Physical performance, bone and joint diseases, and incidence of falls in Japanese men and women: A longitudinal cohort study

ArticleinOsteoporosis International 24(2) · March 2012with10 Reads
DOI: 10.1007/s00198-012-1967-0 · Source: PubMed
Abstract
This study examined whether physical performance and bone and joint diseases were risk factors for falls in 745 men and 1,470 women from the Research on Osteoarthritis/osteoporosis Against Disability (ROAD) study (mean, 69.7 years). Slower walking speed was a risk factor for falls in men and women. Knee pain was a risk factor for falls in women. Introduction The objective of the present study was to clarify the incidence of falls by sex and age and to determine whether physical performance and bone and joint diseases are risk factors for falls in men and women using a large-scale population-based cohort of the ROAD. Methods A total of 745 men and 1,470 women were analyzed in the present study (mean age, 68.5 years). A questionnaire assessed the number of falls during 3 years of follow-up. Grip strength and walking speed were measured at baseline. Knee and lumbar spine radiographs were read by Kellgren–Lawrence (KL) grade; radiographic knee osteoarthritis and lumbar spondylosis were defined as KL = 3 or 4. Knee and lower back pain were estimated by an interview. Results During a mean follow-up of 3 years, 141 (18.9 %) men and 362 (24.6 %) women reported at least one fall. Slower walking speed was a risk factor for falls in men (0.1 m/s decrease; odds ratio [OR], 1.15; 95 % confidence interval [CI], 1.09–1.23) and women (0.1 m/s decrease; OR, 1.05; 95 % CI, 1.01–1.10). Knee pain was also a risk factor for falls (OR, 1.38; 95 % CI, 1.03–1.84) in women, but lower back pain was not. Conclusion We examined the incidence and risk factors for falls in men and women. Slower walking speed was a risk factor for falls in men and women. Knee pain was a risk factor for falls in women.
    • "Physical performance in older adults with OA has been evaluated in a number of studies. However , these studies had rarely evaluated the specific relationship between the reduction in physical performance due to OA and falls [9, 26]. To the best of our knowledge, this was the first study to date describing the influence of impaired physical performance in the association between increased OA symptoms and falls using three different methods of detection. "
    [Show abstract] [Hide abstract] ABSTRACT: Osteoarthritis (OA) exacerbates skeletal muscle functioning, leading to postural instability and increased falls risk. However, the link between impaired physical function, OA and falls have not been elucidated. We investigated the role of impaired physical function as a potential mediator in the association between OA and falls. This study included 389 participants [229 fallers (≥2 falls or one injurious fall in the past 12 months), 160 non-fallers (no history of falls)], age (≥65 years) from a randomized controlled trial, the Malaysian Falls Assessment and Intervention Trial (MyFAIT). Physical function was assessed using Timed Up and Go (TUG) and Functional Reach (FR) tests. Knee and hip OA were diagnosed using three methods: Clinical, Radiological and Self-report. OA symptom severity was assessed using the Western Ontario and McMaster Universities Arthritis Index (WOMAC). The total WOMAC score was categorized to asymptomatic, mild, moderate and severe symptoms. Individuals with radiological OA and 'mild' overall symptoms on the WOMAC score had reduced risk of falls compared to asymptomatic OA [OR: 0.402(0.172-0.940), p = 0.042]. Individuals with clinical OA and 'severe' overall symptoms had increased risk of falls compared to those with 'mild' OA [OR: 4.487(1.883-10.693), p = 0.005]. In individuals with radiological OA, mild symptoms appear protective of falls while those with clinical OA and severe symptoms have increased falls risk compared to those with mild symptoms. Both relationships between OA and falls were not mediated by physical limitations. Larger prospective studies are needed for further evaluation.
    Full-text · Article · Oct 2015
    • "IC 95%, p < 0.001 American cohort The H-EPESE study b Markides K. S et al. 2001 [22] N = 2636 Age: 65 and over 7 years 2.4 m Slow GS was an independent marker of mortality at 2 years by comparing the highest to the lowest (VM: 0 m/s): OR: 7.47 [ gender)4344454648495051. The results were stratified by gender in only one study [51]. In most of the studies, a threshold of 0.7 m/s was significantly associated with fall risk. "
    [Show abstract] [Hide abstract] ABSTRACT: Several frailty screening tests in older cancer patients were developed but their statistical performance is low. We aimed to assess whether measurement of usual gait speed (GS) alone could be used as a frailty screening test in older cancer patients. This systematic review was conducted on "pub med" between 1984 and 2014 and included reviews and original studies. Eligibility criteria were: GS over a short distance, alone or included in composite walking tests (Timed Get Up and Go test: TGUG, Short Physical Performance Battery: SPPB) in older people (aged 65 and over) living in a community setting and predictive value of GS on medical complications associated with frailty. 46 articles were finally selected. GS alone is consensual and recommended for screening sarcopenia in elderly. A slow GS is predictive of early death, disability, falls and hospitalization/institutionalization in older people living in a community setting. GS alone is comparable to composite walking tests that do not provide additional information on the medical complications associated with frailty. Despite few studies in geriatric oncology, GS seems to predict overall survival and disability. We suggest GS over 4m (at a threshold of 1m/s) as a new frailty screening test in older cancer patients (65 and over) to guide the implementation of a comprehensive geriatric assessment during the initial management phase or during follow-up. Prospective cohort studies are needed to validate this algorithm and compare it with other screening tool.
    Full-text · Article · Sep 2015
    • "Knee pain is one of the important factors that deteriorate the postoperative walking ability after hip fracture [6] . Furthermore, in recent studies , knee pain is one of the risk factors for falling [7,8]. In fact, during postoperative rehabilitation, patients frequently present as knee joint effusion and pain, which Shinanomachi, Shinjuku, Tokyo 160-8582, Japan Full list of author information is available at the end of the article impairs the ability to walk. "
    [Show abstract] [Hide abstract] ABSTRACT: Background Symptomatic knee joint effusion is frequently observed after hip fracture, which may lead to postoperative knee pain during rehabilitation after hip fracture surgery. However, unfortunately, very little has been reported on this phenomenon in the literature. The purpose of the current study was to investigate the relationship between symptomatic knee effusion and postoperative knee pain and to clarify the reason of the effusion accompanied by hip fracture.MethodsA total of 100 patients over 65 years of age with an acute hip fracture after fall were prospectively followed up. Knee effusion was assessed on admission and at the operating room before the surgery. If knee effusion was observed at the time of the surgery, synovial fluid was collected into syringes to investigate the cause of the effusion using a compensated polarized light microscope. Furthermore, for each patient, we evaluated age, sex, radiographic knee osteoarthritis (OA), type of the fracture, laterality, severity of the fracture, and postoperative knee pain during rehabilitation. These factors were compared between patients with and without knee effusion at the time of the surgery. As a statistical analysis, we used Mann¿Whitney U-test for patients¿ age and categorical variables were analyzed by chi-square test or Fisher¿s exact test.ResultsA total of 30 patients presented symptomatic knee effusion at the time of the surgery. In patients with knee effusion, numbers of intertrochanteric fracture, radiographic knee OA, and postoperative knee pain were significantly large compared to those without effusion. In terms of synovial fluid analysis, calcium pyrophosphate dihydrate crystals were observed in 80% of patients with knee effusion.Conclusion From our study, approximately 63% of patients with knee effusion at the time of the surgery had postoperative knee pain. In addition, this effusion was basically related to pseudogout.
    Full-text · Article · Jan 2015
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