Clinical Research Directory

Implementing Action Falls for Domiciliary Care

Every year, a lot of older people fall. These falls often lead to serious injuries and are a common reason for moving into care homes, increasing the amount of paid support at home or needing to rely more on family, friends and neighbours for informal support. Falling can make people lose confidence in their abilities to do different activities, leading to loneliness and physical weakness, increasing the risk of more falls. It's important to identify why someone might fall and put things in place to try and reduce these risks. This needs to be done whilst also supporting people to be confident and continue to do the things they enjoy doing. Action Falls is an intervention that aims to find out why someone might fall and suggests ways to help, like checking their medication and encouraging them to stay active. It was first created to try and prevent falls in care homes. We have now adapted the intervention for older people living in their own homes that are supporting by home care services. We now need to try out the adapted intervention to see what people think about it and explore whether it can help manage falls and independence. The Action Falls for home care intervention includes: * Training for home care and reablement staff * Information and resources to help identify potential risks and suggest potential actions * Information for older people and families to consider potential falls risks and actions In order to evaluate the Action Falls for home care we are undertaking a study over 2 years where the intervention will be delivered across home care organisations in Nottinghamshire and Lincolnshire. We are asking home care staff and older people to take part in different parts of the research to explore the different views on how well the intervention has been delivered and whether it has improved confidence in managing falls and promoted independence and activity for older people.

Association Between Intake of Psychotropic Medications and Risk of Falls in Older Adults

The aim of the study is to assess the association between intake of psychotropic medications and increased risk of falls in older adults discharged from Ain Shams University Geriatric Hospital as a primary outcome and incident fractures that may occur as a secondary outcome of such fall.

Turkish Adaptation of the Multidimensional Falls Efficacy Scale in Older Adults

Falls are a major health concern among older adults and can lead to injuries, reduced independence, and a lower quality of life. In addition to physical changes associated with aging, an individual's confidence in preventing falls, maintaining balance, and managing situations during and after a fall may influence daily activities and social participation. The Multidimensional Falls Efficacy Scale (MdFES) is a questionnaire designed to assess older adults' confidence in performing everyday activities without falling. It includes activities related to both daily living and participation in the community. A culturally adapted and reliable Turkish version of this questionnaire is needed to assess fall-related self-efficacy in Turkish-speaking older adults. The aim of this study is to adapt the MdFES into Turkish and evaluate its validity, reliability, and other measurement properties in older adults. The study will examine whether the Turkish version measures fall-related self-efficacy appropriately and provides consistent results. The findings may provide researchers and healthcare professionals with a useful assessment tool for evaluating fall-related self-efficacy in older adults. This may support the identification of individuals who lack confidence in performing daily activities and contribute to research and clinical approaches aimed at improving confidence, independence, and participation in everyday life.

Evaluation of the Relationship Between Fall Risk, Muscle Strength, and Anticholinergic Burden in Geriatric Patients Presenting to the Emergency Department

Falls are common among older adults and can lead to serious injury. This study looks at whether taking many medications (polypharmacy), the anticholinergic burden of those medications (a measure of side effects that can affect memory, balance, and muscle function), and sarcopenia (age-related loss of muscle mass and strength) are related to fall risk in older adults visiting the emergency department. Patients aged 65 and older who come to the emergency department will be invited to take part. With their consent, researchers will review the medications they are taking and calculate an anticholinergic burden score. Researchers will also measure the patients' hand grip strength and use ultrasound to measure the thickness of the quadriceps muscle in the thigh, both of which are used to assess muscle health. Information about the patients' history of falls in the past year, hospital stays, and other health conditions will also be collected. All measurements are non-invasive, are already used in routine clinical practice, and are performed only once during the emergency department visit. No experimental treatment or medication will be given as part of this study. The goal of this study is to understand how polypharmacy, anticholinergic burden, and sarcopenia relate to fall risk, both individually and together, so that older adults at higher risk of falling can be identified earlier and offered appropriate prevention strategies.

Vestibular Balance-Cognition Dual-Task Digital System: Development of a Smart Rehabilitation Platform for the Elderly and Prediction of Balance Function Risks

This study is being done to better understand how vestibular problems and thinking abilities (such as attention and mental flexibility) are related in older adults, and how doing a balance task and a thinking task at the same time affects their performance. Older adults will first complete questionnaires and simple paper-and-pencil tests of attention, memory, and mental rotation while seated. They will then perform standing balance tasks on a portable force platform under different conditions (eyes open, eyes closed, standing on a foam surface) and will repeat some of the thinking tasks at the same time. Next, participants will walk on a treadmill while wearing small motion sensors, both with and without added thinking tasks such as serial subtraction and digit reordering. The total testing time is about 90 minutes. Two groups will be included: healthy older adults and older adults who have had dizziness or falls in the past two years. By comparing these groups, the study aims to provide a basis for designing future dual-task assessment and training programs to reduce balance problems and falls in older adults.

Effect of Testosterone on Elderly Frail Men With Testosterone Deficiency

The purpose of this study is to increase the functional level of the elderly to thereby reduce fall risk, improve motor skills, and increase psychological well-being, as well as to assess whether the restoration of a normal testosterone level contributes to a faster recovery. The effect of testosterone is investigated as measured by physical and mental functional capacity, including cognition, in hypogonadal elderly men with a significant loss of function. The study is aimed at participants who are too weak to participate in the progressive strength training.

Validating a Multifactorial Algorithm to Predict Fall Risk in Community Dwelling Older Persons Aged 65 Years or Older

Falls in older adults have an annual incidence between 23 and 34% for persons of 65 years and older. The lack of transfer of promising research results on falls prevention to daily practice may have several explanations. One of the first concerns for that matter may be a valid and sensitive selection of the persons at risk who are eligible for fall prevention interventions Goals of the prospective obeservational study: 1. To validate a new, comprehensive, multifactorial screeningsintrument to predict the risk on falls in community dwelling, Belgian, older adults (\>65years or older). 2. To optimize the new, comprehensive, multifactorial screeningsintrument and to specify correct cut off scores Researchers will compare the data of the accuracy of new algorithm with the current Belgian policy. Participants will participate in a one-time testing moment, where they will be asked some questions about general characteristics and medical history, followed by two questionnaire and seven physical tests . Based on this data, their fall risk will be assessed. In the year that follows, the older person's fall behavior will be monitored with a monthly falls calender. Participant will be asked to fill out these calenders everyday ('Did you fall today?' YES/NO) and send them at the end of each month to the researchers, digitally or postal.

Validation of the Self-Assessment for Falls in the Elderly (SAFE) Questionnaire to Assess the Risk of Falls in People Aged 60 or Over.

This single-centre, cross-sectional diagnostic study will determine whether the new self-completed Self-Assessment for Falls in the Elderly (SAFE) questionnaire can classify fall-risk level (low, moderate, high) in adults ≥ 60 years as accurately as the current clinician-administered international algorithm that mixes yes/no questions with physical tests; to do so, about 300 participants will (1) sign consent, (2) answer the 5-minute SAFE, and (3) undergo guideline assessment and tests by a clinician in the same visit, after which researchers will compare SAFE and clinician results for sensitivity, specificity, and predictive values, examine agreement and correlations, and give immediate risk-based prevention advice: * Eligibility: men or women ≥ 60 y, stable walking/balance ≥ 1 month, able to read French and perform brief tests; legal guardianship or refusal excludes. * Participant tasks: complete SAFE; perform Timed Up-and-Go, 4 m gait speed, Five-Times-Sit-to-Stand and Short Physical Performance Battery (SPPB) under supervision * Benefits/Risks: instant personalised fall-risk feedback; SAFE is risk-free and physical tests carry only minimal supervised exertion. Falls are a leading cause of injury and death in older adults, and current assessments require trained staff; if SAFE proves equivalent, it could enable large-scale, low-cost self-screening and support future digital monitoring tools for fall prevention.

Does Participation in a Fall Preparedness Program Improve Fall Efficacy Among Older Adults

The purpose of this study is to determine if a fall preparedness program can reduce the fear of falling in older adults and subsequently improve their function and reduce falls with injury. Participants will perform baseline measures 4 weeks before intervention and again at the start of intervention. They will perform a 12-week intervention and then complete outcome measures again at the conclusion of the program.