Physical performance, bone and joint diseases, and incidence of falls in Japanese men and women: A longitudinal cohort study
Department of Clinical Motor System Medicine, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, 113-8655, Japan, . Osteoporosis International
(Impact Factor: 4.17).
03/2012; 24(2). DOI: 10.1007/s00198-012-1967-0
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.
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.
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.
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.
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.
Available from: Rong-Sen Yang
- "The aging index for this area (population over 65 years of age and population under 15 years of age) was 94.1%; therefore, frailty is prevalent in aging communities. Notably , compared with the results of other studies, in which elderly women had high prevalence (Ensrud et al., 2009;Muraki et al., 2013), this study showed that men exhibited a high frailty trend compared to elderly women (69.6% and 30.4%, respectively). The most likely reason for this discrepancy is the differing characteristics between men and women. "
[Show abstract] [Hide abstract]
ABSTRACT: This study explored the risk factors, cut-off points, sensitivity, specificity, positive predictive values, and negative predictive values of physical performance testing among community-dwelling frail elderly people in Taiwan.
The empirical measurement of frailty is based on the following five indicators: weight loss, weakness, exhaustion, slow responses, and minimal physical activity. The frail phenotype is considered present if three or more of the indicators are observed. Meanwhile, a short battery of physical performance tests was conducted to assess the balance, mobility, and flexibility among elderly people.
A cross-sectional research design was executed. Participants were evaluated using a short battery of physical performance tests to assess their physical performance. Multivariate logistic regression and receiver operating characteristic (ROC) analyses were performed.
The logistic regression results showed that the factors significantly correlated to frailty included falls in the previous year, smoking, hypertension, and bone and joint disease. Physical performance test scores were analyzed using the ROC curves to discriminate frailty statuses. The analysis results showed that the areas under the ROC curves for the diagnostic accuracy of right-hand grip, left-hand grip, and the 8-foot up-and-go test reached 0.70, and the optimal cut-off points determined using Youden's index were 17.25 kg, 20.75 kg, and 8.13 s, respectively.
The research findings suggest that physical performance variables can be used to effectively screen elderly people at risk for frailty in the community.
The findings offer reference values for physical performance tests specific to community-dwelling frail elderly people. The information can enable health practitioners to achieve early identification of frailty among elderly people with anthropometric characteristics similar to those associated with people in Asian countries.
Available from: PubMed Central
- "We found that the component reduced mobility was a prominent predictor of falling. This is in accordance with previous findings, where several studies have revealed a relationship between low walking speed and falls in the elderly
[43,44]. Knee pain and lower back pain have also been significantly associated with multiple falls, predominantly in women
[Show abstract] [Hide abstract]
ABSTRACT: Accidental falls in the elderly are a major health problem, despite extensive research on risk factors and prevention. Only a limited number of multifactorial, long-term prospective studies have been performed on risk factors for falls in the general elderly population. The aim of this study was to identify risk factors predicting falls in a general elderly population after three and six years, using a prospective design.
The prevalence of 38 risk factors was recorded at a baseline assessment of 1763 subjects (aged 60--93 years). The incidence of one or more falls was recorded after three and six years. The predicted risk of falling, after exposure to the various risk factors, was analysed in a multiple logistic regression model, adjusted for age and sex, and presented as odds ratios (OR). A principal component analysis (PCA), including the statistical significant factors, was also performed to identify thematic, uncorrelated components associated with falls.
The use of neuroleptics (OR 3.30, 95% CI: 1.15--9.43), heart failure with symptoms (OR 1.88, 95% CI: 1.17--3.04) and low walking speed (OR 1.77, 95% CI: 1.28--2.46) were prominent individual risk factors for falls. In the PCA, three main components predicting falls were identified: reduced mobility, OR 2.12 (95% CI 1.54--2.91), heart dysfunction, OR 1.66 (95% CI 1.26--2.20) and functional impairment including nocturia, OR 1.38 (95% CI 1.01-1.88).
Three main components predicting falls were identified in a general elderly population after three and six years: reduced mobility, heart dysfunction and functional impairment including nocturia. The use of neuroleptic drugs was also a prominent individual risk factor, although the prevalence was low. Heart failure with symptoms was a significant risk factor for falls and may be of clinical importance as the prevalence of this condition in the elderly is increasing worldwide. There is need for further research on the relation between heart failure and falls in the elderly, as the treatment for this condition is poorly documented in this demographic. The findings of this study may be valuable in the development of intervention programmes aimed at sustainable, long-term reduction of falls in the elderly.
[Show abstract] [Hide abstract]
ABSTRACT: Evaluations for knee osteoarthritis (OA) or post-operative total knee arthroplasty (TKA) have mainly been assessed by objective scales. Though the Knee injury and Osteoarthritis Outcome Score (KOOS) is attracting attention as a patient-based outcome score, the relationship with conventional objective scales after TKA remains controversial. The purpose of this study was to investigate the relationship between KOOS and conventional objective scales and evaluate the features of patient-based outcome scores.
Subjects were 130 post-operative patients involving 186 knees treated with TKA. Their mean age was 74.0 ± 8.0 years, and the follow-up period was 43 months. Japanese Orthopaedic Association (JOA) score, original Knee Society Score (KSS) and surgeon's satisfaction score were scored as conventional objective scales besides KOOS. Spearman's correlation coefficient was estimated between these scales. Comparisons between OA and rheumatoid arthritis (RA) as well as primary and revision surgery were performed by the Mann-Whitney U test.
There were strong correlations between KOOS activities of daily living (ADL) and JOA score (r = 0.806), KSS function score (r = 0.803) and between KOOS pain and KSS knee score (r = 0.689). However, there was a poor correlation between KOOS and surgeon's satisfaction score (r = 0.188-0.321). TKA for RA showed poorer results only in KOOS pain (p = 0.003), and revision surgery showed poorer results in KSS function, KOOS symptoms and KOOS quality of life (QOL).
This study suggested that conventional objective scales reflected mainly ADL disturbances in post-operative TKA patients. Furthermore, patient-based outcome scores made it possible to evaluate and detect a minute change of knee pain and QOL in TKA patients. The Japanese KOOS was a useful tool to evaluate conditions after TKA.
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.