Objective:To analyze and provide a comprehensive overview of the knowledge structure and research hotspots of clinical interventions for falls in elderly patients in the community.Methods:The search for publications r...Objective:To analyze and provide a comprehensive overview of the knowledge structure and research hotspots of clinical interventions for falls in elderly patients in the community.Methods:The search for publications related to clinical interventions for falls in elderly patients in the community from 2002 to 2022 was conducted on the Web of Science Core Collection(WoSCC)database.VOSviewers,CiteSpace,and the R package“bibliometrix”were used to conduct this bibliometric analysis.Results:2091 articles from 70 countries,primarily the United States and Australia,were included.The number of publications related to clinical interventions for falls in elderly patients is increasing yearly.The main research institutions in this field were the University of Sydney,Harvard University,and the University of California.BioMed Central(BMC)Geriatrics was the most popular journal in this field and Journals of the American Geriatrics Society was the most co-cited journal.These publications came from 8984 authors among which author Lord SR had published the most papers and author Tinetti Me had the most co-citations.The main keywords in this research field were“balance,”“exercise,”and“risk factor.”Conclusion:This was the first bibliometric study that comprehensively summarized the research hot spots and development of clinical interventions for falls in elderly patients in the community.This paper aims to provide a reference for scholars and researchers in this particular field.展开更多
Background: Falls in the elderly are a global public health problem with serious medical and socio-economic consequences, especially in low and middle-income countries. The aim of this study was to describe the charac...Background: Falls in the elderly are a global public health problem with serious medical and socio-economic consequences, especially in low and middle-income countries. The aim of this study was to describe the characteristics of falls among the elderly in trauma units in Senegal. Materials and Methods: This was a descriptive, prospective study from April 20, 2022 to October 30, 2022 among people aged at least 60 and admitted to the surgical emergency department of Idrissa Pouye Hospital in Dakar following a fall. Socio-demographic, clinical, therapeutic and evolutionary characteristics were collected and analyzed using Sphinx Plus 2 and Excel 2019 for Windows software. Results: Out of 730 elderly people seen during this period, 100 met the criteria, representing a prevalence of 13.69%. The average consultation time was 3.25 +/? 4 days. The average age was 73 +/? 8.43 years, with women predominating (74%). Medical expenses were mainly covered by the family (73%). Most falls occurred during the day (68%), at home (82%), especially in the bedroom (30%), with stumbling (32%) as the main mechanism. The majority of patients (86%) spent less than 30 minutes on the floor. Predisposing factors were dominated by visual disorders (56%) and precipitating factors were mainly environmental (62%). Geriatric syndromes were dominated by frailty (22%). Complications were dominated by fractures (86%), and almost half (47%) had lost their autonomy for post-fall Activities Daily Living (ADL). Prescription medication was almost systematic (98%), dominated by analgesics (98%). Surgery was indicated in 58% of patients. The average waiting time for surgery was 25.36 +/? 19 days. A death rate of 1% was recorded in the emergency department. Conclusion: Falls in the elderly are a frequent occurrence in traumatological emergencies, with etiological factors that are often multiple and interrelated, leading to significant morbidity. Raising awareness among people at risk and setting up an orthogeriatric service would help prevent falls and optimize care in the short and long term.展开更多
Fall behavior is closely related to high mortality in the elderly,so fall detection becomes an important and urgent research area.However,the existing fall detection methods are difficult to be applied in daily life d...Fall behavior is closely related to high mortality in the elderly,so fall detection becomes an important and urgent research area.However,the existing fall detection methods are difficult to be applied in daily life due to a large amount of calculation and poor detection accuracy.To solve the above problems,this paper proposes a dense spatial-temporal graph convolutional network based on lightweight OpenPose.Lightweight OpenPose uses MobileNet as a feature extraction network,and the prediction layer uses bottleneck-asymmetric structure,thus reducing the amount of the network.The bottleneck-asymmetrical structure compresses the number of input channels of feature maps by 1×1 convolution and replaces the 7×7 convolution structure with the asymmetric structure of 1×7 convolution,7×1 convolution,and 7×7 convolution in parallel.The spatial-temporal graph convolutional network divides the multi-layer convolution into dense blocks,and the convolutional layers in each dense block are connected,thus improving the feature transitivity,enhancing the network’s ability to extract features,thus improving the detection accuracy.Two representative datasets,Multiple Cameras Fall dataset(MCF),and Nanyang Technological University Red Green Blue+Depth Action Recognition dataset(NTU RGB+D),are selected for our experiments,among which NTU RGB+D has two evaluation benchmarks.The results show that the proposed model is superior to the current fall detection models.The accuracy of this network on the MCF dataset is 96.3%,and the accuracies on the two evaluation benchmarks of the NTU RGB+D dataset are 85.6%and 93.5%,respectively.展开更多
Objectives:The objective of this study was to examine the falls efficacy of older adults in nursing homes and the related predictors of falling.Methods:A sample of 317 older adults was recruited from 18 nursing homes ...Objectives:The objective of this study was to examine the falls efficacy of older adults in nursing homes and the related predictors of falling.Methods:A sample of 317 older adults was recruited from 18 nursing homes in the Fujian province of China.The Modified Falls Efficacy Scale(MFES)and Kessler Psychological Distress Scale(K10)were employed to collect data.Results:The falls efficacy of older adults was moderate(7.80±1.17).The falls efficacy questionnaire item“Get dressed and undressed”scored the highest(9.12±1.440),while“Crossing roads”scored the lowest(5.77±3.371).Multiple regression analysis demonstrated that mental health status,degree of self-care,age and gender were each predictors of the falls efficacy of older adults.Conclusions:Falls efficacy enhancing programs for nursing home residents should take mental health status,degree of self-care,age and gender into account.展开更多
BACKGROUND: Emergency services manage trauma patients frequently and falls from height comprise the main cause of emergency service admissions. In this study, we aimed to analyse the demographic characteristics of fal...BACKGROUND: Emergency services manage trauma patients frequently and falls from height comprise the main cause of emergency service admissions. In this study, we aimed to analyse the demographic characteristics of falls from height and their relationship to the mortality.METHODS: A total of 460 patients, who admitted to the Emergency Department of Inonu University between November 2011 and November 2014 with a history of fall from height, were examined retrospectively. Demographic parameters, fall characteristics and their effect to mortality were evaluated statistically. RESULTS: The study comprised of 292(63.5%) men and 168(36.5%) women patients. The mean age of all patients was 27±24.99 years. Twenty-six(5.6%) patients died and the majority of them were in ≥62 years old group. The highest percentage of falls was at 0–5 years age group(28.3%). People fell mainly from 1.1–4 metres(m) level(46.1%). The causes of falls were ordered as unintentional(92.2%), workplace(8.1%) and suicidal(1.7%). Skin and soft tissue injuries(37.4%) were the main traumatic lesions. CONCLUSION: Age, fall height, fall place, linear skull fracture, subarachnoidal hemorrhage, cervical fracture, thoracic vertebra fracture and trauma scores had statistically significant effect on mortality. The casualties died because of subarachnoid hemorrhage mostly.展开更多
AIM To investigate whether adductor canal nerve block(ACB) reduces patient falls when compared to femoral nerve block(FNB) after total knee arthroplasty(TKA). METHODS We conducted an institutional review of all-cause ...AIM To investigate whether adductor canal nerve block(ACB) reduces patient falls when compared to femoral nerve block(FNB) after total knee arthroplasty(TKA). METHODS We conducted an institutional review of all-cause falls after TKA from January 2013 to August 2016 using a quality improvement database. Our inclusion criteria were patients with diagnosis of primary knee osteoarthritis who underwent primary unilateral TKA with either a FNB or an ACB and sustained a fall during their hospitalization. We excluded patients who had revision TKA and extensor mechanism reconstruction. We also excluded patients with a history of post-traumatic arthritis, prior history of lower extremity fracture, history of neurological disease, or cerebrovascular disease. RESULTS A total of 834 patients had TKA with femoral nerve block and knee immobilizer(FNB + KI). Of those patients, 11(1.3%) experienced a fall during their hospital stay. In contrast, 791 patients had TKA with ACB. Of those patients, only one(0.13%) patient fall was recorded within this group. We used the Fisher's exact test to compare the differences between the two groups. The difference between the two groups achieves statistical significance(P = 0.006). We also found that 11 out of the 12 patients that fell had a right TKA procedure while one patient had a left TKA procedure. Nine out of twelve patients that fell were female, while only three patients were male.CONCLUSION Given the reduction in the number of falls with ACB, it is recommended that ACB be considered the preferred analgesia for patients undergoing a TKA procedure.展开更多
Background: Ageing of the population is one of the most important demographic facts that come to the foreground in the 21st century. Objective: To assess the relationship between psychological factors (depression, lon...Background: Ageing of the population is one of the most important demographic facts that come to the foreground in the 21st century. Objective: To assess the relationship between psychological factors (depression, loneliness, using anti anxiety medication, fear from falls and internal displacement of the population) and falls among elderly people in Baghdad city, Iraq. Methods: A matched 1:1 community based case-control study involving 716 elderly respondents, recruited randomly from six Non Governmental Organization (NGO) in different areas of Baghdad. Interviews to each respondent were done accordingly. Geriatric depression scale (GDS) was used to assess the depression among the elderly people. Results: The minimum age for cases and controls was 60 years old while the maximum age for cases was 87 and for controls was 85 years old. The female was predominant than male, 53.6% to 46.4% respectively. The relation between depression, fear from fall, using anti anxiety medication, internal displacement and falls was statistically significant展开更多
Purpose: To establish a relationship between falls and handgrip strength (GS) in communitydwelling senior citizens in Egypt. Subjects: Crosssectional study enrolling 132 subjects, all ≥60 years old. Materials and Met...Purpose: To establish a relationship between falls and handgrip strength (GS) in communitydwelling senior citizens in Egypt. Subjects: Crosssectional study enrolling 132 subjects, all ≥60 years old. Materials and Methods: History of falls in the past year and their number as well as GS measurement in both hands using Baseline? pneumatic squeeze handheld dynamometer. Results: There is a highly significant difference between the GS of fallers and non-fallers in both hands (P = 0.000). There is a highly significant negative correlation between the mean GS and the number of falls (P = 0.003). There is a highly significant positive correlation between GS of the right hand with the number of falls (R = 0.226, P = 0.009), as for the correlation with the left GS it was a weaker positive correlation (R = 0.209, P = 0.16). Conclusion: Seniors with history of falls have a lower GS in both dominant and nondominant hands and it is directly related to the number of falls. GS is decreased in senior fallers even if within the normal range.展开更多
This exploratory study investigated the circumstances of falls and fall-related injuries among frail elderly people under home care.A convenience sample of 500 frail elderly(60 e99 years old)from the Wanshoulu and Yuy...This exploratory study investigated the circumstances of falls and fall-related injuries among frail elderly people under home care.A convenience sample of 500 frail elderly(60 e99 years old)from the Wanshoulu and Yuyuantan communities in Beijing's Haidian District during February 2013 and March 2014.Fall circumstances and related injuries were characterized by detailed interviews and questionnaires.The article reports the results of a study that the overall fall incidence was 41.5%,and higher for females than males.Falls mainly occurred in individuals who were over 80 years old(50.0%)and indoors(67.9%).The percentage of subjects who experienced a combined injury after the fall was 56.3%,whereas 19.0%fell causes a fracture.Approximately 35%of the subjects were hospitalized,and 27.6%of the subjects recovered more than 30 days.Results indicate that,falls in the frail elderly caused serious damage,and fall-related circumstances should be a great concern in this population.展开更多
Introduction: Blue Marble Health Company has created a digital fall risk screening tool (Health in Motion©) that can be used by means of self-report (touch/mouse) or by means of motion capture (Microsoft Kine...Introduction: Blue Marble Health Company has created a digital fall risk screening tool (Health in Motion©) that can be used by means of self-report (touch/mouse) or by means of motion capture (Microsoft Kinect Sensor). Health in Motion©consists of automated versions of the Fall Risk Question-naire, 30-Second Chair Stand Test, and the One Leg Stance Test. Methods: We compared the three methods (self-report, sensor, and clinical standard measurement) using stopwatch and observation in 15 community-dwelling older adults, aged 63 - 80 years old. Each version was completed three times each in random order, for a total of nine trials. Results: Health in Motion©falls screening tool accessible via self-report and sensor is a valid and reliable automated at-home self-assessment for falls risk. Conclusion: Results support the use of Health in Motion©falls screening tools as viable alternatives to standard falls risk assessments for use by older adults at home.展开更多
In order to further understand the full vector excursional details of the geomagnetic field, a paleomagnetic and rock magnetic study of four sites has been conducted at the type locality of Pringle Falls, Oregon where...In order to further understand the full vector excursional details of the geomagnetic field, a paleomagnetic and rock magnetic study of four sites has been conducted at the type locality of Pringle Falls, Oregon where 827 samples were drilled and spaced along a distance of 5 km, for their detailed directional and relative paleointensity studies. The profiles have registered a high-reso- lution (>10 cm/kyr) paleomagnetic record of the excursion (ca. 211+/13 ka) as recorded by diatomaceous lacustrine sediments. Remanence as well as induced magnetization experiments to investigate the reproducibility of the signal throughout the profiles have been conducted. In addition, low-field susceptibility vs. temperature analysis was performed indicating that the main magnetic carrier is pure magnetite (Curie point 575 ℃). The magnetic grain size also has indicated Single Domain-Multi-Domain (SD-MD) magnetite. The demagnetization was done by alternating field (a.f.) experiments, and the mean directions were determined by principal component analyses. In addition, induced magnetic tests were done, such as magnetic susceptibility (x) analyses, saturation IRM, anhysteretic remanent magnetization (ARM70) as well as the normalization of J17.5 mT/ARM70 to attempt to obtain relative paleointensity records of these sediments in question. The results of the induced rock magnetic tests such as the normalization studies indicate a direct correlation between the decrease of the relative paleointensity variations (i.e. lows) with respect to the directional changes. The detailed behavior of the paleosignal is highly consistent, since they are rapidly deposited sediments providing a detailed representation of the paleofield. The dissected VGP paths in 3 different phases are highly internally consistent and are defined by clockwise and anticlockwise loops traveling from the high northern latitudes over eastern North America and the North Atlantic to South America and then to high southern latitudes. They then return to the high northern latitudes through the Pacific and over to Kamchatka. This VGP behavior defines the geomagnetic signature of the Pringle Falls excursion as recorded at the type locality.展开更多
Purpose:This study was aimed to determine associations of accelerometer-determined time and bouts of sedentary behavior,light physical activity(LPA),and moderate-to-vigorous PA(MVPA)with sarcopenia and incident falls ...Purpose:This study was aimed to determine associations of accelerometer-determined time and bouts of sedentary behavior,light physical activity(LPA),and moderate-to-vigorous PA(MVPA)with sarcopenia and incident falls over 12 months.Methods:A total of 3334 Swedish 70-year-olds were assessed for sarcopenia,as defined by the revised definition of the European Working Group on Sarcopenia in Older People.Assessments were based on low scores for appendicular lean mass(dual-energy X-ray absorptiometry),hand grip strength,and the Timed Up and Go test.For 7 days after baseline,total time and total number of bouts(≥10 min of continuous activity at a given intensity)of activity performed at sedentary,LPA,and MVPA intensities were assessed by accelerometer.Incident falls were self-reported 6 months and 12 months after baseline.Results:Only 1.8%of participants had probable or confirmed sarcopenia.After multivariable adjustment for other levels of activity,only greater MVPA time was associated with a decreased likelihood of having low appendicular lean mass,low hand grip strength,and slow Timed Up and Go time as defined by the European Working Group on Sarcopenia in Older People criteria(all p<0.05),and only MVPA time was associated with lower likelihood of probable or confirmed sarcopenia(odds ratio=0.80,95%confidence interval:0.71-0.91 h/week).Similar associations were identified for total number of bouts,with no evidence of threshold effects for longer duration of bouts of MVPA.A total of 14%of participants reported-1 fall,but neither total time nor bouts of activity was associated with incident falls(all p>0.05).Conclusion:Higher amounts of accelerometer-determined MVPA are consistently associated with a decreased likelihood of sarcopenia and its components,regardless of the length of bouts or amounts of sedentary behavior.展开更多
AIM: To characterize and compare our current series of patients to prior reports in order to identify any changes in the incidence of neurological injury related to hunting accidents in Rochester, New York.METHODS: Al...AIM: To characterize and compare our current series of patients to prior reports in order to identify any changes in the incidence of neurological injury related to hunting accidents in Rochester, New York.METHODS: All tree stand-related injuries referred to our regional trauma center from September 2003 through November 2011 were reviewed. Information was obtained from the hospital's trauma registry and medical records were retrospectively reviewed for data pertaining to the injuries.RESULTS: Fifty-four patients were identified. Ninetysix percent of patients were male with a mean age of 47.9 years(range 15-69). The mean Injury Severity Score was 12.53 ± 1.17(range 2-34). The average height of fall was 18.2 feet(range 4-40 feet). All patients fell to the ground with the exception of one who landed on rocks, and many hit the tree or branches on the way down. A reason for the fall was documented in only 13 patients, and included tree stand construction(3), loss of balance(3), falling asleep(3), structural failure(2), safety harness breakage(3) or lightheadedness(1). The most common injuries were spinal fractures(54%), most commonly in the cervical spine(69%), followed by the thoracic(38%) and lumbar(21%) spine. Eight patients required operative repair. Head injuries occurred in 22%. Other systemic injuries include rib/clavicular fractures(47%), pelvic fractures(11%), solid organ injury(23%), and pneumothorax or hemothorax(19%). No patient deaths were reported. The average hospital length of stay was 6.56 ± 1.07 d. Most patients were discharged home without(72%) or with(11%) services and 17% required rehabilitation. CONCLUSION: Falls from hunting tree stands are still common, with a high rate of neurological injury. Compared to a decade ago we have made no progress in preventing these neurological injuries, despite an increase in safety advances. Neurosurgeons must continue to advocate for increased safety awareness and participate in leadership roles to improve outcomes for hunters.展开更多
Age-related physiological impairments of heart rate, blood pressure and cerebral blood flow, in combination with comorbid conditions and concurrent medications, account for an increased susceptibility to syncope in ol...Age-related physiological impairments of heart rate, blood pressure and cerebral blood flow, in combination with comorbid conditions and concurrent medications, account for an increased susceptibility to syncope in older adults. Common causes of syncope are orthostatic hypotension, neurally-mediated syncope (including carotid sinus syndrome) and cardiac arrhythmias. A high proportion of older patients with cardiovascular syncope present with falls and deny loss of consciousness. Patients who are cognitively normal and have unexplained falls should have a detailed cardiovascular assessment.展开更多
Patient falls have long been a difficult problem and topic of research in the inpatient hospital environment. Hospitals experience heavy financial burden due to patient falls. Preventing falls can improve patient outc...Patient falls have long been a difficult problem and topic of research in the inpatient hospital environment. Hospitals experience heavy financial burden due to patient falls. Preventing falls can improve patient outcomes as well as reduce financial burden on both the patient as well as the healthcare organization. In this study, we determine the optimal cut-off value for patients at risk for falls using a Falls Screening Tool, the Morse Falls Scale. This study was conducted at a community-owned hospital with 256 acute care private rooms and 36 critical care rooms. This study used only the admission Morse Falls Scale (MFS) score in its analysis.展开更多
Introduction: In older populations, the help of a third person may be necessary for a certain number of individuals in order to fill in questionnaires. The influence of this assistance on the collected information can...Introduction: In older populations, the help of a third person may be necessary for a certain number of individuals in order to fill in questionnaires. The influence of this assistance on the collected information can raise questions, among others concerning the concordance between the information provided by the persons themselves and by their proxies, or the introduction of a potential bias. Our study’s objective is to examine, among older people, the differences in the reported frequency of falls, fear of falling and activity restriction due to fear of falling, according to the fact that people had filled in a questionnaire with or without the help of a third person. Methods: The data used come from the secondary analysis of a cross-sectional survey using a self-administered questionnaire and conducted in 2006 in a Belgian semi-rural town among non-institutionalised persons aged 65 years and over. Results: Among the 501 questionnaires, 16.4% were filled in with the help of another person. In bivariate analysis, the persons who needed help reported fall history, fear of falling and activity restriction significantly more often. In multivariable analysis, when considering concurrently the covariates (sex, age, living alone and fall history for fear of falling and for activity restriction), the influence of having received help to fill in the survey was only significant for activity restriction. Conclusion: Our study shows that it is important to know whether or not a person has received help to fill in a questionnaire. This can actually influence the reported frequency of certain outcomes, even, for activity restriction, when considering simultaneously the effect of other covariates. Given the current and future ageing of our populations, it seems that more extensive exploration is needed of the influence of proxies on the collected information about falls, fear of falling and activity restriction among older people.展开更多
Purpose: To evaluate the relevance and accuracy of determining and predicting risk factors for falls in older women using the International Classification of Functioning, Disability and Health (ICF). Methods: We teste...Purpose: To evaluate the relevance and accuracy of determining and predicting risk factors for falls in older women using the International Classification of Functioning, Disability and Health (ICF). Methods: We tested the accuracy of the ICF against risk of falls amongst 568 community dwelling participants of the Australian Longitudinal Survey on Women’s Health (ALSWH). We linked health-related variables to the ICF using ten linking rules. The logistic regression analysis evaluated the relationship between the variables and the outcome of falls. Self-report surveys measured daily functioning, health service use, medications, housing and social support. Results: Variables aligned with the ICF components of body function, health conditions, environment, activity and participation (ADL/IADL), and general health were significantly associated with falls. Discussion and conclusion: Mapping ALSWH health-related data to ICF components identified significant risk factors for falls are related to health conditions, functional limitations and home hazards. Biopsycho-social approaches guided by the ICF framework are crucial for fall prevention.展开更多
This study aimed to examine differences in the frequency of falls during the past year and fall risk among 392 elderly females was categorized into five groups on the basis of the knee pain expe-rienced: no knee pain,...This study aimed to examine differences in the frequency of falls during the past year and fall risk among 392 elderly females was categorized into five groups on the basis of the knee pain expe-rienced: no knee pain, mild unilateral knee pain, mild bilateral knee pain, severe unilateral knee pain, and severe bilateral knee pain. The subjects participated in a fall risk survey comprising 50 items representing five risk factors: “symptoms of falling”, “disease and physical symptoms”, “en-vironment”, “behavior and character”, and “physical function”. The frequency of falls during the past year, score for each risk factor, and the total fall risk score were not significantly different between the mild unilateral and mild bilateral knee pain groups, and between the severe unilateral and severe bilateral knee pain groups. Therefore, these groups were pooled to form a mild knee pain group and a severe knee pain group and analyzed. The severe knee pain group had experienced a significantly greater number of falls during the past year compared with the no knee pain group. Furthermore, the symptom of falling score was significantly higher in the severe knee pain group than in the no knee pain group, while the disease and physical symptoms score was significantly higher in the mild and severe knee pain groups than in the no knee pain group. The physical function score and total fall risk score were significantly higher in the following order: the severe knee pain group, the mild knee pain group, and the no knee pain group. Our results indicate that for elderly females who can achieve ADL independently, the degree of knee pain (mild or severe) has a marked effect on fall risk, irrespective of laterality of the pain (unilateral or bilateral). Factors such as symptoms of falling, disease and physical symptoms, and physical function are also related to fall risk in this population. Furthermore, elderly individuals with severe knee pain experience frequent falls.展开更多
Falls are a frequent and costly cause of injuries and functional decline in the elderly. Tai Chi is a cost-effective strategy for preventing falls in older adults. Many senior centers have introduced Tai Chi programs ...Falls are a frequent and costly cause of injuries and functional decline in the elderly. Tai Chi is a cost-effective strategy for preventing falls in older adults. Many senior centers have introduced Tai Chi programs to increase mobility and decrease the risk of falls. However, the practice has yet to be widely disseminated to ethnic minorities who are not culturally connected to Tai Chi. This paper describes implementation barriers and recruitment and retention challenges of Arab American participants in a Tai Chi intervention-based health promotion program, including issues related to community organization and staffing, recruitment and retention, need for building relationships, need for translation and interpreters, and cultural barriers & misconceptions. Understanding and paying adequate attention to these challenges may help facilitate in planning other health promotion interventions targeting Arab American population.展开更多
基金This study was supported by the Shanghai Jiaotong University School of Medicine:Nursing Development Program(No.Shanghai Jiaotong University School of Medicine[2021])Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University,School of Medicine“Excellent Nursing Talent Program”LinkedIn Program(JYHRC22-L01).
文摘Objective:To analyze and provide a comprehensive overview of the knowledge structure and research hotspots of clinical interventions for falls in elderly patients in the community.Methods:The search for publications related to clinical interventions for falls in elderly patients in the community from 2002 to 2022 was conducted on the Web of Science Core Collection(WoSCC)database.VOSviewers,CiteSpace,and the R package“bibliometrix”were used to conduct this bibliometric analysis.Results:2091 articles from 70 countries,primarily the United States and Australia,were included.The number of publications related to clinical interventions for falls in elderly patients is increasing yearly.The main research institutions in this field were the University of Sydney,Harvard University,and the University of California.BioMed Central(BMC)Geriatrics was the most popular journal in this field and Journals of the American Geriatrics Society was the most co-cited journal.These publications came from 8984 authors among which author Lord SR had published the most papers and author Tinetti Me had the most co-citations.The main keywords in this research field were“balance,”“exercise,”and“risk factor.”Conclusion:This was the first bibliometric study that comprehensively summarized the research hot spots and development of clinical interventions for falls in elderly patients in the community.This paper aims to provide a reference for scholars and researchers in this particular field.
文摘Background: Falls in the elderly are a global public health problem with serious medical and socio-economic consequences, especially in low and middle-income countries. The aim of this study was to describe the characteristics of falls among the elderly in trauma units in Senegal. Materials and Methods: This was a descriptive, prospective study from April 20, 2022 to October 30, 2022 among people aged at least 60 and admitted to the surgical emergency department of Idrissa Pouye Hospital in Dakar following a fall. Socio-demographic, clinical, therapeutic and evolutionary characteristics were collected and analyzed using Sphinx Plus 2 and Excel 2019 for Windows software. Results: Out of 730 elderly people seen during this period, 100 met the criteria, representing a prevalence of 13.69%. The average consultation time was 3.25 +/? 4 days. The average age was 73 +/? 8.43 years, with women predominating (74%). Medical expenses were mainly covered by the family (73%). Most falls occurred during the day (68%), at home (82%), especially in the bedroom (30%), with stumbling (32%) as the main mechanism. The majority of patients (86%) spent less than 30 minutes on the floor. Predisposing factors were dominated by visual disorders (56%) and precipitating factors were mainly environmental (62%). Geriatric syndromes were dominated by frailty (22%). Complications were dominated by fractures (86%), and almost half (47%) had lost their autonomy for post-fall Activities Daily Living (ADL). Prescription medication was almost systematic (98%), dominated by analgesics (98%). Surgery was indicated in 58% of patients. The average waiting time for surgery was 25.36 +/? 19 days. A death rate of 1% was recorded in the emergency department. Conclusion: Falls in the elderly are a frequent occurrence in traumatological emergencies, with etiological factors that are often multiple and interrelated, leading to significant morbidity. Raising awareness among people at risk and setting up an orthogeriatric service would help prevent falls and optimize care in the short and long term.
基金supported,in part,by the National Nature Science Foundation of China under Grant Numbers 62272236,62376128in part,by the Natural Science Foundation of Jiangsu Province under Grant Numbers BK20201136,BK20191401.
文摘Fall behavior is closely related to high mortality in the elderly,so fall detection becomes an important and urgent research area.However,the existing fall detection methods are difficult to be applied in daily life due to a large amount of calculation and poor detection accuracy.To solve the above problems,this paper proposes a dense spatial-temporal graph convolutional network based on lightweight OpenPose.Lightweight OpenPose uses MobileNet as a feature extraction network,and the prediction layer uses bottleneck-asymmetric structure,thus reducing the amount of the network.The bottleneck-asymmetrical structure compresses the number of input channels of feature maps by 1×1 convolution and replaces the 7×7 convolution structure with the asymmetric structure of 1×7 convolution,7×1 convolution,and 7×7 convolution in parallel.The spatial-temporal graph convolutional network divides the multi-layer convolution into dense blocks,and the convolutional layers in each dense block are connected,thus improving the feature transitivity,enhancing the network’s ability to extract features,thus improving the detection accuracy.Two representative datasets,Multiple Cameras Fall dataset(MCF),and Nanyang Technological University Red Green Blue+Depth Action Recognition dataset(NTU RGB+D),are selected for our experiments,among which NTU RGB+D has two evaluation benchmarks.The results show that the proposed model is superior to the current fall detection models.The accuracy of this network on the MCF dataset is 96.3%,and the accuracies on the two evaluation benchmarks of the NTU RGB+D dataset are 85.6%and 93.5%,respectively.
基金This study was supported by Chinese Nursing Association Research Fund Project(ZHKY201405).
文摘Objectives:The objective of this study was to examine the falls efficacy of older adults in nursing homes and the related predictors of falling.Methods:A sample of 317 older adults was recruited from 18 nursing homes in the Fujian province of China.The Modified Falls Efficacy Scale(MFES)and Kessler Psychological Distress Scale(K10)were employed to collect data.Results:The falls efficacy of older adults was moderate(7.80±1.17).The falls efficacy questionnaire item“Get dressed and undressed”scored the highest(9.12±1.440),while“Crossing roads”scored the lowest(5.77±3.371).Multiple regression analysis demonstrated that mental health status,degree of self-care,age and gender were each predictors of the falls efficacy of older adults.Conclusions:Falls efficacy enhancing programs for nursing home residents should take mental health status,degree of self-care,age and gender into account.
基金The study was approved by the Inonu University Ethics Committee (No：2014/154).
文摘BACKGROUND: Emergency services manage trauma patients frequently and falls from height comprise the main cause of emergency service admissions. In this study, we aimed to analyse the demographic characteristics of falls from height and their relationship to the mortality.METHODS: A total of 460 patients, who admitted to the Emergency Department of Inonu University between November 2011 and November 2014 with a history of fall from height, were examined retrospectively. Demographic parameters, fall characteristics and their effect to mortality were evaluated statistically. RESULTS: The study comprised of 292(63.5%) men and 168(36.5%) women patients. The mean age of all patients was 27±24.99 years. Twenty-six(5.6%) patients died and the majority of them were in ≥62 years old group. The highest percentage of falls was at 0–5 years age group(28.3%). People fell mainly from 1.1–4 metres(m) level(46.1%). The causes of falls were ordered as unintentional(92.2%), workplace(8.1%) and suicidal(1.7%). Skin and soft tissue injuries(37.4%) were the main traumatic lesions. CONCLUSION: Age, fall height, fall place, linear skull fracture, subarachnoidal hemorrhage, cervical fracture, thoracic vertebra fracture and trauma scores had statistically significant effect on mortality. The casualties died because of subarachnoid hemorrhage mostly.
文摘AIM To investigate whether adductor canal nerve block(ACB) reduces patient falls when compared to femoral nerve block(FNB) after total knee arthroplasty(TKA). METHODS We conducted an institutional review of all-cause falls after TKA from January 2013 to August 2016 using a quality improvement database. Our inclusion criteria were patients with diagnosis of primary knee osteoarthritis who underwent primary unilateral TKA with either a FNB or an ACB and sustained a fall during their hospitalization. We excluded patients who had revision TKA and extensor mechanism reconstruction. We also excluded patients with a history of post-traumatic arthritis, prior history of lower extremity fracture, history of neurological disease, or cerebrovascular disease. RESULTS A total of 834 patients had TKA with femoral nerve block and knee immobilizer(FNB + KI). Of those patients, 11(1.3%) experienced a fall during their hospital stay. In contrast, 791 patients had TKA with ACB. Of those patients, only one(0.13%) patient fall was recorded within this group. We used the Fisher's exact test to compare the differences between the two groups. The difference between the two groups achieves statistical significance(P = 0.006). We also found that 11 out of the 12 patients that fell had a right TKA procedure while one patient had a left TKA procedure. Nine out of twelve patients that fell were female, while only three patients were male.CONCLUSION Given the reduction in the number of falls with ACB, it is recommended that ACB be considered the preferred analgesia for patients undergoing a TKA procedure.
文摘Background: Ageing of the population is one of the most important demographic facts that come to the foreground in the 21st century. Objective: To assess the relationship between psychological factors (depression, loneliness, using anti anxiety medication, fear from falls and internal displacement of the population) and falls among elderly people in Baghdad city, Iraq. Methods: A matched 1:1 community based case-control study involving 716 elderly respondents, recruited randomly from six Non Governmental Organization (NGO) in different areas of Baghdad. Interviews to each respondent were done accordingly. Geriatric depression scale (GDS) was used to assess the depression among the elderly people. Results: The minimum age for cases and controls was 60 years old while the maximum age for cases was 87 and for controls was 85 years old. The female was predominant than male, 53.6% to 46.4% respectively. The relation between depression, fear from fall, using anti anxiety medication, internal displacement and falls was statistically significant
文摘Purpose: To establish a relationship between falls and handgrip strength (GS) in communitydwelling senior citizens in Egypt. Subjects: Crosssectional study enrolling 132 subjects, all ≥60 years old. Materials and Methods: History of falls in the past year and their number as well as GS measurement in both hands using Baseline? pneumatic squeeze handheld dynamometer. Results: There is a highly significant difference between the GS of fallers and non-fallers in both hands (P = 0.000). There is a highly significant negative correlation between the mean GS and the number of falls (P = 0.003). There is a highly significant positive correlation between GS of the right hand with the number of falls (R = 0.226, P = 0.009), as for the correlation with the left GS it was a weaker positive correlation (R = 0.209, P = 0.16). Conclusion: Seniors with history of falls have a lower GS in both dominant and nondominant hands and it is directly related to the number of falls. GS is decreased in senior fallers even if within the normal range.
基金The Beijing Municipal Science and Technology Commission(D121100004912004).
文摘This exploratory study investigated the circumstances of falls and fall-related injuries among frail elderly people under home care.A convenience sample of 500 frail elderly(60 e99 years old)from the Wanshoulu and Yuyuantan communities in Beijing's Haidian District during February 2013 and March 2014.Fall circumstances and related injuries were characterized by detailed interviews and questionnaires.The article reports the results of a study that the overall fall incidence was 41.5%,and higher for females than males.Falls mainly occurred in individuals who were over 80 years old(50.0%)and indoors(67.9%).The percentage of subjects who experienced a combined injury after the fall was 56.3%,whereas 19.0%fell causes a fracture.Approximately 35%of the subjects were hospitalized,and 27.6%of the subjects recovered more than 30 days.Results indicate that,falls in the frail elderly caused serious damage,and fall-related circumstances should be a great concern in this population.
文摘Introduction: Blue Marble Health Company has created a digital fall risk screening tool (Health in Motion©) that can be used by means of self-report (touch/mouse) or by means of motion capture (Microsoft Kinect Sensor). Health in Motion©consists of automated versions of the Fall Risk Question-naire, 30-Second Chair Stand Test, and the One Leg Stance Test. Methods: We compared the three methods (self-report, sensor, and clinical standard measurement) using stopwatch and observation in 15 community-dwelling older adults, aged 63 - 80 years old. Each version was completed three times each in random order, for a total of nine trials. Results: Health in Motion©falls screening tool accessible via self-report and sensor is a valid and reliable automated at-home self-assessment for falls risk. Conclusion: Results support the use of Health in Motion©falls screening tools as viable alternatives to standard falls risk assessments for use by older adults at home.
文摘In order to further understand the full vector excursional details of the geomagnetic field, a paleomagnetic and rock magnetic study of four sites has been conducted at the type locality of Pringle Falls, Oregon where 827 samples were drilled and spaced along a distance of 5 km, for their detailed directional and relative paleointensity studies. The profiles have registered a high-reso- lution (>10 cm/kyr) paleomagnetic record of the excursion (ca. 211+/13 ka) as recorded by diatomaceous lacustrine sediments. Remanence as well as induced magnetization experiments to investigate the reproducibility of the signal throughout the profiles have been conducted. In addition, low-field susceptibility vs. temperature analysis was performed indicating that the main magnetic carrier is pure magnetite (Curie point 575 ℃). The magnetic grain size also has indicated Single Domain-Multi-Domain (SD-MD) magnetite. The demagnetization was done by alternating field (a.f.) experiments, and the mean directions were determined by principal component analyses. In addition, induced magnetic tests were done, such as magnetic susceptibility (x) analyses, saturation IRM, anhysteretic remanent magnetization (ARM70) as well as the normalization of J17.5 mT/ARM70 to attempt to obtain relative paleointensity records of these sediments in question. The results of the induced rock magnetic tests such as the normalization studies indicate a direct correlation between the decrease of the relative paleointensity variations (i.e. lows) with respect to the directional changes. The detailed behavior of the paleosignal is highly consistent, since they are rapidly deposited sediments providing a detailed representation of the paleofield. The dissected VGP paths in 3 different phases are highly internally consistent and are defined by clockwise and anticlockwise loops traveling from the high northern latitudes over eastern North America and the North Atlantic to South America and then to high southern latitudes. They then return to the high northern latitudes through the Pacific and over to Kamchatka. This VGP behavior defines the geomagnetic signature of the Pringle Falls excursion as recorded at the type locality.
基金supported by the Swedish Research Council(Grant number 2011-2976)DS is supported by an Australian National Health and Medical Research Council(NHMRC)R.D.Wright Biomedical Career Development Fellowship(Grant number GNT1123014).
文摘Purpose:This study was aimed to determine associations of accelerometer-determined time and bouts of sedentary behavior,light physical activity(LPA),and moderate-to-vigorous PA(MVPA)with sarcopenia and incident falls over 12 months.Methods:A total of 3334 Swedish 70-year-olds were assessed for sarcopenia,as defined by the revised definition of the European Working Group on Sarcopenia in Older People.Assessments were based on low scores for appendicular lean mass(dual-energy X-ray absorptiometry),hand grip strength,and the Timed Up and Go test.For 7 days after baseline,total time and total number of bouts(≥10 min of continuous activity at a given intensity)of activity performed at sedentary,LPA,and MVPA intensities were assessed by accelerometer.Incident falls were self-reported 6 months and 12 months after baseline.Results:Only 1.8%of participants had probable or confirmed sarcopenia.After multivariable adjustment for other levels of activity,only greater MVPA time was associated with a decreased likelihood of having low appendicular lean mass,low hand grip strength,and slow Timed Up and Go time as defined by the European Working Group on Sarcopenia in Older People criteria(all p<0.05),and only MVPA time was associated with lower likelihood of probable or confirmed sarcopenia(odds ratio=0.80,95%confidence interval:0.71-0.91 h/week).Similar associations were identified for total number of bouts,with no evidence of threshold effects for longer duration of bouts of MVPA.A total of 14%of participants reported-1 fall,but neither total time nor bouts of activity was associated with incident falls(all p>0.05).Conclusion:Higher amounts of accelerometer-determined MVPA are consistently associated with a decreased likelihood of sarcopenia and its components,regardless of the length of bouts or amounts of sedentary behavior.
文摘AIM: To characterize and compare our current series of patients to prior reports in order to identify any changes in the incidence of neurological injury related to hunting accidents in Rochester, New York.METHODS: All tree stand-related injuries referred to our regional trauma center from September 2003 through November 2011 were reviewed. Information was obtained from the hospital's trauma registry and medical records were retrospectively reviewed for data pertaining to the injuries.RESULTS: Fifty-four patients were identified. Ninetysix percent of patients were male with a mean age of 47.9 years(range 15-69). The mean Injury Severity Score was 12.53 ± 1.17(range 2-34). The average height of fall was 18.2 feet(range 4-40 feet). All patients fell to the ground with the exception of one who landed on rocks, and many hit the tree or branches on the way down. A reason for the fall was documented in only 13 patients, and included tree stand construction(3), loss of balance(3), falling asleep(3), structural failure(2), safety harness breakage(3) or lightheadedness(1). The most common injuries were spinal fractures(54%), most commonly in the cervical spine(69%), followed by the thoracic(38%) and lumbar(21%) spine. Eight patients required operative repair. Head injuries occurred in 22%. Other systemic injuries include rib/clavicular fractures(47%), pelvic fractures(11%), solid organ injury(23%), and pneumothorax or hemothorax(19%). No patient deaths were reported. The average hospital length of stay was 6.56 ± 1.07 d. Most patients were discharged home without(72%) or with(11%) services and 17% required rehabilitation. CONCLUSION: Falls from hunting tree stands are still common, with a high rate of neurological injury. Compared to a decade ago we have made no progress in preventing these neurological injuries, despite an increase in safety advances. Neurosurgeons must continue to advocate for increased safety awareness and participate in leadership roles to improve outcomes for hunters.
文摘Age-related physiological impairments of heart rate, blood pressure and cerebral blood flow, in combination with comorbid conditions and concurrent medications, account for an increased susceptibility to syncope in older adults. Common causes of syncope are orthostatic hypotension, neurally-mediated syncope (including carotid sinus syndrome) and cardiac arrhythmias. A high proportion of older patients with cardiovascular syncope present with falls and deny loss of consciousness. Patients who are cognitively normal and have unexplained falls should have a detailed cardiovascular assessment.
文摘Patient falls have long been a difficult problem and topic of research in the inpatient hospital environment. Hospitals experience heavy financial burden due to patient falls. Preventing falls can improve patient outcomes as well as reduce financial burden on both the patient as well as the healthcare organization. In this study, we determine the optimal cut-off value for patients at risk for falls using a Falls Screening Tool, the Morse Falls Scale. This study was conducted at a community-owned hospital with 256 acute care private rooms and 36 critical care rooms. This study used only the admission Morse Falls Scale (MFS) score in its analysis.
文摘Introduction: In older populations, the help of a third person may be necessary for a certain number of individuals in order to fill in questionnaires. The influence of this assistance on the collected information can raise questions, among others concerning the concordance between the information provided by the persons themselves and by their proxies, or the introduction of a potential bias. Our study’s objective is to examine, among older people, the differences in the reported frequency of falls, fear of falling and activity restriction due to fear of falling, according to the fact that people had filled in a questionnaire with or without the help of a third person. Methods: The data used come from the secondary analysis of a cross-sectional survey using a self-administered questionnaire and conducted in 2006 in a Belgian semi-rural town among non-institutionalised persons aged 65 years and over. Results: Among the 501 questionnaires, 16.4% were filled in with the help of another person. In bivariate analysis, the persons who needed help reported fall history, fear of falling and activity restriction significantly more often. In multivariable analysis, when considering concurrently the covariates (sex, age, living alone and fall history for fear of falling and for activity restriction), the influence of having received help to fill in the survey was only significant for activity restriction. Conclusion: Our study shows that it is important to know whether or not a person has received help to fill in a questionnaire. This can actually influence the reported frequency of certain outcomes, even, for activity restriction, when considering simultaneously the effect of other covariates. Given the current and future ageing of our populations, it seems that more extensive exploration is needed of the influence of proxies on the collected information about falls, fear of falling and activity restriction among older people.
文摘Purpose: To evaluate the relevance and accuracy of determining and predicting risk factors for falls in older women using the International Classification of Functioning, Disability and Health (ICF). Methods: We tested the accuracy of the ICF against risk of falls amongst 568 community dwelling participants of the Australian Longitudinal Survey on Women’s Health (ALSWH). We linked health-related variables to the ICF using ten linking rules. The logistic regression analysis evaluated the relationship between the variables and the outcome of falls. Self-report surveys measured daily functioning, health service use, medications, housing and social support. Results: Variables aligned with the ICF components of body function, health conditions, environment, activity and participation (ADL/IADL), and general health were significantly associated with falls. Discussion and conclusion: Mapping ALSWH health-related data to ICF components identified significant risk factors for falls are related to health conditions, functional limitations and home hazards. Biopsycho-social approaches guided by the ICF framework are crucial for fall prevention.
文摘This study aimed to examine differences in the frequency of falls during the past year and fall risk among 392 elderly females was categorized into five groups on the basis of the knee pain expe-rienced: no knee pain, mild unilateral knee pain, mild bilateral knee pain, severe unilateral knee pain, and severe bilateral knee pain. The subjects participated in a fall risk survey comprising 50 items representing five risk factors: “symptoms of falling”, “disease and physical symptoms”, “en-vironment”, “behavior and character”, and “physical function”. The frequency of falls during the past year, score for each risk factor, and the total fall risk score were not significantly different between the mild unilateral and mild bilateral knee pain groups, and between the severe unilateral and severe bilateral knee pain groups. Therefore, these groups were pooled to form a mild knee pain group and a severe knee pain group and analyzed. The severe knee pain group had experienced a significantly greater number of falls during the past year compared with the no knee pain group. Furthermore, the symptom of falling score was significantly higher in the severe knee pain group than in the no knee pain group, while the disease and physical symptoms score was significantly higher in the mild and severe knee pain groups than in the no knee pain group. The physical function score and total fall risk score were significantly higher in the following order: the severe knee pain group, the mild knee pain group, and the no knee pain group. Our results indicate that for elderly females who can achieve ADL independently, the degree of knee pain (mild or severe) has a marked effect on fall risk, irrespective of laterality of the pain (unilateral or bilateral). Factors such as symptoms of falling, disease and physical symptoms, and physical function are also related to fall risk in this population. Furthermore, elderly individuals with severe knee pain experience frequent falls.
文摘Falls are a frequent and costly cause of injuries and functional decline in the elderly. Tai Chi is a cost-effective strategy for preventing falls in older adults. Many senior centers have introduced Tai Chi programs to increase mobility and decrease the risk of falls. However, the practice has yet to be widely disseminated to ethnic minorities who are not culturally connected to Tai Chi. This paper describes implementation barriers and recruitment and retention challenges of Arab American participants in a Tai Chi intervention-based health promotion program, including issues related to community organization and staffing, recruitment and retention, need for building relationships, need for translation and interpreters, and cultural barriers & misconceptions. Understanding and paying adequate attention to these challenges may help facilitate in planning other health promotion interventions targeting Arab American population.
