Talk:Falls in older adults

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 18 August 2020 and 3 December 2020. Further details are available on the course page. Student editor(s): Mya.white, TanaeTaylor, Katewolshon11, Riley acz, Erinstlcop.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 21:08, 16 January 2022 (UTC)

Intrinsic factors in fall causation

I've removed urinary incontinence as an intrinsic factor of fall causation. While urinary incontinence may lead to more night-time ambulation in poor lighting and under fatigued conditions, the incontinence itself is not a causation of the fall, the other factors (poor lighting, fatigue, etc.) are the proximate cause of the fall. Unless a specific citation can be provided listing incontinence as a cause of falls, please do not restore this entry to the list. WikiDan61^ChatMe!_ReadMe!! 19:09, 7 November 2016 (UTC)

Though finding sources to support this content won't be difficult, realize that folks that are continent don't have urge incontinence. Those with urge incontenence are more likely to sense the 'urgency' of getting to the bathroom to avoid the unpleasant consequences of uncontrolled urination. Best Regards, Barbara (WVS) ✐  ✉ 14:18, 31 December 2017 (UTC)

I agree that falls would not necessarily be due to incontinence, but moreso associated with the environmental factors as the ones mentioned above. If the environmental factors were/are improved, the number of falls would decrease in my opinion. Great catch!TanaeTaylor (talk) 21:22, 5 October 2020 (UTC)

Preventive measures

I agree with Wikilens addition of hip protectors under preventive measures (Danagg12 (talk) 19:27, 8 November 2016 (UTC)).

I agree that adding information on hip protectors is very important, but I think that they shouldn't be considered a preventive measure per se. Hip protectors don't prevent falls.They may slightly reduce the risk of a fracture after a fall. The cochrane systematic review (CSR) reported little or no effect on falls. I have added some more content from the CSR, and rearranged this section of the article accordingly. Thanks.:)--MonWiki (talk) 18:50, 10 November 2016 (UTC)

I like the hip protector addition. Is there a way we can simplify the sentence a little bit?

What about something like:

Hip Protectors: Use may lead to a decrease in hip fractures, but the risk may slightly increase if the older adults live in nursing homes?(1) JenOttawa (talk) 02:01, 12 November 2016 (UTC)

Hi JenOttawa.Thanks for your suggestion.We can definately simplify the sentence,but not exactly as you've suggested.Both situations were observed in older adults living in nursing homes.No effects were found in community-dwelling older adults.--MonWiki (talk) 20:44, 12 November 2016 (UTC)

Sounds great @MonWiki:! I think that by simplifying the sentence it will be clear for readers without a medical background. From your description, it sounds like the cochrane review has a multifaceted conclusion, so this is not always easy ;)

JenOttawa (talk) 19:23, 14 November 2016 (UTC)

External link addition?

Is https://www.sheffield.ac.uk/FRAX/index.aspx worth adding to the list of External links? Has info for individual countries, lists risk factors, and has a calculation tool. --Treetear (talk) 00:51, 23 February 2018 (UTC)

Too peripheral; WP:ELNO. --Zefr (talk) 02:53, 23 February 2018 (UTC)

Maybe better suited in Fall prevention, if at all. Thank you for linking me that page! Treetear (talk) 13:39, 23 February 2018 (UTC)

TanaeTaylor (talk) 20:07, 4 December 2020 (UTC)== Additions ==

Additions

Student editor(s): Mya.white, TanaeTaylor, Katewolshon11, Riley acz, Erinstlcop are making additions to this article using high quality reviews.Melanievandyke (talk) 16:23, 24 November 2020 (UTC)

1. This addition will allow for more information on the screening and physical assessments for older adults. It is important for older adults and caregivers to be aware of the different screening/assessment options available. 2. Falls in Older Adults, under subheading Screening 3. Ambrose, A. F., Cruz, L., & Paul, G. (2015). Falls and fractures: A systematic approach to screening and prevention. Maturitas, 82(1), 85-93. https://doi-org.stlcopisa.stlcop.edu/10.1016/j.maturitas.2015.06.035 4. Physical examinations are important for assessing falls in older adults. They help reduce falls and more importantly, they help reduce the risk of fractures from falling. a) Vision: Vision should be tested with elderly adults that have fallen more than two times. The treatment in vision impairments have results in the reduction in the risk of falls. A successful study resulted in a decrease of fall rates when single lenses were put in place of multifocal glasses. b) Mental health and cognitive capacity: A cohort study found a link between falls and depression in older adults that live in a community dwelling setting. This link is due to depression having an effect on gait speeds, resulting in slower walking. An assessment can be quickly given by asking “Have you been bothered lately by feeling down, depressed, or hopeless?” and “Have you been bothered lately by little interest or pleasure in doing things?” If this assessment becomes positive, then a full evaluation should be performed. The fear of falling is also a risk factor for falls and this can be assessed by using the Activities-Specific Balance Confidence Scale (ABC Scale). This is a 16-item scale that allows physicians to see how confident adults are with their balance while performing daily activities. As for cognitive capacity assessment, the Mini Mental Status Exam is a screening assessment that can see if the patient has cognitive impairment that put them at great risk for falling. c) Balance tests: Four balance tests to assess elderly adults include Tinetti Mobility Test (TMT), Berg Balance Scale, 30 Second Chair Test, and the Four Stage Balance Test (FSBT). The Tinetti Mobility Test is used to assess static, dynamic, reactive, and anticipatory balance. It is very useful for community-dwelling older adults. The Berg Balance Scale involves 14 mobility tasks that will determines a patient’s score by their ability to complete those tasks. The Four Stage Balance Test and the 30 Second Chair Test are both recommended by the CDC. FSBT has the patient stand in 4 positions, which gets harder with each position. If the patient can’t stand longer than 10 seconds for the third position, then they have a greater risk of falling. The 30 Second Chair Test consists of measuring the number of times a patient can stand up from a seated position within 30 seconds. If the patient ends up not making above the average for their age, then they are at risk for falling. d) Gait evaluation: Stride-to-stride measuring for gait timing has been an evaluation for fall risk. There have also been laboratories used to study the movement of elderly adults during daily tasks, which include sensitive insoles, 3-D imaging, and inertial sensors. Though this technology is good for identifying the risk of falling, it’s still unsure if its results will have the same outcome outside of the laboratories, which is why passive infrared motion sensors were developed to measure older adults gait speeds inside their own homes. Erinstlcop (talk) 04:10, 3 December 2020 (UTC)

a.) My addition to the Wikipedia article feels the content gap by added content that will address how vision impairments in people aged 65 and up can increase the risk of falls. b.) The placement of my article will be under causes specifically under “Intrinsic factors” c.) Saftari, L. N., & Kwon, O. S. (2018). Ageing vision and falls: a review. Journal of physiological anthropology, 37(1), 11. https://doi-org.stlcopisa.stlcop.edu/10.1186/s40101-018-0170-1 d.) As aging occurs, visual function begins to deteriorate which will increase the risk of falls. Visual acuity is related to the vestibule, the part of your ear that helps control balance. If visual acuity becomes weakened and unbalanced then it is more likely to cause falls. With age, the flexibility of the lens decreases causing the eye to struggle focusing on near and far objects. Also, the Melbourne Edge Test [VM1], which assesses contrast sensitivity showed that low contrast sensitivity in the elderly has led to falls due to the lack of being able to detect objects in a visually difficult environment. Contrast sensitivity (differentiating between different luminance levels in a static image) can even become more difficult with certain lightings, such as in a dark area or a room with flashing lights. Depth perception (the ability to perceive distance between something and ourselves) can be measured through a stereo acuity test. The weakness in stereo acuity was also associated with an increase in hip fractures, which is a common injury caused by falls. As an individual’s age increases, the ciliary muscle relaxes which in turn causes the change in diameter. This results in the viewing of objects at various distances to sometimes be inaccurate. The Salisbury Eye Evaluation, a study that tested visual performance of 2520 older adults aged 65 to 84 years old, found that many self-reported falls had to do with the lack of effective vision. ~~ Mya White — Preceding unsigned comment added by 209.54.10.242 (talk) 04:13, 3 December 2020 (UTC)

1.The information within the ‘Results’ and ‘Discussion’ section of my article would best improve my Wiki article’s ‘Epidemiology’ section. As of now, the epidemiology section of my wiki article is broad. It greatly focuses on the risks of falls in older adults without any real sources and/or information to support the actual epidemiology of falls in older adults. Currently, this article only mentions the statistics regarding how falls get worse overtime rather than those that show the benefits of interventions. My addition will provide more information on the positive side of things. Moreover, my addition will come from credible sources with specific and detailed information. I will include specific information from my article outlining the fall prevention interventions that have been studied and proven to decrease falls. 2.My addition to Wikipedia will be placed in Falls in Older Adults under the section titled ‘Epidemiology’ 3.https://doi-org.stlcopisa.stlcop.edu/10.1001/jama.2017.15006 4.Already apart of the article: “The incidence of falls increases progressively with age. According to the existing scientific literature, approximately one-third of the elderly population experiences one or more falls each year, while 10% experience multiple falls annually. The risk is greater in people older than 80 years, in which the annual incidence of falls can reach 50%” My addition: Although risks associated with falls in older adults increase with age, interventions can help reduce them. According to a systematic review and meta-analysis of adults aged 65 years or older, 4 interventions were associated with reducing falls in older adults: 1.Exercise (specifically balance-enhancing exercise) 2.Combined exercise and vision assessment and treatment 3.Exercise combined with vision and environmental assessment and treatment 4.Combined clinic-level quality improvement strategies, multifactorial assessment and treatment, calcium supplementation, and vitamin D supplementation These results are supported by research, however the choice of a particular intervention is based on the patient and/or caregiver’s preference. TanaeTaylor (talk) 20:07, 4 December 2020 (UTC)