To ensure you or a senior you know can go about their day safely in the home, do a safety audit to check for things such as loose railings, unsteady furniture, trip hazards like rugs and grab rails in the bathroom.
https://www.agedcareguide.com.au/talking-aged-care/taking-care-of-yourself-at-home-with-covid-19-restrictions-easing
OLDER PEOPLE AND FALLS PREVENTION
and https://hellocare.com.au/choking-second-common-cause-death-aged-care-falls/
Falls are a major health issue in the community with around 30% of adults over 65 experiencing at least one fall per year. This is set to increase as Australia’s population ages with the proportion of people aged over 65 predicted to increase from 14% (3 million people) in 2010 to 23% (8.1 million people) in 2050. Through the use of appropriate health assessment item numbers and screening tools you can identify people most at risk of falls. The RACGP has published guidelines for falls prevention in older adults.
There are several measures that an older person can take to help prevent a fall - Simple, everyday measures around the home include:
• using non-slip mats in the bathroom
• mopping up spills to avoid wet floors
• getting help lifting or moving items that are heavy or difficult to lift
• removing clutter and ensuring that all areas of the home are properly lit
Falls Prevention Toolkit
The Queensland Stay On Your Feet Toolkit aims to provide anyone who works with older people with easy access to current evidence-based information about falls prevention and healthy active ageing strategies to use in their organisation and local community. The Toolkit will guide you through how to set up and implement an effective falls prevention program using evidence based practical strategies, and how to evaluate its impact and maintain momentum. Initiatives can be undertaken at a community, organisational or individual level, or a combination of all three. The toolkit is available here.
https://bsphn.org.au/wp-content/uploads/2020/01/QI-Toolkit-Older-people-final.pdf
page 21.
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Preventing Head Injuries from Falls
scroll right down to nearly the bottom of this page...
Falls are the number one cause of traumatic brain injuries, especially in older adults. People do not have to fall from a height like falling off a ladder. Simply falling from a standing position and hitting your head can cause severe traumatic brain injuries in some people.
Reducing the risk of falls, especially at home or at work, can help avoid traumatic brain injuries. Preventing falls involves installing good lighting on stairs and hallways and removing obstacles like toys, clothing, or tools on the floor or electrical cords that can trip people. Throw rugs need to be skid resistant or removed to avoid trips and slips that lead to falls. Reasonable precautions that are easy to do may prevent many falls that cause traumatic brain injuries.
New frailty index to benefit aged care
Developed and validated by the SAHMRI-based Registry of Senior Australians (ROSA), the frailty index project was led by ROSA and Flinders University Research Fellow Dr Jyoti Khadka, who explained that the ability to measure frailty at a population level should deliver broad benefits across the aged-care sector. - hospitalhealth.com.au
‘Prehabilitation’ Boosts Recovery For Older Surgery Patients
By HelloCare - Journalist Team. Dec 22, 2020
https://hellocaremail.com.au/prehabilitation-recovery-older-surgery-patients/
Older adults about to undergo elective surgery should undertake a sustained programme of targeted exercise beforehand to counteract the muscle-wasting effects of bedrest, new research suggests.
A study published by researchers in the University of Birmingham’s School of Sport, Exercise and Rehabilitation Sciences showed that short term ‘prehabilitation’ strength exercises, undertaken pre-surgery, are insufficient to prevent muscle loss.
The team’s detailed analysis showed that, while short-term exercise prehabilitation does enhance the body’s muscle-building processes, thigh muscle-wasting was about 3-4 per cent in both legs – roughly equivalent to what older adults would typically lose over 3-5 years of ageing. The researchers recommend that one approach to protect older muscle from wasting during hospitalisation is to perform longer-term strength exercise prehabilitation beforehand.
Dr Leigh Breen, the study’s corresponding author, says: “Although short-term prehabilitation offers a cost-effective and easy-to-implement strategy, it does not prevent muscle wasting among older adults undergoing bed-rest. This muscle loss may be extremely hard to recover from and can lead to long-term health and disease complications.”
The team recommend that prehabilitation exercise programmes should also incorporate aerobic exercise alongside strength training to protect cardiovascular health, and a protein rich diet to increase muscle mass levels in a way that will effectively cancel out the muscle loss that is experienced during bed-rest.
They also recommend that, where appropriate and safe, hospitalised older patients should aim to get back on their feet and mobile again as quickly as possible. Post-surgery exercise and dietary strategies will also be important to ensure a return to full health and lower the risk of future health complications.
Dr Benoit Smeuninx, now at Monash University in Australia, is lead author on the paper.
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Receive quality physio treatment from the comfort of your own home
Griffith University:
Did you know that physiotherapists can provide you with quality and effective treatment online?
In the wake of the COVID-19 outbreak, our physiotherapy clinic continues to support our community and both our students and fully-qualified practitioners are currently providing online consultations via telehealth. This enables you to receive the same great services as you would in our regular clinic while helping to limit community exposure and transmission of COVID-19.
* Our student physiotherapy clinic recommenced this week and are currently offering $20 consultations via telehealth (initial consultation is $30).
Appointments available now:
If you'd like to experience telehealth for yourself, our physiotherapists are currently on hand and appointments are available.
Please call our reception team on 1800 188 295 or email us at [email protected]
- 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -
https://www.the-scientist.com/news-opinion/adult-humans-can-regenerate-cartilage--study-66558
Adult Humans Can Regenerate Cartilage: Study Collagen inside ankles has more turnover than that in hips, thanks to the action of microRNAs.
Oct 10, 2019
SHAWNA WILLIAMS
Humans, unlike some lucky members of the animal kingdom, have a very limited ability to regrow damaged or missing body parts. But a study published yesterday (October 9) in Science Advances finds that we can generate new proteins in joint cartilage, and this ability is more pronounced in joints farther from the center of the body, such as the ankles, than in those nearer in, such as the hips. The mechanism for this ability resembles that used by animals such as salamanders and axolotls to regrow lost limbs.
“We believe that an understanding of this ‘salamander-like’ regenerative capacity in humans, and the critically missing components of this regulatory circuit, could provide the foundation for new approaches to repair joint tissues and possibly whole human limbs,” says coauthor Virginia Kraus, who researches osteoarthritis at Duke University School of Medicine, in a university press release.
Kraus and her colleagues analyzed proteins from cartilage tissue from human hips, knees, and ankles for changes to amino acids that occur with time. “We suddenly started noticing that the ankle proteins tended by and large to be much younger than the same proteins in the knee and the same proteins in the hip,” Kraus tells The Guardian.
The researchers found that the prevalence of younger proteins was tied to the abundance of a microRNA that blocks the action of a messenger RNA that inhibits the production of new collagen proteins. Similar microRNAs are active in animals that can regrow limbs, the authors note—and, as in humans, the animals’ regeneration ability is greater in distal parts of the body than in more central ones.
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Antidepressants, opioids can more than double risk of falls
by: Dallas Bastian in News, June 3, 2019
"Older Australians starting antidepressants or opioids face more than double the risk of a fall or hip fracture, a new paper says. For the study, published today in Australian Prescriber, the research team compared 8828 veterans with hip fractures with 35,310 people of the same age and gender, examining their medicine use in the previous six months.
The risk of hip fracture was higher for all five groups of drugs tested (antidepressants, opioids, antiepileptic drugs, benzodiazepines and antipsychotics).
The highest risk, more than double, was when selective serotonin reuptake inhibitors or opioids were started. The team said this risk remained high with ongoing use.
Co-lead author Professor Libby Roughead from the University of South Australia said combining any of the five medications increases the risk even further – up to five times when antidepressants and anxiety medicines are started together."
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Certain medication doubles the risk of falls and fractures in elderly
by Liz Alderslade
6 June 2019
A newly published paper from University of South Australian researchers found the use of antidepressants and opioids by older people doubled the risk of fall or hip fractures. Professor Libby Roughead and Doctor Kerrie Westaway, lead authors of the study from the University of South Australia, uncovered the impact of psychotropic drugs on the elderly and its contribution to falls.
The researchers found that psychotropic drugs are used on a variety of conditions, like depression, pain and dementia, but the side effects can be quite significant, including drowsiness, dizziness and blurred vision, all of which increase the risk of falls and fractures.
Professor Roughead says, “Antidepressants, opioids, antiepileptic medicines, benzodiazepines (used to treat anxiety) and antipsychotics all increase the risk of hip fractures."
“Combining them increases the risk even further, up to five times in the case of starting antidepressants and anxiety medicines together.”
The study found there is one extra hip fracture for every 17 patients aged 80 years and over who will be treated for a year.
To reduce the risk of falling, the study suggested reducing psychotropic medication use, as well as increase exercise and other interventions like occupational therapy and podiatry.
An estimated 28,000 Australians over the age of 50 were hospitalised with a hip fracture in 2018. Five percent of those Australians died in hospital and another 10 percent were discharged to an aged care facility. The data for this research was pulled from the Australian Government Department of Veterans’ Affairs, comparing 8,828 veterans with hip fractures to 35,310 people of the same age and gender. It also examined their medicine use in the last six months."
- - - - - - - - - - - - - - - - - - - - - - -
30 September 2019
New biofabrication method creates one scaffold to guide regeneration of multiple tissues
https://medicalxpress.com/news/2019-09-biofabrication-method-scaffold-regeneration-multiple.html
by Lehigh University
Articular cartilage, which exists where bones meet at the joints. This type of cartilage provides a cushioning material to protect the ends of bones and is tightly integrated with bone through a gradient region known as the osteochondral interface—osteo means related to bone, chondral related to cartilage. When articular cartilage is absent or damaged, debilitating pain results.
Unlike some tissues, cartilage cannot regenerate. It lacks blood vessels to support such repair. After injury or damage, cartilage degeneration progresses, leading to osteoarthritis, which affects approximately 27 million Americans.
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QUALITY USE OF MEDICINES TO OPTIMISE AGEING IN OLDER AUSTRALIANS:
Recommendations for a National Strategic Action Plan to Reduce Inappropriate Polypharmacy.
As our population ages, more people are living with multiple chronic diseases with an associated increase in polypharmacy (multiple medicines use). Medicines use in older people is a complex balance between managing disease and avoiding medicines related problems. Supervised withdrawal of unnecessary medicines (deprescribing) is safe and may improve quality of life in older people.
Fraility -
Hip Fracture and recovery:
This booklet has been put together to help shine a light on the important steps to follow when you leave hospital to best support your hip fracture recovery. It includes basic hip fracture information, treatment options and a guide to osteoporosis planning to support bone health when you leave hospital. Go online to watch NeuRA’s short talks series on hip fracture and falls prevention at neuratalks.org
---------------------------------------------
A new pilot study coming out of the UK has found that one extra meal a day can cut the deaths of those who suffer hip fractures in half.
The Northumbria Healthcare NHS Foundation Trust’s hip fracture quality improvement programme noted that patients were deficient in certain nutrients and found that an extra meal a day would have a positive impact on recovery.
The extra meal led to improved morale and provided the extra calories needed to recover. Strikingly, it saw the mortality rates among hip fracture patients drop from 11 per cent to 5.5 per cent.
28 February 2019
---------------------------------------------
Oct 23, 2017 HEALTH & CARE
" 'Love Your Bones’ to Prevent Osteoporosis"
Osteoporosis affect more than one million people across Australia.
Osteoporosis is a condition where a person’s bones become weak and brittle, often resulting in an increased risk of breaks and fractures.
Healthy bones are made up of minerals – calcium being the one people are more familiar with. And when the body loses calcium faster than they are able to replace them with, it causes the bones to lose mass or density. Any bone can be affected by osteoporosis, but the most common sites are the hip, spine and wrist.
There are also a number of factors that increase a person’s chance of developing osteoporosis. This may include a family history of osteoporosis, low levels of Calcium and Vitamin D, lifestyle factors, such as alcohol consumption, smoking and lack of physical activity.
There are also other medical conditions that can lead to a higher risk of developing osteoporosis:
https://www.medicalsearch.com.au/falls-and-fall-prevention/f/20834
Falls & fall prevention have been well documented in recent years, as Australia realizes the significant strain this common problem has on the health system.14 January 2019
A federal Department of Health and Ageing report suggested that if preventative measures were not in put in place, then by 2051 major impacts might include the total health cost attributable to fall related injury to increase almost threefold to $1.37 billion! The report entitled "Projected costs of fall related injury to older persons due to demographic change in Australia", stated that an extra 2500 permanent beds would be needed for falls treatment and 3320 additional nursing home places.
In other findings, the Australian Institute of Health and Welfare last year released the Hospitalisations due to falls in older people, Australia 2008-09 report. It revealed that 78,600 people over the age of 65 were hospitalised for injuries sustained from falls. About one third of these cases resulted in injuries to the patient's hips or thighs - with the majority being hip fractures. Head injuries were present in 1 in 5 cases and were more common for males than females.
Less commonly spoken about is the fear of falling associated with this common problem, and the increasing amount of people who are experiencing this condition.
A complete shake-up of a patient's confidence, the fear of falling, can be described as anxiety related to walking or the concern of falling.
If you have an ongoing disease, exercise is as essential to your well-being as taking your medication.
Modern health-care systems are mostly organised around single-system illnesses. However, many elderly people have multiorgan problems.
Frailty is a practical, unifying notion in the care of elderly patients.
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The care of older people, whether living in the community or residential aged care facilities (RACFs), is often complex. The challenge is to provide appropriate care of the highest quality to these patients regardless of where they live. GPs are often required to collaborate with the patient’s broader multidisciplinary healthcare team, including RACF staff, carers, nurses, other specialist medical practitioners, and allied health professionals, in a way that focuses on the patient’s individual needs.
New aged care guide – Silver Book
The RACGP Silver Book Expert Advisory Group is pleased to present the new edition of the RACGP aged care clinical guide (Silver Book). The fifth edition provides GPs with up-to-date information on the complex care of older people. The Silver Book is now published on a newly designed website and will feature three interweaving parts:
The first section to be published – Part A: common clinical conditions in aged care – is intended to be used as a point-of-care reference. It is designed to assist in clinical decision-making by presenting a snapshot view of the diagnosis and management of a range of clinical conditions. The RACGP aged care clinical guide (Silver Book) is now available online.
Medical care of older persons in residential aged care facilities, a Royal Australian College of General Practitioners (RACGP) publication commonly known as the Silver Book, is one of the RACGP’s flagship clinical resources. First developed more than 20 years ago as a brief manual of 17 pages, there have been four editions to date. While the resource doubled in size from the third to fourth editions, much of the content is now out of date or obsolete.
This fifth edition builds on the remarkable foundation set by the previous four editions, and is retitled the RACGP aged care clinical guide (Silver Book) to reflect the increasing prevalence of older people choosing to live their old age in the community, or remaining in the community for longer.
The fifth edition of the Silver Book will be significantly expanded from previous editions, both in scope and content, and will be released online in three interweaving parts:
Part A: Common clinical conditions in aged care (October 2019)
Part B: General approaches to aged care (early-to-mid 2020)
Part C: Organisational approaches to aged care (mid-to-late 2020)
The guide will be released online only to ensure regular updates can be undertaken and the information can remain up to date and relevant for GPs.
25 October 2019
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Understanding Fraility, Falls, and Frequent infections that directs attention away from organ-specific diagnoses towards a more holistic viewpoint of the patient and their predicament.
Frailty is a state of increased vulnerability to poor resolution of homoeostasis after a stressor event, which increases the risk of adverse outcomes, including falls, delirium, and disability. Frailty is a long-established clinical expression that implies concern about an elderly person's vulnerability and outlook.
An apparently small insult (eg, a new drug, minor infection, or minor surgery) results in a striking and disproportionate change in health state—ie, from independent to dependent, mobile to immobile, postural stability to proneness to falling, or lucid to delirious.
The Edmonton Frail Scale is a multidimensional assessment instrument that includes the timed-up-and-go test and a test for cognitive impairment. The test is quick (it takes less than 5 min) and is valid, reliable, and feasible for routine use by non-geriatricians, but its diagnostic accuracy has not been investigated.
The five phenotype model indicators of frailty and their associated measures
---------------------------------------------------
Weight loss
Self-reported weight loss of more than 4·5 kg or recorded weight loss of =/>5% per year
Self-reported exhaustion
Self-reported exhaustion on US Center for Epidemiological Studies depression scale (3–4 days per week or most of the time)
Low energy expenditure
Energy expenditure <383 kcal/week (men) or <270 kcal/week (women)
Slow gait speed
Standardised cutoff times to walk 4·57 m, stratified by sex and height
Weak grip strength
Grip strength, stratified by sex and body-mass index.
===========================================
Falls Prevention (stability control)
http://www.healthyageing.eu/sites/www.healthyageing.eu/files/featured/Healthy%20and%20Active%20Ageing.pdf
The good news is that there are a number of things you can do to help prevent falls and minimise your injuries if you do fall. Knowing your risk factors and taking a few precautions is a good start.
Click on some of these Handy Tips:- Finding your Feet falls prevention, Blue Care Allied Health, Blue Care Service Centre 1300 258 322.
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Stationary exercise pedals have been found to be superior to traditional rehabilitation methods for knee replacement patients.
Research led by Bond University found that the simple home fitness equipment improved function and reduced pain in patients within two weeks of surgery compared to those undertaking standard rehabilitation.
There are 50,000 knee replacements in Australia every year and the healthcare cost burden is set to increase with an ageing population and rising obesity rates. Using the exercise bike instead of expensive and complicated rehabilitation programs could potentially save Australian patients at least $25 million per year.
“We were surprised that it was superior to standard rehabilitation methods,” said senior orthopaedic physiotherapist Larissa Sattler, lead researcher on the study. “Those that did the pedalling not only felt better, they could walk faster and further.”
Read more: https://www.hospitalhealth.com.au/content/aged-allied-health/news/breakthrough-in-knee-replacement-recovery-1290447580#ixzz5n8PAclpP
A new pilot study coming out of the UK has found that one extra meal a day can cut the deaths of those who suffer hip fractures in half.
The Northumbria Healthcare NHS Foundation Trust’s hip fracture quality improvement programme noted that patients were deficient in certain nutrients and found that an extra meal a day would have a positive impact on recovery.
The extra meal led to improved morale and provided the extra calories needed to recover. Strikingly, it saw the mortality rates among hip fracture patients drop from 11 per cent to 5.5 per cent.
28 February 2019
https://www.agedcareguide.com.au/talking-aged-care/taking-care-of-yourself-at-home-with-covid-19-restrictions-easing
OLDER PEOPLE AND FALLS PREVENTION
and https://hellocare.com.au/choking-second-common-cause-death-aged-care-falls/
Falls are a major health issue in the community with around 30% of adults over 65 experiencing at least one fall per year. This is set to increase as Australia’s population ages with the proportion of people aged over 65 predicted to increase from 14% (3 million people) in 2010 to 23% (8.1 million people) in 2050. Through the use of appropriate health assessment item numbers and screening tools you can identify people most at risk of falls. The RACGP has published guidelines for falls prevention in older adults.
There are several measures that an older person can take to help prevent a fall - Simple, everyday measures around the home include:
• using non-slip mats in the bathroom
• mopping up spills to avoid wet floors
• getting help lifting or moving items that are heavy or difficult to lift
• removing clutter and ensuring that all areas of the home are properly lit
Falls Prevention Toolkit
The Queensland Stay On Your Feet Toolkit aims to provide anyone who works with older people with easy access to current evidence-based information about falls prevention and healthy active ageing strategies to use in their organisation and local community. The Toolkit will guide you through how to set up and implement an effective falls prevention program using evidence based practical strategies, and how to evaluate its impact and maintain momentum. Initiatives can be undertaken at a community, organisational or individual level, or a combination of all three. The toolkit is available here.
https://bsphn.org.au/wp-content/uploads/2020/01/QI-Toolkit-Older-people-final.pdf
page 21.
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Preventing Head Injuries from Falls
scroll right down to nearly the bottom of this page...
Falls are the number one cause of traumatic brain injuries, especially in older adults. People do not have to fall from a height like falling off a ladder. Simply falling from a standing position and hitting your head can cause severe traumatic brain injuries in some people.
Reducing the risk of falls, especially at home or at work, can help avoid traumatic brain injuries. Preventing falls involves installing good lighting on stairs and hallways and removing obstacles like toys, clothing, or tools on the floor or electrical cords that can trip people. Throw rugs need to be skid resistant or removed to avoid trips and slips that lead to falls. Reasonable precautions that are easy to do may prevent many falls that cause traumatic brain injuries.
New frailty index to benefit aged care
Developed and validated by the SAHMRI-based Registry of Senior Australians (ROSA), the frailty index project was led by ROSA and Flinders University Research Fellow Dr Jyoti Khadka, who explained that the ability to measure frailty at a population level should deliver broad benefits across the aged-care sector. - hospitalhealth.com.au
‘Prehabilitation’ Boosts Recovery For Older Surgery Patients
By HelloCare - Journalist Team. Dec 22, 2020
https://hellocaremail.com.au/prehabilitation-recovery-older-surgery-patients/
Older adults about to undergo elective surgery should undertake a sustained programme of targeted exercise beforehand to counteract the muscle-wasting effects of bedrest, new research suggests.
A study published by researchers in the University of Birmingham’s School of Sport, Exercise and Rehabilitation Sciences showed that short term ‘prehabilitation’ strength exercises, undertaken pre-surgery, are insufficient to prevent muscle loss.
The team’s detailed analysis showed that, while short-term exercise prehabilitation does enhance the body’s muscle-building processes, thigh muscle-wasting was about 3-4 per cent in both legs – roughly equivalent to what older adults would typically lose over 3-5 years of ageing. The researchers recommend that one approach to protect older muscle from wasting during hospitalisation is to perform longer-term strength exercise prehabilitation beforehand.
Dr Leigh Breen, the study’s corresponding author, says: “Although short-term prehabilitation offers a cost-effective and easy-to-implement strategy, it does not prevent muscle wasting among older adults undergoing bed-rest. This muscle loss may be extremely hard to recover from and can lead to long-term health and disease complications.”
The team recommend that prehabilitation exercise programmes should also incorporate aerobic exercise alongside strength training to protect cardiovascular health, and a protein rich diet to increase muscle mass levels in a way that will effectively cancel out the muscle loss that is experienced during bed-rest.
They also recommend that, where appropriate and safe, hospitalised older patients should aim to get back on their feet and mobile again as quickly as possible. Post-surgery exercise and dietary strategies will also be important to ensure a return to full health and lower the risk of future health complications.
Dr Benoit Smeuninx, now at Monash University in Australia, is lead author on the paper.
= = = = = = = = = = = = = = = =
Receive quality physio treatment from the comfort of your own home
Griffith University:
Did you know that physiotherapists can provide you with quality and effective treatment online?
In the wake of the COVID-19 outbreak, our physiotherapy clinic continues to support our community and both our students and fully-qualified practitioners are currently providing online consultations via telehealth. This enables you to receive the same great services as you would in our regular clinic while helping to limit community exposure and transmission of COVID-19.
* Our student physiotherapy clinic recommenced this week and are currently offering $20 consultations via telehealth (initial consultation is $30).
Appointments available now:
If you'd like to experience telehealth for yourself, our physiotherapists are currently on hand and appointments are available.
Please call our reception team on 1800 188 295 or email us at [email protected]
- 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 - 0 -
https://www.the-scientist.com/news-opinion/adult-humans-can-regenerate-cartilage--study-66558
Adult Humans Can Regenerate Cartilage: Study Collagen inside ankles has more turnover than that in hips, thanks to the action of microRNAs.
Oct 10, 2019
SHAWNA WILLIAMS
Humans, unlike some lucky members of the animal kingdom, have a very limited ability to regrow damaged or missing body parts. But a study published yesterday (October 9) in Science Advances finds that we can generate new proteins in joint cartilage, and this ability is more pronounced in joints farther from the center of the body, such as the ankles, than in those nearer in, such as the hips. The mechanism for this ability resembles that used by animals such as salamanders and axolotls to regrow lost limbs.
“We believe that an understanding of this ‘salamander-like’ regenerative capacity in humans, and the critically missing components of this regulatory circuit, could provide the foundation for new approaches to repair joint tissues and possibly whole human limbs,” says coauthor Virginia Kraus, who researches osteoarthritis at Duke University School of Medicine, in a university press release.
Kraus and her colleagues analyzed proteins from cartilage tissue from human hips, knees, and ankles for changes to amino acids that occur with time. “We suddenly started noticing that the ankle proteins tended by and large to be much younger than the same proteins in the knee and the same proteins in the hip,” Kraus tells The Guardian.
The researchers found that the prevalence of younger proteins was tied to the abundance of a microRNA that blocks the action of a messenger RNA that inhibits the production of new collagen proteins. Similar microRNAs are active in animals that can regrow limbs, the authors note—and, as in humans, the animals’ regeneration ability is greater in distal parts of the body than in more central ones.
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Antidepressants, opioids can more than double risk of falls
by: Dallas Bastian in News, June 3, 2019
"Older Australians starting antidepressants or opioids face more than double the risk of a fall or hip fracture, a new paper says. For the study, published today in Australian Prescriber, the research team compared 8828 veterans with hip fractures with 35,310 people of the same age and gender, examining their medicine use in the previous six months.
The risk of hip fracture was higher for all five groups of drugs tested (antidepressants, opioids, antiepileptic drugs, benzodiazepines and antipsychotics).
The highest risk, more than double, was when selective serotonin reuptake inhibitors or opioids were started. The team said this risk remained high with ongoing use.
Co-lead author Professor Libby Roughead from the University of South Australia said combining any of the five medications increases the risk even further – up to five times when antidepressants and anxiety medicines are started together."
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Certain medication doubles the risk of falls and fractures in elderly
by Liz Alderslade
6 June 2019
A newly published paper from University of South Australian researchers found the use of antidepressants and opioids by older people doubled the risk of fall or hip fractures. Professor Libby Roughead and Doctor Kerrie Westaway, lead authors of the study from the University of South Australia, uncovered the impact of psychotropic drugs on the elderly and its contribution to falls.
The researchers found that psychotropic drugs are used on a variety of conditions, like depression, pain and dementia, but the side effects can be quite significant, including drowsiness, dizziness and blurred vision, all of which increase the risk of falls and fractures.
Professor Roughead says, “Antidepressants, opioids, antiepileptic medicines, benzodiazepines (used to treat anxiety) and antipsychotics all increase the risk of hip fractures."
“Combining them increases the risk even further, up to five times in the case of starting antidepressants and anxiety medicines together.”
The study found there is one extra hip fracture for every 17 patients aged 80 years and over who will be treated for a year.
To reduce the risk of falling, the study suggested reducing psychotropic medication use, as well as increase exercise and other interventions like occupational therapy and podiatry.
An estimated 28,000 Australians over the age of 50 were hospitalised with a hip fracture in 2018. Five percent of those Australians died in hospital and another 10 percent were discharged to an aged care facility. The data for this research was pulled from the Australian Government Department of Veterans’ Affairs, comparing 8,828 veterans with hip fractures to 35,310 people of the same age and gender. It also examined their medicine use in the last six months."
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30 September 2019
New biofabrication method creates one scaffold to guide regeneration of multiple tissues
https://medicalxpress.com/news/2019-09-biofabrication-method-scaffold-regeneration-multiple.html
by Lehigh University
Articular cartilage, which exists where bones meet at the joints. This type of cartilage provides a cushioning material to protect the ends of bones and is tightly integrated with bone through a gradient region known as the osteochondral interface—osteo means related to bone, chondral related to cartilage. When articular cartilage is absent or damaged, debilitating pain results.
Unlike some tissues, cartilage cannot regenerate. It lacks blood vessels to support such repair. After injury or damage, cartilage degeneration progresses, leading to osteoarthritis, which affects approximately 27 million Americans.
= = = = = = = = = = = = = = = =
QUALITY USE OF MEDICINES TO OPTIMISE AGEING IN OLDER AUSTRALIANS:
Recommendations for a National Strategic Action Plan to Reduce Inappropriate Polypharmacy.
As our population ages, more people are living with multiple chronic diseases with an associated increase in polypharmacy (multiple medicines use). Medicines use in older people is a complex balance between managing disease and avoiding medicines related problems. Supervised withdrawal of unnecessary medicines (deprescribing) is safe and may improve quality of life in older people.
Fraility -
- They are usually very thin and look like they have lost vitality.
- They look tired.
- They walk as if just doing so might make them fall down.
- It's one of those conditions that physicians and non-physicians alike kind of know when they see it. It has always been around, but it's only in the past 30 years or so that frailty has gotten a formal definition.
- Frail people typically have at least three of five symptoms, including unintended weight loss of roughly five kilograms or more within the past year, tiredness, loss of muscle mass as well as weakness, walking slowly and physical inactivity.
- Falls prevention
Hip Fracture and recovery:
This booklet has been put together to help shine a light on the important steps to follow when you leave hospital to best support your hip fracture recovery. It includes basic hip fracture information, treatment options and a guide to osteoporosis planning to support bone health when you leave hospital. Go online to watch NeuRA’s short talks series on hip fracture and falls prevention at neuratalks.org
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A new pilot study coming out of the UK has found that one extra meal a day can cut the deaths of those who suffer hip fractures in half.
The Northumbria Healthcare NHS Foundation Trust’s hip fracture quality improvement programme noted that patients were deficient in certain nutrients and found that an extra meal a day would have a positive impact on recovery.
The extra meal led to improved morale and provided the extra calories needed to recover. Strikingly, it saw the mortality rates among hip fracture patients drop from 11 per cent to 5.5 per cent.
28 February 2019
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Oct 23, 2017 HEALTH & CARE
" 'Love Your Bones’ to Prevent Osteoporosis"
Osteoporosis affect more than one million people across Australia.
Osteoporosis is a condition where a person’s bones become weak and brittle, often resulting in an increased risk of breaks and fractures.
Healthy bones are made up of minerals – calcium being the one people are more familiar with. And when the body loses calcium faster than they are able to replace them with, it causes the bones to lose mass or density. Any bone can be affected by osteoporosis, but the most common sites are the hip, spine and wrist.
There are also a number of factors that increase a person’s chance of developing osteoporosis. This may include a family history of osteoporosis, low levels of Calcium and Vitamin D, lifestyle factors, such as alcohol consumption, smoking and lack of physical activity.
There are also other medical conditions that can lead to a higher risk of developing osteoporosis:
- Corticosteroids – commonly used for asthma, rheumatoid arthritis and other inflammatory conditions
- Low hormone levels – in women this can be early menopause and in men low testosterone levels
- Thyroid conditions
- Conditions leading to malabsorption eg: coeliac disease, inflammatory bowel disease
- Chronic diseases such as rheumatoid arthritis, chronic liver or kidney disease
- Some treatments for breast cancer, prostate cancer, epilepsy and some antidepressants
https://www.medicalsearch.com.au/falls-and-fall-prevention/f/20834
Falls & fall prevention have been well documented in recent years, as Australia realizes the significant strain this common problem has on the health system.14 January 2019
A federal Department of Health and Ageing report suggested that if preventative measures were not in put in place, then by 2051 major impacts might include the total health cost attributable to fall related injury to increase almost threefold to $1.37 billion! The report entitled "Projected costs of fall related injury to older persons due to demographic change in Australia", stated that an extra 2500 permanent beds would be needed for falls treatment and 3320 additional nursing home places.
In other findings, the Australian Institute of Health and Welfare last year released the Hospitalisations due to falls in older people, Australia 2008-09 report. It revealed that 78,600 people over the age of 65 were hospitalised for injuries sustained from falls. About one third of these cases resulted in injuries to the patient's hips or thighs - with the majority being hip fractures. Head injuries were present in 1 in 5 cases and were more common for males than females.
Less commonly spoken about is the fear of falling associated with this common problem, and the increasing amount of people who are experiencing this condition.
A complete shake-up of a patient's confidence, the fear of falling, can be described as anxiety related to walking or the concern of falling.
If you have an ongoing disease, exercise is as essential to your well-being as taking your medication.
Modern health-care systems are mostly organised around single-system illnesses. However, many elderly people have multiorgan problems.
Frailty is a practical, unifying notion in the care of elderly patients.
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The care of older people, whether living in the community or residential aged care facilities (RACFs), is often complex. The challenge is to provide appropriate care of the highest quality to these patients regardless of where they live. GPs are often required to collaborate with the patient’s broader multidisciplinary healthcare team, including RACF staff, carers, nurses, other specialist medical practitioners, and allied health professionals, in a way that focuses on the patient’s individual needs.
New aged care guide – Silver Book
The RACGP Silver Book Expert Advisory Group is pleased to present the new edition of the RACGP aged care clinical guide (Silver Book). The fifth edition provides GPs with up-to-date information on the complex care of older people. The Silver Book is now published on a newly designed website and will feature three interweaving parts:
- Part A: common clinical conditions in aged care (available online now)
- Part B: general approaches to aged care (early-to-mid 2020)
- Part C: organisational approaches to aged care (mid-to-late 2020).
The first section to be published – Part A: common clinical conditions in aged care – is intended to be used as a point-of-care reference. It is designed to assist in clinical decision-making by presenting a snapshot view of the diagnosis and management of a range of clinical conditions. The RACGP aged care clinical guide (Silver Book) is now available online.
Medical care of older persons in residential aged care facilities, a Royal Australian College of General Practitioners (RACGP) publication commonly known as the Silver Book, is one of the RACGP’s flagship clinical resources. First developed more than 20 years ago as a brief manual of 17 pages, there have been four editions to date. While the resource doubled in size from the third to fourth editions, much of the content is now out of date or obsolete.
This fifth edition builds on the remarkable foundation set by the previous four editions, and is retitled the RACGP aged care clinical guide (Silver Book) to reflect the increasing prevalence of older people choosing to live their old age in the community, or remaining in the community for longer.
The fifth edition of the Silver Book will be significantly expanded from previous editions, both in scope and content, and will be released online in three interweaving parts:
Part A: Common clinical conditions in aged care (October 2019)
Part B: General approaches to aged care (early-to-mid 2020)
Part C: Organisational approaches to aged care (mid-to-late 2020)
The guide will be released online only to ensure regular updates can be undertaken and the information can remain up to date and relevant for GPs.
25 October 2019
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Understanding Fraility, Falls, and Frequent infections that directs attention away from organ-specific diagnoses towards a more holistic viewpoint of the patient and their predicament.
Frailty is a state of increased vulnerability to poor resolution of homoeostasis after a stressor event, which increases the risk of adverse outcomes, including falls, delirium, and disability. Frailty is a long-established clinical expression that implies concern about an elderly person's vulnerability and outlook.
An apparently small insult (eg, a new drug, minor infection, or minor surgery) results in a striking and disproportionate change in health state—ie, from independent to dependent, mobile to immobile, postural stability to proneness to falling, or lucid to delirious.
The Edmonton Frail Scale is a multidimensional assessment instrument that includes the timed-up-and-go test and a test for cognitive impairment. The test is quick (it takes less than 5 min) and is valid, reliable, and feasible for routine use by non-geriatricians, but its diagnostic accuracy has not been investigated.
- As we age, we lose functions, whether it is physical or cognitive; there is a sliding scale of a loss of functionality further resulting in a loss of independence. The Edmonton Frail Scale is a multidimensional assessment instrument that includes the timed-up-and-go test and a test for cognitive impairment.
The five phenotype model indicators of frailty and their associated measures
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Weight loss
Self-reported weight loss of more than 4·5 kg or recorded weight loss of =/>5% per year
Self-reported exhaustion
Self-reported exhaustion on US Center for Epidemiological Studies depression scale (3–4 days per week or most of the time)
Low energy expenditure
Energy expenditure <383 kcal/week (men) or <270 kcal/week (women)
Slow gait speed
Standardised cutoff times to walk 4·57 m, stratified by sex and height
Weak grip strength
Grip strength, stratified by sex and body-mass index.
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Falls Prevention (stability control)
http://www.healthyageing.eu/sites/www.healthyageing.eu/files/featured/Healthy%20and%20Active%20Ageing.pdf
The good news is that there are a number of things you can do to help prevent falls and minimise your injuries if you do fall. Knowing your risk factors and taking a few precautions is a good start.
Click on some of these Handy Tips:- Finding your Feet falls prevention, Blue Care Allied Health, Blue Care Service Centre 1300 258 322.
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Stationary exercise pedals have been found to be superior to traditional rehabilitation methods for knee replacement patients.
Research led by Bond University found that the simple home fitness equipment improved function and reduced pain in patients within two weeks of surgery compared to those undertaking standard rehabilitation.
There are 50,000 knee replacements in Australia every year and the healthcare cost burden is set to increase with an ageing population and rising obesity rates. Using the exercise bike instead of expensive and complicated rehabilitation programs could potentially save Australian patients at least $25 million per year.
“We were surprised that it was superior to standard rehabilitation methods,” said senior orthopaedic physiotherapist Larissa Sattler, lead researcher on the study. “Those that did the pedalling not only felt better, they could walk faster and further.”
Read more: https://www.hospitalhealth.com.au/content/aged-allied-health/news/breakthrough-in-knee-replacement-recovery-1290447580#ixzz5n8PAclpP
A new pilot study coming out of the UK has found that one extra meal a day can cut the deaths of those who suffer hip fractures in half.
The Northumbria Healthcare NHS Foundation Trust’s hip fracture quality improvement programme noted that patients were deficient in certain nutrients and found that an extra meal a day would have a positive impact on recovery.
The extra meal led to improved morale and provided the extra calories needed to recover. Strikingly, it saw the mortality rates among hip fracture patients drop from 11 per cent to 5.5 per cent.
28 February 2019