Objectives

The purpose of this study was to examine if fall risk scores were affected by the interaction between muscle strength and visual contrast sensitivity.

Methods

Ninety-one individuals aged 19-79 years completed assessments of knee extension strength, visual contrast sensitivity, and fall risk. Correlations and moderation analysis were completed in combination with analysis of variance. Data were categorized into groups: 1) higher strength-higher visual contrast sensitivity, 2) higher strength-lower visual contrast sensitivity; 3) lower strength- higher visual contrast sensitivity, and 4) lower strength-lower visual contrast sensitivity.

Results

Knee extension strength via peak torque relative to body mass (R= -0.57, P<0.001) and visual contrast sensitivity (R=-0.63, P<0.001) were both negatively correlated with age, while fall risk scores were positively correlated with age (R=0.34, P=0.001). The interaction between muscle strength and visual contrast sensitivity was a significant predictor of fall risk scores (t=2.420, P=0.018) when controlling for age. Participants exhibiting lower strength-lower contrast sensitivity (12.96±1.93) had significantly worse fall risk scores compared to higher strength-higher visual contrast sensitivity (11.53±1.75, P=0.045).

Conclusion

Lower levels of lower body muscle strength combined with lower visual contrast sensitivity interact to negatively influence fall risk.

Objectives

Despite global guidelines and evidence, fall prevention services in Kuwait are limited. This study sought to understand older people’s perspectives towards falls and falls prevention within the context of limited fall prevention services.

Methods

Qualitative interviews explored the perceptions of falls and fall prevention among Kuwaiti older people (50+ years) and their caregivers (N=16).

Results

Falls prevention was an unfamiliar issue; participants’ knowledge of falls came from personal and others’ experiences, which motivated individuals to eliminate what they perceived as risk factors, but gaps in understanding remained (theme 1). Older people were found to have positive attitudes towards preventing falls, and beliefs around fate and autonomy towards falls prevention were found to independently co-exist (theme 2). Attitudes towards falls prevention were shaped by simplified understanding and concerns about falling (theme 3). Social networks were important in older people’s lives, and valuable sources of support and influence were identified (theme 4). A new concept of ‘circular care benefits’ was developed, contributing an understanding that caring for others helps build subjective norms.

Conclusions

The interview findings contribute to the Theory of Planned Behaviour in the context of falls prevention, with further contribution to the understanding of co-existing beliefs and ‘subjective norms’.

Objectives

To examine shifts in frailty among spinal stenosis patients during the COVID-19 pandemic and associations with interventions and outcomes.

Methods

This retrospective analysis compared types of management and rates of in-hospital mortality between pre-pandemic (January 1, through December 31, 2019) and pandemic phases (March 5, 2020 through May 17, 2022) among spinal stenosis patients across a network of 76 hospitals in Germany, utilizing logistic generalized linear mixed models. Frailty was quantified using the Hospital Frailty Risk Score (HFRS) and categorized as low (<5 points), intermediate (5-15 points), and high (>15 points).

Results

Among the 59,130 patients with spinal stenosis, 39,448 were hospitalized during the pandemic, and 19,682 in 2019. During the pandemic, the proportion of patients with high frailty rose from 4.7%-5.5% to 6.2%-7.3% (p < 0.01), except in pandemic wave 5. Among low frailty patients, rates of decompressive surgery increased from 42.4%-46.0% to 48.4%-52.8% (p<0.001), and of fusion surgery from 15.7%-16.6% to 19.2%-22.8% (p<0.001). Throughout the pandemic, in-hospital mortality rates increased from 0.8%-1.0% to 1.0%-2.5% (p<0.017), yet without differences across frailty groups.

Conclusions

Among those hospitalized for spinal stenosis during the COVID-19 pandemic in Germany, frailty increased and low frailty was associated with rising rates of spine surgery.

Falls among older adults in residential long-term care (RLTC) remain a significant concern, with prevention efforts often yielding inconsistent results due to the complexity of implementation. This umbrella review synthesised evidence from ten systematic reviews to explore the factors influencing the implementation of falls prevention interventions in RLTC, using the i-PARIHS framework. Six EBSCO databases and Scopus were searched without date or language limiters. Risk of bias was assessed using the AMSTAR-2 checklist. The review was conducted in accordance with the PRIOR guideline for overviews of reviews. Seventy-three specific factors were identified. Interventions that are simple, engaging, tailored, and supported by leadership were more effectively adopted. Staff knowledge, clarity of roles, and multidisciplinary collaboration and co-design further facilitated implementation, while organisational constraints such as limited resources, rigid routines, and under-resourcing posed substantial barriers. External contextual influences, including funding mandates and policy frameworks. Moreover, this review identified four factors that did not fall under any of the key characteristics of the i-PARIHS framework: the technological fit of innovations, the health status of residents, changes within the RLTC population, and facilitators’ skills in navigating complexity. This review underscores the importance of contextually sensitive, system-wide strategies that consider the evolving realities of RLTC.

Bioelectrical impedance analysis (BIA) is a non-invasive method used to assess body composition and estimate metabolic age (MA). However, the clinical significance of BIA-estimated MA remains poorly understood. We explored the associations of MA with chronological age (CA), multimorbidity, and physical frailty (PF) in falls clinic attendees. Participants aged ≥50 years were assessed for multimorbidity using the Cumulative Illness Rating Scale-Geriatric, PF using the SHARE Frailty Instrument for Primary Care, and underwent BIA. Among 107 participants (mean age 69.8 years, 57% women), MA showed a moderate correlation with CA (r=0.62, p<0.001). On bivariate analysis, participants with MA>CA were younger, had higher multimorbidity, and were frailer compared to those with MA<CA. Multivariate linear regression analyses revealed that MA was independently associated with CA and BIA-estimated fat mass in both sexes, BIA-estimated muscle mass in men, and PF in women, but not with multimorbidity. BIA-estimated MA mostly reflects CA and BIA’s own body composition estimates, but was significantly associated with PF in women. Research should externally validate this finding and investigate the responsiveness of BIA-estimated MA to interventions.