| 61. |
- Lundin-Olsson, Lillemor, 1950-
(författare)
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Prediction and prevention of falls among elderly people in residential care
- 2000
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Among elderly people, falls lead to a considerable amount of immobility, morbidity, and mortality. The purpose of this study was to develop and evaluate methods for predicting falls, and to evaluate a fall prevention program among elderly people living in residential care facilities. A fall was defined as any event in which the resident unintentionally came to rest on the floor or the ground regardless of whether or not an injury was sustained.In developing the prediction methods, it was hypothesised that older persons showing difficulties in performing a familiar second task while walking were more likely to fall within six months. For residents who stopped walking when talking, the relative risk of falling was 3.5 (95% CL2.0-6.2) compared to those who continued walking. For residents with a time difference (diffTUG) of at least 4.5 seconds between two performances of the Timed Up&Go test, with and without carrying a glass, the hazard ratio for falls was 4.7 (95% Cl: 1.5-14.2) compared to those with a shorter diffTUG.A screening tool, the Mobility Interaction Fall (MIF) chart, was developed and evaluated, then validated in a new sample. This tool included a mobility rating, ‘Stops walking when talking’, ‘diffTUG’, a test of vision, and a concentration rating. In the first sample, the hazard ratio was 12.1 (95% 0:4.6-31.8) for residents classified as ‘high-risk’ compared to ‘low-risk’. The positive predictive value was 78%, and the negative predictive value, the sensitivity, and the specificity were above 80% for falling in six months. In the second sample the prediction accuracy of the MIF chart was lower (hazard ratio 1.7, 95% Cl: 1.1-2.5) and a 6-month fall history or a global rating of fall risk by staff were at least equally valuable. A combination of any two of the methods - the MIF chart, staff judgement, fall history - was more accurate at identifying high risk residents than any method alone. Half of the residents classified by two methods as ‘high risk’ sustained a fall within 6 months.In a randomised study a prevention program directed to residents, staff, and environment resulted in a significant reduction in the number of residents falling (44% vs. 56%; odds ratio 0.62, 95% CF0.41-0.92), the incidence of falls (incidence rate ratio IRR 0.80, 95% CF0.69-0.94) and of femoral fractures (IRR 0.25, 95% 0:0.08-0.82) in the intervention compared to the control group.In conclusion, a combination of any two of the staff judgement, fall history or MIF chart has the potential to identify a large proportion of residents at particular high fall risk. A multidisciplinary and multifactorial fall prevention program directed to residents, staff, and the environment can reduce the numbnumber of residents falling, of falls and of femoral fractures.
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| 62. |
- Lundin-Olsson, Lillemor
(författare)
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På säkrare ben : fallförebyggande arbete
- 2012
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Ingår i: Äldres Hälsa. - : Studentlitteratur. - 9789144073125 ; , s. 107-125
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 63. |
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| 64. |
- Lundin-Olsson, Lillemor, et al.
(författare)
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The Mobility Interaction Fall chart
- 2000
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Ingår i: Physiotherapy Research International. - : Wiley. - 1358-2267 .- 1471-2865. ; 5:3, s. 190-201
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: The aim of this study was to develop and evaluate a screening tool for the identification of older people living in residential care facilities who are prone to falling. METHOD: Two tests focusing on attentional demands while walking were performed: 'Stops walking when talking' and the 'diffTUG'. Medical assessment, rating for cognition, depression and activities of daily living were also carried out. Falls indoors were followed up prospectively over a period of six months. A flowchart, the Mobility Interaction Fall (MIF) chart, for the identification of older people who are prone to falling was developed. The MIF chart includes an observation of mobility level and 'Stops walking when talking', the diffTUG, a test of vision and a rating of concentration. Study subjects were 78 residents, aged over 65 years, in one residential care facility (22 M; 56 F; median age 82 years, range 66-99 years) in Umea, Sweden. RESULTS: Thirty-three (42%) subjects suffered at least one fall indoors during the follow-up period. The rate of falls differed significantly between those subjects classified as being at risk of falls and those not so classified (log rank test 39.1; p < 0.001; hazard ratio 12.1; 95% CI 4.6-31.8). The positive predictive value for the classification was 78% (95% CI 67-87%) and the negative predictive value was 88% (95% CI 79-95%). CONCLUSION: The initial findings for the MIF chart indicate a promising way of classifying older people at residential care facilities as being at high or low risk of falling. The classification is quick and easy and requires no expensive equipment
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| 65. |
- Melander-Wikman, Anita, et al.
(författare)
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Developing mobile ICT for improved health, safety and well-being together with elderly people : experiences from the MyHealth@Age (2008-2010) project
- 2010
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Ingår i: Ubiquitous Healthcare and Supporting Technolgies (UBI-HEALTH'10). ; , s. 1-5
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Konferensbidrag (refereegranskat)abstract
- The population is ageing in most economically developed countries. For elderly persons, safety is seen as important. The fear of falling is an experience that has been reported by numerous studies. Falls present the most common cause of injury in old age. A "health ageing paradigm" is a comprehensive approach to prevent injuries from falling. Home-based and mobile monitoring technology is considered to assist elderly people in terms of keeping healthy and staying at home longer. The MyHealth@Age Project (2008-2010) involves partners from Northern Ireland, Norway and Sweden. It aims to provide mobile ICT products and services to promote a process of healthy ageing. Thirteen elderly persons, 63-80 years of age, are the research persons in the Swedish part. The project-methodology is participatory and collaborative. It draws upon FormIT, Participatory and Appreciative Action & Reflection research (PAAR) and Living Lab approaches. Three areas were identified; safety, prescribed healthcare and social networking. Safety and freedom of mobility were the most important identified needs. Much of the learning was accumulated with regard to the processes of empowerment. It is important to co-construct empowering research and development methodologies, products and services, which promote social participation of elderly persons in order to keep healthy, safe and to promote well-being
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| 66. |
- Melander-Wikman, Anita, et al.
(författare)
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Project: e-Balance
- 2014
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Annan publikation (populärvet., debatt m.m.)
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| 67. |
- Melander-Wikman, Anita, et al.
(författare)
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Project: Early signs of mobility limitations and fall events in old age: long-term consequences and tailored preventive interventions through interactive media
- 2012
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Annan publikation (populärvet., debatt m.m.)abstract
- The aims of this project are 1) to investigate the consequences over five years of early signs of mobility limitations expressed as fallevents, a changed walking pattern with a cognitive load (dual-task costs), and decreased balance confidence on severe fall-relatedinjuries, perceived health, participation, activities of daily living, and gait performance, and 2) to develop, together with older people,and evaluate tailored fall-prevention through interactive media in a randomized controlled trial with two arms.
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| 68. |
- Mendham, Amy E., et al.
(författare)
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Sarcopenia in older black South African women and relationships with physical activity and protein intake
- 2020
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Ingår i: 13th European Nutrition Conference, FENS 2019, 15–18 October 2019, Malnutrition in an Obese World: European Perspectives. - : Cambridge University Press. ; , s. E150-E150
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: South Africa (SA) is a developing country with an ageing population. Adequate nutrition and physical activity (PA) protect against the loss of muscle mass and physical function, both of which are important components of sarcopenia. This study aimed to measure the prevalence of sarcopenia in older black SA women and investigate its associations with PA and protein intake.Materials and Methods: Older black SA women (age, 68 (range; 60–85 years) n = 122) completed sociodemographic questionnaires, 24 h urine collection (estimate protein intake), venous blood (hs-C-reactive protein (hs-CRP) and ferritin), functional tests (grip strength, 3 m timed-up-and-go (TUG), 10 m walk test) and PA monitoring (activPAL). Dual-energy x-ray absorptiometry whole-body scans assessed fat and fat-free soft tissue mass (FFSTM).Results: According to the European Working group on Sarcopenia in Older People (EWGSOP)2, 2.5% (n = 3) had confirmed sarcopenia of a low severity based on normal physical function. Of the total cohort, 9% (n = 11) had low grip strength, 22.1% (n = 27) had a low appendicular skeletal muscle index (ASMI), and no women had low TUG (s) or gait speed (m/s). Higher ASMI was associated with lower hs-CRP (p = 0.05; Rho = -0.209) and higher ferritin (Rho = 0.252; p = 0.019), grip strength (kg, Rho = 0.223; p = 0.015), and gait speed (m/s, Rho = 0.180; p = 0.050). Protein intake suggested intake of 41.8g/day/ or 0.51 g/kg of body mass/day. Higher total protein intake (g/24h), was associated with higher FFSTM (kg) and ASMI (p < 0.001). PA outcomes were not correlated with FFSTM or ASMI (p > 0.05), however, there was a strong positive correlation of TUG (s) and gait speed (m/s) with time spent: 1) stepping per day (min) and; 2) at a high cadence (> 100 steps/min) (all p < 0.01). Daily step count was 7137 ± 3233 (mean ± Standard deviation), with 97.9 ± 38.7 min of total time spent stepping and 12.6 ± 16.8 min spent stepping at a high cadence (> 100 steps/min). Of note, 13.9% (n = 17) of women were completing > 10,000 steps/day.Discussion: Based on the EWGSOP2 criteria, there is a low prevalence of sarcopenia in older black SA women, explained by the maintenance of strength and physical function that directly related to PA, especially that performed at higher intensities. In contrast, low muscle mass was relatively prevalent (22.1%) and was associated with low dietary protein and not PA. Notably, it may be important to review the cut-points of EWGSOP2 criteria to be specific to the older SA women from disadvantaged communities.
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| 69. |
- Mendham, Amy E., et al.
(författare)
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Sarcopenic Obesity in Africa: A Call for Diagnostic Methods and Appropriate Interventions
- 2021
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Ingår i: Frontiers in Nutrition. - : Frontiers Media S.A.. - 2296-861X. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- This perspective aims to highlight the lack of current knowledge on sarcopenic obesity in Africa and to call for diagnostic methods and appropriate interventions. Sarcopenic obesity has been defined as obesity that occurs in combination with low muscle mass and function, which is typically evident in older adults. However, there has been no clear consensus on population-specific diagnostic criterion, which includes both gold-standard measures that can be used in a more advanced health care system, and surrogate measures that can be used in low-income settings with limited resources and funding. Importantly, low and middle-income countries (LMICs) across Africa are in an ongoing state of economic and social transition, which has contributed to an increase in the aging population, alongside the added burden of poverty, obesity, and associated co-morbidities. It is anticipated that alongside the increased prevalence of obesity, these countries will further experience an increase in age-related musculoskeletal diseases such as sarcopenia. The developmental origins of health and disease (DOHaD) approach will allow clinicians and researchers to consider developmental trajectories, and the influence of the environment, for targeting high-risk individuals and communities for treatment and/or prevention-based interventions that are implemented throughout all stages of the life course. Once a valid and reliable diagnostic criterion is developed, we can firstly assess the prevalence and burden of sarcopenic obesity in LMICs in Africa, and secondly, develop appropriate and sustainable interventions that target improved dietary and physical activity behaviors throughout the life course.
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| 70. |
- Mendham, Amy E., et al.
(författare)
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Understanding factors associated with sarcopenic obesity in older African women from a low-income setting : a cross-sectional analysis
- 2021
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Ingår i: BMC Geriatrics. - : BioMed Central. - 1471-2318 .- 1471-2318. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: High rates of food insecurity, obesity and obesity-related comorbidities in ageing South African (SA) women may amplify the risk of developing sarcopenic obesity. This study aimed to investigate the prevalence and correlates of sarcopenic obesity and its diagnostic components [grip strength, appendicular skeletal muscle mass (ASM) and body mass index (BMI)] in older SA women from a low-income setting.Methods: This cross-sectional study recruited black SA women between the ages of 60–85 years (n = 122) from a low-income community. Testing included a fasting blood sample (markers of cardiometabolic risk, HIV), whole body and regional muscle and fat mass (dual-energy absorptiometry x-ray), anthropometry, blood pressure, functional movement tests, current medication use, demographic and health questionnaires, physical activity (PA; accelerometery), household food insecurity access scale, and a one-week quantified food frequency questionnaire. Foundation for the National Institutes of Health (FNIH) criteria (grip strength and ASM, adjusted for BMI) were used to classify sarcopenia. Participants with sarcopenia alongside a BMI of > 30.0 kg/m2 were classified as having sarcopenic obesity. Prevalence using other criteria (European Working Group on Sarcopenia in Older People, Asian Working Group for Sarcopenia and the International Working Group for Sarcopenia) were also explored.Results: The prevalence of sarcopenia was 27.9%, which comprised of sarcopenia without obesity (3.3%) and sarcopenic obesity (24.6%). Other classification criteria showed that sarcopenia ranged from 0.8–14.7%, including 0.8–9.8% without obesity and 0–4.9% with sarcopenic obesity. Using multivariate-discriminant analysis (OPLS-DA) those with sarcopenic obesity presented with a descriptive profile of higher C-reactive protein, waist circumference, food security and sedentary time than women without sarcopenic obesity (p = 0.046). A similar profile described women with low BMI-adjusted grip strength (p < 0.001).Conclusions: The majority of women with sarcopenia were also obese (88%). We show a large discrepancy in the diagnostic criteria and the potential for significantly underestimating the prevalence of sarcopenia if BMI is not adjusted for. The main variables common to women with sarcopenic obesity were higher food security, lower PA and chronic inflammation. Our data highlights the importance of addressing obesity within these low-income communities to ensure the prevention of sarcopenic obesity and that quality of life is maintained with ageing.
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