATHOLOGY IN AUTOSOMAL DOMINANT ALZHEIMER`S DISEASE

Previous reports suggest that physical activity (PA) may have beneficial effects on cognitive function, cognitive decline and Alzheimer's disease (AD) risk in elderly people. In addition, PA may modify pathological changes associated with AD. However, the putative effects of PA on cognitive performance and AD biomarkers in cerebrospinal fluid (CSF) in autosomal dominant Alzheimer's disease (ADAD) are still unknown. A total of 372 individuals (224 mutation carriers [MCs] and 148 non-carriers [NCs]) participating at the Dominantly Inherited Alzheimer Network (DIAN) study were examined to evaluate the cross-sectional relationship between PA and cognitive performance, functional status, cognitive decline and AD biomarkers in CSF. MCs were categorized into those with high PA (≥150 minutes/week) vs. those with low PA (<150 minutes/week). MCs with high PA showed significantly better cognitive and functional performance at baseline and with respect to estimated years from expected symptom onset (EYO) compared to individuals with low PA. In addition, MCs with high PA demonstrated significantly less AD-like pathology in CSF compared to individuals with low PA. MCs with high PA scored 3.4 points better on MMSE evaluation at expected symptom onset and fulfilled diagnosis of very mild dementia 15.1 years later compared to MCs with low PA. These results are supportive of a beneficial effect of PA on cognition and AD pathology even in individuals with genetically driven ADAD. A physically active lifestyle may play an important role in slowing the development and progression of ADAD.

Development of the Japanese version of the Westmead Home Safety Assessment for the elderly in Japan.

ObjectiveHome safety assessment and intervention is a key component in the management of fall risk in elderly people. However, a standardised assessment for home safety has not yet been established in Japan. We developed a Japanese version of the Westmead Home Safety Assessment by partially modifying the original version according to house structures and lifestyles in Japan and examined its inter-rater reliability and content validity.MethodsJapanese elderly in the community who had fear of falls were recruited to investigate the reliability of the Japanese version of the Westmead Home Safety Assessment. Two occupational therapists simultaneously visited a participant’s home to perform the Japanese version of the Westmead Home Safety Assessment independently. Further, an expert panel of 18 occupational therapists evaluated the relevance of each item of the Japanese version of the Westmead Home Safety Assessment.ResultsFifty elderly people (aged 78.2 ± 7.1 years) participated in this reliability study. The most frequent hazards were identified as internal steps/stairs, seating, bathroom, bath, and external steps/stairs. Forty-nine items (69%) in the Japanese version of the Westmead Home Safety Assessment were rated to have fair to good (0.40 < κ < 0.75) or excellent (κ ≥ 0.75) reliability as well as excellent validity (item content validity ≥0.78). These items were concerned with basic activities of daily living and some simple instrumental activities of daily living. The scale content validity was 0.78 ± 0.16 but was not excellent (scale content validity index <0.90).ConclusionsThis study suggested that 49 items in the Japanese version of the Westmead Home Safety Assessment were appropriate for home safety assessment for Japanese elderly. Further research is necessary to improve the reliability and validity of the present version of the Japanese version of the Westmead Home Safety Assessment for this population.

Validation of an ambient system for the measurement of gait parameters

Fall risk in elderly people is usually assessed using clinical tests. These tests consist in a subjective evaluation of gait performed by healthcare professionals, most of the time shortly after the first fall occurrence. We propose to complement this one-time, subjective evaluation, by a more quantitative analysis of the gait pattern using a Microsoft Kinect. To evaluate the potential of the Kinect sensor for such a quantitative gait analysis, we benchmarked its performance against that of a gold-standard motion capture system, namely the OptiTrack. The “Kinect” analysis relied on a home-made algorithm specifically developed for this sensor, whereas the OptiTrack analysis relied on the “built-in” OptiTrack algorithm. We measured different gait parameters as step length, step duration, cadence, and gait speed in twenty-five subjects, and compared the results respectively provided by the Kinect and OptiTrack systems. These comparisons were performed using Bland-Altman plot (95% bias and limits of agreement), percentage error, Spearman’s correlation coefficient, concordance correlation coefficient and intra-class correlation. The agreement between the measurements made with the two motion capture systems was very high, demonstrating that associated with the right algorithm, the Kinect is a very reliable and valuable tool to analyze gait. Importantly, the measured spatio-temporal parameters varied significantly between age groups, step length and gait speed proving the most effective discriminating parameters. Kinect-monitoring and quantitative gait pattern analysis could therefore be routinely used to complete subjective clinical evaluation in order to improve fall risk assessment during rehabilitation.

Low plasma tryptophan is associated with olfactory function in healthy elderly community dwellers in Japan

BackgroundDecreased circulating tryptophan (Trp) levels are frequently observed in elderly patients with neurodegenerative disease including Alzheimer’s disease. Trp may serve as a potential biomarker for monitoring disease risk in elderly people. We aimed to investigate the association between low plasma Trp levels and olfactory function, which is known to predict age-related diseases including dementia in elderly people.MethodsA total of 144 healthy elderly Japanese community (≥ 65 years old) dwellers from the Health, Aging and Nutritional Improvement study (HANI study) were the subjects of our analysis. Low Trp levels were classified using the lower limit values of the reference interval according to a previous report. Olfactory function was assessed using a card-type test called Open Essence, which includes 12 odour items that are familiar to Japanese people. The elderly subjects with low circulating Trp levels were compared to a control group with normal plasma Trp levels.ResultsWe conducted the analyses using 144 people aged 65 years or older (mean age 73.7 ± 5.5 years; 36.1% men). The subjects showed normal serum albumin levels (4.4 ± 0.2 g/dL) and no daily living disabilities. Low plasma Trp levels (low Trp group) were found in 11.1% of the study population. The low Trp group showed a significantly lower correct-answer rate for the items india ink, perfume, curry and sweaty smelling socks than control group (P < 0.05). There was also a significant association between low Trp levels and low olfactory ability, after adjusting for age and sex.ConclusionsLower plasma Trp levels were associated with a decrease in olfactory function in functionally competent older individuals. Because olfactory dysfunction predicts age-related diseases, low plasma Trp levels may represent a clinical sign of disease risk in elderly people.