PubMed · 8577589
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G Cannard. Falling trend.. https://pubmed.ncbi.nlm.nih.gov/8577589/
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BACKGROUND: Falling is a major cause of disability and morbidity among older adults. Because poor balance is a major reason for frequent falls, assessment of balance and its risk factors are important. In this study, we postulated that cerebral changes identified on magnetic resonance (MR) imaging are related to balance, and that older adults with balance problems would have significantly greater prevalence of such brain abnormalities than older adults without balance problems. DESIGN AND MEASUREMENTS: Several measures of balance were examined in more than 700 community-dwelling older men and women, blacks and whites. Balance measures included dynamic posturography, functional reach, Romberg and 1-foot stand tests, tandem stand, and 1-foot stand. Cerebral MR imaging assessments included ventricular size, sulcal widening, white matter disease, and ischemic infarctions. Cardiovascular disease and hypertension were determined and controlled for in the analyses. RESULTS: A summary of the balance measures was significantly related to each of the 4 MR imaging measures, with those with poorer balance having more disease. The strongest associations with balance were seen for white matter disease and ventricular size. All but the ischemic infarction variable remained significantly associated with balance after adjustments for sex, race, age, cardiovascular disease, and hypertension. CONCLUSION: Cerebral changes identified by MR imaging are associated with poorer balance among older adults.
Fracture of the thumb sesamoid bones is rare. We report here a fracture of the ulnar sesamoid in a 25-year-old man caused by a fall on his outstretched hand. He complained of pain and loss of thumb motion. Physical examination revealed tenderness, swelling, and a hematoma over the first metacarpal joint of the right thumb. Radiographs showed a fracture of the ulnar sesamoid which should not be confused with normal variants that occasionally arise from ossifications centers that fail to unite.
OBJECTIVE: The purpose of the study is to report relationships between visual function parameters and falls, hip fractures, and gait time in adults. DESIGN: Population-based study. PARTICIPANTS: The 3722 persons who participated in the 5-year follow-up of the Beaver Dam Eye Study cohort. MAIN OUTCOME MEASURES: The visual functions measured at the examination were best-corrected visual acuity, current binocular acuity, near acuity, contrast sensitivity, and visual threshold to light. Information on falls and hip fractures was obtained by structured interview. Gait time was measured by standardized protocol. RESULTS: History of falls and hip fractures increased with age, as did time to walk a measured course. Falls were more commonly reported for all persons who had poorer visual function, although not all relationships were significant in persons less than 60 years of age. In persons 60 years of age and older, hip fractures after the age of 40 were significantly related to all measures of visual function. Time to walk a measured course was significantly related to all measures of visual function. CONCLUSIONS: These data indicate a consistent relationship between falls, fractures, gait time, and visual functions. Longitudinal data are necessary to accurately determine temporal relationships and to determine the likelihood of a causal association. In the interim, these data suggest that improving visual function may have benefits such as decreased traumatic events and improved mobility.