The risk factors of falls in the elderly

BACKGROUND: Falls in the elderly can lead to disability, hospitalizations, and premature death. Even if the fall does not cause significant injury, it may lead to fear of falling, loss of self confidence and restriction of ambulation. Thus, we conducted this study to examine the risk factors of falls in the elderly. METHODS: The study population consisted of 70 persons, older than 65 years. Subjocts were subdivided into 3 groups according to their experience of falls, during the past 2 year period. Among them, 30 persons had no previous experience, 20 had one fall, and 20 more than one fall. Age, past history, situations surrounding falls, MMSE K, GDS short form, ADL, IADL, Mini Nutritional assessment (MNA) were reviewed, and the Get up and go test, evaluation of orthostic hypotension and hearing were done. T-test, chi square, ANOVA, logistic regression test using the SAS program was performed. RESULTS: The mean age of the participants was 75.4 years with 62.9% malas. The factors associated with falling were age (P=0.01), scores of MNA (P=0.04), Get up and go test (P=0.004), past history (P=0.01), MMSE K (P=0.02), GDS short form (P=0.001), ADL (P=0.003) and IADL (P=0.002). Those in the group who fell once occured mostly while doing a riskful task, while those who fell more than once happened mostly during positional change (p<0.0001). Independent predictors of falls were get up and go test results and GDS short form scores. CONCLUSION: The independent predictors of falls were Get up and go test results and Geriatric Depression Scale scores.

The effects of the adolescent smoking cessation program

BACKGROUND: Despite widespread recognition of the hazardous health effects of smoking, adolescent smoking continues to increase, emerging as a public health problem. However few studies have focused on smoking cessation programs for adolescent smokers. The purpose of this study was to measure the short-term effects of the adolescent smoking cessation program performed by the Seoul School Health Center. METHODS: Four hundred and twenty adolescent smokers referred from their schools from March to December of 1996 were assessed before and immediately after the program with a self-questionnaire. The data acquired from these 420 students was analyzed. RESULTS: Males were found to have a higher rate of daily smoking as compared with females. Middle school students had a earlier starting age than those of high school students. About 70% of the students had tried to stop smoking and about 1/3 had a high level of self-efficacy in stop smoking. More than 80% of the students were current alcohol drinkers and 10% ever had experience with other drugs. Many showed poor academic performance and low degree of satisfaction with their schools. More than 50% had experienced punishment at school Middle and high economic status were more common than low status, 73.3% had smokers in their families and 43.3% showed severe dysfunction in family APGA-R. Smoking cessation rate immediately after the program was 37.4%, highest in female high school students and lowest in male high school students Factors shown to be significantly associated with smoking cessation in males were school age, FTQ scores, presence of peer smokers, smoking and alcohol status, self-efficacy in stop smoking and degree of satisfaction with their schools. School age, presence of peer smakers, smoking and other drug use status, self-efficacy in stop smoking, academic performance, degree of satisfaction with their schools, experienoe of runaway from home, economic status and presence of smokers in their families were significant factors in females. Stepwise logistic regression showed that current alcohol users were less likely to succeed in smoking cessation and those with a higher level of self-efficacy in stop smoking were more likely to succeed in males. In females, high school students with higher economic status were more likely to succeed while those with smokers in their families or experience of runaway from home were less likely to succeed. CONCLUSIONS: To promote smoking cessation, specified and risk-based approaches are considered to encourage the motivation of adolescent smokers. For more effectiveness, programs will need to comprehensively include the school, the family, peers, alcohol and other drug issues as well as smoking problem itself.