Thesis (M.S.)--University of British Columbia, 2004. / Includes bibliographical references (leaves 92-102).

Thesis (M.A.)--Northern Kentucky University, 2006. / Made available through ProQuest. Publication number: AAT 1438634. ProQuest document ID: 1203575541. Includes bibliographical references (p. 62-63)

Falls among elderly people have been identified as a significant and serious medical problem confronting a growing number of older people. Falls have been found to be a leading cause of disability, distress, admission to supervised care and death among older persons that pose a serious problem to public health. The purpose of this study was to determine the prevalence of and risk factors for falls in the community-dwelling elderly persons in the Umutara province of Rwanda.

Falls among elderly people have been identified as a significant and serious medical problem confronting a growing number of older people. Falls have been found to be a leading cause of disability, distress, admission to supervised care and death among older persons that pose a serious problem to public health. The purpose of this study was to determine the prevalence of and risk factors for falls in the community-dwelling elderly persons in the Umutara province of Rwanda.

Thesis (M Sport Sc)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Falling is a common occurrence and one of the most serious problems in the elderly population (65 years and older). Falls account for 70% of accidental deaths in persons aged 75 years and older. Falls can be markers/indicators of poor health and declining function, and are often associated with significant morbidity. More than 90% of hip fractures occur as a result of falls, with most of these fractures occurring in persons over 70 years of age (Fuller, 2000). About one third of people aged 65 years and older fall each year, resulting in a substantial decrease in quality of life in addition to placing a huge burden on current health care systems. The purpose of this study was to determine whether a 12-week exercise intervention programme, consisting of two 30 minute exercise sessions a week, could lower the risk of falling in a group of elderly women. Female subjects (n=22) with an average age of 79.5 years were selected from three retirement homes situated in Stellenbosch, Western Cape, South Africa, according to specific inclusion and exclusion criteria. The subjects included presented no major cardiovascular and pulmonary disease signs and symptoms as recognised by the American College of Sports Medicine (2011); had no serious illnesses or co-morbidities; were mobile with no significant musculoskeletal disorders; had no uncorrected visual or vestibular problems as well as no significant cognitive impairments or major psychological disturbances; were not taking any psychotropic medications or Benzodiazepines that could affect their progress. Subjects also had to be willing to follow the 12-week exercise intervention programme and sign an informed consent document. The selected subjects then underwent a pre- and post-intervention assessment consisting of a subjective rating of their fear of falling, the Fall Risk Assessment: Biodex Balance system, Balance Evaluations Systems Test (BESTest) and the 30-Second Chair Stand Test. Statistica 10 was used to analyse the data. Data was analysed to assess any significant improvements that the exercise intervention had on each fall risk variable tested. The main fall risk variables consisted of: fear of falling, muscular strength, balance, gait and getting up strategies. Statistically significant improvements (p<0.001) were seen in: Fear of falling, muscular strength, balance, gait and getting up strategies after the 12-week exercise intervention programme. This study suggests that exercise intervention has the potential to decrease the risk of falling among elderly women and should play an extremely important role in the prevention of falling amongst this population group. / AFRIKAANSE OPSOMMING: Om te val is ‘n alledaagse gebeurtenis en een van die mees ernstige probleme vir ons bejaarde bevolking (65 jaar en ouer). Insidente van val verklaar tot 70% van toevallige sterftes met betrekking tot persone van 75 jarige ouderdom en ouer. Om te val kan ‘n teken van swak gesondheid en/of ‘n afname in funksionele kapasiteit wees, en is gewoonlik met morbiditeitspatrone gekoppel. Meer as 90% van heupfrakture kom as gevolg van valle voor, waar die meeste van die frakture in persone bo 70 jarige ouderdom voorkom (Fuller, 2000). Minstens een derde van persone bo 65 jaar en ouer val elke jaar, so ‘n val het ‘n noemenswaardige afname in lewenskwaliteit tot gevolg asook ‘n enorme druk wat op huidige gesondheidsorg sisteme geplaas word. Die doel van die studie was om te bepaal of ‘n 12 week oefenintervensieprogram, wat uit twee oefen sessies van 30 minute elk bestaan, die risiko van val vir n groep bejaarde vroue kan verlaag. Vroulike individue (n=22) met ‘n gemiddelde ouderdom van 79.5 jaar uit drie ouetehuise/aftree oorde in Stellenbosch, Wes-Kaap, Suid-Afrika geleë; is volgens bepaalde insluitings- en uitsluitingskriteria geselekteer. Individue wie ingesluit is het geen tekens of simptome van grootskaalse kardiovaskulêre of pulmonêre siekte getoon nie, soos herken deur die “American College of Sports Medicine (2011) ; het aan geen ernstige siektes of ko-morbiditeite gely nie; kon stap met geen merkwaardige muskulo-skeletale afwykings nie; het geen nie-gekorrigeerde visie of vestibulêre probleme asook geen beduidende kognitiewe gestremdhede of ernstige sielkundige steurnisse gehad nie; het nie enige psigotropiese medikasie of Benzodiazepines geneem wat hul kon beinvloed nie. Individue moes bereid gewees het om die 12 week oefenintervensieprogram te volg en moes ook ‘n ingeligte toestemmingsvorm onderteken. Die geselekteerde individue het ‘n pre- en post-intervensie assessering ondergaan wat uit ‘n subjektiewe bepaling van hul vrees vir val bestaan het, die Val Risiko Assessering asook “Biodex Balans System Test, Balance Evaluations Systems Test (BESTest)” asook die 30 Sekonde Stoel-staan Toets. Statistica 10 is gebruik om die data te analiseer. Data was geanaliseer om enige merkwaardige verandering wat die oefenintervensie op elke val risiko veranderlike wat getoets was gehad het, te bepaal. Die belangrikste val risiko veranderlikes het uit: die vrees vir val, spier sterkte, balans, stappatroon en opstaan tegnieke bestaan. Betekenisvolle statistiese veranderinge (p<0.001) is gerapporteer in: die vrees vir val, spiersterkte, balans, stappatroon en opstaan tegnieke na die 12 week oefenintervensieprogram. Die studie bevind dat die intervensieprogram die potensiaal het om die risiko van val onder bejaarde vroue te verminder en behoort ‘n uiters belangrike rol in die voorkoming van val onder die bevolkingsgroep te speel.

published_or_final_version / Geography / Master / Master of Philosophy

Thesis (M.Sc.)--University of Alberta, 2010. / A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Master of Science in Rehabilitation Science, Faculty of Rehabilitation Medicine. Title from pdf file main screen (viewed on February 16, 2010). Includes bibliographical references.

published_or_final_version / Community Medicine / Master / Master of Public Health

In the United States, falls are the leading cause of unintentional death with one of every three people 65 years and older falling each year. Falls account for approximately 95% of hip fractures among older adults and falls to the side predominate hip fracture related falls in this population. However, risk factors for side and frequent falls are poorly understood. Furthermore, few data exist to explain differences in bone mineral density among older postmenopausal women. In particular, data regarding the timing of hormone replacement therapy (HRT) among older women is scarce. In the first aim of this dissertation, we examined changes in mobility and balance-related risk factors for side falls as well as differences in these risk factors according to fall status in a population of 107 independent, elderly women (>70 yrs), who were followed over 2 years. We found hip abduction strength decreased (p<.001) in all subjects, with side-fallers exhibiting weaker hip abduction strength (p=.008), greater sway velocity (p=.027), and slower performances on the tandem walk (p=.039) and Get Up and Go (p<.001) compared to non-fallers. For the second study, in the same population, we examined 2-year changes in balance self-efficacy (BSE) and the relationship of BSE to side fall risk factors and falls incidence. Results showed BSE at baseline was predictive of Get Up and Go, hip abduction strength and tandem walk at follow-up (p<.008), but that BSE decreased only among the non-fallers (p=.013). In the third study, we examined 3-yr hip bone mineral density (BMD) changes in women with distinct hormone replacement therapy (HRT) profiles: 1) no hormone replacement therapy (N0HRT), 2) HRT continually since menopause (Continual), 3) HRT begun 10 years after menopause (Late), 4) HRT initiated within 5 years (New), and compared the change in BMD of the hip across HRT groups. Only the NoHRT group lost bone over the 3 years (p=.014). We also assessed BMD of the lateral spine across levels of estrogen use in a sub-sample of participants and found long-term HRT users had significantly higher lateral spine BMD (p=.041) compared to women who had never been on HRT. / Graduation date: 2003

This study was designed to investigate the relationship between retinol intake, bone mineral density, and falls in 101 elderly women aged 72 to 90 years (78.6 yrs. �� 4.3 yrs.). Bone mineral density (BMD) (g/cm��) of the left hip, anterior-posterior lumbar spine (L3), and lateral spine (L3) was measured using dual-energy x-ray absorptiometry. Dietary intake and physical activity were assessed by validated questionnaires (the 100-item Block Food Frequency Questionnaire and the Physical Activity Scale for the Elderly, respectively). Isometric hip abduction strength of the right and left legs was assessed using a hand-held dynamometer. Fall surveillance was collected using a "postcard" system at three-month intervals over a two-year period. Multiple regression analyses were used to show the predictability of retinol, vitamin D, calcium, years past menopause, years on hormone replacement therapy, and physical activity on BMD variables. Together, these variables explained 14% of the variance in total hip BMD at follow-up (R��=0.14, SEE=0.12, p=0.020), 26% of the variance in the anterior-posterior spine BMD at follow-up BMD (R��=0.26, SEE=0.17, p=0.051), and 33% of the variance in lateral spine BMD at follow-up (R��=0.33, SEE=0.10, p=0.009). Two-year changes in hip BMD were poorly predicted using the model with only 5% of total hip BMD variance being explained by the six independent variables (R��=0.05, SEE=0.03, p=0.558). Logistic regression was used to determine whether the likelihood of being a faller vs. a non-faller could be predicted from a model using retinol, vitamin D, average hip strength, and physical activity. It was shown that 11.5% of the variability in fall status could be explained by the model (Cox & Snell's R��=0.115). Using an ROC curve analysis, the model correctly classified 69% of the individuals into the correct "fall category". We conclude that retinol, although not an independent predictor of BMD or fall status, is an important component in the prediction of both BMD and falls. Further interventional research is needed to determine the effects of retinol on BMD and falling. / Graduation date: 2004