Falls in Older People : Risk Factors and Strategies for Prevention.

Cover -- Half-title -- Title -- Copyright -- Contents -- Preface -- Acknowledgements -- Part I Risk factors for falls -- 1 Epidemiology of falls and fall-related injuries -- The definition of a fall -- Falls ascertainment -- The incidence of falls in older people -- Community-dwellers -- Residents of long-term care institutions -- Particular groups -- Falls location -- Consequences of falls -- The cost of falls -- Conclusion -- REFERENCES -- 2 Postural stability and falls -- Postural stability when standing -- Postural stability during leaning tasks -- Responses to external perturbations -- Voluntary stepping -- Normal walking -- Tandem walking -- Ability in navigating obstacles -- Postural control when performing multiple tasks -- Conclusion -- REFERENCES -- 3 Sensory and neuromuscular risk factors for falls -- Age-related changes in sensorimotor function -- Vision -- Visual field dependence -- Peripheral sensation -- Vestibular sense -- Muscle strength -- Reaction time -- Integration, interaction and summation -- Conclusion -- REFERENCES -- 4 Medical risk factors for falls -- Neurological problems -- Stroke -- Parkinson's disease -- Myelopathy -- Cerebellar disorders -- Vestibular pathology -- Peripheral neuropathy -- Cardiovascular problems resulting in neural failure of postural control -- Orthostatic hypotension -- Drop attacks -- Syncope -- Visual problems -- Cataracts -- Macular degeneration -- Glaucoma -- Lower extremity problems -- Osteoarthritis -- Foot problems -- Urinary incontinence -- Psychological and cognitive factors -- Conclusion -- REFERENCES -- 5 Medications as risk factors for falls -- Design issues and limiting factors -- Drug classes implicated in falls in older people -- Psychoactive medications -- Hypnotics and anxiolytics -- Antidepressants -- Antipsychotics.

Pooling the data: meta-analysis findings for the relationship between psychoactive medications and falls -- Cardiovascular system medications -- Antihypertensive agents -- Diuretics -- Other cardiovascular system medications -- Anti-inflammatories and analgesics -- Pooling the data: meta-analysis findings for the relationship between cardiac and analgesic medications and falls -- Physiological mechanisms underlying the association between medications and falls -- Conclusion -- REFERENCES -- 6 Environmental risk factors for falls -- Proportion of falls involving environmental factors -- Suggested environmental risk factors -- Evidence regarding environmental risk factors -- Private residences -- Residential aged care facilities -- Public places -- The interaction between the individual and the environment -- Conclusion -- REFERENCES -- 7 The relative importance of falls risk factors: an evidence-based summary -- Psychosocial and demographic Factors -- Postural instability -- Sensory and neuromuscular factors associated with falls -- Medical factors -- Medication use -- Environmental factors -- Conclusion -- REFERENCES -- Part II Strategies for prevention -- Overview: Falls prevention -- REFERENCE -- 8 Exercise interventions to prevent falls -- Exercise and falls -- Exercise options, falls and falls risk factors -- Resistance training -- Background -- Effects on falls and falls risk -- Effects on functional abilities -- Endurance training -- Background -- Effects on falls and falls risk -- Effects on functional abilities -- Individual physiotherapy intervention -- Background -- Effects on falls and falls risk -- Effects on functional abilities -- General exercise -- Background -- Effects on falls and falls risk: group exercise -- Effects on falls and falls risk: home exercise -- Effects on functional abilities -- Setting -- Conclusion -- REFERENCES.

9 Modifying the environment to prevent falls -- Environmental modification strategies -- Environmental modification as an individual intervention -- Environmental modification in multifactorial programmes -- Barriers to environmental modification -- Public places and design issues -- Conclusion -- REFERENCES -- 10 The role of footwear in falls prevention -- Heel height -- Midsole cushioning -- Slip-resistance of footwear outersoles -- Heel collar height -- Midsole flaring -- Conclusion -- REFERENCES -- 11 Assistive devices -- Walking aids -- Indications -- Prescription principles -- Limitations -- Alternatives -- Other physical assistive devices -- Spectacles -- Hip protectors -- Aids to prevent 'long lies' -- Restraints -- Conclusion -- REFERENCES -- 12 Prevention of falls in hospitals and residential aged care facilities -- Incidence and risk factors -- Hospitals -- Residential aged care facilities -- An integrated approach to falls prevention in institutional settings -- Screening protocols -- Risk factor modification -- Environmental interventions -- Increase awareness of falls risk -- Reduce falls injury -- Discharge planning -- Post-fall assessment -- Evaluation of strategies for falls prevention in institutions -- Conclusion -- REFERENCES -- 13 The medical management of older people at risk of falls -- Medical management of conditions associated with falls -- Counselling the older adult at risk of falling -- General practice assessment of the at-risk older patient -- Vision -- Sensation -- Strength -- Reaction time -- Balance -- The assessment of orthostatic hypotension -- Conclusion -- REFERENCES -- 14 Modifying medication use to prevent falls -- Medication withdrawal and falls -- Alternatives to pharmacological treatments of anxiety, depression and sleep disturbances in older people -- Psychosocial therapies -- Simple behavioural strategies.

Exercise -- Environmental interventions -- Conclusion -- REFERENCES -- 15 Targeted falls prevention strategies -- Evaluation of targeted falls prevention strategies -- Conclusion -- REFERENCES -- 16 A physiological profile approach for falls prevention -- The physiological profile assessment for assessing falls risk -- Using the PPA to optimize falls prevention strategies in at-risk older people: a randomized controlled trial -- The exercise intervention -- The visual intervention -- The peripheral sensation counselling intervention -- The vestibular system and visual field dependence counselling intervention -- Conclusion -- REFERENCES -- Part III Research issues in falls prevention -- 17 Falls in older people: future directions for research -- Studies on human balance and related sensorimotor systems -- Transient risk factors -- Neuropsychological risk factors -- Falls prevention in population subgroups -- Intensity and type of exercise intervention programmes -- Optimal shoe designs -- Preventing falls in institutions -- Home modifications -- Interventions for modifying medication use -- Intervention compliance -- Evaluation of falls clinics -- Multifactorial targeted interventions -- Determining the best interventions -- Conclusion -- REFERENCES -- Index.

This book provides a survey of the most recent developments in the area. Coverage includes epidemiology, critical appraisal of the roles of exercise, environment, footwear, and medication, evidence-based risk assessment, and falls-prevention strategies. Falls in Older People will be invaluable to clinicians, physiotherapists, occupational therapists, nurses, and researchers.

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Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, 2024. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries.