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An unsteady pensioner
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
Despite many falls in the elderly having an underlying cause (e.g. UTI, atrial fibrillation, heart failure, anaemia, pneumonia, etc), the fall itself often has the greatest effect on the patient’s lifestyle. Falling, especially when patients are unable to get up unaided, is an extremely unpleasant experience, and the fear of further falls tends to lead to a vicious cycle (i.e. the fear itself leading to deteriorating mobility).
Falls
Published in Henry J. Woodford, Essential Geriatrics, 2022
A wide range of risk factors for falling has been identified. These include gait and balance disorders, visual impairment, arthritis, depression, cognitive impairment and frailty. Gait disorders result from combinations of peripheral (e.g. osteoarthritis) and central (e.g. neurodegenerative or cerebrovascular) abnormalities. Older people more often sustain injuries after falling than younger people. This difference is partly attributed to blunted reaction times for protective reflexes and a higher prevalence of osteoporosis. Serious complications of falling include hip fracture and traumatic brain injury. Following a fall there is also a high incidence of ‘fear of falling' that can lead to reduced mobility and social isolation. A negative spiral can develop where older people mobilise less due to this fear, and thereby become deconditioned. Then, on the occasions that they do walk, they are less steady on their feet and more likely to fall, further worsening their fear.
Rehabilitation after Trauma
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
Whilst most RTCs involve cars or lorries, motorbike collisions result in a greater proportion of spinal cord injuries due to the lack of protection and exposure. Falling from a height or downstairs is the mechanism in most falls. Horse riding, diving and altitude sports cause a greater number of SCI than rugby when proportional participation is taken into account.
The Role of Altered Sensory Processing and Its Association with Participation in Daily Activities and Quality of Life among Older Adults in the Community
Published in Occupational Therapy In Health Care, 2023
Yael Zilbershlag, Keren Ravitz-Ron, Batya Engel-Yeger
The high prevalence of falls among older adults has serious consequences on daily functioning, subsequent quality of life (QoL), and increases risk of mortality, all factors that contribute to increased healthcare usage and costs (Beard et al., 2016). Risk factors for falling in older adults are numerous and include advanced age, polypharmacy, history of previous falls, cognitive deficits and age-related physiological changes such as impaired balance and vision (Ambrose et al., 2013; Montero‐Odasso and Speechley, 2018; Phelan et al., 2015; Wheeler et al., 2018). A recent study on healthy older adults emphasized the role of integrative processing of sensory information on functional independence and its possible contribution to fall risk. Specifically, poor visual somatosensory integration was associated with worse balance and increased risk of incident falls (Mahoney et al. 2019).
Evaluation of race as a predictor of fear of falling in Black older adults
Published in Clinical Gerontologist, 2023
Selena E. Washington, Makenna Snyder, Yi-Ling Hu, Susan L. Stark
One in four older adults (aged ≥65 years) in the United States experiences a fall each year (Centers for Disease Control and Prevention [CDC], 2018), and falls are the most common cause of fatal injury and nonfatal hospital admissions for older adults (Burns, Stevens, & Lee, 2016). The risk of falling is associated with multiple factors including: sociodemographic factors such as age and gender; psychological diagnoses such as depression; medical factors such as Parkinson’s disease, comorbidity, medication use, self-perceived health status, fear of falling, physical mobility, and recurrent falls; and environmental factors such as living conditions and indoor versus outdoor environments (Silvia et al., 2010; Sun, Huang, Varadhan, & Agrawal, 2016). Recent evidence utilizing the National Health and Aging Trends Study [NHATS] (2019) population data has concluded that Black older adults are less likely to fall compared to White older adults (Nicklett & Taylor, 2014; Singh, Bélanger, & Thomas, 2018; Sun et al., 2016). However, what is unknown is whether race predicts fear of falling (FOF) within the older adult population at greater risk for falls, where FOF is “a lasting concern about falling that leads to an individual avoiding activities that he/she remains capable of performing” (Tinetti & Powell, 1993).
Reliability and validity of Persian versions of Mini-BESTest and Brief-BESTest in persons with Parkinson’s disease
Published in Physiotherapy Theory and Practice, 2022
Amin Nakhostin-Ansari, Noureddin Nakhostin Ansari, Milad Mellat-Ardakani, Mostafa Nematizad, Soofia Naghdi, MohammadJavad Babaki, Mehdi Farhangian, Amir Hassan Habibi, Abbas Tafakhori, Scott Hasson
Parkinson’s disease (PD) affects about 4.1 million people globally. It has been estimated that about 8.7 million people will be affected by 2030. Most of the persons with PD will be from developing countries (Dorsey et al., 2007). The incidence of PD increases by age, especially after the age of 60 (Van Den Eeden et al., 2003). Postural instability, freezing of gait, impaired anticipatory and reactive balance, impaired cognition, reduced leg muscle strength, reduced proprioception, and frontal lobe impairment are causes of balance impairment and falls in persons with PD (Kim, Allen, Canning, and Fung, 2013; Latt, Lord, Morris, and Fung, 2009; Paul et al., 2014). About 68.3% of persons with PD fall annually and about 50.5% of them are recurrent fallers (Wood, Bilclough, Bowron, and Walker, 2002). Falling puts persons with PD at a higher risk of fractures, soft tissue injury, immobilization, depression, daily activity restriction, and mortality (Adkin, Frank, and Jog, 2003; Bloem et al., 2001; Bloem, Hausdorff, Visser, and Giladi, 2004; Melton et al., 2006). As a result, balance assessment has a major role in diagnosing persons with PD who are at risk of falling and also the determination of intervention outcomes.