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Sleep Science
Published in Gia Merlo, Kathy Berra, Lifestyle Nursing, 2023
Glenn S. Brassington, Glenn T. Brassington
Although there was not sufficient data in Itani and colleagues’ meta-analysis to assess depression, sleep disturbances and short sleep have been identified as risk factors for depression elsewhere (Kalmbach et al., 2017; Li et al., 2016). Further support for the role of sleep as a causal factor for mental health problems comes from a study of 3755 participants who received digital cognitive behavioral therapy for insomnia (Freeman et al., 2017), in which insomnia mediated changes in paranoia and hallucinations. Finally, sleep problems have been shown to be a risk factor for falls in older adults (Brassington et al., 2000; Stone et al., 2014).
Injury Prevention
Published in James M. Rippe, Manual of Lifestyle Medicine, 2021
Falls among older adults are a major public health burden in the United States. Each year more than one in four (28.7%) of older adults aged 65 or older sustain a fall. Falls in older adults result in seven million injuries requiring medical treatment or restricted activity at an average cost of $10,000 per medically treated fall.
Psychological and Psychiatric Treatment of Chronic Pain in Geriatric Populations
Published in Andrea Kohn Maikovich-Fong, Handbook of Psychosocial Interventions for Chronic Pain, 2019
Luis Richter, Shruti Shah, Stephanie Wheeler
Exercise-based interventions that improve balance and strength have been found to be effective in reducing the prevalence of falls in older adults. Tai chi has been explored as one of these interventions for older adults. Tai chi has been found to reduce multiple fall risk by about 47.6% (Wolf et al., 1996). The significant effects of tai chi on reducing falls (including injurious falls) have been observed at six months post-treatment even when using a control group consisting of basic stretching-based exercises (Li et al., 2005). There is also some evidence that a 12-week tai chi intervention may not only lead to improved physical functioning but may also significantly reduce pain in an older population with osteoarthritis (Rhayun et al., 2003).
Kinematic Measures for Recovery Strategy Identification following an Obstacle-Induced Trip in Gait
Published in Journal of Motor Behavior, 2023
Falls in older adults are a worldwide health concern (Tuunainen et al., 2014), which can lead to serious consequences including fractures, traumatic head injuries, and even mortality (Norton et al., 1997; Stevens & Sogolow, 2005). Falls mainly occur because older adults fail to recruit the primary defense mechanism (i.e., reactive balance control) against unexpected, externally induced slip- or trip-like perturbations (Nieuwenhuijzen & Duysens, 2007; Tang et al., 1998). The failure to recruit appropriate reactive balance mechanisms affects the ability to maintain and regulate the center of mass (COM) state within the base of support (BOS), resulting in loss of balance (LOB) and the initiation of one or more compensatory steps following touchdown of the perturbed foot (Bhatt et al., 2006). If this LOB persists after compensatory stepping, a fall will be inevitable. Thus, preventing LOB is considered the foremost defense against falling and can eliminate the requirement of a compensatory step (Ashton-Miller et al., 1996; Pai et al., 2003). Therefore, investigating key factors contributing to LOB can provide a better understanding of prognostic and preventative measures for older adults at increased risk of falls.
Homelessness and rates of physical dysfunctions characteristic of premature geriatric syndromes: systematic review and meta-analysis
Published in Physiotherapy Theory and Practice, 2022
Kevin Suh, Jordan Beck, Wendy Katzman, Diane D. Allen
Geriatric syndromes are a compilation of various impairments commonly seen in adults over the age of 65. Geriatric syndromes include frailty, cognitive impairment, functional limitation, falls, urinary incontinence, and depression (Brown, Kiely, Bharel, and Mitchell, 2012). The Fried criteria for defining frailty includes unintentional weight loss, exhaustion, low physical activity, slow walking speed, and weak handgrip (Fried et al., 2001). Many of the impairments of geriatric syndromes can be treated by healthcare professionals. Specifically, healthcare professionals such as physical therapists (PTs) and occupational therapists (OTs) can effectively address weakness, fatigue, incontinence, and slow walking speed, along with functional limitations such as difficulty completing basic activities of daily living (ADL) and instrumental activities of daily living (IADL) (Apóstolo et al., 2018; Siemonsma et al., 2018). Physical therapists can also help prevent falls in older adults by prescribing therapeutic exercises for balance training and providing education about safety (El-Khoury, Cassou, Charles, and Dargent-Molina, 2015). Thus, much of the physical dysfunction characteristic of geriatric syndromes is modifiable if the healthcare system can identify patients and populations that need these services and improve their access to care.
Anticholinergics and falls in older adults
Published in Expert Review of Clinical Pharmacology, 2022
Numerous risk factors for falls have been reported within the published literature, including cognitive decline, visual impairment, hearing loss, age, environmental factors, and chronic disease [11–14]. As the risk of comorbidity increases with increasing age, the older adult is consequently also at greater risk of experiencing the prescription of multiple medications, so-called polypharmacy [15]. While the use of medications is considered a well-established risk factor for falls in older adults, the evidence on falls and medications is confusing. Emerging evidence suggests that the presence of polypharmacy is no longer associated with falls if Fall Risk Increasing Drugs (FRIDs), which include angiotensin converting enzyme inhibitors, beta-blockers, diuretics, calcium channel blockers, and antidepressants, are removed [16–18]. The relationship between the use of medications with anticholinergic properties with falls in older adults has also been highlighted recently [19].