Characteristics associated with falls among the elderly within aged care wards in a tertiary hospital: a retrospective / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Falls are the most frequently reported adverse events in inpatient settings. We conducted a retrospective case-control study of inpatient falls within aged care wards in a tertiary hospital to investigate the associated characteristics of elderly patients suffering from falls and fall-related characteristics.</p><p><b>METHODS</b>Consecutive retrospective cross-sectional design spanned July 2006 to December 2008.</p><p><b>PATIENT GROUP</b>Information on all aged care inpatients who suffered from 1 or more falls was extracted from Incident Information Management System (IIMS). Further details about the particular admission(s) were obtained from patients' medical records, e.g., patients' characteristics and circumstances surrounding the falls. Randomly selected aged care patients who did not suffer from a fall and who were discharged from the hospital in the same period served control group. Characteristics among patients with single fall and recurrent falls, as well as non-fallers were compared.</p><p><b>RESULTS</b>Of the 438 falls evaluated, 71.9% occurred in patients' room and 18.9% in patients' bathroom/toilet. The common activities were moving/transferring and taking shower/toileting, respectively, 70.3%, 12.1% while occurring falls; and time of falls had a high peak during 9:00-11:00 a.m. Many were unassisted while falling. The common contributing factors for fall were intrinsic factors. Patients with recurrent falls were more likely to have lower Mini-Mental State Examination (MMSE) score. Logistic regression analysis showed length of stay longer than five weeks, dementia and stroke were independent risk factors for recurrent falls; and living in hostel/nursing home preadmission, needing assistance with mobility, cognitive impairment, stroke, incontinence and arthritis/osteoporosis were independent risk factors for fall.</p><p><b>CONCLUSIONS</b>In an aged care ward, falls are independently associated with recurrent factors. Cognitive impairment/dementia was a strong risk factor for falls, and main causes leading to fall were intrinsic factors. For patients with cognitive impairment/dementia and behavioral disorder providing special and effective interventions is of paramount importance for reducing the incidence of fall in an aged care ward in hospital settings.</p>

Preliminary evaluation of the role of biomarkers in diagnosing dementia

Background: Dementia is a common pathological condition that affects older people. Most causes of dementia are Alzheimer\u2019s disease and vascular dementia. Diagnosing these conditions mostly relied on clinical patterns, but some biomarkers have been mentioned as the indicators of this condition. Objectives: 1) To evaluate the alteration of some biomarkers in cerebrospinal fluid (CSF) samples from Alzheimer\u2019s patients. 2) To compare the concentration of biomarkers in CSF samples from patients with vascular dementia and Alzheimer\u2019s disease. Subjects and method: Case group involved 41 patients who were diagnosed as AD and vascular dementia based on DSM-IV criteria. 31 matched healthy people were included in control group. All subjects were given neuro-psychological tests and thorough clinical examination. Brain CT scan and MRI were done for both groups. CSF samples were taken from patients in the study group to measure levels of some biomarkers. Results. The levels of total taurine (T-tau) and phosphorylated taurine (P-tau) 181 proteins are higher in the dementia group. The concentration of Abeta-42 is significantly different between case and control groups, but similar between vascular dementia and Alzheimer\u2019s disease patients. Conclusion: Changes in biomarkers are valuable in different diagnosis of Alzheimer\u2019s disease and other types of dementia. However, findings of CSF studies have to be considered with findings from imaging studies and clinical examination.

Prevalence of epilepsy in Phu Linh \ufffd?Soc Son \ufffd?Ha Noi, 2003

Background: Epilepsy is a chronic disease, the incidence of epilepsy was from 5/1000 to 10/1000 population. In developed countries the rate of epileptic patients are managed much higher than in developing countries due to the differences in socioeconomic conditions as well as understanding of epilepsy. In Vietnam, few epidemiological studies about epilepsy were published. Objectives: To reveal the prevalence of epilepsy in a rural community in Viet Nam and the relation between the prevalence and age, career, level of education, economic condition of the patient. Subjects and method: This was a cross-sectional described study. Door \ufffd?to \ufffd?door survey based on WHO\u2019s questionnaires was conducted by neurologists and student of Faculty of Public healthy of Hanoi Medical University on people at Phu Linh commune, Soc Son district, Hanoi city. Data was processed by SPSS 10.0 program. Results: Periodic prevalence was 7.5\ufffd?(5.5\ufffd?was active epilepsy). Generalized epilepsy: 79.66%, focal epilepsy: 16.95% indeterminate epilepsy: 3.39%. There was a significant relation between education and prevalence of epilepsy. Conclusion: Periodic prevalence of Epilepsy in Phu Linh (2003) was 7.5\ufffd? Toninco-colonique seizures were dominant. A significant relation between number of epileptic patients and level of education was found.