Physical consequences of falls in the elderly: a literature review from 1995 to 2010

In the last decade, population ageing has been registered as a global phenomenon. A relation exists between falling and ageing, since falling frequency increases significantly with age. In fact, one in three older adult falls annually. Although ageing is generically associated with decrease and degeneration of psychological and physical functions, it is still not common for the correct identification of risk factors to lead to a clinical prognosis of the elder being in risk of falling. Therefore, the goal of this review article is to identify, categorise and analyse typical ageing and fall factors mentioned in the literature as well as to quantify the number of times they were referenced. The research considered hundreds of publications, but analysis was then restricted to the 87 most pertinent articles written in English and published in journals or scientific magazines between 1995 and 2010. We concluded that falls among older adults can be characterised by the following: anatomic characteristics and physiological consequences of ageing; the pathologies that induce falls, which can be neurological, musculoskeletal, cardiovascular and other diseases; causes and risk factors of falls that can be behavioural, biological, environmental or socio-economic; type of physical consequences of falls, including fractures, bruises, injuries or other physical consequences; and strategies to prevent, mitigate or rehabilitate, which can be of a physical, environmental or behavioural nature.     

Aging, physical activity, and hormones in women--a review

Women experience significant changes in endocrine function during aging. Decreasing levels of anabolic hormones may be associated with musculoskeletal atrophy and decrease in function that is observed in older women and, as a result, there has been an increase in the use of pharmacological hormone therapies. It is difficult to distinguish, however, between physiological changes that are truly age related and those that are associated with lifestyle factors such as physical activity participation. Some research has shown that circulating levels of anabolic hormones such as DHEA(S) and IGF-I in older women are related to physical activity, muscle function, and aerobic power. Exercise-intervention studies have generally shown that increasing age blunts the acute hormonal response to exercise, although this might be explained by a lower exercise intensity in older women. There have been relatively few studies that examine hormonal adaptations to exercise training. Physical activity might have an effect on hormone action as a result of changes in protein carriers and receptors, and future research needs to clarify the effect of age and exercise on these other components of the endocrine system. The value and safety of hormone supplements must be examined, especially when used in combination with an exercise program.     

The beneficial effects of different types of exercise interventions on motor and cognitive functions in older age: a systematic review

The decline in cognitive and motor functions with age affects the performance of the aging healthy population in many daily life activities. Physical activity appears to mitigate this decline or even improve motor and cognitive abilities in older adults. The current systematic review will focus mainly on behavioral studies that look into the dual effects of different types of physical training (e.g., balance training, aerobic training, strength training, group sports, etc.) on cognitive and motor tasks in older adults with no known cognitive or motor disabilities or disease. Our search retrieved a total of 1095 likely relevant articles, of which 41 were considered for full-text reading and 19 were included in the review after the full-text reading. Overall, observations from the 19 included studies conclude that improvements on both motor and cognitive functions were found, mainly in interventions that adopt physical-cognitive training or combined exercise training. While this finding advocates the use of multimodal exercise training paradigms or interventions to improve cognitive-motor abilities in older adults, the sizeable inconsistency among training protocols and endpoint measures complicates the generalization of this finding.     

Migrant women farm workers in the occupational health literature

Little attention has been given to the vulnerable populations of migrant women agricultural workers. A systemic review in PubMed was carried out (1990-2008) using terms related to migrant agricultural workers, with specific focus on women. Case studies from Lebanon and California are presented to highlight key physical, psychosocial, and cultural risk factors among these working populations. The review revealed a host of potential problems that span from pesticide exposure and musculoskeletal disorders to socio-cultural barriers. Comprehensive exposure-outcome and intervention studies focusing specifically on migrant women in agriculture are lacking. In depth studies focusing on the work environment of migrant women workers in the agricultural sector are needed. Personal and environmental factors that influence health should be considered in any effective intervention aiming to influence policy making and have a positive impact on these vulnerable working populations.     

Age-related changes in musculoskeletal function,balance and mobility measures in men aged 30–80 years

Objectives.?This study aimed to establish age-related changes in musculoskeletal function, balance and mobility measures in men.

Design.?An observational, cross-sectional cohort study was undertaken.

Methods.?One hundred six healthy, community-ambulant men (30–80 years) participated in this study. Recruitment of a convenience sample continued until a minimum of 20 men represented each decade between 30 and 80 years. Demographics (age, height, weight), health and current activity level were recorded. Balance and mobility were measured using the timed up and go test, the step test, functional and lateral reach. Reaction time was determined from limits of stability test. Leg muscle strength was measured with a spring gauge (kg), and ankle flexibility was measured using goniometry.

Results.?Balance, mobility and most strength measures were reduced by the 60s while ankle flexibility declined by the 70s (p?<?0.01). Reaction times increased by the 60s (p?<?0.01).

Conclusion.?This study of men demonstrated reduced musculoskeletal function, balance and mobility generally by the 60s. These results provide health professionals with normal performance levels to use as therapeutic goals as well as identify musculoskeletal factors associated with reducing balance and mobility. Hence, these results inform clinicians and policy makers for the establishment of pre-emptive interventions to promote healthier ageing.     

How to improve gait and balance function in elderly individuals—compliance with principles of training

Most balance training regimens for elderly individuals focus on self-controlled exercises, although automatic postural responses after a balance perturbation are not under direct volitional control. We critically review the literature on this topic, and notice that several studies fail to comply with basic principles of training and therefore show little improvement in function. Some present the view that physical function in the too frail and too fit cannot be improved, which we instead argue would be the effect of nonspecific training programs. We propose a concept for balance training that incorporates voluntary exercises as well as perturbation and dual-task exercises to improve balance control. The program is performed on five different levels where levels 1–4 exercises focus on the skill to maintain balance and level 5 adds perturbation exercises that focus on the skill to recover balance as well as dual task exercises providing a cognitive load during execution of a balance motor task. Functional requirements for muscle strength and power are directly incorporated into the program. The feasibility of the concept has been demonstrated on elderly fallers. A randomized control trial is underway to investigate the effects on healthy elderly individuals. Further intervention studies using this concept are encouraged.     

Physical activity, genes, and lifetime predisposition to chronic disease

This mini-review summarizes the main associations between physical activity and chronic diseases and discusses the basic concepts related to the role of genetic factors in studies evaluating the effects of physical activity/exercise therapy on chronic disease prevention/treatment during the life course. Many observational cohort studies have shown that high physical activity during young adulthood or middle age is associated with reduced later life morbidity, mobility limitations and mortality. Physical activity or exercise therapy has a positive effect on health via many disease-specific mechanisms. The most consistent finding of the various randomized controlled studies conducted to date is that aerobic/functional capacity and/or muscle strength can be improved by exercise training among patients with different chronic diseases. Genes are known to play a role in chronic disease predisposition and to contribute to physical fitness levels, physical activity participation and ageing. Physical fitness, physical activity and health outcomes may be partly due to underlying genetic factors that have a favourable effect on all these traits (genetic pleiotropy). This means that in observational studies, the relationship between baseline activity and the later occurrence of diseases may not be interpreted entirely as causal. Increased knowledge on the role of nuclear genome, mitochondrial genome, epigenetics, telomeres and regulation of gene expression will increase our understanding of their relationships with physical activity and morbidity.     

Effects of testosterone supplementation on prevention of age-related penile remodeling

Abstract

Erectile dysfunction develops among 46.2% of men between 40 and 70 years. Studies demonstrated substitution on detrusor muscle by collagen due testosterone deprivation. It is clear the correlation among aging and oxidative stress, accelerating apoptosis process in many tissues. This study aims to demonstrate the collagen substitution over the muscle fibers on muscle structure of rat’s penis and the effects of testosterone supplementation. Sixteen senescent Wistar rats were divided into two groups: treatment (receiving standard supplementation testosterone dose) and control (receiving equivalent saline solution). Testosterone was dosed on D0 and D56 of study. All penises were prepared with picrosirius colored histology; stereology was applied to determine the volumetric density of collagen fibers (Vv). Analysis of variance demonstrated testosterone group’s replacement therapy to be effective, while the androgenic decline continued by the time of experiment in control group (p?<?0.05). Testosterone group had Vv of 20.6%, lower than control group (47.8%); t-test (p?<?0.001). Pearson’s correlation demonstrated an inverse correlation between the Vv and testosterone’s levels (p?<?0.001). This is a pioneer study on demonstration of structural alterations over the cavernous corpora muscle caused by deprivation of testosterone on elderly rat. These finding implicate that the testosterone levels can influence, not only the libido, but also the erectile function.     

Shared Physical Custody and Children’s Experience of Stress

This article studies shared physical custody in Sweden, the country in the world where the phenomenon is most prevalent. We ask whether children in shared physical custody settings are more likely to report high levels of stress compared to children living in sole custody. The analysis is based on data with combined information from parents, children, and administrative registers. The models are controlled control for interparental as well as parent–child relationship quality and parents’ income. The results show that children sharing residence equally have lower likelihood of experiencing high levels of stress. The results can be interpreted as evidence for a positive effect of continuing everyday-like parental relationships after a family dissolution.     

Motor variability--an important issue in occupational life

Several recent reviews have reported that 'repetitive movements' is a risk factor for occupational musculoskeletal disorders (MSD) in the neck, shoulder and arm regions. More variation in biomechanical exposure is often suggested as an effective intervention in such settings. While increasing variation using extrinsic methods like job rotation may not always be possible in an industrial context, the intrinsic variability of the motor system may offer an alternative opportunity to increase variation. Motor variability (MV) refers to the natural variation in postures, movements and muscle activity observed to different extents in all tasks. The current review explores the state of the art in MV research from motor control, sports and occupational biomechanics literature to answer whether MV is important to consider in an occupational context, and if yes, whether this literature stimulates further studies to test if MV can be manipulated as a deliberate intervention for increasing biomechanical variation without jeopardizing production.     

Endurance training for cancer patients during and shortly after completion of the anti-cancer treatment

Cardiorespiratory fitness is one of the most important indicators of health and improves length of life. The attention and acceptance for endurance training in patients with several cancer diagnoses increased during the last decade. This review highlight’s the effect of endurance training in cancer patients by summarizing exemplary randomized clinical trials and systematic reviews both within the acute hospital treatment context, as in a rehabilitation setting. To date, most studies focus on endurance training in patient groups with moderate to good prognosis. The studies within these patient groups evaluate the endurance training in cancer patients using a moderate training intensity between 50 and 75 % of the VO₂ peak with an exercise time varying from 20 min (five times per week) in hospital up to 45 min (two to three times per week) in an ambulatory setting. Recently, the American College of Sports Medicine indicated that cancer survivors should follow the Physical Activity Guidelines for Americans, which represents ≥150 min per week of moderate intensity, ≥75 min per week of vigorous intensity aerobic exercise, or an equivalent combination of moderate and vigorous intensity aerobic exercises. To date, fewer studies evaluate the effects of endurance training in a palliative setting to maintain physical function of the patient. Future studies should investigate the effect of endurance training by evaluating different types of intensity training (moderate vs. high intensity training), the use of high-tech devices to improve physical activity, and to evaluate the effect of endurance training in patients with a palliative intention.     

Roadmap for a communication maturity index for organizations—Theorizing,analyzing and developing communication value

This study employed a constitutive (CCO) communication approach to advance the dynamic concept of communication maturity for the purpose of theorizing, analyzing, and developing communication value on an organizational level. A literature review resulted in six theoretical areas related to communication maturity: understanding, function, organization, prerequisites, competence and practices including assessments of communication. These were analyzed in a qualitative comparative case study including 85 key stakeholders from eleven organizations. Findings illustrated the relevance of the theoretical areas to stakeholders’ perceptions of their respective organizations’ communication maturity. A first version of a Communication Maturity Index including four levels of maturity; immature, emerging, established, and mature is proposed. Based on the qualitative analysis, organizations’ communication maturity levels varied from emerging to mature. Findings of this study are limited to participating organizations and interviewed stakeholders. The CMI can be further developed in quantitative studies to investigate the constitutive role of communication in organizations and to be used in practice to develop higher levels of communication maturity.     

The insulin-like growth factor-I receptor: Implications for the aging process

Aging is associated with decreased levels of growth hormone and both circulating and local levels of insulin-like growth factor-I (IGF-I). The decline in IGF-I has been postulated to be important in both physiological aging and pathological states that are seen with aging. In parallel, inappropriate apoptosis is thought to play a role in some of these same processes. In experimental models, IGF-I signalling through the IGF-I receptor confers a protective effect from apoptosis. This review summarizes the results of studies documenting the IGF-I anti-apoptotic effect in neuronal model systems. The known downstream signalling cascades that mediate this signal are beginning to be elucidated; these include MAP kinase and Akt. In addition, IGF-I prevents the reduction of anti-apoptotic proteins of the bcl-2 family induced by hyperosmotic conditions in cultured neuronal cells. IGF-I has been shown to positively impact on tau, the microtubule-associated protein, possibly preventing the degradation of proteins that are associated with the neurofibrils seen in Alzheimer's disease. All of the studies to date support the hypothesis that appropriately high levels of IGF-I signalling prevent some of the processes associated with aging.     

Research on rural ageing: Where have we got to and where are we going in Europe?

This paper examines the extent to which rural studies conducted in Europe (compared to other countries in the Global North) have addressed the phenomenon of rural ageing. Through a review of the literature published on rural ageing research in the last decade, it compares the research goals identified by the International Rural Ageing Project (IRAP) in 1998 with progress in this area. In addition to the key themes for rural ageing research identified by IRAP, the authors believe that there are others topics that will emerge and impact on rural ageing in Europe in the coming decade. These have been highlighted consistently in futures studies as ‘global challenges’ and can be grouped as social, economic and political, technological, relating to climate change, or related to agriculture and food security. In addition to the literature review, the authors undertook a consultation exercise with more than 50 eminent academics and directors of key organisations who were interested in rural issues, ‘global challenges’ or rural ageing. Their feedback is included within a framework for future rural research. The article concludes with a discussion of emerging areas for rural ageing in the European context and the challenges that the EU may potentially face over the coming decades.     

Encountering the ageing body in modernity: fear,vulnerability and “contamination”

This paper attempts to understand the exclusion of ageing people within contemporary society through developing a model around the notion of the “encounter with the ageing body”. It is divided into three parts. In the first, I develop a model of the encounter through combining Sara Ahmed’s notion of “affective economies” with Shildrick’s theory of the encounter with the “vulnerable self”. I argue that the fear of ageing becomes embodied within the encounter with the ageing body. Specifically, the fear is vulnerability: within the encounter, the youthful self is forced into the recognition of his/her own vulnerability. Modernity requires that this be disavowed, with the ageing body banished to the margins through sequestration to foreclose the possibility of a repeat. In the second section, I discuss the nature of vulnerability within modernity. I explore two approaches to this: in the first, the vulnerability is to the threat of death, which has become particularly problematic within modernity; in the second, the vulnerability is the loss of subjectivity resulting from the ageing body’s failure to correspond to constructions of the ideal body within contemporary capitalism. In the final section, I evaluate whether recent social shifts promise a brighter future for ageing people, arguing that although the situation is not black and white, there is, nevertheless, unfortunately currently relatively limited potential for real change for older people.     

Occupational musculoskeletal injuries in the health care environment and its impact on occupational therapy practitioners: a systematic review

The purpose of this systematic review was to explore the occupational and personal factors associated with occupational musculoskeletal injuries among health care providers and to identify the psychosocial issues as a result of the injuries. Then, an extrapolation developed to link the potential risks to occupational therapy practitioners. The inclusion criteria that developed from ten articles was based on content from the health and social science literatures. Searches were conducted via internet databases, hard-copy search of bibliographies, and citation review of article references. This review included 22 research studies over the past fifteen years (1990-2005). Classic scientific research studies and classical readings that went beyond the specified period were also included. The review revealed that patient handling was the most common occupational factor to cause work-related injuries. Inexperience and young age were major personal factors associated with injuries. Fear, anger, isolation, inability to perform duties and leisure activities were common psychosocial issues as a result of the injuries. It was extrapolated that occupational therapy practitioners were at risk for occupational musculoskeletal injuries. Future studies are recommended to examine the prevalence and risk factors specific to occupational therapy practitioners.     

Effects of motor practice on cognitive disorders in older adults

The demographics of our societies have changed drastically during the past few decades. The general population is aging rapidly as human life spans continue to expand and more adults are set to mature during the next quarter century. This aging process has numerous implications for the way we live and will have particularly important impacts on health and healthcare. In particular, substantial evidence suggests that cognitive–motor function deteriorates considerably as the result of inactive life style, biological aging, and cognitive impairments. The number of individuals with Alzheimer's disease (AD), an aging-related cognitive disorder, is expected to increase significantly during the next 40 years. The development of mild cognitive impairment (MCI) or AD can exaggerate the functional declines observed in cognitive or motor performance. The functional declines affect an array of social, cognitive, mental, physical, and motor activities in our daily lives. However, recent studies suggest that cognitive, physical, motor practice, or skill learning can improve motor speed, smoothness, and accuracy in both MCI and AD patients and their age-matched healthy peers. From theoretical and practical perspectives, this paper addresses several critical aspects of motor deficits and the kinematical characteristics of motor skill development in MCI and AD populations. Empirical data will be presented relative to the sensory–motor functions of MCI and AD, the motor skill acquisition, exercise rehabilitation in older adults with memory loss, as well as the implications for therapies. Finally, this review concludes with thoughts and suggestions for future research in these areas.     

Marketization process predicts trust decline in China

Although previous literature has revealed the predictive effect of trust on economic development, whether the level of China’s market economy development predicts changes in trust across birth cohorts remains unknown. Study 1, a cross-temporal meta-analysis of 82 studies (N = 34,151), indicated that Chinese college students’ scores on the Interpersonal Trust Scale (ITS) decreased significantly from 1998 to 2011, and that the decline in interpersonal trust across birth cohorts was negatively associated with and predicated by the marketization index. Study 2 found that the levels of marketization of different provinces in China were negatively associated with the levels of trust in these provinces. The present research first proposed that the marketization process in China may predict or correlate with a trend of declining trust, and then demonstrated the validity of the proposal based on both longitudinal and cross-sectional evidence.     

Elderly-technology interaction: accessibility and acceptability of technological devices promoting motor and cognitive training

As the world population is ageing, studies on the socio-economic and health consequences are proliferating. Little has been done on the effectiveness and impact elderly may benefit from the use of technology in their everyday life. The pilot study, implemented within a funded project aimed at identifying sustainable actions to promote Seniors' quality of life, intended to investigate this kind of interaction in terms of accessibility and acceptability that senior citizen experience with technological devices promoting motor and cognitive training. In the hypothesis, interfaces and technological artifacts, that still take in little account the seniors' physical characteristics (e.g. physiological limitations in sight, hearing, movement) and cognitive processes (selective memory often driven by practical needs), can cause elderly to mistrust technology. Study participants were twenty over seventy-year-old people, who were observed and interviewed in context in a two-hour training session regarding the technological devices user experience. The results are presented with scenario-based techniques that help represent typologies of users in different use situations. Findings confirm the hypothesis, highlighting that elderly may accept technological artifacts when they perceive them as bringing benefits in terms of well-being and health.