Accidents among the aged: Incidence, causes and prevention

Rodstein, Manuel

doi:10.1016/0021-9681(64)90061-x

Cited by 53 publications

(29 citation statements)

References 5 publications

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“…Moreover, the lack of correlation between indicators of adiposity and fracture rates in the present series con trasts with the protective effect of adiposity in pre vious studies of both older women and men in the general population [1,15]. Diabetes, cigarette smok ing, and hypogonadism, significant correlates of frac tures in general populations of older women and men [1,16], were also unrelated to fractures in our institu tionalized men. Accordingly, our Nursing Home men appear to differ from the general population of men Nursing Home Fractures not only in their five to 11 times greater fracture rate, but also in their profile of endogenous risk factors.…”

Section: Resultscontrasting

confidence: 50%

Fractures in the men of a Veterans Administration Nursing Home: relation to 1,25-dihydroxyvitamin D.

Rudman

Mattson

et al. 1989

Journal of the American College of Nutrition

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One hundred fifty-three men, age 48-96, 86% white, had resided in this Nursing Home for an average of 6.3 years (range 1.3-36) as of August 1984. At that time, we reviewed their medical charts to record the numbers and sites of fractures which had been diagnosed during the preceding 1 to 5 years of Nursing Home residence, the duration of this period depending on the duration of institutionalization. In addition, a clinical database was compiled comprising 70 attributes, including diagnoses, drugs, plasma (serum) chemistries, and measures of hematologic, nutritional, and functional status. Fractures during the studied period of Nursing Home residence had occurred in 24 of 153 men; six residents had experienced two or more fractures. Fracture rates in hip, spine, and wrist were 2564, 366, and 549 per 100,000 patient years, respectively. The total fracture rate, hip fracture rate, and limb fracture rate were five to 11 times higher than in the age-matched general population of white men in the United States; in Rochester, MN; in Dundee, England; in Oxford, England; or in Finland. Univariate statistical analysis showed that the rates for hip fracture or for fracture at any site were significantly associated with 13 attributes: directly with age, plasma somatomedin C, blood urea N, serum creatinine, serum uric acid, serum 25-hydroxyvitamin D (25-OH-D), degree of functional impairment, and chronic urinary tract infection, and inversely with serum 1,25-dihydroxyvitamin D [1,25-(OH)2-D], serum albumin, hematocrit, and hemoglobin. There was not a significant correlation with the number of falls/month which occurred during the 7 months after August 1984. After the effect of age was partialed out, somatomedin C, 25-OH-D, 1,25-(OH)2-D, and the diagnosis of urinary tract infection were still significantly related to the occurrence of fractures. The fact that Nursing Home fracture cases had significantly higher blood urea nitrogen and 25-OH-D, and significantly lower 1,25-(OH)2-D, than their non-fracture counterparts suggests that impaired renal production of the latter vitamin D metabolite contributed to the excessive rate of fractures.

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Section: Resultscontrasting

confidence: 50%

Fractures in the men of a Veterans Administration Nursing Home: relation to 1,25-dihydroxyvitamin D.

Rudman

Mattson

et al. 1989

Journal of the American College of Nutrition

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“…As early as 1950, Castle (10) implicated lighting and stair structure as causes of falls ( Table 2). In 1955, Droller (21) implicated loose rugs and defective floors, and others (54,83,92) have implicated light switch hazards, thresholds, extension cords, slippery sur faces, and other household prodUCts. Architectural design of stairways and homes and visual patterns on flooring can cause missteps and increase the risk of falling (3,13,49,70).…”

Section: Risk Factors Related To the Environmentmentioning

confidence: 99%

Falls Among Older Persons: A Public Health Perspective

Sattin

1992

Annu. Rev. Public Health

564

249

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“…This is primarily due to inadequate constriction of the veins and arteries and decreased strength of muscle contraction in the lower extremities. Orthostatic hypotension is uncommon in younger persons because reflex constriction of the veins and arteries and an increase in heart rate are so rapid, aided by strong contractions of the lower‐extremity muscles, that the adverse effect of gravity is overcome almost instantaneously with little or no diminution of venous return to the heart, cardiac output and blood pressure (11).…”

Section: Discussionmentioning

confidence: 99%

“…Fractures in the aged are common and serious, and are more closely related to the degree of weakening of bone than to the severity of the accidental trauma. Accidents in the aged are often the last of a series of falls which resulted in little or no injury; on the day of the fall and fracture, the bone was ready to break (11).…”

Section: Discussionmentioning

confidence: 99%

Interrelations of the Aging Process and Accidents*

Rodstein¹

1972

J American Geriatrics Society

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With the twelfth chapter of Ecclesiastes as a background, the author draws analogies to life for the aged. The various aspects discussed include intellectual function, memory, orientation, tremor, acrophobia, gait, hypo‐hyperkinesia, muscle weakness, homeostasis, orthostatic hypotension, visual and auditory acuity, osteoporosis and fractures. Deficiencies involving these factors make the aged person particularly prone to accidental injury. The more optimistic side of the picture is represented by the many people who remain mobile and active in old age.

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Accidents among the aged: Incidence, causes and prevention

Cited by 53 publications

References 5 publications

Fractures in the men of a Veterans Administration Nursing Home: relation to 1,25-dihydroxyvitamin D.

Fractures in the men of a Veterans Administration Nursing Home: relation to 1,25-dihydroxyvitamin D.

Falls Among Older Persons: A Public Health Perspective

Interrelations of the Aging Process and Accidents*

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