Predictors of Falls and Fractures Leading to Hospitalization in People With Dementia: A Representative Cohort Study

Sharma, Shalini; Mueller, Christoph; Stewart, Robert; Veronese, Nicola; Vancampfort, Davy; Koyanagi, Ai; Lamb, Sarah E; Perera, Gayan; Stubbs, Brendon

doi:10.1016/j.jamda.2018.03.009

Cited by 52 publications

(57 citation statements)

References 34 publications

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“…There are still a large number of medical schools in SSA who do not teach geriatrics. Healthcare needs such as orthostatic hypertension measurement/management, vision assessment, toileting schedule (Colon-Emeric et al, 2018;Sharma et al, 2018) may require comorbidity management. This has implications for the quality of care delivered (Colon-Emeric et al, 2018) to them.…”

Section: Concerns With Care Provision For Older Peoplementioning

confidence: 99%

“…Geriatric care is associated with hospitalization, bringing to the fore the fact that older adults have a myriad of problems with their living conditions such as the absence of segregated care for older persons at health facilities including healthcare expenditures (Dovie, 2018b;Sharma et al, 2018;Ghiara and Russo, 2019). Constraints regarding geriatric care and social services and care have culminated in increased needs for formal income support including care provision for older adults.…”

Section: The Geriatric Care Concernsmentioning

confidence: 99%

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The Status of Older Adult Care in Contemporary Ghana: A Profile of Some Emerging Issues

Dovie

2019

Front. Sociol.

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The paper examines how the healthcare and social care pillars of social policy for aging societies shape inequalities in health and well-being at old age, utilizing qualitative and quantitative datasets. The results intimate the lack of geriatric infrastructure, hence the inadequacy of geriatric care provision for older adults. Systemic problems or gaps existent in Ghana led to private individuals taking advantage of the situation, turning it into an opportunity for service providers. Thus, the evolution of recreational/residential homes in Ghana is situated along three distinct patterns or forms namely the occasional, the adult day care center and residential archetypes. Collectively, these constitute formal and informal care facilities. These are often privately owned and at a cost. The nature of quality of care may be affected by the types of homes available, especially in the globalized cultural setting. A growing number of older adults resort to care homes as an alternative measure. These are discussed from two viewpoints. First, geriatric data generation, the absence of which impedes healthcare provision. Second, cash-for-care policies may exacerbate existing inequalities in care with negative consequences for health and well-being. In short, policies for aging populations are being implemented across Ghana with too little known about their consequences for inequalities in health and well-being in later life. The paper sought to address this knowledge gap by exploring a significant infrastructure by undertaking a systematic examination of how recent policy developments for aging exacerbate or reduce inequalities in health and well-being among older adults. The paper concludes that social policy for aging societies' specific key pillars (healthcare and social care research) offers opportunities for analyzing and understanding internal dynamics including the effects of policy implementation for inequalities in health and well-being at older ages, therefore enabling the identification of strategies to improve older adults' circumstances, without which older adult population will far outpace elder care provision.

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Section: Concerns With Care Provision For Older Peoplementioning

confidence: 99%

Section: The Geriatric Care Concernsmentioning

confidence: 99%

The Status of Older Adult Care in Contemporary Ghana: A Profile of Some Emerging Issues

Dovie

2019

Front. Sociol.

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“…Impairments to balance and gait are common in PWD and are associated with elevated falls risk [9][10][11] . To this end, clinical measures of balance are commonplace in the assessment of physical function in older people.…”

mentioning

confidence: 99%

Association between the instrumented timed up and go test and cognitive function, fear of falling and quality of life in community dwelling people with dementia

Williams

Nyman

2018

JFSF

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Dementia is a highly prevalent neurodegenerative disorder characterised by changes in behaviour and cognition 1. The prevalence and incidence of dementia has been reported at approximately 15% and 3% respectively 2 and it has been reported to affect approximately 47 million people worldwide 1. People with dementia (PWD) show symptoms ranging from cognitive, social and motor impairment, all of which can significant affect quality of life (QoL) 3,4. PWD have been shown to have greater falls risk compared to those either with mild cognitive impairment or intact cognition 5. Indeed this appears to remain true for PWD within care homes 6 and for those within their own home, where the risk is double 5,7. In addition to a greater risk of falls, the risk of hip fracture has been found to be almost 5-fold that of matched-controls 5 and PWD are 58% more likely to be admitted to hospital with a hip fracture than those without dementia, where mortality following hip fracture can be as high as 30% 8. Therefore PWD are at great risk of injurious falling.

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“…CRIS has been linked to a number of other informative data sources, including data on all hospitalisations regardless of specialty or location in England (national hospital episode statistics (HES)). The SLaM BRC case register contains data on more than 400 000 patients with a range of mental disorders and CRIS-supported investigations have included several longitudinal cohort studies of depression and other mental disorders of later life 18–20. The database has full approval for secondary analysis from Oxford Research Ethics Committee (Oxford Research Ethics Committee C, reference 18/SC/0372).…”

Section: Methodsmentioning

confidence: 99%

Predictors of cerebrovascular event reoccurrence in patients with depression: a retrospective cohort study

et al. 2020

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ObjectivesTo identify predictors of recurrent cerebrovascular morbidity in a cohort of patients with depression and a cerebrovascular disease (CBVD) history.MethodsWe used the Maudsley Biomedical Research Centre Case Register to identify patients aged 50 years or older with a diagnosis of depressive disorder between 2008 and 2017 and a previous history of hospitalised CBVD. Using depression diagnosis as the index date we followed patients until first hospitalised CBVD recurrence or death due to CBVD. Sociodemographic data, symptom and functioning scores of Health of the Nation Outcome Scales, medications and comorbidities were extracted and modelled in multivariate survival analyses to identify predictors of CBVD reoccurrence.ResultsOf 1292 patients with depression and CBVD (mean age 75.6 years; 56.6% female), 264 (20.4%) experienced fatal/non-fatal CBVD recurrence during a median follow-up duration of 1.66 years. In multivariate Cox regression models, a higher risk of CBVD recurrence was predicted by older age (HR, 1.02; 95% CI, 1.01 to 1.04) (p=0.002), physical health problems (moderate to severe HR, 2.47; 95% CI, 1.45 to 4.19) (p=0.001), anticoagulant (HR, 1.40; 95% CI, 1.01 to 1.93) (p=0.041) and antipsychotic medication (HR, 0.66; 95% CI 0.44 to 0.99) (p=0.047). Neither depression severity, mental health symptoms, functional status, nor antidepressant prescribing were significantly associated with CBVD recurrence.ConclusionsApproximately one in five patients with depression and CBVD experienced a CBVD recurrence over a median follow-up time of 20 months. Risk of CBVD recurrence was largely dependent on age and physical health rather than on severity of depressive symptoms, co-morbid mental health or functional problems, or psychotropic prescribing.

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Predictors of Falls and Fractures Leading to Hospitalization in People With Dementia: A Representative Cohort Study

Cited by 52 publications

References 34 publications

The Status of Older Adult Care in Contemporary Ghana: A Profile of Some Emerging Issues

The Status of Older Adult Care in Contemporary Ghana: A Profile of Some Emerging Issues

Association between the instrumented timed up and go test and cognitive function, fear of falling and quality of life in community dwelling people with dementia

Predictors of cerebrovascular event reoccurrence in patients with depression: a retrospective cohort study

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