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Fall Rate (fall + rate)

Distribution by Scientific Domains

Medical Sciences	88%

Selected Abstracts

Differing Risk Factors for Falls in Nursing Home and Intermediate-Care Residents Who Can and Cannot Stand Unaided

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2003
Stephen R. Lord PhD
Objectives: To determine fall risk factors in nursing home and intermediate-care residents who can and cannot stand unaided. Design: Prospective cohort study. Setting: Residential elderly care facilities in Sydney, Australia. Participants: One thousand people aged 65 to 103 (mean age ± standard deviation: 85.0 ± 7.4). Measurements: Accidental falls. Results: Fall rates were highest in those with fair standing balance, intermediate in those with the best standing balance, and lowest in those with the worst standing balance. This nonlinear pattern was even more striking when subjects were categorized according to their standing balance and ability to rise from a chair. Using this dual classification, fall rates were highest in those who could rise from a chair but could not stand unaided (81%) and lowest in those who could neither rise from a chair nor stand unaided (48%). In residents who could stand unaided, risk factors included increased age, male sex, higher care classifications, incontinence, psychoactive medication use, previous falls, and slow reaction times. In contrast, quite different risk factors were evident in residents who could not stand unaided, with a number of known fall risk factors (previous stroke, reduced ability to rise from a chair, slow reaction times) being associated with fewer falls. In this group, risk factors were intermediate versus nursing home care, poor health status, psychoactive medication use, Parkinson's disease, previous falls, and being able to get out of a chair. Conclusion: The findings indicate that there are different risk factors for falls for people living in residential aged care facilities who can and cannot stand unaided. These findings provide important information for developing fall-prevention strategies and suggest that those who can stand unaided but have multiple falls risk factors constitute the highest priority group for such interventions. [source]

Identifying interacting predictors of falling among hospitalized elderly in Japan: A signal detection approach

GERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 2 2007
Atsuko Nabeshima
Falling is a complex phenomenon that involves interaction of multiple risk factors. The authors analyzed factors related to falls in a geriatric hospital to elucidate interaction of multiple risk factors for falls in elderly inpatients. Subjects were 364 patients (mean age, 81.7; women 76.7%) who were aged 60 years and over and had been hospitalized for more than 6 months between April 2000 and March 2001. A signal detection model was used to identify baseline variables that best divided the sample into subgroups using incidence of falling as an outcome variable. During a follow-up period, 91 patients (25%) had at least one incident of fall. Out of 14 independent variables, a higher-order interaction consisting of six significant variables was identified. Consequently, the subjects were categorized into seven subgroups whose fall rate varied 5.7,80.9%. We found that the combination of non-bedridden state, dementia, and medication of tranquilizers or sleeping drugs was the highest fall rate (80.9%). Signal detection analysis is useful to identify the combination of multiple risk factors of falling, and applicable to develop prevention programs for each subgroups. [source]

Risk factors for falling in a psychogeriatric unit

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 8 2001
A. John de Carle
Abstract Objective To identify risk factors associated with falls in a psychogeriatric inpatient population. Design Retrospective cohort study. Setting A psychogeriatric inpatient unit in a Brown University affiliated psychiatric hospital. Participants A total of 1834 men and women who represented all admissions to the psychogeriatric inpatient unit between January 1992 and December 1995. Results Over the study period a total of 175 falls were recorded, giving a fall rate of 9.5%. Using a logistic regression model, six variables were found to be independently associated with an increased risk of falling: female gender, electroconvulsive therapy (ECT), mood stabilizers, cardiac arrhythmias, Parkinson's syndrome and dementias. Falls and ECT were associated with longer hospital stay, when adjusted for confounders including ECT. Conclusions These findings support previous results and identify ECT as a possible risk factor for falling in a hospital setting. Copyright © 2001 John Wiley & Sons, Ltd. [source]

Effective assessment of use of sitters by nurses in inpatient care settings

JOURNAL OF ADVANCED NURSING, Issue 2 2008
Huey-Ming Tzeng
Abstract Title.,Effective assessment of use of sitters by nurses in inpatient care settings Aim., This paper is a report of the evaluation of the impact of adopting the Patient Attendant Assessment Tool (PAAT) on nurses' requests for sitters, use of restraints, and falls and fall injury rates. Background., Staffing should be the primary issue in eliminating risks of patient falls during hospital stays. Method., Data were collected in two acute adult medical units of a Michigan hospital from August 2005 to February 2007. Data from three sources were merged for analyses: (1) study units' monthly reports; (2) quarterly reports of the National Database of Nursing Quality Indicators and (3) PAAT reports collected from October 2006 to February 2007. The primary outcome variables were the use of sitters, number of restraints ordered and fall and fall injury rates. Independent t -tests and correlation analyses were used for data analyses. The data before and after adopting this tool were compared using independent t -tests. Findings., The PAAT helped improve the fill/request rates for sitters. The use of soft limb holders decreased after adoption of this tool. The results also showed that if the number of sitter requests was higher, the total number of restraints would be lower but the total fall rate would be higher. Conclusion., Hospitals should include a tool similar to the PAAT in guidelines related to provision of constant observation or use of sitters. Further investigations of the optimum combination of staffing patterns and infrastructure are needed to promote safer hospital stays. [source]

An 8-Year Prospective Study of the Relationship Between Cognitive Performance and Falling in Very Old Adults

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2006
Kaarin J. Anstey PhD
OBJECTIVES: To determine whether cognitive performance, as distinct from cognitive impairment, predicts falling during an 8-year follow-up in a community-based sample of very old adults and to evaluate how cognitive change is associated with falling. DESIGN: Prospective cohort study including three waves of data collected in 1992, 1994, and 2000. SETTING: Population based, with the baseline sample drawn from the electoral roll. PARTICIPANTS: Inclusion criteria were completion of at least three cognitive tests at baseline and completion of the falls questionnaire at Wave 6 (N=539). MEASUREMENTS: Assessments of health and medical conditions, visual acuity, cognitive function, functional reach, semitandem stand, and grip strength were conducted in 1992 (baseline), 1994, and 2000. Self-report information on falls in the previous 12 months was obtained on each of these occasions. Marginal models using generalized estimating equations were used to assess the association between baseline cognitive performance and falling over 8 years, adjusting for sociodemographic, health, and sensorimotor variables. Random effects models were used to assess the relationship between change in cognitive performance and change in fall rate and fall risk over 8 years. RESULTS: Mini-Mental State Examination and verbal reasoning at baseline predicted rate of falling over an 8-year period. Within individuals, declines in verbal ability, processing speed, and immediate memory were associated with increases in rates of falling and fall risk. CONCLUSION: Cognitive performance is associated with falling over 8 years in very old adults and should be assessed in clinical practice when evaluating short- and long-term fall risk. [source]

Association of SLC6A12 variants with aspirin-intolerant asthma in a Korean population

ANNALS OF HUMAN GENETICS, Issue 4 2010
Charisse Flerida A. Pasaje
Summary Aspirin-intolerant asthma (AIA) occurs from asthma exacerbation after exposure to aspirin. However, the underlying mechanisms of AIA occurrence are still unclear. The critical role of the solute carrier family 6 (neurotransmitter transporter, betaine/GABA) member 12 (SLC6A12) gene in GABAergic transmission, which is associated with mucus production in asthma, makes it a candidate gene for AIA association study. Eight single nucleotide polymorphisms (SNPs) in SLC6A12 were genotyped in 163 aspirin-intolerant asthma (AIA) and 429 aspirin-tolerant asthma (ATA) patients of Korean ethnicity. Associations between polymorphisms of SLC6A12 and AIA were analysed using multivariate logistic analysis. Results showed that two polymorphisms and a haplotype in SLC6A12, rs499368 (P= 0.005; Pcorr= 0.03), rs557881 (non-synonymous C10R, P= 0.007; Pcorr= 0.04), and SLC6A12_BL1_ht1 (P= 0.009; Pcorr= 0.05) respectively, were significantly associated with AIA after multiple testing corrections. In addition, SNPs of SLC6A12 were significantly associated with the fall rate of FEV1 by aspirin provocation suggesting that SLC6A12 could affect reversibility of lung function abnormalities in AIA patients. Although these results are preliminary and future replications are needed to confirm these findings, this study showed evidence of association between variants in SLC6A12 and AIA occurrence among asthmatics in a Korean population. [source]

Dynamic Balance and Stepping Versus Tai Chi Training to Improve Balance and Stepping in At-Risk Older Adults

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 12 2006
Joseph O. Nnodim MD
OBJECTIVES: To compare the effect of two 10-week balance training programs, Combined Balance and Step Training (CBST) versus tai chi (TC), on balance and stepping measures. DESIGN: Prospective intervention trial. SETTING: Local senior centers and congregate housing facilities. PARTICIPANTS: Aged 65 and older with at least mild impairment in the ability to perform unipedal stance and tandem walk. INTERVENTION: Participants were allocated to TC (n= 107, mean age 78) or CBST, an intervention focused on improving dynamic balance and stepping (n=106, mean age 78). MEASUREMENTS: At baseline and 10 weeks, participants were tested in their static balance (Unipedal Stance and Tandem Stance (TS)), stepping (Maximum Step Length, Rapid Step Test), and Timed Up and Go (TUG). RESULTS: Performance improved more with CBST than TC, ranging from 5% to 10% for the stepping tests (Maximum Step Length and Rapid Step Test) and 9% for TUG. The improvement in TUG represented an improvement of more than 1 second. Greater improvements were also seen in static balance ability (in TS) with CBST than TC. CONCLUSION: Of the two training programs, in which variants of each program have been proven to reduce falls, CBST results in modest improvements in balance, stepping, and functional mobility versus TC over a 10-week period. Future research should include a prospective comparison of fall rates in response to these two balance training programs. [source]