Greater daily defined dose of antihypertensive medication increases the risk of falls in older people--a population-based study.

Objectives: To determine whether there is a relationship between daily defined dose (DDD) of antihypertensive drugs and the risk of falls.

Design: Prospective population-based cohort study.

Setting: Tasmanian Study of Cognition and Gait, Australia.

Single and dual task tests of gait speed are equivalent in the prediction of falls in older people: a systematic review and meta-analysis.

Although simple assessments of gait speed have been shown to predict falls as well as hospitalisation, functional decline and mortality in older people, dual task gait speed paradigms have been increasingly evaluated with respect to fall prediction. Some studies have found that dual task walking paradigms can predict falls in older people. A systematic review and meta-analysis was conducted to determine whether dual task walking paradigms involving a secondary cognitive task have greater ability to predict falls than single walking tasks.

Incidental and Planned Exercise Questionnaire for seniors: validity and responsiveness.

Purpose: This study assessed the criterion validity and responsiveness of the Incidental and Planned Exercise Questionnaire (IPEQ) specifically developed for aging research.

Methods: The sample comprised 315 community-dwelling inactive older adults (mean age = 73.2 yr) who participated in a trial investigating the effect of a walking program on falls.

Sub-cortical infarcts and the risk of falls in older people: combined results of TASCOG and Sydney MAS studies.

Background: White matter hyperintensities increase the risk of multiple falls in older people, but the effect of sub-cortical infarcts is unknown.

Aims: By pooling data from two Australian population-based studies, we aimed to investigate the association between sub-cortical infarcts and multiple falls and whether this relationship, and that of white matter hyperintensities, is mediated or modified by cognitive or sensorimotor factors.

Methods: Participants underwent structural magnetic resonance imaging and cognitive and sensorimotor assessments.

Self-reported chronic pain is associated with physical performance in older people leaving aged care rehabilitation.

Background/objectives: The impact of pain on the physical performance of patients in aged care rehabilitation is not known. The study sought to assess 1) the prevalence of pain in older people being discharged from inpatient rehabilitation; 2) the association between self-reported pain and physical performance in people being discharged from inpatient rehabilitation; and 3) the association between self-reported pain and physical performance in this population, after adjusting for potential confounding factors.

Methods: This was an observational cross-sectional study of 420 older people at two inpatient aged care rehabilitation units.

Associations between obesity and overweight and fall risk, health status and quality of life in older people.

Objectives: To determine whether overweight and obese individuals have higher reported fall and fall injury risk than individuals of healthy weight, and to examine the influence of BMI on health, quality of life and lifestyle characteristics of fallers.

Methods: A representative sample of community-based individuals aged 65 years and older in New South Wales was surveyed regarding their history of falls, height, weight, lifestyle and general health within a 12-month period.

Results: Obese individuals had a 31% higher risk of having fallen, but no higher risk of a fall-related injury compared to healthy-weight individuals.

Predictors of nontransport of older fallers who receive ambulance care.

Objectives: To identify patient, clinical, and operational factors associated with nontransport of older people who have fallen and received ambulance care; and to develop a nontransport prediction tool that could be utilized during the dispatch process to rationalize allocation of emergency ambulance resources.

Methods: The study was a planned subanalysis using data collected during a prospective observational cohort study of nonconsecutive emergency responses to older people aged 65 years or more who had fallen between October 1, 2010 and June 30, 2011. The data consisted of routinely collected ambulance dispatch and clinical records, combined with prospectively collected fall-specific information.

Epidemiology of emergency medical service responses to older people who have fallen: a prospective cohort study.

Objectives: To describe the characteristics of older people who fall and call an emergency ambulance, and the operational and clinical impact of the ambulance responses they receive.

Methods: A prospective cohort study of people aged ≥65 who had fallen and called for an ambulance was conducted between October 1, 2010 and June 30, 2011. Fall-related data were collected using a project-specific data collection tool.

Effect of a multifactorial, interdisciplinary intervention on risk factors for falls and fall rate in frail older people: a randomised controlled trial.

Background: frail older people have a high risk of falling.

Objective: assess the effect of a frailty intervention on risk factors for falls and fall rates in frail older people.

Design: randomised controlled trial.

The ReSPonD trial--rivastigmine to stabilise gait in Parkinson's disease a phase II, randomised, double blind, placebo controlled trial to evaluate the effect of rivastigmine on gait in patients with Parkinson's disease who have fallen.

Background: Gait impairment is common in people with Parkinson's disease. There is a lack of effective interventions to target this debilitating complication and therefore a need to identify new therapeutic options. An underlying cholinergic deficit contributes to both the gait and cognitive dysfunction seen in Parkinson's disease.

Effects of nonslip socks on the gait patterns of older people when walking on a slippery surface.

Background: Slips are a common cause of falls, and nonslip socks have been marketed to prevent slips in older people. However, few studies have investigated the biomechanical and clinical effects of walking in nonslip socks. This study aimed to examine gait parameters in older people walking on a slippery surface wearing nonslip socks compared with standard sock and barefoot conditions.

Older people's perceptions of a multifaceted podiatric medical intervention to prevent falls.

Background: Falls are common in older people and are associated with substantial health-care costs. A recent randomized controlled trial of a multifaceted podiatric medical intervention demonstrated a 36% reduction in the fall rate over 12 months. We evaluated the acceptability of and levels of satisfaction with this intervention in the older people who participated in the trial.

The relative contribution of physical and cognitive fall risk factors in people with Parkinson's disease: a large prospective cohort study.

Background: In order to develop multifaceted fall prevention strategies for people with Parkinson's disease (PD), greater understanding of the impact of physical and cognitive performance on falls is required.

Objective: We aimed to identify the relative contribution of a comprehensive range of physical and cognitive risk factors to prospectively-measured falls in a large sample of people with PD and develop an explanatory multivariate fall risk model in this group. METHODS MEASURES: of PD signs and symptoms, freezing of gait, balance, mobility, proprioception, leg muscle strength, and cognition were collected on 205 community-dwelling people with PD.

Sensorimotor and postural control factors associated with driving safety in a community-dwelling older driver population.

Background: To establish whether sensorimotor function and balance are associated with on-road driving performance in older adults.

Methods: The performance of 270 community-living adults aged 70-88 years recruited via the electoral roll was measured on a battery of peripheral sensation, strength, flexibility, reaction time, and balance tests and on a standardized measure of on-road driving performance.

Results: Forty-seven participants (17.

Neuropsychological, physical, and functional mobility measures associated with falls in cognitively impaired older adults.

Background: Older people with cognitive impairment have an elevated fall risk, with 60% falling annually. There is a lack of evidence for fall prevention in this population, in part due to limited understanding of risk factors. This study examined fall risk in older people with cognitive impairment with an emphasis on identifying explanatory and modifiable risk factors.

Development and validation of a fall-related impulsive behaviour scale for residential care.

Introduction: impulsivity in older people with cognitive impairment has yet to be examined rigorously as a risk factor for falls. The objective of this study was to evaluate the psychometric properties of a new fall-related impulsive behaviour scale (FIBS) for a cognitively impaired population living in residential care.

Methods: one hundred and nine care home residents (84.

A Stroop Stepping Test (SST) using low-cost computer game technology discriminates between older fallers and non-fallers.

Background: impaired stepping and reduced cognitive functioning have both been identified as fall-risk factors in older people. We developed a Stroop Stepping Test (SST) that combines stepping and response inhibition using low-cost computer game technology to provide a functional measure that reflects real-life behaviour and determined whether this test discriminates between older fallers and non-fallers.

Methods: a cross-sectional study, including 103-independent living cognitively intact older people (70-93 years), was conducted.

Neuropsychological, balance, and mobility risk factors for falls in people with multiple sclerosis: a prospective cohort study.

Objectives: To determine whether impaired performance in a range of vision, proprioception, neuropsychological, balance, and mobility tests and pain and fatigue are associated with falls in people with multiple sclerosis (PwMS).

Design: Prospective cohort study with 6-month follow-up.

Setting: A multiple sclerosis (MS) physiotherapy clinic.

Age-associated changes in head jerk while walking reveal altered dynamic stability in older people.

Many older people have impaired dynamic stability, and up to one in three people over 65 fall each year. It is thought that older people walk more slowly to compensate for reduced capabilities. Here, we investigate whether head jerk, the first time derivative of acceleration, can further our understanding of age-associated changes in dynamic stability while walking.

Intervention to prevent further falls in older people who call an ambulance as a result of a fall: a protocol for the iPREFER randomised controlled trial.

Background: An increasing number of falls result in an emergency call and the subsequent dispatch of paramedics. In the absence of physical injury, abnormal physiological parameters or change in usual functional status, it could be argued that routine conveyance by ambulance to the Emergency Department (ED) is not the most effective or efficient use of resources. Further, it is likely that non-conveyed older fallers have the potential to benefit from timely access to fall risk assessment and intervention.

Provision of out-of-hospital analgesia to older fallers with suspected fractures: above par, but opportunities for improvement exist.

Objectives: Paramedics frequently attend older patients who have fallen and sustained suspected fractures, a population of patients who may be at risk of inadequate analgesic care. This prospective study aimed to describe the rate and effectiveness of analgesia administered by paramedics to older patients with suspected fractures secondary to falls and to identify predictive factors associated with provision of analgesia.

Methods: A cohort of older patients aged greater than 65 years with suspected fall-related fractures was extracted from a database of 1,610 cases collected during a prospective, nonconsecutive observational study of older people who had fallen and received an ambulance response from October 1, 2010, through June 30, 2011.

Systematic review of non-transportation rates and outcomes for older people who have fallen after ambulance service call-out.

Aim: To review the evidence regarding non-transported older people who have fallen in relation to non-transportation rates, outcomes and impact of alternate care pathways.

Method: Electronic databases and reference lists of included studies (up to December 2011) were systematically searched. Studies were eligible if they included data on non-transportation rates, information on outcomes or alternate care pathways for older people who have fallen.

Force-controlled balance perturbations associated with falls in older people: a prospective cohort study.

Balance recovery from an unpredictable postural perturbation can be a challenging task for many older people and poor recovery could contribute to their risk of falls. This study examined associations between responses to unpredictable perturbations and fall risk in older people. 242 older adults (80.

Comparison of handheld video camera and GAITRite® measurement of gait impairment in people with early stage Parkinson's disease: a pilot study.

In this pilot study, we investigated the validity and reliability of low-cost handheld video camera recordings for measuring gait in people with early stage Parkinson's disease (PD). Five participants with PD, Hoehn & Yahr stage I-II, mean age 66.2 years and five healthy age-matched controls were recruited.

Validation of the Iconographical Falls Efficacy Scale in cognitively impaired older people.

Background: This study evaluated psychometric properties of the Iconographical Falls Efficacy Scale (Icon-FES) to measure fear of falling in cognitively impaired older people. Icon-FES uses pictures as visual cues to prompt responses.

Methods: A total of 50 community-dwelling older people with moderate cognitive impairment were assessed on Icon-FES, Falls Efficacy Scale-International, and various physical and cognitive measures.