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Book: Falls in older people

Lord, Stephen R. / Sherrington, Catherine / Naganathan, Vasi

risk factors, strategies for prevention and implications for practice

2021

Author's details	edited by Stephen R. Lord, Catherine Sherrington, Vasi Naganathan
Keywords	Accidental Falls / prevention & control ; Aged ; Risk Factors ; Wounds and Injuries / epidemiology
Language	English
Size	xvi, 487 Seiten, Illustrationen
Edition	Third edition
Publisher	Cambridge University Press
Publishing place	Cambridge
Publishing country	Great Britain
Document type	Book
Note	Preceded by Falls in older people / Stephen R. Lord ... [et al.]. 2nd ed. c2007 ; Includes bibliographical references and index
HBZ-ID	HT021202016
ISBN	978-1-108-70608-7 ; 9781108594455 ; 1-108-70608-8 ; 110859445X
Database	Catalogue ZB MED Medicine, Health

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2022 A 162	available for loan (reading room)	Lesesaal EG

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Book ; Online ; E-Book: Balance, gait, and falls

Day, Brian L. / Lord, Stephen R.

(Handbook of clinical neurology ; 159)

2018

Author's details	volume editors Brian L. Day and Stephen R. Lord
Series title	Handbook of clinical neurology ; 159
Collection
Language	English
Size	1 Online-Ressource (xvi, 432 Seiten), Illustrationen, Diagramme
Publisher	Elsevier
Publishing place	Amsterdam
Publishing country	Netherlands
Document type	Book ; Online ; E-Book
Remark	Zugriff für angemeldete ZB MED-Nutzerinnen und -Nutzer
HBZ-ID	HT019935306
ISBN	978-0-444-63917-2 ; 9780444639165 ; 0-444-63917-9 ; 0444639160
Database	ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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Article ; Online: Is Maximal or Usual Walking Speed from Large Scale Wrist Sensor Data Better at Predicting Dementia, Depression and Death?

Chan, Lloyd L Y / Lord, Stephen R / Brodie, Matthew A

Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference

2023 Volume 2023, Page(s) 1–4

Abstract: Older people are at increased risk of many adverse health outcomes, including dementia and depression, that burden the global health system. This paper presents algorithms for the large-scale assessment of daily walking speeds. We hypothesize that (i) ... ...

Abstract	Older people are at increased risk of many adverse health outcomes, including dementia and depression, that burden the global health system. This paper presents algorithms for the large-scale assessment of daily walking speeds. We hypothesize that (i) data from wrist-worn sensors can be used to assess walking speed accurately; and that (ii) maximal daily walking speed is a better predictor of health outcomes than usual daily walking speed. First, algorithms were developed and tested using data from 101 participants aged 19 to 91 (47 ± 18) years. Participants wore an AX3 accelerometer (Axivity, UK) on their dominant wrist while undertaking daily life activities with electronic walkway data used for ground truth. Subsequently, prediction models for dementia, depression and death were developed using the data of 47,406 participants (≥ 60 years) from the UK Biobank study. Daily walking speeds were derived from 7-day AX3 data with time-to-events using electronic health records. The accuracy of derived walking speeds was assessed using root mean square error (RMSE). Time-to-events were modelled using Cox regression with inverse hazard ratios reported for univariable models and Harrell's concordance for multivariable models. Derived walking speeds had an RMSE of between 3% and 4% depending on arm position. We found that for simple models, maximal walking speed was significantly better than usual walking speed at predicting time to dementia (1.62 vs 1.34), depression (1.29 vs 1.17) and death (1.56 vs 1.27). However, the addition of known risk factors in subsequent multivariable models reduced the apparent benefit of using maximal as opposed to usual daily walking speed as the gait parameter. In summary, walking speed was accurately measured with a wrist-worn device, and maximal daily waking speed may be better than usual daily walking speed at predicting some adverse health outcomes.Clinical Relevance- This study demonstrated the validity of using a simple and unobtrusive wrist-worn sensor to remotely assess daily walking speed. As a single, modifiable and easily understood measure, maximal walking speed was shown to be better than usual walking speed at predicting time-to-dementia, depression and death. Therefore, the inclusion of maximal daily walking speed into screening programs and clinical interventions presents a promising area for further research.
MeSH term(s)	Humans ; Aged ; Walking Speed ; Walking ; Wrist ; Depression/diagnosis ; Dementia/diagnosis
Language	English
Publishing date	2023-12-11
Publishing country	United States
Document type	Journal Article
ISSN	2694-0604
ISSN (online)	2694-0604
DOI	10.1109/EMBC40787.2023.10340255
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Prediction of Incident Depression in Middle-Aged and Older Adults using Digital Gait Biomarkers Extracted from Large-Scale Wrist Sensor Data.

Chan, Lloyd L Y / Brodie, Matthew A / Lord, Stephen R

Journal of the American Medical Directors Association

2023 Volume 24, Issue 8, Page(s) 1106–1113.e11

Abstract: Objectives: To determine if digital gait biomarkers captured by a wrist-worn device can predict the incidence of depressive episodes in middle-age and older people.: Design: Longitudinal cohort study.: Setting and participants: A total of 72,359 ... ...

Abstract	Objectives: To determine if digital gait biomarkers captured by a wrist-worn device can predict the incidence of depressive episodes in middle-age and older people. Design: Longitudinal cohort study. Setting and participants: A total of 72,359 participants recruited in the United Kingdom. Methods: Participants were assessed at baseline on gait quantity, speed, intensity, quality, walk length distribution, and walk-related arm movement proportions using wrist-worn accelerometers for up to 7 days. Univariable and multivariable Cox proportional-hazard regression models were used to analyze the associations between these parameters and diagnosed incident depressive episodes for up to 9 years. Results: A total of 1332 participants (1.8%) had incident depressive episodes over a mean of 7.4 ± 1.1 years. All gait variables, except some walk-related arm movement proportions, were significantly associated with the incidence of depressive episodes (P < .05). After adjusting for sociodemographic, lifestyle, and comorbidity covariates; daily running duration, steps per day, and step regularity were identified as independent and significant predictors (P < .001). These associations held consistent in subgroup analysis of older people and individuals with serious medical conditions. Conclusions and implications: The study findings indicate digital gait quality and quantity biomarkers derived from wrist-worn sensors are important predictors of incident depression in middle-aged and older people. These gait biomarkers may facilitate screening programs for at-risk individuals and the early implementation of preventive measures.
MeSH term(s)	Middle Aged ; Humans ; Aged ; Longitudinal Studies ; Depression/diagnosis ; Depression/epidemiology ; Wrist ; Gait ; Walking ; Biomarkers
Chemical Substances	Biomarkers
Language	English
Publishing date	2023-05-23
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2171030-2
ISSN	1538-9375 ; 1525-8610
ISSN (online)	1538-9375
ISSN	1525-8610
DOI	10.1016/j.jamda.2023.04.008
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Article ; Online: Treadmill induced belt-accelerations may not accurately evoke the muscle responses to obstacle trips in older people.

Phu, Steven / Sturnieks, Daina L / Song, Patrick Y H / Lord, Stephen R / Okubo, Yoshiro

Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology

2024 Volume 75, Page(s) 102857

Abstract: Background: Treadmill belt-accelerations are a commonly utilised surrogate for tripping, but their physiological validity is unknown. This study examined if a treadmill belt-acceleration induces lower limb muscle activation responses similar to a trip ... ...

Abstract	Background: Treadmill belt-accelerations are a commonly utilised surrogate for tripping, but their physiological validity is unknown. This study examined if a treadmill belt-acceleration induces lower limb muscle activation responses similar to a trip on a walkway. Methods: 38 older people (65+ years) experienced one treadmill belt-acceleration and one walkway obstacle trip in random order. Muscle responses were assessed bilaterally using surface electromyography on the rectus femoris (RF), tibialis anterior (TA), semitendinosus (ST) and gastrocnemius medial head (GM). Unperturbed muscle activity, post-perturbation onset latency, peak magnitude, time to peak and co-contraction index (CCI) were examined. Results: Muscle activity in the right ST was greater during unperturbed walking on the treadmill compared to walkway (P=0.011). Compared to a treadmill belt-acceleration, a walkway trip elicited faster onset latencies in all muscles; greater peak magnitudes in the left RF, TA, GM and right GM; faster time to peaks in the left TA and right GM; and lower knee and ankle muscle CCI (P<0.05). Conclusions: Walkway trips and treadmill belt-accelerations elicit distinct muscle activation patterns. While walkway trips induced faster and larger muscle responses, treadmill belt-accelerations involved greater co-contraction. Therefore, treadmill belt-accelerations may not accurately simulate the muscle responses to trips.
MeSH term(s)	Humans ; Aged ; Muscle, Skeletal/physiology ; Gait/physiology ; Walking/physiology ; Electromyography ; Acceleration
Language	English
Publishing date	2024-01-23
Publishing country	England
Document type	Journal Article
ZDB-ID	1073161-1
ISSN	1873-5711 ; 1050-6411
ISSN (online)	1873-5711
ISSN	1050-6411
DOI	10.1016/j.jelekin.2024.102857
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Article ; Online: Brain and brawn in balance: Central processing speed and muscle torque development speed are independently associated with the ability to recover balance with feet-in-place.

van Schooten, Kimberley S / Sturnieks, Daina L / Menant, Jasmine / Lord, Stephen R / Delbaere, Kim

Gait & posture

2024 Volume 111, Page(s) 132–135

Abstract: Background: Stepping thresholds, i.e. the maximum perturbation one can withstand without taking a step, predict falls in older people. This ability requires fast central processing of sensory information followed by rapid execution of adequate motor ... ...

Abstract	Background: Stepping thresholds, i.e. the maximum perturbation one can withstand without taking a step, predict falls in older people. This ability requires fast central processing of sensory information followed by rapid execution of adequate motor responses, both of which are affected by age. However, there is limited evidence on their combined effect on stepping thresholds. Research question: Are cognitive and motor speeds important for stepping thresholds and do they interact, allowing for compensation? Methods: Two-hundred forty-two people (mean age: 80 years, standard deviation 4; 110 women) underwent a series of waist-pulls of increasing magnitude to assess stepping thresholds in anterior, posterior and mediolateral directions. Cognitive function was assessed as simple hand reaction time and trail making test performance, and muscle function was assessed as isometric peak and rate of torque development of dominant leg muscles. Principal component analysis reduced these variables to four factors: peak muscle strength, muscle torque development speed (motor speed), executive function and central processing speed (cognitive speed). These factors were used in univariable and multivariable regression models to determine their association with stepping thresholds. Results: Faster central processing speed (beta:2.69; 95 %CI:1.49-3.88) and faster muscle torque development speed (beta:2.60, 95 %CI:0.63-4.57) were associated with higher stepping thresholds. These associations remained in a multivariable model. No interaction was found between cognitive and motor speed on stepping thresholds (p = 0.602). Significance: Central processing speed and muscle torque development speed affect stepping thresholds independently from each other and may both be important age-related motor impairment targets for preventing falls in older people.
Language	English
Publishing date	2024-04-10
Publishing country	England
Document type	Journal Article
ZDB-ID	1162323-8
ISSN	1879-2219 ; 0966-6362
ISSN (online)	1879-2219
ISSN	0966-6362
DOI	10.1016/j.gaitpost.2024.04.010
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Article ; Online: Fall prevention in older people: past, present and future.

Close, Jacqueline C T / Lord, Stephen R

Age and ageing

2022 Volume 51, Issue 6

Abstract: Over the past 50 years we have transitioned from accepting falls as an inevitable consequence of ageing to something that can and should be prevented. Numerous studies have elucidated the contributors to falls and how to assess a person's risk of falling. ...

Abstract	Over the past 50 years we have transitioned from accepting falls as an inevitable consequence of ageing to something that can and should be prevented. Numerous studies have elucidated the contributors to falls and how to assess a person's risk of falling. There are many effective approaches to preventing falls in older people including those with cognitive and physical impairments. Exercise is the most tried and tested approach with good evidence that moderate to high intensity balance training is an effective fall prevention strategy. Other successful single modality interventions include enhanced podiatry, home safety interventions, expedited cataract extraction, cardiac pacing for people with carotid sinus hypersensitivity and vitamin D supplementation in people living in care homes. Multiple interventions (everyone receives the same intervention package) and multifactorial interventions (interventions tailored to identified risk factors) are effective particularly in high-risk populations. In more recent years we have seen the emergence of new technologies such as devices and software programs that can offer low-cost interventions which may be more sustainable than our traditional time- and resource-limited approach to prevention. There is still more to be done and a translational focus is needed to ensure that effective interventions are scaled up and delivered to more people while at the same time maximising adherence and maintaining the fidelity of the interventions.
MeSH term(s)	Aged ; Aging ; Exercise ; Humans ; Podiatry ; Risk Factors
Language	English
Publishing date	2022-06-13
Publishing country	England
Document type	Journal Article
ZDB-ID	186788-x
ISSN	1468-2834 ; 0002-0729
ISSN (online)	1468-2834
ISSN	0002-0729
DOI	10.1093/ageing/afac105
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Book: Falls in older people

Lord, Stephen R.

risk factors and strategies for prevention

2007

Author's details	Stephen R. Lord
Keywords	Accidental Falls / prevention & control ; Aged ; Risk Factors ; Wounds and Injuries / epidemiology
Language	English
Size	XI, 395 S. : Ill., graph. Darst.
Edition	2. ed.
Publisher	Cambridge Univ. Press
Publishing place	Cambridge
Publishing country	Great Britain
Document type	Book
Old title	1. Aufl. u.d.T. Lord, Stephen R. : Falls in older people
HBZ-ID	HT015341350
ISBN	978-0-521-68099-8 ; 0-521-68099-9
Database	Catalogue ZB MED Medicine, Health

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2008 A 389	order for loan	Magazin

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Article ; Online: Virtual reality and the prevention of falls in the real world.

Lord, Stephen R

Lancet (London, England)

2016 Volume 388, Issue 10050, Page(s) 1132–1134

MeSH term(s)	Accidental Falls ; User-Computer Interface ; Virtual Reality
Language	English
Publishing date	2016-08-11
Publishing country	England
Document type	Journal Article ; Comment
ZDB-ID	3306-6
ISSN	1474-547X ; 0023-7507 ; 0140-6736
ISSN (online)	1474-547X
ISSN	0023-7507 ; 0140-6736
DOI	10.1016/S0140-6736(16)31347-2
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Article ; Online: Impact of pathological conditions on postural reflex latency and adaptability following unpredictable perturbations: A systematic review and meta-analysis.

Phu, Steven / Lord, Stephen R / Sturnieks, Daina L / Okubo, Yoshiro

Gait & posture

2022 Volume 95, Page(s) 149–159

Abstract: Background: Pathological conditions can impair responses to postural perturbations and increase risk of falls.: Research question: To what extent are postural reflexes impaired in people with pathological conditions and can exercise interventions ... ...

Abstract	Background: Pathological conditions can impair responses to postural perturbations and increase risk of falls. Research question: To what extent are postural reflexes impaired in people with pathological conditions and can exercise interventions shorten postural reflexes? Methods: MEDLINE, EMBASE, Scopus, SportDiscus and Web of Science were systematically searched for articles comparing muscle activation onset latency in people with pathological conditions to healthy controls following unpredictable perturbations including the effect of exercise interventions (registration: CRD42020170861). Results: Fifty-three articles were included for systematic review. Significant delays in muscle activity onset following perturbations were evident in people with multiple sclerosis (n = 7, mean difference [MD]: 22 ms, 95% confidence interval [CI]: 11, 33), stroke (n = 10, MD: 34 ms, 95% CI: 19, 49), diabetes (n = 2, MD: 19 ms, 95% CI: 10, 27), HIV (n = 3, MD: 9 ms, 95% CI: 4, 14), incomplete spinal cord injury (n = 2, MD: 57 ms, 95% CI: 33, 80) and back and knee pain (n = 7, MD: 12 ms, 95% CI: 6, 18), but not in people with Parkinson's disease (n = 10) or cerebellar dysfunction (n = 4). Following exercise interventions, the paretic limb of stroke survivors (n = 3) displayed significantly faster muscle activation onset latency compared to pre-exercise (MD: -13 ms, 95% CI: -24, -4), with no significant changes in Parkinson's disease (n = 3). Conclusions: This systematic review demonstrated that postural reflexes are significantly delayed in people with multiple sclerosis (+22 ms), stroke (+34 ms), diabetes (+19 ms), HIV (+9 ms), incomplete spinal cord injury (+57 ms), back and knee pain (+12 ms); pathological conditions characterized by impaired sensation or neural function. In contrast, timing of postural reflexes was not impaired in people with Parkinson's disease and cerebellar dysfunction, confirming the limited involvement of supraspinal structures. The meta-analysis showed exercise interventions can significantly shorten postural reflex latencies in stroke survivors (-14 ms), but more research is needed to confirm this finding and in people with other pathological conditions.
MeSH term(s)	HIV Infections ; Humans ; Multiple Sclerosis/complications ; Pain ; Parkinson Disease ; Postural Balance/physiology ; Reflex ; Spinal Cord Injuries ; Stroke
Language	English
Publishing date	2022-04-21
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Review ; Systematic Review ; Research Support, Non-U.S. Gov't
ZDB-ID	1162323-8
ISSN	1879-2219 ; 0966-6362
ISSN (online)	1879-2219
ISSN	0966-6362
DOI	10.1016/j.gaitpost.2022.04.014
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