OBJECTIVE: To estimate the prevalence of falls in elderly individuals and to analyze associated factors. METHODS: Cross-sectional study with 420 elderly subjects (aged 60 years or older) living in the city of Juiz de Fora (Southeastern Brazil) in 2010. A household survey was conducted and the occurrence of falls in the 12 previous months was described. For the analysis of factors associated with the outcome, a theoretical determination model with three hierarchical blocks was built. The variables were adjusted among each other within each block; those with level of signifi cance ≤ 0.20 were included in the Poisson regression model and adjusted to the immediately higher level, with 5% signifi cance level. RESULTS: The prevalence of falls among the elderly was 32.1% (95%CI: 27.7; 36.9). Among those who experienced falls, 53% had a single fall and 19% had fractures as a consequence. Most of the falls (59%) occurred at the elderly person's home. The occurrence of falls was associated with old age, female sex, need of help for locomotion and self-reported diagnosis of osteoporosis. CONCLUSIONS: Falls are frequent among the elderly. Knowledge of the factors associated with the occurrence of this event can aid the development of prevention strategies and adequate health services.

Associations between walking speed and other variables have been investigated in a group of 67 women and 58 men aged between 65 and 90 years and living independently. In men, walking speed was related positively to calf strength, step-score (a measure of customary physical activity), hours spent in active leisure, height and weight, and negatively to age and the presence of health problems. In women, the relations were the same, with the exception of weight, and reported leg pain was negatively associated with walking speed. Multiple regression analysis showed that in men 44% of the variance in walking speed was accounted for by height, calf strength and the presence of health problems, and that in women 42% of the variance was accounted for by height, calf strength, step-score and the presence of leg pain limiting mobility. The significance of these findings to maintenance and improvement of walking speed in the elderly is discussed.

1. Objective measurements of the maximal voluntary strength of triceps surae and the amount and speed of customary walking have been made in 56 men and 66 women aged over 65 years, who were living independently. 2. Strength was measured using a dynamometer based upon a hydraulic system (Bourdon tube). Walking was assessed, for amount using a mechanical accelerometer (pedometer) over a week, and for speed using a self-paced test for normal walking over 100 m on the level. The reliability and validity of these methods has been described. 3. The men were significantly stronger (1128 +/- 206 vs 873 +/- 177 N) even after adjustment for body weight; their amount of walking was similar to that of women, but they walked significantly faster (4.8 +/- 0.6 vs 4.2 +/- 0.6 km/h). Men were significantly more active in leisure pursuits (as assessed by questionnaire). 4. Significant associations between strength and chosen normal walking speed were found for both sexes (r = 0.41, P less than 0.001 for men and r = 0.36, P less than 0.01 for women). The amount of walking (daily stepscore as a mean from 7 consecutive days recorded) was significantly but less strongly correlated with strength (r = 0.30, P less than 0.05) in the men only. 5. Multiple regression analysis showed that in men neither age nor amount of walking had any further effect in addition to speed, but in women age had an additional effect (multiple R = 0.48). 6. An association has been demonstrated which raises the possibility of reversing loss of muscle strength through increased daily activity.

Muscle strength, overlying skinfold thickness and calculated muscle area for the triceps surae muscle of the calf and the biceps brachii of the upper arm are described in 184 subjects (100 female, 84 male) aged between 65 and 90 years. The group comprised mobile volunteers, living independently, from a large group-practice. Health screening was minimal. Relationships between anthropometric and strength variables are explored and compared with other studies. This was apparently a well-nourished group. Muscle strengths and areas were low compared to younger subjects. Strength in relationship to area was variable, lower than in the younger subjects and also lower in the females than the males. Strength of the calf compared to body weight fell below unity in some cases.

The yeast Candida albicans causes life-threatening candidemia. A general-purpose genotype (GPG; corresponds to clade 1) causes more infections than other C. albicans genotypes. To investigate if GPG strains also cause higher mortality, we developed a duplex PCR assay which was 98% accurate in identifying GPG strains in an international collection of strains typed with probe Ca3. We applied the assay to 635 European C. albicans candidemia isolates. Of these, 18% conformed to the GPG genotype, 4% were of a borderline genotype, and 78% were of a non-GPG genotype, broadly consistent with genotype distributions in earlier studies. The prevalence of GPG strains was increased in females and in younger patients, exceeding 40% in infants aged <1 year. Logistic regression confirmed sex and age as significant determinants of GPG prevalence. Across the entire patient cohort, there was no difference in mortality for patients infected with GPG strains or other strains (36% versus 37%). However, mortality in patients aged <48 years was 33% for infection with GPG strains but only 15% for infection with other strains (z test; P < 0.01). Mortality rates associated with GPG and non-GPG strains were comparable in older patients (39% versus 46%). A logistic regression analysis confirmed the age-dependent impact of genotype on mortality. Thus, GPG strains may be more virulent than other strains in younger patients. Because candidemia is usually caused by endogenous strains, our PCR assay could potentially be used as a risk assessment tool for identifying younger patients most at risk of death from candidemia.

The use of a penetrometer provided a reliable and simple method of measuring stool hardness which enabled the stool softening effect of Senokot medication to be quantified.

Within a group of 184 subjects (100 females) aged 65-90 years living independently, age was found to have a significant negative correlation with strength of triceps surae in the calf and biceps brachii in the arm. Muscle area in the limbs also declined significantly with age in males. Weight and strength per cross-sectional area in the calves declined significantly with age in females. Superficial fat did not change with age; height declined, perhaps due to kyphosis. The strength of the calf compared to body weight also declined significantly with age in both sexes. Multiple regression analysis has been used to describe the effects of sex, age and weight on muscle variables.

727completely healthy, without neurological symptoms or Kayser-Fleischer ring, and liver test results were normal. Serum caeruloplasmin1 was slightly decreased at 95 mg/l (normal value in our laboratory 130-270 mg/l), and urine copper excretion was raised at 1-27 1Lmol/24th (81 gg/24 h) (normal value 0-78 Lmol/24 h (50 sg/24 h)). After a diagnostic test with 64Cu2 a preclinical stage of Wilson's disease was diagnosed.He was given D-penicillamine 1 g/day. No side effects were observed during the first 13 months. In May 1973 he developed weakness of the right ocular muscles; in particular, ptosis was more pronounced at the end of the day. During the next 10 days the weakness became worse and left ptosis developed; no other muscles showed weakness. After edrophonium chloride 10 mg intravenously rapid opening of both eyes was noted. Electromyography and immunological investigations were not performed. Penicillamine was withdrawn and he was given neostigmine. After six weeks he showed no symptoms of myasthenia.Eight months later he still had no neurological symptoms. Laboratory investigations confirmed the diagnosis of Wilson's disease. An electromyogram and a laminagram of the mediastinum were normal. Though weak antibodies to smooth muscles were detected in the serum by indirect immunofluorescence no antinuclear antibodies were found.The I should like to thank Mr. J. Blal-e and Dr. R. Courtenay-Evans for permission to report this case and for their advice in preparation of the manuscript.