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Body pain, sleep problems and falls are commonly reported among the elderly population. This study aimed to explore the mediating role of pain in the association of sleep problems with fall-outcomes (falls, fall-injury, and multiple falls) among older adults. Cross-sectional data from the baseline survey of Longitudinal Aging Study in India (LASI),...
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Citations
... In this study, we focused on the situation of insufficient sleep time due to the limitations of the sample data, preventing us from obtaining more detailed information about the sleep status of the subjects. In the subsequent clinical study, assessment tools like the Jenkins Sleep Scale (JSS)-4 [34], the Pittsburgh Sleep Quality Index (PSQI) [35] and the Bergen Short sleep duration Scale (BIS) [36] can be used to comprehensively evaluate the sleep status of individual patients. Furthermore, it is important to acknowledge that there are numerous causes of short sleep duration, and insufficient sleep time may be a result of either short sleep or reduced sleep duration. ...
... KHB is a regression-based method is a measure to separate the impact of confounding variables through regression model (Breen et al., 2021). KHB is widely used to assess the mediating effect (Muhammad et al., 2023). All statistical analyses were performed using STATA 15 (StataCorp, LP, College Station, Texas). ...
... Other covariates. Previous research has identified a number of determinants of functional difficulty and falls, such as socio-demographics, household factors, lifestyle factors 55 and health-related factors 49,56 . The study used socio-demographic variables such as age (recoded as 60-69, 70-79 and 80 +), sex (male and female), education (recoded as none, primary, secondary and higher), marital status (recoded as married, widowed and others which included separated, divorced and never married) and work status (recoded as never worked, currently working, not working and retired). ...
... The higher prevalence of functional disability corroborates the argument of WHO that the prevalence of disability among older adults is increasing drastically due to the combined effect of demographic and epidemiological transitions 61 . Further, in the past 2 years, a significant percentage of older adults reported falling (12.36%), which is lesser than the estimates projected by research conducted in other nations 49 . The pooled prevalence of falls was found to be 31% in a systematic review and meta-analysis of the burden of falls among older Indians 27 . ...
... Consequently, there remains the possibility of underestimation or overestimation of the burden of falls due to recall bias 27 . Nevertheless, the prevalence of falls, multiple falls, and fall-related injuries in the present study were consistent with prior evidence from India 49,62 . ...
The construct of intrinsic capacity (IC) in the context of integrated care for older adults emphasizes functional assessment from a holistic perspective. It provides reliable and comparable insights on subsequent functioning and disability. Given the paucity of research on IC and health outcomes in low- and middle-income countries (LMICs), the present study examined the association of IC with geriatric conditions of functional limitations and multiple fall outcomes among older adults in India. The data used for analysis come from the first wave of the Longitudinal Aging Study in India (LASI), 2017–2018. The final sample size contains 24,136 older adults (11,871 males and 12,265 females) age 60 years or above. Multivariable binary logistic regression is employed to examine the association of IC and other explanatory factors with outcome variables of difficulty in activities of daily living (ADL) and instrumental activities of daily living (IADL), falls, fall injury, and multiple falls. Of the total sample, 24.56% of older adults were observed to be in the high IC category. The prevalence of ADL difficulty, IADL difficulty, falls, multiple falls and fall-related injury is estimated to be 19.89%, 45.00%, 12.36%, 5.49% and 5.57%, respectively. Older adults who reported high IC had a significantly lower prevalence of ADL difficulty (12.26% vs 22.38%) and IADL difficulty (31.13% vs 49.52%) than those who reported low IC. Similarly, a lower prevalence of falls (9.42% vs 13.34%), fall-related injury (4.10% vs 6.06%) and multiple falls (3.46% vs 6.16%) were reported among those who had high IC. After adjusting for a large number of confounders such as age, sex, health-related attributes and lifestyle behaviors, older adults with high IC had significantly lower odds of ADL difficulty [aOR: 0.63, CI: 0.52–0.76], IADL difficulty [aOR: 0.71, CI: 0.60–0.83], falls [aOR: 0.80, CI: 0.67–0.96], multiple falls [aOR: 0.73, CI: 0.58–0.96] and fall-related injury [aOR: 0.78, CI: 0.61–0.99]. That a high IC was independently associated with a lower risk of functional difficulty and fall outcomes in later life is of enormous value in predicting subsequent functional care needs. More specifically, the findings here imply that because regular IC monitoring can predict poor health outcomes in older adults, improvements in IC should be prioritized while formulating disability and fall prevention strategies.
Introduction
Peripheral artery and aorta diseases contribute to complex consequences in various areas, as well as increasing physical and mental discomfort resulting from the progressive limitation or loss of functional capacities, in particular in relation to walking, decreased endurance during physical exercise, a drop in effort tolerance, and pain suffered by patients. Limitations in functional capacities also increase the risk of falls. Most falls take place during the performance of simple activities. The aim of this study was to investigate factors associated with moderate-to-high risk of future falls in patients scheduled for vascular surgeries.
Methods
This cross-sectional study included patients aged 33–87, scheduled for vascular surgeries. Based on the Timed Up and Go test, patients were categorized as having a moderate-to-high (≥ 10 s) or low risk of falls. Multiple logistic regression was carried out to assess the relationship between fall-risk levels and independent sociodemographic and clinical variables.
Results
Forty-eight percent of patients were categorized as having a moderate-to-high risk of future falls. Females (OR = 1.67; Cl95%: 1.07–2.60) and patients who suffered from hypertension (OR = 2.54; Cl95%: 1.19–5.40) were associated with a moderate-to-high risk of future falls. The Barthel Index correlated negatively (OR = 0.69; Cl95%: 0.59–0.80), while age correlated positively with fall-risk levels (OR = 1.07; Cl95%: 1.02–1.12).
Conclusion
Factors that may be associated with a moderate-to-high risk of future falls in patients scheduled for vascular surgeries include age, female gender, hypertension, and the Barthel Index.
Hypertension has become a global health concern and is recognized as an important modifiable risk factor for
cardiovascular diseases (CVDs). There are very limited studies in India and worldwide focused on sleep problems,
activities of daily living (ADL), instrumental ADL (IADL) and mobility limitations, and their discrete and combined effects on hypertension. Therefore, this study examined whether sleep problems are associated with hypertension, and whether the association is more pronounced among middle-aged and older adults with
functional/mobility limitations. This study used data from the Longitudinal Ageing Study in India (LASI) wave 1,
2017–18, with a total sample of 59,951 adults aged 45 years and above. Log-binomial regression, and interaction
terms were used to assess the relationship between sleep problems and hypertension, and the moderating effect
of functional/mobility limitations. Respondents with sleep problems had a 29 % higher prevalence of hypertension [PR (prevalence ratio): 1.29; CI (confidence interval): 1.20–1.39]. Those with ADL and IADL limitations
had 20 % [PR: 1.20; CI: 1.09–1.32] and 9 % [PR: 1.09; CI: 1.00–1.18] greater prevalence of hypertension.
Interaction analysis revealed that individuals with ADL, IADL, and mobility limitations had 58 %, 52 %, and 45
% higher prevalence of hypertension, respectively, and was especially pronounced among women. Our findings
highlight that improved sleep can reduce the prevalence of hypertension in middle-aged and older adults. Individuals with functional/mobility limitations may need additional care and support from their family members
or the community, which could lower the prevalence of elevated blood pressure due to their sleep problems.
