TUESDAY, Oct. 9, 2018 (HealthDay News) — One in four Americans 65 and older falls each year, with some ending up in hospitals or even dying. But new research suggests that it’s possible to avoid some of these serious injuries.
When seniors who are at risk of falling have a prevention plan, they’re less likely to suffer a tumble-related hospitalization, the study found.
“We saw statistically significant change that reduced fall risk in people at risk of falls to almost the same as those who weren’t at risk of a fall [at the start of the study],” said the study’s lead author, Yvonne Johnston, an associate professor at the Binghamton University School of Nursing in New York.
“Considering the cost of one hospitalization for fall, avoiding just one hospitalization compared to the cost of the program makes it a worthwhile program,” she noted.
In 2014, 29 million older adults reported a fall, and 7 million of those resulted in an injury, according to the study. Johnston said that many falls go unreported, so these numbers may underestimate the extent of the problem.
In 2016, falls were responsible for 29,000 deaths in the United States, the study authors said. Medical costs related to falls may be as much as $50 billion.
The current study looked at a U.S. Centers for Disease Control and Prevention fall prevention initiative. It included screening to identify older people who are at risk of falling. This assessment looked at vision problems, low blood pressure, medications, home hazards and functional ability such as leg strength.
The initiative also included interventions such as a strength and balance program, medication changes, corrective eyewear and occupational therapy.
For the study, researchers divided more than 12,000 older adults into three fall-risk groups. One group was at-risk and received the “Fall Plan of Care” intervention; another group was determined to be at-risk but received no formal plan; and the final group wasn’t at risk of falling.
The study found that at-risk adults who received the intervention had similar odds for falling as adults who weren’t at risk of a fall, and 40 percent lower odds than those at risk without a fall prevention plan.
Johnston said this type of program needs to be individualized because some people need a more structured program, while others benefit from things like tai chi.
Becky Turpin, director of home and community safety for the National Safety Council, said individualizing fall prevention for seniors is crucial.
“As we age, there are natural changes that occur in the body, but that doesn’t mean that falls are a natural part of aging. There are things we can do — if we’re aware of the issue — to account for changes, like occupational therapy for lower leg strength or cataract surgery to improve vision,” she said.
Turpin said it’s important to talk to your doctor about your risk of falling. Your medications should be reviewed to make sure you’re not taking something that might increase your fall risk. Some medications can make you dizzy or sleepy.
It’s also important to get your vision checked annually. “Cataracts can have huge implications for fall risk,” Turpin said.
Seniors and their loved ones should take a good look at the home and how people live their lives.
For example, if a senior is afraid of falling on the stairs, try to figure out why. Is there trouble with depth perception? Is it hard for them to see the stairs well? These problems suggest an eye exam might be in order. If they have trouble lifting their leg up each stair, physical therapy might help.
Some seniors still get on a step stool to reach serving dishes in a high cabinet. “Could you rearrange the kitchen to make the things you need more accessible?” Turpin suggested.
It’s also important to ask your senior if he or she has already fallen. “There’s a fear of telling anyone. They don’t want to scare family members, and they’re worried about losing their independence. But falls are an indication that something is going on, and that’s when to intervene,” Turpin said.
The study was published recently in the journal Gerontologist.
Learn where to find community-based fall prevention programs from the National Safety Council.
SOURCES: Yvonne Johnston, Dr.Ph., M.P.H., M.S., associate professor, Binghamton University Decker School of Nursing, State University of New York; Becky Turpin, M.S., director, home and community safety, National Safety Council; Sept. 20, 2018, Gerontologist, online
THURSDAY, Oct. 4, 2018 (HealthDay News) — Vitamin D supplements have long been touted as a way to improve bone health and possibly ward off the bone-thinning disease osteoporosis in older adults.
But a new study contends that claims of benefits from supplements of the “sunshine vitamin” fall flat.
A review of previously published studies found that taking either high or low doses of vitamin D supplements didn’t prevent fractures or falls, or improve bone density.
Vitamin D is found in very few foods. One of the biggest sources of the vitamin is exposure to sunlight.
“Vitamin D supplement use is common, particularly in North America,” where up to 40 percent of older people take them, said lead researcher Dr. Alison Avenell. She is clinical chair in health services research at the University of Aberdeen in Scotland.
“Most adults don’t need to take vitamin D supplements, although they are unlikely to do harm if taken in low doses,” she added.
Vitamin D supplements do prevent rare conditions, such as rickets in children and osteomalacia (softening of bones) in adults. People at risk of vitamin D deficiency include those with little or no sun exposure, such as nursing home residents who are indoors all the time, or those who always cover their skin when outside, Avenell said.
There’s also existing evidence that vitamin D helps prevent cancer or heart disease, she added.
“Preserving bone strength involves keeping active, not smoking, not being too thin, and taking medications for osteoporosis,” Avenell said.
Based on the new findings, Avenell thinks guidelines that recommend vitamin D supplements for bone health should be changed.
For the new report, Avenell and her colleagues reviewed 81 studies, most of which dealt with vitamin D alone, not in combination with the mineral calcium.
“Calcium supplements on their own have minimal effect on bone mineral density and fracture, and may increase the risk of cardiovascular disease,” Avenell said.
The only evidence that calcium and vitamin D together prevent fractures comes from a trial of older people with very low vitamin D levels in nursing homes. But calcium and vitamin D may also increase the risk of cardiovascular disease, Avenell said.
In addition, most of the studies covered in the new review included women aged 65 and older who took more than 800 IUs (international units) of vitamin D daily.
The new study found no meaningful effect of vitamin D supplementation when it came to reducing any fracture, hip fractures or falls.
This type of study, called a meta-analysis, tries to find common elements among previously published studies. This kind or research, however, is limited by differences in the methods and conclusions of the different studies analyzed by researchers, so the findings may not be consistent across the board.
Dr. Minisha Sood, an endocrinologist at Lenox Hill Hospital in New York City, said this new study should convince doctors that vitamin D supplements don’t have a role in maintaining healthy bones, but they do have other benefits.
Previous research suggests that vitamin D, when taken in tandem with calcium, may help prevent certain cancers and protect against age-related declines in thinking and memory.
“What is important to keep in mind is that those with low vitamin D were not represented in this meta-analysis, and vitamin D supplementation — repletion, actually — is still necessary for those with low vitamin D levels, regardless of age,” Sood said.
The findings were published online Oct. 4 in The Lancet Diabetes and Endocrinology.
For more on vitamin D, visit the U.S. National Institutes of Health.
SOURCES: Alison Avenell, M.D., clinical chair, health services research, University of Aberdeen, Scotland; Minisha Sood, M.D., endocrinologist, Lenox Hill Hospital, New York City; Oct. 4, 2018, The Lancet Diabetes and Endocrinology, online
New research pinpoints three genes responsible for skeletal development that appear to be connected to chronic back pain.
The study authors said their findings could shed new light on the biological factors involved in the development of the condition and lead to new treatments for back pain, which is the leading cause of disability around the world.
For the study, an international team of researchers conducted a genome-wide association to search for gene variants associated with back pain. The study involved 158,000 adults of European ancestry. Of these participants, more than 29,000 suffered from chronic back pain.
The scientists identified three new genetic variants linked to chronic back pain. The SOX5 gene, which is involved in nearly all phases of embryonic development, had the strongest link to the condition.
Previous animal studies have shown that deactivation of this variant is linked to defects in cartilage and skeleton formation in mice.
The study also showed that another gene, which has been associated with intervertebral disc herniation (commonly called a slipped disc), was also linked to back pain. The researchers also identified a third gene involved in spinal cord development, which could affect the risk for back pain due to its influence on pain sensation.
The findings were published Sept. 27 in the journal PLOS Genetics.
“The results of our genome-wide association study point to multiple pathways that may influence risk for chronic back pain,” said study leader Dr. Pradeep Suri, of the U.S. Department of Veterans Affairs in Seattle.
“Chronic back pain is linked to changes in mood, and the role of the central nervous system in the transition from acute to chronic back pain is well-recognized,” he said in a journal news release.
“However, the top two genetic variants we identified suggest causes implicating the peripheral structures, such as the spine,” Suri added. “We expect that further large-scale genetic studies will reveal the importance of both peripheral and central contributors to the complex experience of chronic back pain.”
The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases provides more information on chronic back pain.
SOURCE: PLOS Genetics, news release, Sept. 27, 2018