1) To characterize mild, moderate, and severe fear of falling in older emergency department (ED) patients for minor injuries, and 2) to assess whether fear of falling could predict falls and returns to the ED within 6 months of the initial ED visit.

This study was part of the Canadian Emergency and Trauma Initiative (CETI) prospective cohort (2011–2016). Patients ages ≥ 65, who were independent in their basic daily activities and who were discharged from the ED after consulting for a minor injury, were included. Fear of falling was measured by the Short Falls Efficacy Scale International (SFES-I) in order to stratify fear of falling as mild (SFES-I = 7-8/28), moderate (SFES-I = 9-13/28), or severe (SFES-I = 14-28/28). Many other physical and psychological characteristics where collected. Research assistants conducted follow-up phone interviews at 3 and 6 months’ post-ED visit, in which patients were asked to report returns to the ED.

A total of 2,899 patients were enrolled and 2,009 had complete data at 6 months. Patients with moderate to severe fear of falling were more likely to be of ages ≥ 75, female, frailer with multiple comorbidities, and decreased mobility. Higher baseline fear of falling increased the risk of falling at 3 and 6 months (odds ratio [OR]-moderate-fear of falling: 1.63, p < 0.05, OR-severe-fear of falling 2.37, p < 0.05). Fear of falling positive predictive values for return to the ED or future falls were 7.7% to 17%.

Although a high fear of falling is associated with increased risk of falling within 6 months of a minor injury in older patients, fear of falling considered alone was not shown to be a strong predictor of return to the ED and future falls.

The aims of this study were to examine the preparedness of vulnerable people ages 75 years and older and to clarify the characteristics of older adults that are associated with disaster preparedness.

We conducted interviews with persons requiring special care ages 75 years and older living in coastal communities of western Japan, where earthquakes and tsunami disasters are a concern. The survey included participant characteristics such as demographic indicators, physical function, health status, community involvement, and disaster preparedness. Binomial logistic regression analysis was performed with participant characteristics as independent variables and disaster preparedness as the dependent variables.

The characteristics related to disaster preparedness were age, family composition, cognitive function, level of interaction with neighbors, and participation in community activities.

Being female, living alone, and having cognitive impairment were factors that led to decreased disaster preparedness. However, it was suggested that close human interactions in the community facilitated preparedness. Community engagement is crucial in reducing disaster damage and recovering effectively. In order to facilitate preparedness measures for persons requiring special care ages 75 and older, it is important to establish community preparedness.

Getting lost is a recognized complication in patients with dementia. Preventive measures are lacking. This study aims to investigate the effectiveness of a home-based missing incident prevention program (HMIPP) in reducing missing incidents, time of searching, and caregivers' stress.

The design was a pre- and post-intervention study. Patients were recruited from a hospital-based Geriatric Memory Clinic. Inclusion criteria were as follows: aged 60 years or above, established dementia, and Modified Functional Ambulation Categories score VI or VII. An occupational therapist performed the interventions at the patients's home. These included dementia education, prescription of assistive devices, on-site skills training, environmental modifications, community service referrals, and redesigning of daily life routine tasks. The number of missing incidents and caregivers’ stress at three months and one year were compared with baseline data from one year before and the secondary outcome was time for searching of the last incident.

A total of 54 patients were recruited. The mean age was 78.8 years and 54% were females. Majority of patients had moderate dementia. The mean number of missing incidents per year was significantly reduced at three months and one year (0.70, 0.22, and 0.14 at 0, 3, and 12 months, respectively; p < 0.001). The time for searching of last missing episode was reduced significantly (6.25, 0.13, and 0.35 hours, respectively; p < 0.001). The caregivers’ stress also decreased significantly at three months and one year.

The HMIPP was effective in reducing the number of missing incidents, searching time, and caregivers’ stress at three months and one year.

Previous studies have reported that self-rated health (SRH) predicts subsequent mortality. However, less is known about the association between SRH and functional ability. The aim of this study was to examine whether SRH predicts decline in basic activities of daily living (ADL), even after adjustment for depression, among community-dwelling older adults in Japan.

A three-year prospective cohort study was conducted among 654 residents aged 65 years and older without disability in performing basic ADL at baseline. SRH was assessed using a visual analogue scale (range; 0–100), and dichotomized into low and high groups. Information on functional ability, sociodemographic factors, depressive symptoms, and medical conditions were obtained using a self-administered questionnaire. Logistic regression analysis was used to examine the association between baseline SRH and functional decline three years later.

One hundred and eight (16.5%) participants reported a decline in basic ADL at the three-year follow-up. Multiple logistic regression analysis showed that the low SRH group had a higher risk for functional decline compared to the high SRH group, even after controlling for potential confounding factors (odds ratio (OR) = 2.4; 95% confidence interval (CI) = 1.3–4.4). Furthermore, a 10-point difference in SRH score was associated with subsequent functional decline (OR = 1.37; 95% CI = 1.16–1.61).

SRH was an independent predictor of functional decline. SRH could be a simple assessment tool for predicting the loss or maintenance of functional ability in community-dwelling older adults. Positive self-evaluation might be useful to maintain an active lifestyle and stay healthy.

To evaluate the prevalence of undernutrition among community-dwelling elderly people in Spain using the Mini Nutritional Assessment (MNA) and to analyse its distribution according to age, gender and residence region.

Cross-sectional study assessing the nutritional status of elderly persons through both the short form and the full version of the MNA test.

Pharmacy offices across the whole country (Spain) were enrolled to recruit participants.

A total of 22 007 participants (8014 men and 13 993 women), aged ≥65 years, assessed during the last two months of 2005.

According to MNA screening, 4·3 % subjects were classified as undernourished (MNA score <17) and 25·4 % were at risk of undernutrition (MNA score ≥17 to ≤23·5). The MNA short form correlated strongly with the full MNA version (r = 0·85). MNA total score was significantly higher in men than in women (25·4 (sd 3·7) v. 24·6 (sd 3·9); P < 0·001) and lower in the oldest than in the youngest subjects (P < 0·001) in both genders. According to regional distribution, the best nutritional status was found in elderly from the north of Spain excluding the north-west area.

Female gender, older age and living in the south half or north-west of the country were associated with higher rates of undernutrition among community-dwelling elderly persons in Spain.