			Home About us Contact

Home Hazards (home + hazard)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

The physical environment as a fall risk factor in older adults: Systematic review and meta-analysis of cross-sectional and cohort studies

AUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 1 2010
Lori Letts
Background/aim:,Evidence that the physical environment is a fall risk factor in older adults is inconsistent. The study evaluated and summarised evidence of the physical environment as a fall risk factor. Methods:,Eight databases (1985,2006) were searched. Investigators evaluated quality of two categories (cross-sectional and cohort) of studies, extracted and analysed data. Results:,Cross-sectional: falls occur in a variety of environments; gait aids were present in approximately 30% of falls. Cohort:,Home hazards increased fall risk (odds ratio (OR) = 1.15; 95% confidence interval (CI): 0.97,1.36) although not significantly. When only the high quality studies were included, the OR = 1.38 (95% CI: 1.03,1.87), which was statistically significant. Use of mobility aids significantly increased fall risk in community (OR = 2.07; 95% CI: 1.59,2.71) and institutional (OR = 1.77; 95% CI: 1.66,1.89) settings. Conclusions:,Home hazards appear to be a significant risk factor in older community-dwelling adults, although they may present the greatest risk for persons who fall repeatedly. Future research should examine relationships between mobility impairments, use of mobility aids and falls. [source]

Effectiveness of a Falls-and-Fracture Nurse Coordinator to Reduce Falls: A Randomized, Controlled Trial of At-Risk Older Adults

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2008
(See editorial comments by Dr. Mary Tinetti on pp 156, 1565)
OBJECTIVES: To assess the effectiveness of a community-based falls-and-fracture nurse coordinator and multifactorial intervention in reducing falls in older people. DESIGN: Randomized, controlled trial. SETTING: Screening for previous falls in family practice followed by community-based intervention. PARTICIPANTS: Three hundred twelve community-living people aged 75 and older who had fallen in the previous year. INTERVENTION: Home-based nurse assessment of falls-and-fracture risk factors and home hazards, referral to appropriate community interventions, and strength and balance exercise program. Control group received usual care and social visits. MEASUREMENTS: Primary outcome was rate of falls over 12 months. Secondary outcomes were muscle strength and balance, falls efficacy, activities of daily living, self-reported physical activity level, and quality of life (Medical Outcomes Study 36-item Short Form Questionnaire). RESULTS: Of the 3,434 older adults screened for falls, 312 (9%) from 19 family practices were enrolled and randomized. The average age was 81±5, and 69% (215/312) were women. The incidence rate ratio for falls for the intervention group compared with the control group was 0.96 (95% confidence interval=0.70,1.34). There were no significant differences in secondary outcomes between the two groups. CONCLUSION: This nurse-led intervention was not effective in reducing falls in older people who had fallen previously. Implementation and adherence to the fall-prevention measures was dependent on referral to other health professionals working in their usual clinical practice. This may have limited the effectiveness of the interventions. [source]

A Randomized Trial of a Multicomponent Home Intervention to Reduce Functional Difficulties in Older Adults

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2006
Laura N. Gitlin PhD
OBJECTIVES: To test the efficacy of a multicomponent intervention to reduce functional difficulties, fear of falling, and home hazards and enhance self-efficacy and adaptive coping in older adults with chronic conditions. DESIGN: A prospective, two-group, randomized trial. Participants were randomized to a treatment group or no-treatment group. SETTING: Urban community-living older people. PARTICIPANTS: Three hundred nineteen community-living adults aged 70 and older who reported difficulty with one or more activities of daily living. INTERVENTION: Occupational and physical therapy sessions involving home modifications and training in their use; instruction in strategies of problem-solving, energy conservation, safe performance, and fall recovery techniques; and balance and muscle strength training. MEASUREMENTS: Outcome measures included self-rated functional difficulties with ambulation, instrumental activities of daily living, activities of daily living, fear of falling, confidence performing daily tasks, and use of adaptive strategies. Observations of home hazards were also conducted. RESULTS: At 6 months, intervention participants had less difficulty than controls with instrumental activities of daily living (P=.04, 95% confidence interval (CI)=,0.28,0.00) and activities of daily living (P=.03, 95% CI=,0.24 to ,0.01), with largest reductions in bathing (P=.02, 95% CI=,0.52 to ,0.06) and toileting (P=.049, 95% CI=,0.35,0.00). They also had greater self-efficacy (P=.03, 95% CI=0.02,0.27), less fear of falling (P=.001, 95% CI=0.26,0.96), fewer home hazards (P=.05, 95% CI=,3.06,0.00), and greater use of adaptive strategies (P=.009, 95% CI=0.03,0.22). Benefits were sustained at 12 months for most outcomes. CONCLUSION: A multicomponent intervention targeting modifiable environmental and behavioral factors results in life quality improvements in community-dwelling older people who had functional difficulties, with most benefits retained over a year. [source]

Longitudinal study of the Home Falls and Accidents Screening Tool in identifying older people at increased risk of falls

AUSTRALASIAN JOURNAL ON AGEING, Issue 2 2009
Lynette Mackenzie
Aim:, To evaluate the predictive validity and responsiveness of the Home Falls and Accidents Screening Tool (HOME FAST). Methods:, A prospective study of 727 community dwelling Veterans and war widows aged 70 years and over. The outcome was 6-month recall of any fall at 3-year follow-up. Baseline measurements were taken of common falls risk factors, and home hazards (using the HOME FAST). Changes in the prevalence of HOME FAST items were calculated and a logistic regression model was computed to determine predictors of falls at follow-up. Results:, Prevalence of 14 HOME FAST items was significantly reduced from baseline to follow-up (P , 0.05). Falls were significantly related to the baseline HOME FAST score (odds ratio (OR) 1.016, 95% confidence interval (CI) 1.004,1.098, P = 0.006), and a reduction in home hazards at follow-up (OR 0.984, 95% CI 0.973,0.996, P = 0.02). Conclusion:, The HOME FAST can predict falls in older people and is responsive to change. [source]