Based on the results, we believe that developing novel fall risk assessment tools reflecting the various clinical factors identified is necessary. Beta blockers, calcium channel blockers, angiotensin II receptor antagonists, angiotensin-converting enzyme inhibitors, digoxin, loop diuretics, other diuretics (thiazides or spironolactone), alpha blockers, anticholinergics, antihistamines, weak opioids, opioids, antipsychotics, anticonvulsants, benzodiazepine, hypnotics, anti-dementia drugs, antiparkinsonians, selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants, other antidepressants, vasodilating agents, and muscle relaxants were included in FRIDs. [50] Comorbidities are associated with frailty which in turn can result in greater risk of falling. J.H. Med. Beggs funnel plot for publication bias (with 95% pseudo confidence limits) of the observational studies that investigated no age differences between fallers and non-fallers after lower extremity joint replacement (. https://www.ahrq.gov/sites/default/files/publications/files/fallpxtoolkit.pdf, http://creativecommons.org/licenses/by/4.0/, Falls in oldest-old adults hospitalized in acute geriatric ward, Osteoporotic fractures and subsequent fractures: imminent fracture risk from an analysis of German real-world claims data. If you have blond or red hair, light-colored eyes, and freckle or sunburn easily, you . We investigated whether clinical factors including comorbidities, medications, and laboratory results predict inpatient fall risk in older adults. Your message has been successfully sent to your colleague. [55]. Patient demographics, type and duration of blocks were considered Falls in the elderly - PMC - National Center for Biotechnology Information 65, 12421249 (2010). Research Article: Systematic Review and Meta-Analysis. Google Scholar. Proc. Sci. Matching characteristics identified were age (within two years), admission date (within two weeks), ward, and length of stay before falls. 67, 10691075 (2011). All analyses were performed using IBM SPSS Statistics for Windows version 21.0 (IBM Corp., Armonk, NY, USA) and R Studio version 3.6.1. Beninato M, Portney LG, Sullivan PE. Three individual studies compared the overweight (BMI 25 kg/m2) between fallers and non-fallers. BackgroundAccording to epidemiological evidence, people with type 2 diabetes mellitus have a higher risk of developing colorectal cancer.ObjectiveTo examine the relationship between colorectal cancer (CRC) and serum levels of IGF-1, IGF-1R, AGEs,RAGE and sRAGE in patients with type 2 diabetes.MethodsBy using RNASeq data of CRC patients from The Cancer Genome Atlas (TCGA) database, we . Thus, suggested that age-related factors such as impaired reflexes, reduced motor strength, proprioceptive loss, and balance may play a role. [35]. Tai Chi has popular in China for several centuries, Tai Chi is of great significance to improving balance-control and flexibility in geriatric persons, suggesting a protective function against falls. Aranda-Gallardo, M., Morales-Asencio, J. M., Canca-Sanchez, J. C., Mora-Banderas, A. M. & Moya-Suarez, A. Recently, the Agency for Healthcare Research and Quality (AHRQ) suggested that evaluating medications, disease states, laboratory results, and patients education levels can prevent falls in hospitals8. Several fall risk assessment tools such as the Morse Fall Scale (MFS)3, St Thomass Risk Assessment Tool in Falling Elderly Inpatients4, and the Hendrich Fall Risk Model have been utilized in hospitals5. Also, a manual search of references in the identified articles and systematic reviews was performed for possible inclusion. Prevention strategies, including exercise and assistive devices, help you lead a healthier life overall. A fall was defined as unintentionally coming to rest on the ground, or a lower level. Older adults commonly use diuretics as antihypertensives and for treating and preventing heart failure as well as ascites in liver cirrhosis. Phys Med Rehab 2010;91:10614. Osteoporosis | National Institute on Aging J. Hyponatremia as a fall predictor in a geriatric trauma population. Take vitamin D supplements if you are vitamin deficient. . A longitudinal comparative study of, [30]. [43]. Prevention of. B. Pre-operative predictors of post-operative. Muir, S. W., Gopaul, K. & Montero Odasso, M. M. The role of cognitive impairment in fall risk among older adults: a systematic review and meta-analysis. Table 3 shows the comparison of medications and FRID between the groups. 3B), with no heterogeneity (P = .510, I2 = 0; Table 2). Advanced age, low bone mass, and previous fractures are strong risk factors for fractures at nearly all skeletal sites. Outcome measures include advanced age, female, Overweight (BMI25 kg/m2), falls history, use of walking aid, diabetes, cardiac disease, hypertension, COPD and depressive symptoms. The study took place at an academic tertiary hospital in a city in Korea. However, among the five studies, one that was conducted with patients in acute care hospitals reported that calcium channel blockers were significantly associated with fall risk (OR 2.45, 95% CI 1.205.01)26, which was consistent with our findings. Smoking and dementia are strongly related to increased mortality . Fall prevention in older adults : The Nurse Practitioner - LWW . Falls in persons with arthroplasty are common. There are many predisposing factors that may lead to falls. Sci. Abbreviations: ABC Scale = Activities-specific Balance Confidence Scale, BMI = body mass index, COPD = chronic obstructive pulmonary disease, NOS = newcastleottawa scale, OA = osteoarthritis, OR = odd ratio, SMD = standard mean difference, THA = total hip arthroplasty, TJA = total joint arthroplasty, TKA = total knee arthroplasty. Incidence rates by age at diagnosis, all cancer types. Memtsoudis SG, Dy CJ, Ma Y, et al. Falls in Older Persons: Risk Factors and Prevention - The Second Fifty Years - NCBI Bookshelf. Fall risk factors for individuals under the age of 65 years with type 2 As falls are generally considered to be a marker of frailty and decreased mobility, it is not surprising that falls are associated with advanced age and impairments in activities of daily living. Physical Restraints; Slide 11. Correspondence to Osteoarthritis (OA) of the knee and hip is a common debilitating chronic condition affecting the elderly population,[1,2] and total knee arthroplasty (TKA) and total hip arthroplasty (THA) are widely believed to be the best choice for the treatment of end-stage OA, and the procedure can significantly relieve pain and restore physical functioning and improve the quality of life for these patients. Nurs. However, after sensitive analysis by excluding outlier studies, the I2 value lowered to 45.7%, and the significance did not change, indicating the result was reliable. Pain intensity in total hip arthroplasty patients: how communication influences satisfaction. Data were pooled and a meta-analysis completed. & Heinze, C. Fall risk factors in older people with dementia or cognitive impairment: a systematic review. [58]. Neurol. Anti-hypertensive medication and COPD were both associated with increased fall risk. This means that half of cancer cases occur in people below this age and half in people above this age. Mean (standard deviation) or frequency (percentage) was used to describe patients general characteristics. Commonly used in older adults, a fall risk assessment checks your risk of falling. Med. Jrgensen CC, Henrik K. Fall-related admissions after fast-track total hip and knee arthroplasty cause of concern or consequence of success? Keyword Highlighting Centers for Disease Control and Prevention. ORs also indicated that among older adults prescribed FRIDs, those taking calcium channel blockers, diuretics (thiazides or spironolactone), anticonvulsants, and benzodiazepines had higher fall risks by 1.71 times (95% CI 1.012.88), 2.24 times (95% CI 1.024.90), 3.04 times (95% CI 1.735.32), and 2.26 times (95% CI 1.054.85), respectively. A systematic review and meta-analysis of fall incidence and risk - LWW Health-related quality of life in total hip and total knee arthroplasty. A similar pattern is seen for many common cancer types. The literature search and data extraction strategy were shown in the Figure 1. Ask you to describe your previous falls, such as what caused the fall, what happened after the fall and whether you received medical treatment. The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request. This study had several strengths. 7, 9 In addition, people with mild cognitive impairment (MCI) and mild AD seem to present distinct characteristics regarding history of falls. Volpato, S., Leveille, S. G., Blaum, C., Fried, L. P. & Guralnik, J. M. Risk factors for falls in older disabled women with diabetes: the Womens Health and Aging Study. Age-related loss of muscle mass (known as sarcopenia), problems with balance and gait, and blood pressure that drops too much when you get up from lying down or sitting (called postural hypotension) are all risk factors for falling. Mean scores of MFS items were higher among fallers than controls (39.3 and 30.4, respectively, P<0.001). Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly. The following fall risk factors were examined for differences between groups (fallers vs. non-fallers): age, body mass index, depression, fear of falling, neuropathy, number of medications, sedentary behavior, and visual co-morbidities. [26] A random-effect model was used to calculate pooled ORs in the case of significant heterogeneity (P < .10 or I2 > 50%); otherwise, a fixed-effect model was used. Last Reviewed: May 12 . Sci. This makes sense in view of a systematic review and meta-analysis that reported that cognitive impairment was associated with falls, injurious falls, and distal radius fractures22. [2]. [59]. According to practice guidelines from various organizations, you should have a fall risk assessment at least once a year. Minimize your risk of falling or hurting yourself. Advertising on our site helps support our mission. Drugs Aging 26, 847852 (2009). Second, it is difficult to completely distinguish the effects of comorbidities, related medications, and laboratory results. Too little blood reaches the brain. Laboratory tests included complete blood count, blood urea nitrogen, creatinine, serum electrolytes, glucose, hemoglobin A1c, aspartate aminotransferase (AST), alanine aminotransferase (ALT), protein, and albumin. The authors have no conflicts of interests to disclose. To prevent older patients from accidentally falling while hospitalized, it is necessary to assess the risk of falls and accordingly provide the necessary interventions. Yau, R. K. et al. Additionally, they demonstrated that the presence of hyponatremia and leukocytosis on admission increased the risk of falls11. Comparisons of receiver operating characteristic curves. Switch medication or reduce the dose of any medications that increase fall risk. Consequences of Falls; Slide 12a. Each year, approximately 30% to 40% of people aged 65 years and older who live in the community fall. BMJ 315, 10491053 (1997). Oliver, D., Britton, M., Seed, P., Martin, F. C. & Hopper, A. H. Development and evaluation of evidence-based risk assessment tool (STRATIFY) to predict which elderly inpatients will fall: case-control and cohort studies. [79] Pain and disability often persist following the total joint arthroplasty (TJA) surgery which may predispose to increased risk of falling. Safarpour M, Hosseini SR, Mohamadzade M, et al. We excluded patients admitted to psychiatric wards (n=23) and those who did not match the control characteristics (n=18), resulting in 210 fallers being eligible for this study. [40] There were many physiological characteristics for postmenopausal women, such as somatosensory retardation, mineral deficiencies and autonomic nervous dysfunction, meanwhile the risk of cardiovascular and cerebrovascular diseases and cerebellar function degeneration also increase the risk of falls for elderly women. If youre 65 or older, talk to your healthcare provider about having a comprehensive fall risk assessment. For more information, please refer to our Privacy Policy. Postoperative falls incidence was consistently higher in those who had falls history compared with those who did not. Lancet 2011;377:211526. Having less pigment (melanin) in your skin means you have less protection from damaging UV radiation. Common Types of Falls in the Elderly Population, Their Associated Risk Assoc. Swinkels A, Newman JH, Allain TJ. However, there was no significant difference between the groups based on medication changes on the day before falls (P=0.099). From January 2016 through December 2018, 369 inpatient falls occurred in the study hospital. For example, in the United States of America, 20-30% of older people who fall suffer moderate to severe injuries such as bruises, hip fractures, or head trauma. Comorbidities and impairments explaining the association between diabetes and lower extremity disability: The Women's Health and Aging Study. Five studies reported diabetes. 108, 174179 (2013). Activities of daily living decrease similarly in hospital-treated patients with a hip fracture or a vertebral fracture: a one-year prospective study in 151 patients. Risk factors. First, the setting was a single Korean tertiary hospital, which might not be representative of the general population. The present study aimed to quantitatively and comprehensively conclude the risk factors of falls after TJA in elderly patients. Curcio CL, Gomez F, Reyesortiz CA. Advancing age is the most important risk factor for cancer overalland for many individual cancer types. Soc. Clin Interv Aging 2013;8:156976. Drug-related falls in older patients: implicated drugs, consequences Fall Risk Assessment: MedlinePlus Medical Test In addition, we analyzed risk-discriminative performances between the MFS alone and MFS plus clinical factors. Fear of falling and restriction of mobility in elderly fallers. Risk factors and characteristics of falls among hospitalized adult patients with hematologic diseases. Meta-analysis of these studies showed that overweight patients appeared more prone to falling (OR 1.18, 95% CI 1.081.29; Table 2; Fig. Sci. It is called a "silent disease" because people who develop it may not notice any changes until a bone breaks usually a bone in the hip, spine, or wrist. Epidemiology of Fracture Risk With Advancing Age Hung WW, Ross JS, Boockvar KS, et al. CAS All the data were carefully extracted from all eligible studies independently by the 2 reviewers (Xintao Wu and Hao Liu). Morse, J. M. The safety of safety research: the case of patient fall research. [45] However, some studies stated that experience of fall alone cannot limit physical activity and predict fall effectively. The measurements of various risk factors differed from each other, and follow-up periods ranged widely from several months to several years Nevertheless, the 2 reviewers evaluated the identified studies independently and any disagreement was resolved by discussion and consensus. J. Adv. Your healthcare provider might ask you whether you: If you answer yes to any of these questions, your healthcare provider will recommend an additional, more thorough evaluation. Fall predictors beyond fall risk assessment tool items for acute hospitalized older adults: a matched casecontrol study. to maintaining your privacy and will not share your personal information without Risk factors of falls following TKA have been attributed to several factors such as falls history, higher preoperative depression, and persistence of impaired lower limb proprioception postoperatively. Potential publication bias was detected by Beggs funnel plots, and P < .05 was judged as statistically significant. The facility provides medical services in 33 departments including internal medicine, family medicine, general surgery, neurology, orthopedics, urology, otorhinolaryngology, ophthalmology, pediatrics, psychiatrics, and obstetrics and gynecology. [3,4], Falls in the elderly have become a serious social problem,[5,6] and lower limb OA is also a major risk for falls with up to 50% reporting falling each year, which almost double the 33% reported in dwelling ageing people. Diabetes Care 36, 39853991 (2013). For older adults, falls can be dangerous: 1 in 5 falls causes a serious injury, such as broken bones or a head injury. Scientific Reports (Sci Rep) Related prophylaxis strategies should be implemented in elderly patients involved with above-mentioned risk factors to prevent falls after TJA. Both number of total medications and FRID were higher in fallers than controls (all P<0.001). Rittenhouse, K. J. et al. -If you base a patient's individualized care plan on their fall risk score alone, their care plan will not be tailored to their risk factors. Canovas F, Dagneaux L. Quality of life after total knee arthroplasty. The following fall risk factors were examined for differences between groups (fallers vs. non-fallers): age, body mass index, depression, fear of falling, neuropathy, number of medications, sedentary behavior, and visual co-morbidities. . Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. J. [17]. This study examined the indoor and outdoor environmental risk factors for falls and compared the data for men and women among U.S. older adults using nationally representative data. Only full-text articles without language restriction were included in this meta-analysis. Three studies have investigated falls in the pre or postoperative period for TJA patients, which providing new insights into the factors that likely lead to falls. Falls are common in the aged with potential severe consequences. In adults with advanced cancer, we aimed to prospectively document the incidence of falls, identify the risk factors, and determine if falls in this population occur predominantly in older patients. [53]. MathSciNet To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Falls occur more often with advancing age. Muscle weakness and, [40]. Data is temporarily unavailable. According to the most recent statistical data from NCIs Surveillance, Epidemiology, and End Results (SEER) Program, the median age of a cancer diagnosis is 66 years. Type of fall and risk of hip and wrist fractures: the study of . Hypertension 2003;16:A222. Several types of drugs have been associated with an increased fall risk. [26]. Ethgen O, Bruyre O, Richy F, et al. In this manner, 251 fallers were identified. Fall Prevention: Patient-Centered Outcomes - @ASHA Fall predictors beyond fall risk assessment tool items for acute hospitalized older adults: a matched casecontrol study, https://doi.org/10.1038/s41598-021-81034-9. [54]. Finally, although we considered comprehensive factors, the AUC of the final model was 0.726, which is not very high, indicating that there is a need for further research to identify other possible fall-related factors. All analyses were performed by the software Stata 11.0 (Stata Corporation, College Station, TX). Many different conditions can increase your risk of falling, such as: In addition, certain treatments, lifestyle habits and other factors can raise your risk as well: A fall risk assessment may include several steps. After inclusion and exclusion criteria were applied, 14 full text articles were chosen for this meta-analysis. Oncol. [50]. Clinical comorbidity in patients with osteoarthritis: a case-control study of general practice consulters in England and Wales. Wedmann, F., Himmel, W. & Nau, R. Medication and medical diagnosis as risk factors for falls in older hospitalized patients. Cite this article. Internet Explorer). A total of 14 studies were included, which altogether included 1284456 patients with TJA, of them 12879 cases of falls occurred after surgery, suggesting the accumulated incidence of 13.1% and the prevalence of in-hospital falls was 1.0%. Geriatr. at the National Institutes of Health, An official website of the United States government, Cancer Stat Facts for Common Cancer Types, U.S. Department of Health and Human Services.
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