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Does the ‘Otago exercise programme’ reduce mortality and falls in older adults?: a systematic review and meta-analysis
- Authors:
- THOMAS Susie, MACKINTOSH Shylie, HALBERT Julie
- Journal article citation:
- Age and Ageing, 39(6), November 2010, pp.681-687.
- Publisher:
- Oxford University Press
A systematic review with meta-analysis was conducted to evaluate the effectiveness of a strength and balance retraining programme designed to prevent falls in older people living in the community, the Otago exercise programme. The meta-analysis included seven trials, involving 1503 participants. Outcomes of interest included risk of death, number of falls, number of injurious falls and compliance to the exercise programme. The Otago exercise programme was found to significantly reduced the risk of death over 12 months, and significantly reduced fall rates. There was no significant difference in the risk of a serious or moderate injury occurring as the result of a fall . Of the 747 participants who remained in the studies at 12 months, 274 (36.7%) were still exercising three or more times per week.
Determinants of disparities between perceived and psychological risk of falling among elderly people: cohort study
- Authors:
- DELBAERE Kim, et al
- Journal article citation:
- British Medical Journal, 28.8.10, 2010, p.436.
- Publisher:
- British Medical Association
This study investigated older people’s fear of falling by exploring the prevalence and determinants of perceived fall risk (measured by the falls efficacy scale international) and physiological fall risk (measured by the physiological profile assessment) and to understand the role of disparities in perceived and physiological risk in the cause of falls. It was found that many elderly people underestimated or overestimated their risk of falling. These disparities were primarily associated with psychological measures and strongly influenced the probability of falling. It is concluded that measures of both physiological and perceived fall risk should be included in fall risk assessments to allow tailoring of interventions for preventing falls in elderly people.
The fear of falling is a significant problem
- Author:
- GARVEY Gina
- Journal article citation:
- Nursing and Residential Care, 12(10), October 2010, pp.482-486.
- Publisher:
- MA Healthcare Ltd.
- Place of publication:
- London
More than 400,000 older people in England attend A&E departments following an accident each year. This article explains how advances in technology, such as nurse call systems, could prevent injury and limit long-term physical impairment which result from falls. The article discusses risk factors such as environment, balance impairment; muscle weakness, unhelpful drug combinations and sleep disturbances. These risk factors can result in psychological problems such as fear of falling and loss of confidence, loss of mobility leading to social isolation, and an increase in dependency. The use of equipment such as wandering alarms and monitors and protective clothing such as hip protectors are discussed. The article concludes by promoting an emphasis on prevention by training care staff, which can shift the focus from treatment to living in a safe environment.
Falls among the elderly: key is prevention, not detection
- Author:
- KINSELLA Audrey
- Journal article citation:
- Journal of Assistive Technologies, 4(3), September 2010, pp.25-28.
- Publisher:
- Emerald
Falls at home among the elderly are frequent and costly occurrences. While timely response systems to falls can be installed in the home to assist these elders, such as the widespread use of Personal Emergency Response Systems (PERS), there is a particular need to look at preventative measure to help prevent these falls from occurring. This study identified and assessed these available precautionary measures and tools. Means to prevent falls among the elderly include using higher technology such as telehealth systems and lower technology such as home modifications that better ensure safety of elderly residents. The article concludes that fall prevention programmes that are developed specifically for the elderly living in their own homes need to comprise a combination of low-tech preventative measures, such as medication assessment, vision check-ups, encouraging exercises, and making home modifications, and high-tech telehealth strategies, such as blood pressure checks and gait assessment.
Enhancing student gerocompetencies: evaluation of an intergenerational service learning course
- Authors:
- DAUENHAUER Jason A., et al
- Journal article citation:
- Journal of Gerontological Social Work, 53(4), May 2010, pp.319-335.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Training students in gerontological social work is of increasing importance as the ageing population grows. As such, this article describes the development and evaluation of an intergenerational service-learning course designed to encourage social work gerocompetencies. Service-learning opportunities were structured into the course, including an optional evidence-based falls prevention programme for older adults, entitled A Matter of Balance. Results indicated major differences between pre- and post-test scores on the Geriatric Social Work Competency Scale (GSWCS), as noted for 13 female students in the service learning course. Once A Matter of Balance was introduced as an independent variable, the Matter of Balance participants scored the highest mean post-test scores for 2 GSWCS domains: values, ethics, and theoretical perspectives; and intervention. In ending, the authors discuss the benefits of utilising social work gerocompetencies to guide course objectives, content, and student outcomes.
Prevention of patient falls in a university hospital
- Author:
- ALSENANY Samira
- Journal article citation:
- Generations Review, 20(2), April 2010, Online only
- Publisher:
- British Society of Gerontology
This study looks at the problem of falls in a University Hospital in Jeddah, Saudi Arabia, based on a review of 104 accident reports over a three-year period (2003-2005). It was designed to uncover factors related to accidents and to use the findings as a basis for reducing the frequency of preventable injuries and accidental falls. All patients studied had an incident report completed by a member of the nursing staff and a physician. To prevent falls, a systematic therapeutic approach to patients who have fallen is necessary, and close attention must be paid to identifying and reducing risk factors for falls among frail older persons who have not yet fallen.
Taking a firm stand
- Author:
- MOONEY Helen
- Journal article citation:
- Health Service Journal, 27.5.10, 2010, pp.22-23.
- Publisher:
- Emap Healthcare
The problem of patients who fall in hospital settings such as acute hospitals, mental health trust units and community hospitals is discussed. The article highlights the importance of involving all professionals from across disciplines to address the problem. It also highlights the guide 'The 'how to' guide for reducing harm from falls' published by Patient Safety First. Statistics detailing the number of falls in hospital locations are also presented.
Community falls prevention for people who call an emergency ambulance after a fall: randomised controlled trial
- Authors:
- LOGAN Philippa A., et al
- Journal article citation:
- British Medical Journal, 15.05.10, 2010, p.1070.
- Publisher:
- British Medical Association
Participants in this randomised controlled trial were 204 adults aged more than 60 living at home or in residential care who had fallen and called an emergency ambulance but were not taken to hospital. Participants were taken from four primary care trusts in England. Participants were referred to community fall prevention services or standard medical and social care. The primary outcome was the rate of falls over 12 months, ascertained from monthly diaries. Secondary outcomes were scores on the Barthel index, Nottingham extended activities of daily living scale, and falls efficacy scale at baseline and by postal questionnaire at 12 months. 102 people were allocated to each group. 99 (97%) participants in the intervention group received the intervention. Falls diaries were analysed for 88.6 person years in the intervention group and 84.5 person years in the control group. The incidence rates of falls per year were 3.46 in the intervention group and 7.68 in the control group. The intervention group achieved higher scores on the Barthel index and Nottingham extended activities of daily living and lower scores on the falls efficacy scale at the 12 month follow-up. The number of times an emergency ambulance was called because of a fall was significantly different during follow-up. It is concluded that a service to prevent falls in the community reduced the fall rate and improved clinical outcome in the high risk group of older people who call an emergency ambulance after a fall but are not taken to hospital.
Reflections on a falls prevention peer education project
- Author:
- VERNON Susan
- Journal article citation:
- Journal of Interprofessional Care, 24(1), January 2010, pp.119-121.
- Publisher:
- Taylor and Francis
One of the health education methods used to engage older people with fall prevention advice has been the use of peer educators, and this brief article reports on the rationale, methods and some issues from the development of a fall prevention peer education project in Melbourne, Australia. A manual was developed by a multidisciplinary team including an occupational therapist and health promotion coordinator, and peer educators were given a three day training course and taught different methods of presenting information. The peer educators' brief was to deliver a short fall prevention advice to known community groups following a prescribed format. The evaluation, covering the effect on the peer educators and on individuals and groups involved and the view of health professionals involved, will be reported on at the end of the project.
Falls squad keeps users out of hospital
- Author:
- GRIFFITHS Julie
- Journal article citation:
- Community Care, 4.2.10, 2010, pp.30-31.
- Publisher:
- Reed Business Information
A pilot project in Hertfordshire helps older people avoid unnecessary trips to A&E. Social workers are included in responding to 999 calls from people aged over 65 who have suffered a fall at home.