Risk factors for falls as a cause of hip fracture in women

Article Abstract:

Osteoporosis, a disease in which bone mass is lost, predisposes bones to fracture. Hip fracture, often causing permanent impairment and serious complications in the elderly, is the most significant consequence of osteoporosis. Most hip fractures in older women result from falls, although most falls do not lead to fractures. Knowledge concerning risk factors for falls could be beneficial for predicting and avoiding hip fracture. To learn more about this issue, 174 women, 45 years of age or older, hospitalized with their first hip fracture (cases) were compared with 174 similarly-aged women who were hospitalized for other reasons (controls). Several characteristics were examined: leg function before the fracture; degree of visual impairment; presence of neurologic disease and cognitive function; history of Parkinson's disease (a degenerative neurologic condition) or stroke (sudden loss of blood flow to a region of the brain); and use of alcohol and medication. Ninety-seven percent of the hip fractures studied were the result of a fall. The risk of a fall was increased for patients with impaired leg function or vision, or for those who used ambulatory aids (canes, walkers). Women with Parkinson's disease or a history of stroke were also at increased risk; those with increased body mass were at lower risk. The use of long-acting barbiturates also increased the risk of falling, but such use was infrequent among the case patients. No elevation in risk was associated with dizziness, limping, or balance problems. No relationship was found between increased risk for falling and alcohol use, based on self-reports. Comparisons between the kind of fall that led to hip fracture and the kind experienced by control patients (44 women) who had fallen during the previous six months showed that case patients had a greater incidence of falls from a standing (or higher) position. Case patients younger than 75 were more likely than older patients to have struck a hard surface. A discussion is presented of the biomechanics of falling. The results indicate that programs to prevent falls are also likely to prevent hip fractures. Most falls occur in the home, and strategies for improving the safety of this environment are described. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Complications and side effects, Risk factors, Falls (Accidents), Accidental falls, Osteoporosis, Fractures (Injuries), Fractures, Hip joint, Hip fractures

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Nursing home residents' preferences for life-sustaining treatments

Article Abstract:

Many nursing home residents apparently prefer to receive life-sustaining treatments if hospitalized but few have discussed their wishes with their health care providers. Researchers interviewed 421 elderly people in 49 nursing homes in the Philadelphia metropolitan area who were capable of understanding the nature of life-sustaining treatment. Sixty percent of those who understood cardiopulmonary resuscitation (CPR) wanted to receive CPR if they experienced cardiac arrest. However, several residents decided against CPR when the procedure was explained in detail. Eighty-nine percent wanted to be hospitalized if they became critically ill. One-third of those who understood enteral feeding wanted to have a feeding tube inserted if they sustained brain damage and could not eat. Only 12% of the residents had discussed their wishes with their health care providers and only 31% had discussed it with a family member.

Planning, Beliefs, opinions and attitudes, Hospitalization, Nursing home patients, Critically ill, Life support systems (Critical care), Life support care

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Statins and over-the-counter availability

Article Abstract:

Over-the-counter status offers some clear potential advantages over prescription status. Statins are great prescription drugs, but the considerations suggest that they would make poor over-the-counter drugs.

Marketing procedures, New England States, Evaluation, Marketing, Company marketing practices, New England, Nonprescription drugs, Statins

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