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      Health, Functional and Nutritional Determinants of Falls Experienced in the Previous Year—A Cross-Sectional Study in a Geriatric Ward

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          Abstract

          Falls are a serious health problem in older adults. A limited number of studies assessed their multifactorial nature in geriatric ward patients. The aim of this study is to explore health, functional and nutritional correlates of experiencing fall(s) in the previous year by older inpatients. A cross-sectional study of patients admitted to the department of geriatrics was conducted. A “faller status” was defined based on positive history of falls in the previous 12 months. Health, functional and nutritional factors associated with falls were evaluated, and multivariable logistic regression analysis models were built. A total of 358 patients (median age 82 (IQR 76–86) years, 77.9% women) were recruited, 43.9% of whom reported falls. The “fallers” presented with a significantly higher number of chronic diseases, higher prevalence of Parkinson’s disease, peripheral arterial disease, chronic osteoarthritis, more frequently reported urinary incontinence and were dependent on others for daily living activities. They had significantly worse results for the assessment of gait, balance and frailty status. The Mini Nutritional Assessment-Short Form scores and the mean value of serum albumin were significantly lower in the fallers’ group. Parkinson’s disease (OR = 2.82, CI—1.07–7.45; p = 0.04) and osteoarthritis (OR = 2.08, CI—1.02–4.23; p = 0.04) were the main variables for the outcome prediction, according to the direct multivariable logistic regression analysis. Our findings suggest that Parkinson’s disease and osteoarthritis are the main predictors independently associated with a history of falls in patients admitted to the geriatric ward, although the influence of some factors may be underestimated due to the tendency of not taking the history of falls in very frail, functionally dependent and bedridden individuals.

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          Lack of exercise is a major cause of chronic diseases.

          Chronic diseases are major killers in the modern era. Physical inactivity is a primary cause of most chronic diseases. The initial third of the article considers: activity and prevention definitions; historical evidence showing physical inactivity is detrimental to health and normal organ functional capacities; cause versus treatment; physical activity and inactivity mechanisms differ; gene-environment interaction (including aerobic training adaptations, personalized medicine, and co-twin physical activity); and specificity of adaptations to type of training. Next, physical activity/exercise is examined as primary prevention against 35 chronic conditions [accelerated biological aging/premature death, low cardiorespiratory fitness (VO2max), sarcopenia, metabolic syndrome, obesity, insulin resistance, prediabetes, type 2 diabetes, nonalcoholic fatty liver disease, coronary heart disease, peripheral artery disease, hypertension, stroke, congestive heart failure, endothelial dysfunction, arterial dyslipidemia, hemostasis, deep vein thrombosis, cognitive dysfunction, depression and anxiety, osteoporosis, osteoarthritis, balance, bone fracture/falls, rheumatoid arthritis, colon cancer, breast cancer, endometrial cancer, gestational diabetes, pre-eclampsia, polycystic ovary syndrome, erectile dysfunction, pain, diverticulitis, constipation, and gallbladder diseases]. The article ends with consideration of deterioration of risk factors in longer-term sedentary groups; clinical consequences of inactive childhood/adolescence; and public policy. In summary, the body rapidly maladapts to insufficient physical activity, and if continued, results in substantial decreases in both total and quality years of life. Taken together, conclusive evidence exists that physical inactivity is one important cause of most chronic diseases. In addition, physical activity primarily prevents, or delays, chronic diseases, implying that chronic disease need not be an inevitable outcome during life. © 2012 American Physiological Society. Compr Physiol 2:1143-1211, 2012.
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              The development, validity, and reliability of the OARS multidimensional functional assessment questionnaire.

              This report outlines the development, validity, and reliability of Part A of the OARS Multidimensional Functional Assessment Questionnaire. Part A permits assessment of individuals' functioning on each of five dimensions (social, economic, mental health, physical health and self-care capacity), the detailed information in each area being summarized on a 6-point rating scale by a rater. Content and consensual validity were ensured by the manner of construction. Information on criterion validity was obtained for all dimensions except social. The criterion used and their associated Kendall's Tau values were: an objective economic scale (.62); ratings based on personal interviews by geropsychiatrists (.60); physician's associates (.82); and physical therapists (.89). For 11 geographically dispersed raters from research and clinic settings, intraclass correlational coefficients, based on 30 subjects, ranged from .66 on physical health to .87 in self-care capacity; 74% of the ratings were in complete agreement, 24% differed by one point.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                02 July 2020
                July 2020
                : 17
                : 13
                : 4768
                Affiliations
                [1 ]Doctoral Studies, Department of Geriatrics, Faculty of Health Sciences, Medical University of Bialystok, 15-471 Białystok, Poland; magnuszewskilukas@ 123456gmail.com (L.M.); marta.swietek@ 123456umb.edu.pl (M.S.); janbaczek@ 123456gmail.com (J.B.)
                [2 ]Department of Geriatrics, Hospital of the Ministry of Interior and Administration in Bialystok, 15-471 Bialystok, Poland; akasiukiewicz@ 123456o2.pl (A.K.); barti.bial@ 123456wp.pl (B.K.)
                [3 ]Department of Geriatrics, Medical University of Bialystok, 15-471 Bialystok, Poland
                Author notes
                [* ]Correspondence: wojszel@ 123456umb.edu.pl ; Tel.: +48-85-869-4982
                Author information
                https://orcid.org/0000-0003-0419-5709
                https://orcid.org/0000-0002-6472-5241
                Article
                ijerph-17-04768
                10.3390/ijerph17134768
                7369737
                32630725
                df7e2093-ddf7-47b9-8e23-c07d88b7cabd
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 15 June 2020
                : 30 June 2020
                Categories
                Article

                Public health
                fall risk factors,fall detection,fall epidemiology,geriatrics,older patients
                Public health
                fall risk factors, fall detection, fall epidemiology, geriatrics, older patients

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