Interactions between medications (e.g. polypharmacy), psychotropic medications, and environmental risks (e.g. loose rugs, insufficient lighting) have been identified as major extrinsic risk Cytoskeletal Signaling inhibitor factors [122–125]. Importantly, fear of falling is not only a consequence of falling as noted above, but also an important psychological risk factor for falls. Fear of falling
may lead to restriction of physical activities and social participation and, as a consequence, increase the risk for physical frailty and falls . All these risk factors have been identified in a variety of settings and almost always in the general older population. click here Until recently, no high-quality studies have examined risk factors for falling specific to dementia. In the largest prospective study to date, Allan and colleagues identified non-modifiable risk factors such as a diagnosis of Lewy body disorder, longer duration of dementia and previous history of falls or recurrent falls. More importantly, they also identified potentially modifiable risk factors such as use of cardioactive medications, autonomic symptoms, symptomatic
orthostatic hypotension, depression, and limitation of physical activity . Although there is substantial evidence that fall prevention strategies JQ-EZ-05 nmr reduce the number of falls and risk of falling in the community setting, and preliminary evidence for the residential and acute hospital setting, less evidence is available about their effectiveness in preventing fall-related injuries (e.g. sprains, bruises, and head-injuries) and fractures (e.g. arm and hip fractures) [110, 122, 127, 128]. Despite this, clinicians should use an integrated approach for fall and fracture prevention since many of the previous mentioned risk factors for falls have been shown to increase fracture risk as well [105, 122]. For community-dwelling older adults, single as well as multifactorial fall prevention strategies have been shown
to effectively reduce falls in older adults. Single-fall prevention strategies In single-fall prevention strategies, physical therapy, and exercise have been the most investigated interventions, and various reviews oxyclozanide and meta-analyses support the use of Tai Chi, progressive balance, and gait and strength training; however, evidence about endurance and flexibility training is inconclusive [122, 127–129]. A meta-analysis of muscle strengthening and balance retraining exercises individually prescribed and delivered at home to older women and men (age 65 to 97 years) showed a reduction in the number of falls and fall-related injuries by 35% (RR = 0.65; 95% CI, 0.57–0.75 and RR = 0.65; 95% CI, 0.53–0.81, respectively) and these exercises were of most benefit to those individuals aged over 80 years and showed a higher absolute reduction in injurious falls in those with a history of a previous fall .