Objective: To analyze the influence of chronic diseases on falls among middle-aged and older Chinese. Methods: Baseline data of 13 670 middle-aged and older adults recruited from China Health and Retirement Longitudinal Study (CHARLS) in 2011 were used and followed up to 2018, among those were 7 443 (54.45%) middle-aged people aged 45-59 and 6 227 (45.55%) older adults aged 60 and above. The Cox proportional hazards model was used to analyze the effects of different types, the number of chronic diseases and the interaction between chronic illness and other factors on the fall risk of middle-aged and older people. Results: After adjusting for confounding factors, respiratory diseases increased the risk of falls by 21% (HR=1.21, 95%CI:1.02-1.45), and arthritis increased the risk of falls by 27% (HR=1.27,95%CI: 1.12-1.43) in the group aged 45-59, kidney disease increased the risk of falls by 26% (HR=1.26, 95%CI: 1.03-1.53) in the group aged 60 and above. A linear dose-response relationship between the number of chronic diseases and fall risk (χ2=133.61, P<0.001) was found in all the age groups. The interaction between having chronic diseases and the factors of females (HR=1.64, 95%CI: 1.43-1.89), impaired activities of daily living (ADL) (HR=1.66, 95%CI: 1.39-1.99), and having a fall history (HR=2.58, 95%CI: 2.24-2.97) increased the risk of falls. Conclusions: There is a positive linear relationship between the number of chronic diseases and the fall risk among Chinese aged 45 and above. The female middle-aged and elderly patients with chronic diseases and the middle-aged and elderly patients with impaired ADL or a history of falls are the high-risk groups for falls that need to be focused on intervention. The window of fall injury prevention should be moved forward to the middle-aged stage in time.
Accidental Falls ; Activities of Daily Living ; Aged ; China/epidemiology* ; Chronic Disease ; Cohort Studies ; Female ; Humans ; Longitudinal Studies ; Middle Aged ; Risk Factors

risk factors (noise, vibration, abnormal temperature, etc.) and shift work.]]>
Accidental Falls ; Employment ; Fatigue ; Logistic Models ; Risk Factors ; Salaries and Fringe Benefits ; Vibration

To investigate vitamin D status according to the diseases in patients admitted to the department of rehabilitation medicine. In total, 282 patients admitted to the department of rehabilitation medicine in our hospital were included. Patients were classified into 4 groups according to ailment: stroke, traumatic brain injury, spinal cord injury, and fracture. All patients were also classified as ambulatory or non-ambulatory. Serum 25-hydroxyvitamin D (25[OH]D) levels were estimated at admission and at discharge. Bone mineral density (BMD) and ionized calcium levels were also measured. All subjects completed the Desmond Fall Risk Questionnaire for fall risk assessment. In total, 92 patients (59 males and 33 females; mean age, 69.09 ± 9.4 years) was enrolled. Low serum 25(OH)D levels (6–28 ng/mL) were observed in all patients in this study, and these were lower in the group of fractures resulting from falls than in the group of strokes (p < 0.05). Significant correlations were found between BMD and ionized calcium levels, Desmond Fall Risk Questionnaire scores and BMD, and questionnaire scores and serum 25(OH)D (p < 0.05). Serum 25(OH)D levels were lower in the department of rehabilitation medicine inpatients in our study than in the general population. The ambulatory patients had higher serum 25(OH)D levels at discharge than the non-ambulatory patients'. The hospitalized rehabilitation patients had lower serum 25(OH)D compared with the community. There were lower serum 25(OH)D levels in patients with fractures and non-ambulatory groups. We should pay attention to serum vitamin D levels of rehabilitation center inpatients.
Accidental Falls ; Bone Density ; Brain Injuries ; Calcium ; Female ; Humans ; Inpatients ; Male ; Rehabilitation Centers ; Rehabilitation ; Risk Assessment ; Spinal Cord Injuries ; Stroke ; Vitamin D ; Vitamins

OBJECTIVE: To predict the risk of falls, Fall Risk Assessment (FRA) system has been newly developed to measure multi-systemic balance control among community-dwelling older adults. The aim of this study was to examine the association between FRA and fall-related physical performance tests. METHODS: A total of 289 community-dwelling adults aged 65 years and older participated in this cross-sectional study. All participants underwent FRA test and physical performance tests such as Short Physical Performance Battery (SPPB), Berg Balance Scale (BBS), and Timed Up and Go Test (TUG). RESULTS: Participants who were younger, male, highly educated, living with family members, having high body mass index, having high appendicular lean mass index, and having no irritative lower urinary tract syndrome were more likely to have higher FRA scores. SPPB (β=1.012), BBS (β=0.481), and TUG (β=-0.831) were significantly associated with FRA score after adjusting for the variables (all p < 0.001). CONCLUSION: FRA composite score was closely correlated with SPPB, BBS, and TUG, suggesting that FRA is a promising candidate as a screening tool to predict falls among community-dwelling elderly people.
Accidental Falls ; Adult ; Aged ; Body Mass Index ; Cross-Sectional Studies ; Humans ; Male ; Mass Screening ; Risk Assessment ; Urinary Tract

PURPOSE: This study was conducted to obtain data for the development of an effective fall risk assessment tool for pediatric inpatients through a systematic review and meta-analysis of the diagnostic test accuracy of existing scales. METHODS: A literature search using Medline, Science Direct, CINAHL, EMBASE, and the Cochrane Library was performed between March 1 and 31, 2018. Of 890 identified papers, 10 were selected for review. Nine were used in the meta-analysis. Stata version 14.0 was used to create forest plots of sensitivity and specificity. A summary receiver operating characteristic curve was used to compare all diagnostic test accuracies. RESULTS: Four studies used the Humpty Dumpty Falls Scale. The most common items included the patient's diagnoses, use of sedative medications, and mobility. The pooled sensitivity and specificity of the nine studies were .79 and .36, respectively. CONCLUSION: Considering the low specificity of the pediatric fall risk assessment scales currently available, there is a need to subdivide scoring categories and to minimize items that are evaluated using nurses' subjective judgment alone. Fall risk assessment scales should be incorporated into the electronic medical record system and an automated scoring system should be developed.
Accidental Falls ; Diagnosis ; Diagnostic Tests, Routine* ; Electronic Health Records ; Forests ; Humans ; Inpatients* ; Judgment ; Pediatrics ; Risk Assessment* ; ROC Curve ; Sensitivity and Specificity ; Weights and Measures*

STUDY DESIGN: Retrospective database analysis. PURPOSE: To identify risk factors that predict mortality following acute spine fractures in geriatric patients of Singapore. OVERVIEW OF LITERATURE: Acute geriatric spinal fractures contribute significantly to local healthcare costs and hospital admissions. However, geriatric mortality following acute spine fractures is scarcely assessed in the Asian population. METHODS: Electronic records of 3,010 patients who presented to our hospital’s emergency department and who were subsequently admitted during 2004–2015 with alleged history of traumatic spine fractures were retrospectively reviewed, and 613 patients (mean age, 85.7±4.5 years; range, 80–101 years; men, 108; women, 505) were shortlisted. Mortality rates were reviewed up to 1 year after admission and multivariate analyses were performed to identify independent risk factors correlating with mortality. RESULTS: Women were more susceptible to spine fractures (82.4%), with falls (77.8%) being the most common mechanism of injury. Mortality rates were 6.0%, 8.2%, and 10.4% at 3, 6, and 12 months, respectively. The most common causes of death at all 3 time points were pneumonia and ischemic heart disease. Based on the multivariate analysis at 1-year follow-up, elderly women had a lower mortality rate compared to men (p<0.001); mortality rates increased by 6.3% (p=0.024) for every 1-year increase in the patient’s age; and patients with an American Spinal Injury Association (ASIA) score of A–C had a much higher mortality rate compared to those with an ASIA score of D–E (p<0.001). CONCLUSIONS: An older age at presentation, male sex, and an ASIA score of A–C were identified as independent factors predicting increased mortality among geriatric patients who sustained acute spine fractures. The study findings highlight at-risk groups for acute spine fractures, thereby providing an opportunity to develop strategies to increase the life expectancy of these patients.
Accidental Falls ; Aged ; Asia ; Asian Continental Ancestry Group ; Cause of Death ; Emergency Service, Hospital ; Female ; Follow-Up Studies ; Health Care Costs ; Humans ; Life Expectancy ; Male ; Mortality ; Multivariate Analysis ; Myocardial Ischemia ; Pneumonia ; Retrospective Studies ; Risk Factors ; Singapore ; Spinal Cord Injuries ; Spinal Fractures ; Spinal Injuries ; Spine

OBJECTIVES: To clarify the prevalence and characteristics of pain associated with sarcopenia and to verify the usefulness of evaluation of pain for sarcopenia. METHODS: In total, 759 community-dwelling people (aged 65–79 years) with or without sarcopenia and lower limb pain were classified into 4 groups (NSp, nonsarcopenia; NSpP, nonsarcopenia with pain; Sp, sarcopenia; and SpP, sarcopenia with pain). Body composition, motor function, history of fractures since age 50 years, and number of falls in the past 1 year were compared between the groups. RESULTS: Participant proportions by group were: NSp, 53.9%; NSpP, 42.8%; Sp, 1.3%; and SpP, 2.0%. Participants with lower limb pain showed low single leg standing, walking speed, and 2-step value scores and high 25-question Geriatric Locomotive Functional Scale (GLFS-25) score after adjusting for age, sex, body mass index, and presence of sarcopenia. The SpP group showed lower functional reach test and higher GLFS-25 scores than the Sp group. Regarding the history of fractures since 50 years of age and falls in past 1 year, a high retention rate of fracture was noted in the NSpP group. They also experienced significantly more falls in the past 1 year than those in the NSp group. The SpP group noted more falls and fractures although it was insignificant. CONCLUSIONS: The results indicate that participants with lower limb pain showed declining motor function and a high risk for falls and fractures. Sarcopenia could escalate this risk. Therefore, evaluating patients for both pain and sarcopenia may be useful for risk assessment and treatment.
Accidental Falls ; Aged ; Body Composition ; Body Mass Index ; Humans ; Leg ; Lower Extremity ; Prevalence ; Risk Assessment ; Sarcopenia ; Walking

OBJECTIVE: To investigate the risk factors for fall in the elderly population residing in rural areas of Korea and provide useful data for their prevention. METHODS: As part of farmers’ health promotion project, a retrospective study was conducted with a total of 350 elderly people recruited from March 2016 to December 2016. These subjects were divided into two groups: 254 non-fallers and 96 fallers. A person who fell to the floor at least once in the past year was defined as a faller. Participants were asked to visit the hospital once. The demographic characteristics, social environment, and educational levels were surveyed using a questionnaire. Physical examination was performed in the following order: cognitive function, lower leg strength and torque, body composition, and knee image test. RESULTS: Statistically significant factors for falls in univariate analysis were female gender, age, living alone, educational level less than middle school, skeletal muscle mass, Mini-Mental State Exam, knee osteoarthritis, hip torque, hip power mean, knee torque, and knee power mean. Multivariate analysis was performed to identify variables most relevant to falls among statistically significant factors in univariate logistic analysis. It was confirmed that female gender and age of 70–79 years were statistically significant factors related to falls. CONCLUSION: Female gender and elderly status (70–79 years) are important risk factors for falls in rural areas underscoring the need for special attention when considering risk factors for falls among the elderly living in rural areas.
Accidental Falls ; Aged ; Body Composition ; Cognition ; Female ; Health Promotion ; Hip ; Humans ; Knee ; Korea ; Leg ; Multivariate Analysis ; Muscle, Skeletal ; Osteoarthritis, Knee ; Physical Examination ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Sociological Factors ; Torque

BACKGROUND: Falls are the most frequent adverse events reported in hospitals. The aim of this study was to investigate the incidence rate and characteristics of falls in patients who used comprehensive nursing care service in National Health Insurance Service Ilsan Hospital. METHODS: Incidence rate of falls was investigated in patients using comprehensive nursing care service, from July 2013 to Jun 2017 and compared with those not using this service. The characteristics and risk factors for falls, and fall-related injuries were obtained. RESULTS: Among the 62,445 patients who used the comprehensive nursing care service for 4 years, total of 672 falls were reported. The incidence rate of falls per 1,000 patients-day was 1.15. The percentage of fall-related injuries was 26.9% and that of major injury was 2.2%. Although the incidence rate of all falls was slightly higher in patients using comprehensive nursing care service than those not using this service, falls-related injuries were not correlated with the implementation of this service. CONCLUSION: The falls could be more frequently detected and reported in comprehensive nursing care service, but there was no difference in fall-related injuries.
Accidental Falls ; Humans ; Incidence ; National Health Programs ; Nursing Care ; Nursing ; Risk Factors

PURPOSE: The purpose of this study is to identify risk factors of accidental falls by age in the Korean elderly. METHODS: The study subjects included 10,242 community-dwelling elders aged 65 or over. The data were analyzed by logistic regression analysis. RESULTS: The risk factors of accidental falls in the younger old group (aged 65~74) include fear of falling (OR=16.28, 95% CI: 12.03~22.03), depression (OR=1.24, 95% CI: 1.06~1.44), and hearing impairment (OR=1.20, 95% CI: 1.01~1.43). The risk factors of accidental falls in the older old group (aged 75~84) include fear of falling (OR=11.54, 95% CI: 7.04~18.93), muscle strength (OR=1.36, 95% CI: 1.15~1.60), number of chronic disease (OR=1.65, 95% CI: 1.09~2.50), and presence of spouse (OR=1.27, 95% CI: 1.06~1.51). The risk factors of accidental falls in the oldest old group (aged 85 years old or older) include fear of falling (OR=8.05, 95% CI: 1.85~34.98) and exercise (OR=2.91, 95% CI: 1.36~6.24). Fear of falling is defined as a common factor in the all age groups. CONCLUSION: Different strategies should be developed for age groups to prevent elderly falls with understanding of contributing factors of falls in each group.
Accidental Falls ; Aged ; Aged, 80 and over ; Chronic Disease ; Depression ; Hearing Loss ; Humans ; Logistic Models ; Muscle Strength ; Risk Factors ; Spouses