부산대학교 도서관

Americans over the age of 65 are at a higher risk of falls. After falling, they commonly experience decreases in functionality, independence, and quality of life. In ACSM's Guidelines of Exercise Testing and Prescription, older adults are recommended to participate in aerobic exercise 5 days a week, supplemented with 2 days of flexibility and resistance training. We propose additional considerations may be required for adults who have previously experienced a fall. PURPOSE: To evaluate the effect of past falls on likelihood and incidence of future falls among older adults. METHODS: We evaluated 615 patients consecutively admitted in a single year to a Level 1 trauma center for a fall-related injury. All patients were > 65 years of age. We conducted a retrospective analysis to determine the number of previous admissions for fall-related injuries over a 5-year period, and we tracked patients prospectively, recording the number of additional falls experienced for 8 months. We estimated the odds that a patient would experience a future fall using logistic regression and the number of future falls experienced with negative binomial regression. The primary predictor was number of previous falls; we held constant admission month, cognitive decline, and medication use associated with compromised balance. RESULTS: Patients were 80.0 ± 9.1 years old, 71.9% were female, they had 1.9 ± 1.3 previous fall-related injuries, and they sustained 0.5 ± 0.9 falls during the tracking period. With confounders held constant, each additional previous fall predicted a 3.9-fold increase in the odds of experiencing a future fall (p < 0.001; 95% CI of OR: 3.131 to 4.961); the overall model was significant (p < 0.001; pseudo R2 = 0.460). Age (p = 0.351) and sex (p = 0.236) were not significant predictors. Holding the same confounders constant, negative binomial regression found each additional previous fall to predict a 94.9% increase in the number of future falls (p < 0.001; 95% CI of IRR: 1.728 to 2.198); age (p=0.283) and sex (p=0.163) were not significant. CONCLUSIONS: Our findings highlight the importance of screening older adults for a history of falls prior to exercise prescription. For clients and patients who report experiencing a fall, it may be prudent to incorporate safe forms of balance and stability training. [ABSTRACT FROM AUTHOR]