Archives of gerontology and geriatrics
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Arch Gerontol Geriatr · Jan 2015
Depressive symptoms increase fall risk in older people, independent of antidepressant use, and reduced executive and physical functioning.
Depressive symptoms and antidepressant use are associated with greater fall risk in older people. This prospective study investigated interactions between depressive symptoms, antidepressant use and physical and cognitive function measures in relation to injurious or multiple falls in a large sample of community-living older people. Four-hundred and eighty-eight community-dwelling older people aged 70 years and over, underwent a comprehensive psychological, cognitive and physiological assessment and were prospectively monitored for falls over a 12-month follow up period. ⋯ Fall risk increased with the number of risk factors present: i.e. by 55% in participants with any two risk factors (RR=1.55; 95% CI=1.17-2.04) and by 144% in participants with three or four risk factors (RR=2.44; 95% CI=1.75-3.43). The study findings indicate that higher depressive symptoms and antidepressant use predict falls over 12-months, independent of reduced executive and physical functioning. Treatment of depressive symptoms using non-pharmacological approaches should be considered as part of fall prevention programs, especially in populations at high risk of falls.
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Arch Gerontol Geriatr · Nov 2014
Gender differences in the clinical characteristics of traumatic spinal fractures among the elderly.
In order to illustrate the epidemiology of traumatic spinal fractures among the elderly, with an emphasis on exploring gender differences in clinical characteristics, we retrospectively reviewed hospital records on all elderly patients with traumatic spinal fractures who were 60 years of age or older at two university-affiliated hospitals between January 2001 and December 2010. A total of 642 elderly patients with traumatic spinal fractures were identified, of whom 249 were male and 393 were female. Accidental falls from low heights were the most common cause of traumatic spinal fractures among the elderly (50.8%). ⋯ Frequencies of cervical spinal fractures, spinal cord injuries, associated non-spinal injuries (ASOIs) and mean injury severity scores (ISSs) were significantly higher in males than in females (P<0.05). Frequencies of thoracic and thoracolumbar spinal fractures in females were significantly higher than in males (P<0.05). Clinicians should make their diagnoses and direct their injury prevention strategies according to gender differences in the clinical characteristics of traumatic spinal fractures among the elderly.
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Arch Gerontol Geriatr · Nov 2014
Inflammatory mediators, muscle and functional performance of community-dwelling elderly women.
The purpose of this study was to investigate the correlation and association between inflammatory mediators and muscle and functional performance in elderly women. We conducted a cross-sectional study. Plasma concentrations of interleukin-6 (IL-6) and soluble receptor for tumor necrosis factor alpha (sTNFR1) were determined by enzyme-linked immune sorbent assay. ⋯ For the average power of knee flexors, the final model showed that the factors IL-6 and level of physical activity explained 4.1% (R(2)=0.041, p<0.01). There was no negative correlation between inflammatory mediators and muscle or physical performance in elderly women. These results may be explained by the fact that the cytokine levels did not reach the threshold needed to influence the muscle tissue and functionality of the participants.
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Arch Gerontol Geriatr · Sep 2014
Sarcopenia and falls in community-dwelling elderly subjects in Japan: Defining sarcopenia according to criteria of the European Working Group on Sarcopenia in Older People.
This study assessed the association between sarcopenia (using the definition of the European Working Group on Sarcopenia in Older People) and fall in the past year among community-dwelling Japanese elderly. Subjects were 1110 community-dwelling Japanese aged 65 or older. We used bioelectrical impedance analysis (BIA) to measure muscle mass, grip strength to measure muscle strength, and usual walking speed to measure physical performance in a baseline study. "Sarcopenia" was characterized by low muscle mass and low muscle strength or low physical performance. "Presarcopenia" was characterized only by low muscle mass. ⋯ The odds ratio for fall in the sarcopenia group relative to the normal group was 4.42 (95%CI 2.08-9.39) in men and 2.34 (95%CI 1.39-3.94) in women. This study revealed sarcopenia to be associated with falling in elderly Japanese. Sarcopenia prevention interventions may help prevent falls among elderly individuals.
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Arch Gerontol Geriatr · Sep 2014
Randomized Controlled Trial Comparative StudyA randomized trial comparing Tai Chi with and without cognitive-behavioral intervention (CBI) to reduce fear of falling in community-dwelling elderly people.
The aim of this randomized trial was to compare the effects of Tai Chi with and without CBI on a primary outcome of reducing the fear of falling, and on secondary outcomes including encouraging better social engagement, improving self-perceived personal wellbeing, and achieving better mobility among elderly people with fear of falling. One hundred and twenty-two community-dwelling elderly people aged ≥ 65 were randomly assigned to either a Tai Chi or a Tai Chi plus CBI group. Participants' level of fear of falling, physical mobility, self-perceived personal wellbeing and social participation were compared before and after completing the 8-week intervention and then at a 2-month follow-up. ⋯ Apart from a slight improvement in participants' self-perceived personal wellbeing, other outcome effects were similar for Tai Chi with and without CBI. This finding raises a question about the additive effects of combined intervention over Tai Chi alone in reducing elderly people's fear of falling. In view of the higher demand for resources and manpower to implement a combined intervention, further study is still required to confirm the potential additional benefits of this combined intervention prior to recommending it to community services.