Study objectives: Depression and falls are two common conditions that impair the health of older people. Both are relatively underdiagnosed and undertreated problems in primary care. The study objective was to investigate whether there was a common set of risk factors that could predict an increased risk of both falls and depression. Design: This was a cohort study drawn from a primary care clinic, with a one year follow up. Dependent measures included: reporting two or more falls in the past year and a score of 7 or over on the S-GDS (Short Geriatric Depression Scale). A parsimonious set of risk factors was selected that predicted both outcomes based on a series of discriminant function analyses. Participants and setting: The setting was a primary care clinic serving a mixed socioeconomic population, in Beer Sheva, Israel. The sample included 283 General Sick Fund members, aged 60 and over, who completed both baseline assessments and one year follow up interviews. Main results: At the one year follow up, 12% of the sample reported frequent falls in the past year and 25.5% of the sample screened positive for depressive symptoms. A set of five risk factors that included: poor self rated health, poor cognitive status, impaired ADL, two or more clinic visits in the past month, and slow walking speed (>10 seconds over five metres) was successful at discriminating between fallers and non-fallers (86% discrimination) and between those with and without depressive symptoms (76%). For every risk factor added, there was a significant increase in the proportion of respondents who had depressive symptoms. A similar result was found for falls. Conclusions: These results show that there is a common set of risk factors that increase the risk of two common outcomes in geriatric medicine, falls and depression. For a general practitioner or a geriatric physician, it might be easier to detect these risk factors than to diagnose depression or high risk for falls. When these risk factors are detected in patients the physician can then be more active in direct probing about depression and falls. F alls and depression are common problems in the elderly that generally escape detection and therefore go untreated in primary care.1 2 There is a consensus, however, that their prevention and treatment could greatly benefit the health and wellbeing of the elderly population.3 The development of a clearer understanding of their causes would help to formulate more effective means of prevention and treatment.The reported prevalence of mild depressive symptoms among community dwelling elderly people over the age of 65 is between 15%-20% 4 5 although prevalence of major depressive disorders is only 2%-5%. 4 The vast majority of elderly people, an estimated 80%, who suffer from symptoms of depression will not receive any treatment. 6Falls are also a common problem among elderly people; approximately 30% of those over 65 will fall each year, with rates rising with increasing age reaching about 40% in those over age 80.7 While most falls do not resu...

Falls are the most common type of injury among the elderly, and the source of both functional and psychological morbidity. The aim of this study was to validate the Elderly Fall Screening Test (EFST). In a community primary-care clinic, the members 60 years or older who were functionally independent were screened. Of the 568 elderly persons who met these criteria, 361 were interviewed once and 283 persons were re-interviewed a year later. The EFST, a five-item test, was used to divide participants into low- and high-risk groups. Concurrent criterion validity was assessed by physical examinations conducted by physicians who were blind as to the risk designation. Using data from the follow-up interview, predictive validity was assessed on both fall-related and general health measures. Based on the results of the EFST, 28% of the respondents were designated as being at high risk for falls (i.e. having a score of two or more risk items). The results of physicians' examinations corroborated the screening test results in 75% of the cases, with 83% sensitivity and 69% specificity. In the follow-up interview, the high-risk group, as compared to the low-risk group, was more likely to have high scores on EFST, a fall in the past month or year, frequent near falls, and an injurious fall. Those with high EFST scores were more likely to report four or more sick days in the past six months, a hospitalization in the past year, poor self-rated health, a decline in health in the past 6 months, and symptoms of depression. The EFST has both criterion and predictive validity. It can be useful in community-based prevention programmes with functionally independent elderly people.

This study evaluated short-and long-term effects of courses in gerontology and geriatrics on changes in knowledge, attitudes, and work preferences among medical, nursing, and social work students in Israel. The results showed that nursing and social work students increased their knowledge measured by Palmore's Facts on Aging Quiz. No significant changes were found in the level of knowledge of medical students and in the attitudes and work preferences of any of the studied groups. No correlation was found among knowledge, attitudes, and work preferences within each of the three groups, which implies that increased knowledge about the elderly does not necessarily lead to changes in negative attitudes and work preferences. Formal lectures appear to be a more effective way of transmitting knowledge than group discussions and contact with older persons.

BackgroundThe annual Scientific Meeting of the Canadian Association on Gerontology was held on October 24 and 25, 2008 in London, Ontario. Prior to the annual meeting, mobility and cognition experts met on October 23, 2008 to engage in a pre-conference workshop.MethodsDiscussions during the workshop addressed novel areas of research and knowledge and research gaps pertaining to the interaction between mobility and cognition in seniors.ResultsWorkshop presenters moved from the neuromuscular, biomechanics, and neurology of gait impairments, and falls through the role of cognition and mood on mobility regulation to the whole person in the environment. Research gaps were identified.ConclusionsDespite a consensus that mobility and cognition are increasingly correlated as people age, several gaps in our understanding of mechanisms and how to assess the interaction were recognized. The gaps originally identified in 2008 are still pertinent today. Common and standardized assessments for “mobility and cognition” are still not in place in current practice. Interventions that target mobility and cognitive decline as a single entity are still lacking.

A case-control study was performed to evaluate factors associated with successful rehabilitation in elderly patients who sustained hip fractures. All 170 patients with fractured hips hospitalized in the geriatrics ward of the Soroka Medical Center in Beer-Sheva, Israel between 1987 and 1991 were studied. Success of rehabilitation was determined by staff evaluation of the patient's ability to walk and perform activities of daily living. The independent variables, including sociodemographic and medical variables, and mental and functional assessments, were assessed by chart reviews, staff evaluation and mental tests. One-hundred and twenty-nine patients (75.9%) were successfully rehabilitated. A normal mental state (p < 0.0001), female gender (p < 0.02) and absence of diabetes mellitus (p < 0.008) were associated significantly with successful rehabilitation.