Gait and foot clearance parameters obtained using shoe-worn inertial sensors in a large-population sample of older adults.

In order to distinguish dysfunctional gait, clinicians require a measure of reference gait parameters for each population. This study provided normative values for widely used parameters in more than 1,400 able-bodied adults over the age of 65. We also measured the foot clearance parameters (i.

Fallers in postacute rehabilitation have worse functional recovery and increased health services use.

Objectives: To determine characteristics associated with single and multiple fallers during postacute rehabilitation and to investigate the relationship among falls, rehabilitation outcomes, and health services use.

Design: Retrospective cohort study.

Setting: Geriatric postacute rehabilitation hospital.

Predictors of functional recovery in patients admitted to geriatric postacute rehabilitation.

Objective: To examine characteristics associated with functional recovery in older patients undergoing postacute rehabilitation.

Design: Observational study.

Setting: Postacute rehabilitation facility.

[How to prevent functional decline: an acute care integrated model for the elderly].

Hospitalization in older patients is frequently associated with functional decline. Hospital factors and inadapted process of care are factors leading to this decline. Acute care units specifically developed for older patients can prevent functional decline.

[Assessment of life expectancy in older people].

Evaluation of the remaining life expectancy in elderly persons plays an important role in their care, most importantly when treatments are associated with severe side effects or when they reduce the quality of life. Prognostic scores, incorporating the functional status in addition to age and comorbidities, enable evaluation of the mortality risk during different periods of time. Despite some limitations, these scores are useful in establishing individualized treatment plans.

[Principles for the assessment and management of polymorbid elderly patients: a guide for clinicians].

Providing care to multimorbid older patients is complex, not only because of the coexistence of multiple chronic conditions, but also because of their frequent intrication with psychological and social problems. This article describes a guide for clinicians to assess and manage multimorbid older patients. This guide was adapted from the work of a group of expert US geriatricians.

Heel and toe clearance estimation for gait analysis using wireless inertial sensors.

Tripping is considered a major cause of fall in older people. Therefore, foot clearance (i.e.

Instruments measuring spirituality in clinical research: a systematic review.

Introduction: Numerous instruments have been developed to assess spirituality and measure its association with health outcomes. This study's aims were to identify instruments used in clinical research that measure spirituality; to propose a classification of these instruments; and to identify those instruments that could provide information on the need for spiritual intervention.

Methods: A systematic literature search in MEDLINE, CINHAL, PsycINFO, ATLA, and EMBASE databases, using the terms "spirituality" and "adult$," and limited to journal articles was performed to identify clinical studies that used a spiritual assessment instrument.

[Miliary tuberculosis: unexpected autopsy finding in an elderly person].

Miliary tuberculosis is a rare disease that is difficult to diagnose because of its non-specific presentation. It should be suspected in elderly patients who complaint of failure to thrive, unexplained fatigue and weight loss. Using a clinical situation where the diagnosis was made only at autopsy, we briefly review the epidemiology of miliary tuberculosis and propose recommendations for the diagnosis and the prophylaxis of latent tuberculosis.

Interventions aiming at balance confidence improvement in older adults: an updated review.

Background: Loss of balance confidence is a frequent condition that affects 20-75% of community-dwelling older persons. Although a recent fall is a common trigger, loss of balance confidence also appears independent of previous experience with falls. Maintaining or improving balance confidence is important to avoid unnecessary, self-imposed restrictions of activity and subsequent disability.

3D gait assessment in young and elderly subjects using foot-worn inertial sensors.

This study describes the validation of a new wearable system for assessment of 3D spatial parameters of gait. The new method is based on the detection of temporal parameters, coupled to optimized fusion and de-drifted integration of inertial signals. Composed of two wirelesses inertial modules attached on feet, the system provides stride length, stride velocity, foot clearance, and turning angle parameters at each gait cycle, based on the computation of 3D foot kinematics.

What is the relationship between fear of falling and gait in well-functioning older persons aged 65 to 70 years?

Objective: To investigate the association between fear of falling and gait performance in well-functioning older persons.

Design: Survey.

Setting: Community.

[What's new in geriatric medicine].

Several studies clarified the role of different interventions such as vitamine D replacement, denosumab treatment, and vertebroplasty in the prevention and management of falls and fractures. A trial tested the effectiveness of pharmaceutical assistance at the time of discharge, emphasizing the potential benefits for the patients and the health care system. Syncopal episodes frequently lead to hospital admission.

Frailty and use of health and community services by community-dwelling older men: the Concord Health and Ageing in Men Project.

Background: frailty is a concept used to describe older people at high risk of adverse outcomes, including falls, functional decline, hospital or nursing home admission and death. The associations between frailty and use of specific health and community services have not been investigated.

Methods: the cross-sectional relationship between frailty and use of several health and community services in the last 12 months was investigated in 1,674 community-dwelling men aged 70 or older in the Concord Health and Ageing in Men study, a population-based study conducted in Sydney, Australia.

Vulnerability in high-functioning persons aged 65 to 70 years: the importance of the fear factor.

Background And Aims: Falls efficacy has been shown to predict functional decline, but whether it is independently associated with frailty is still unclear. This study investigated the cross-sectional association between falls efficacy and the frailty phenotype in high-functioning older persons.

Methods: Subjects (n=861) were a sub-sample of community-dwelling persons aged 65 to 70 years enrolled in the "Lc65+" cohort, who had gait assessment.

Pain, frailty and comorbidity on older men: the CHAMP study.

Intrusive pain is likely to have a serious impact on older people with limited ability to respond to additional stressors. Frailty is conceptualised as a functional and biological pattern of decline accumulating across multiple physiological systems, resulting in a decreased capacity to respond to additional stressors. We explored the relationship between intrusive pain, frailty and comorbid burden in 1705 community-dwelling men aged 70 or more who participated in the baseline phase of the CHAMP study, a large epidemiological study of healthy ageing based in Sydney, Australia.

Validation of an adapted falls efficacy scale in older rehabilitation patients.

Objective: To determine the psychometric properties of an adapted version of the Falls Efficacy Scale (FES) in older rehabilitation patients.

Design: Cross-sectional survey.

Setting: Postacute rehabilitation facility in Switzerland.

Success of referral for alcohol dependent patients from a general hospital: predictive value of patient and process characteristics.

To assess the effectiveness of a multidisciplinary evaluation and referral process in a prospective cohort of general hospital patients with alcohol dependence. Alcohol-dependent patients were identified in the wards of the general hospital and its primary care center. They were evaluated and then referred to treatment by a multidisciplinary team; those patients who accepted to participate in this cohort study were consecutively included and followed for 6 months.

[Acute confusional state in the elderly].

Delirium is common and associated with important adverse consequences in elderly persons. It is an acute syndrome characterized by the rapid onset of cognitive and attention impairment, with a fluctuating course. In most cases, the etiology is multifactorial, combining predisposing and precipitating factors.