Multifactorial and multiple component interventions for preventing falls in older people living in the community

Hopewell, Sally; Adedire, Olubusola; Copsey, Bethan; Boniface, Graham; Sherrington, Catherine; Clemson, Lindy; Close, Jacqueline C.T.; Lamb, Sarah E

doi:10.1002/14651858.cd012221.pub2

Cited by 303 publications

(305 citation statements)

References 221 publications

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“…Current evidence suggests that progressive resistance training improves risk factors for falls and fractures such as muscle function, balance, and functional mobility . However, it is unclear if the effect of progressive resistance training translates directly into a reduction in incidence of falls and fractures . Further randomized controlled trials examining the effect of progressive resistance training on falls and fractures outcomes are warranted.…”

Section: Discussionmentioning

confidence: 99%

Sarcopenia and its association with falls and fractures in older adults: A systematic review and meta‐analysis

Yeung

Reijnierse

Pham

et al. 2019

J cachexia sarcopenia muscle

616

463

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Sarcopenia is a potentially modifiable risk factor for falls and fractures in older adults, but the strength of the association between sarcopenia, falls, and fractures is unclear. This study aims to systematically assess the literature and perform a meta‐analysis of the association between sarcopenia with falls and fractures among older adults. A literature search was performed using MEDLINE, EMBASE, Cochrane, and CINAHL from inception to May 2018. Inclusion criteria were the following: published in English, mean/median age ≥ 65 years, sarcopenia diagnosis (based on definitions used by the original studies' authors), falls and/or fractures outcomes, and any study population. Pooled analyses were conducted of the associations of sarcopenia with falls and fractures, expressed in odds ratios (OR) and 95% confidence intervals (CIs). Subgroup analyses were performed by study design, population, sex, sarcopenia definition, continent, and study quality. Heterogeneity was assessed using the I 2 statistics. The search identified 2771 studies. Thirty‐six studies (52 838 individuals, 48.8% females, and mean age of the study populations ranging from 65.0 to 86.7 years) were included in the systematic review. Four studies reported on both falls and fractures. Ten out of 22 studies reported a significantly higher risk of falls in sarcopenic compared with non‐sarcopenic individuals; 11 out of 19 studies showed a significant positive association with fractures. Thirty‐three studies (45 926 individuals) were included in the meta‐analysis. Sarcopenic individuals had a significant higher risk of falls (cross‐sectional studies: OR 1.60; 95% CI 1.37–1.86, P < 0.001, I 2 = 34%; prospective studies: OR 1.89; 95% CI 1.33–2.68, P < 0.001, I 2 = 37%) and fractures (cross‐sectional studies: OR 1.84; 95% CI 1.30–2.62, P = 0.001, I 2 = 91%; prospective studies: OR 1.71; 95% CI 1.44–2.03, P = 0.011, I 2 = 0%) compared with non‐sarcopenic individuals. This was independent of study design, population, sex, sarcopenia definition, continent, and study quality. The positive association between sarcopenia with falls and fractures in older adults strengthens the need to invest in sarcopenia prevention and interventions to evaluate its effect on falls and fractures.

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Section: Discussionmentioning

confidence: 99%

Sarcopenia and its association with falls and fractures in older adults: A systematic review and meta‐analysis

Yeung

Reijnierse

Pham

et al. 2019

J cachexia sarcopenia muscle

616

463

View full text Add to dashboard Cite

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“…Nevertheless, as previously discussed in detail (Langeard et al, 2016), our population is very similar to the general population: a harmless fall in a large number of participants, and mean cognitive and mobility scores within the normal range. In addition, because 30% of individuals older than 65 years fall every year (Hopewell et al, 2018), and since we specifically searched for individuals who had fallen in the previous year, after our 5 years of inclusion we had likely collected a significant part of the general population. Regarding the small number of men in our sample, it is inherent to the lower number of men than women admitted to the hospital, and who experienced a fall with a low-energy fracture (21% in the initial description of the osteoporosis cohort of the University hospital in Caen (Levasseur et al, 2007) and 16% during the inclusion period of the present study), together with the well-known fact that men are less likely to agree to participate in this type of research (Markanday et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Psychotropic Polypharmacy in Adults 55 Years or Older: A Risk for Impaired Global Cognition, Executive Function, and Mobility

et al. 2020

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Objectives: With their broad spectrum of action, psychotropic drugs are among the most common medications prescribed to the elderly. Consequently, the number of older adults taking multiple psychotropic drugs has more than doubled over the last decade. To improve knowledge about the deleterious effects of psychotropic polypharmacy, we investigated whether there is a threshold number of psychotropic molecules that could lead to impairment of global cognition, executive function, or mobility. Furthermore, relationships between the number of psychotropic molecules and cognitive and mobility impairment were examined. Design: Cross-sectional studySetting: University Hospital of Caen (France) and advertisements in medical offices Participants: Community-dwelling older adults 55 years and older (n = 177; 69.8 ± 9.3 years; 81% women) Measurements: Number of psychotropic molecules taken daily, global cognition assessed with the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA), processing speed with the Trail Making Test (TMT) A, executive function with the TMT B and TMT B-A, and mobility with the Time Up and Go (TUG). The threshold numbers of psychotropic molecules were determined by ROC curves analysis. Based on these threshold values, multinomial logistic regression adjusting for covariates was then performed.Results: Logistic regressions showed that the threshold of two daily psychotropic molecules, identified by the ROC curves analysis, increases the risk of impaired executive function (p = .05 and.005 for the TMT B and TMT B-A, respectively), global cognition (p = .006 and.001 for the MMSE and MoCA, respectively), and mobility (p = .005 for the TUG), independent of confounding factors, including comorbidities. Furthermore, psychotropic polypharmacy would affect mobility through executive functions.Conclusion: Impairment of global cognition, executive function, and mobility when as few as two psychotropic molecules are consumed in relatively healthy young older adults should alert physicians when prescribing combinations of psychotropic medications.

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“…posición, haciendo que el paciente pueda tropezar fácilmente; esto incrementa el riesgo de caída y por tanto es fundamental extremar el cuidado dichos pacientes al tiempo que se hace énfasis en la necesidad de programas de educación que advirtan del riesgo adicional que se puede causar el uso de estos dispositivos (17,18).…”

Section: Discusión [T1]unclassified

“…El tener catéter venoso periférico también aumentó el riesgo de desarrollo de caídas, lo que concuerda con el estudio de Méndez (6).Dado que este tipo de dispositivo se usa con alta frecuencia en la atención habitual de los pacientes hospitalizados, es importante evaluar la pertinencia de su uso valorando otras opciones de tratamiento, pues con este no solo aumenta el riesgo de caídas, sino que de infecciones también. En este aspecto también es importante que se entrene al personal de salud, al paciente y a su familia sobre su manejo (17)(18).…”

Section: Discusión [T1]unclassified

Factores de riesgo asociados a las caídas intrahospitalarias en tres instituciones de Colombia

et al. 2020

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Introducción. Las caídas intrahospitalarias son eventos adversos que se relacionan con múltiples factores de riesgo y que tienen implicaciones importantes para los pacientes y los sistemas de salud.Objetivo. Determinar los factores de riesgo asociados a las caídas intrahospitalarias en tres hospitales de tercer nivel de Colombia.Materiales y métodos. Estudio observacional analítico de casos y controles. La muestra mínima requerida fue de 270 casos y 270 controles (error alfa del 5%). Se incluyeron 690 pacientes y se analizaron 17 variables. El análisis de los datos se realizó mediante el cálculo del OR y el desarrollo de un modelo de regresión logística con un nivel de significancia del 5%.Resultados. Los factores de riesgo fueron tener catéter venoso periférico (OR: 2.92, IC95%: 1.01-8.43), contar con medidas de sujeción o sedación (OR: 2.35, IC95%: 1.11-4.97), tener una estancia hospitalaria mayor a ocho días (OR: 2.85, IC95%: 2.0-4.06), estar en tratamiento con medicamentos de alto riesgo (OR: 2.82, IC95%: 1.86-4.28), no contar con acompañante permanente (OR: 2.68, IC95%: 1.87-3.83) y, por último, ser un paciente no colaborador (OR: 1.61, IC95%: 0.84-3.0), variable sin significancia estadística, pero clínicamente relevante.Conclusión. Fue posible determinar factores de riesgo relacionados a las caídas intrahospitalarias que requieren ser abordados por estas tres instituciones para prevenir y disminuir la presentación de estos eventos adversos. Asimismo, otros hospitales del país pueden utilizar los resultados aquí reportados para mejorar el cuidado de sus pacientes y prevenir este fenómeno dentro de sus instalaciones.

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Multifactorial and multiple component interventions for preventing falls in older people living in the community

Cited by 303 publications

References 221 publications

Sarcopenia and its association with falls and fractures in older adults: A systematic review and meta‐analysis

Sarcopenia and its association with falls and fractures in older adults: A systematic review and meta‐analysis

Psychotropic Polypharmacy in Adults 55 Years or Older: A Risk for Impaired Global Cognition, Executive Function, and Mobility

Factores de riesgo asociados a las caídas intrahospitalarias en tres instituciones de Colombia

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