bluuebunny/crossref_metadata_2025_split huggingface dataset:
158 Is it Just an Idea…Or More? Gerontechnology Research in Monash University Malaysia
Authors: Teh Pei-Lee 
Published: December 2019

Abstract
Malaysia is set to become an ageing population by 2030, when older people aged 65 years and above will constitute over 7% of the total population. In a bid to prepare for rapid ageing, Monash University Malaysia took the lead to establish the Gerontechnology Laboratory in 2016, the first of its kind in Malaysia. The aims of the Gerontechnology Laboratory are to translate research into new products, change existing business models and services, and shape public policies to improve the health and wellbeing of older people and those who care for them. The Gerontechnology Laboratory is a multidisciplinary research platform that brings together students, researchers, business partners, universities, government and the broader community to lead on research and innovations for older people within the five domains of human activity: health and self-esteem, housing and daily living, mobility and transport, communication and governance, and work and leisure. The lab also serves as a centre for education and training, assessment and consultation concerning gerontechnology, home safety, and independent living environment. Examples of external engagement include Gerontechnology Symposium (2017, 2018), Monash-Petrosains Gerontechnology Challenge (2018) and Monash Gerontechnology Lab Volunteer Community (2017-present). At the international level, the Monash University Malaysia’s Gerontechnology Lab was recognised as one of 21 international AACSB Innovations that Inspire 2019. This seminar will share how Monash University Malaysia builds the gerontechnology hub and leads the research and development for the study of gerontechnology in Malaysia.
161 Brain Activation Assessed with Functional Near-Infrared Spectroscopy (FNIRS) During Stepping and Gait in Older People and Those with PD
Authors: Menant Jasmine , Pelicioni Paulo , Okubo Yoshiro , Canning Colleen , Sturnieks Daina , Lord Stephen 
Published: December 2019

Abstract

Background and Aim
Past research has shown that compared with healthy peers, people with Parkinson’s Disease (PD) generate poorer stepping responses and display reduced ability to adapt gait to unexpected targets and obstacles. However, the neural basis of these impairments in PD is unclear. Here, we aimed to investigate cortical activation in pre-frontal and motor areas using functional near-infrared spectroscopy (fNIRS) during stepping and gait adaptability in people with PD, compared with healthy adults.

Methods
Forty-four people with PD (&gt;40 years, Hoen & Yahr stage 1-3) and 44 healthy age and sex-matched healthy adults performed three cognitively-demanding stepping tasks and a test of gait adaptability. We recorded relative changes in oxy-haemoglobin (HbO) and deoxy-haemoglobin (HbR) concentrations in the dorsolateral prefrontal cortex, supplementary motor area, premotor cortex and primary cortex using fNIRS.

Results
Data collection is ongoing with &gt;75% participants already assessed. We will conduct between group-comparisons to compare HbO and HbR concentrations in the selected regions of interest in the stepping and the gait adaptability tests. Physical and cognitive predictors of brain activation in each task in each group will also be computed using regression models.

Conclusion
Based on the results of our recent systematic review of fNIRS-recorded brain activation during walking tasks (1), we hypothesise that compared with healthy-aged matched peers, people with PD will show increased prefrontal and motor cortices activation during stepping and gait adaptability tests. This would suggest that people with PD require more attentional resources for safe walking.

Reference
(1) Pelicioni et al. Prefrontal cortical activation measured by fNIRS during walking: effects of age, disease and secondary task. Peer J 2019; 7: e6833.
164 Increasing Uptake and Adherence in Falls Prevention Interventions
Authors: Todd Chris 
Published: December 2019

Abstract
There is compelling evidence from Cochrane reviews that strength and balance exercise delivered with fidelity to the evidence and that is to dose, challenging, progressive and regular prevents falls. A core issue is found in these requirements since unless the exercise is done it will not work.
First we consider the various definitions used in the uptake and adherence literature (completion/ retention; drop-out; attendance; duration adherence; intensity adherence; uptake) revealing there is no standard approach (Hawley-Hague et al 2016. http://dx.doi.org/10.1136/bmjopen-2016-011560)
Improving uptake and adherence is deeply rooted in psychology, since at its essence is the issue of how to change behaviour. Over recent years a number of theories and approaches have been developed to behaviour change. We have recently developed an approach to aimed at improving uptake and adherence to exerciser based on the Health Action Process Approach (HAPA) (Boulton et al 2019 https://doi.org/10.1016/j.pcad.2019.01.003).
This paper describes the HAPA model and how it has been implemented in a paper and pencil based intervention as well as in a smartphone App version of the same intervention (aLiFE/eLiFE) and how this could be extended to the field of fall prevention in the future.
19 The Efficacy, Safety and Acceptability of Non-Pharmacologic Therapy for Orthostatic Hypotension in Older People: A Mixed Methods Study
Authors: Frith James , Robinson Lisa , Newton Julia 
Published: December 2019

Abstract

Introduction
First-line treatment for OH is typically with non-pharmacologic therapy. However, the current evidence base is poor, particularly in older people.

Aim
Determine the safety, efficacy and acceptability of single and combination therapies for OH in older people.

Methods
A three-stage, mixed-methods study consisting of a phase 2 efficacy study with a nested qualitative study. Stage One calculated response rates to therapy (defined as an improvement in standing systolic blood pressure (SSBP) by ≥10 mmHg). Stage Two explored the tolerability of therapies in qualitative interviews. Stage Three evaluated response rates to combinations of the most efficacious and tolerable therapies. All participants were aged ≥60 years, had OH and were recruited from a UK Falls and Syncope Service.

Results
Stage One. Response rates to therapies were evaluated in 25 older people (74 years, 60-92): Bolus-water drinking 56% (95%CI 35, 76); abdominal compression 52% (95%CI 31, 72), physical counter-maneuvers 44% (PCM, 95%CI 24, 65), full-leg length compression 32% (95%CI 15, 54).
Stage Two. PCM was considered an acceptable therapy as no equipment is required, is only needed during postural change and can be performed conspicuously. Water was largely acceptable but there were concerns around urinary frequency. Compression stockings were considered unacceptable due to cosmesis, practicalities and discomfort. There were mixed views on the tolerability of abdominal compression. There were no adverse events.
Stage Three. Response rates to combination therapy were evaluated in 37 older people (71 years, 60-94). Bolus water drinking + PCM 38% (95%CI 22, 55); water + PCM + abdominal compression 46% (95%CI 29, 63).

Conclusions
Due to its superior efficacy, safety and acceptability, bolus water drinking should become standard first-line therapy. Conversely, compression stockings should be disregarded in this population, as they are the least efficacious and most unacceptable treatment. Surprisingly, there is no additional benefit of combining therapies.
20 Optic Flow Stimuli Effects on Standing Balance in Young and Older People with Low and High Fall Risk
Authors: Sturnieks Daina , Tan Brandon , Persiani Michela , Brodie Matthew , Lord Stephen 
Published: December 2019

Abstract

Introduction
Optic flow stimuli can destabilise postural control, especially those with increased visual field dependence. This study aimed to examine the effects of optic flow stimuli on postural stability between: 1) younger and older adults; and 2) low-falls-risk and high-falls-risk older adults.

Methods
76 participants were grouped into ‘young’ (20-40 years, n=25), and ‘old’ (≥65 years, n=51); the latter was further stratified into ‘old-LFR’ (low fall risk, n=27) and ‘old-HFR’ (high fall risk, n=24). Participants stood on a force platform in a dark room with motion capture markers on the head, torso and lower limb. Optic flow stimuli were projected on a large screen encompassing the field of view as moving white dots for 30 seconds in four different conditions: radial expansion, radial contraction, circular (roll vection) anticlockwise and circular clockwise. Postural control was calculated from center of pressure (COP) and lower limb joint and trunk angles; changes between baseline (static dots) and optic flow conditions were compared between groups.

Results
Optic flow stimuli led young and older participants to shift their COP in the expected direction for each stimulus condition (forward for expansion, backward for contraction, left for anticlockwise, right for clockwise). For radial expansion, significantly increased anteroposterior sway was found in old-LFR and old-HFR (p≤0.001) but not \young (p≥0.17). Similar results were seen for radial contraction. For circular clockwise, significantly increase mediolateral sway was found in old-HFR (p=0.002) but not young (p=0.912) or old-LFR (p=0.749). Results differed for circular anticlockwise, with greater changes seen in anteroposterior sway compared with mediolateral, particularly in old-HFR. No stimuli by group interaction effects were seen in body kinematics.

Conclusions
Optic flow stimuli have a more destabilising effect on balance in older than younger adults, particularly those at increased risk of falling.
27 Cerebral Autoregulation Associated with Falls in Older Persons with Orthostatic Hypotension?
Authors: Saedon Nor Izzati , Hian Goh Choon , James Frith , Adnan Wan Azman Wan , Pin Tan Maw 
Published: December 2019

Abstract

Background
It is considered well-established that orthostatic hypotension (OH) is associated with falls, population-based studies have found that a large proportion of community-dwelling older adults fulfill the criteria for OH without experiencing falls. It is therefore postulated that older individuals with OH may only experience fall if cerebral autoregulation, which is the mechanism by which the brain blood flow is maintained constant through a autoregulatory range, is impaired.

Objective
To evaluate the relationship between cerebral autoregulation and OH in older individuals with and without a history of falls.

Method
Individuals aged 3 60 years were recruited from medical clinics, by word of mouth, and from existing research registries. Baseline sociodemographics, detailed medical history and medication history were obtained. Bilateral middle cerebral artery (MCA) blood flow were recorded using transcranial Doppler ultrasound (TCD) synchronized with non-invasive continuous blood pressure and ECG recordings. Synchronized brain blood flow signals, heart trace and blood pressure signals were first recorded during 10 minutes’ supine rest.
Participants were then be asked to perform a standard set of mathematical calculations, a Valsalva maneuver and to stand up from a seated position.

Results
36 participants have been evaluated to date (13 fallers, 23 non-Fallers). There is no statistically significant difference in gender, ethnicity or height and weight between groups. Fluctuations in MCA flow velocity were observed with spontaneous fluctuations in blood pressure at rest and with induced blood pressure changes during the challenge maneuvers. Visual inspection of the signals obtained suggested that changes in MCA flow velocity were more marked among fallers and non-fallers.

Conclusion
Synchronization of cerebral blood flow and continuous blood pressure signals opens up numerous new possibilities in research and clinical practice. Our preliminary findings suggest that cerebral autoregulation does play a role in determining the presence of symptomats in older individuals with OH.
31 Evidence, Assumptions, and Emerging Treatments for Falls Prevention
Authors: Montero-Odasso Manuel 
Published: December 2019

Abstract
Falls is a common geriatric syndrome that increases morbidity and mortality. Much of our understanding of falls mechanisms derives from studies that excluded or did not evaluate cognitively impaired older adults. This has limited the evidence for managing falls in this population and generated gaps in our understanding of how cognitive processes affect the pathophysiology of falls. This presentation will provide an overview of the role of cognition in falls with potential implications for managing and preventing falls in older adults. A thorough review of observational and interventional studies addressing the role of cognition on falls will be appraised. The importance of the gait-cognition relationship in aging and neurodegeneration is revised to highlight the role of brain motor control deficits in fall risk. The benefits of dual-task gait assessments as a marker of fall risk is reviewed. Therapeutic approaches for reducing falls by improving certain aspects of cognition will be also appraised.
32 Effect of Dual Task Training Regarding to Postural Stability in the Healthy Elderly
Authors: Yingyongyudha Anyamanee , Ramrong Thanakorn , Yodkue Piyatip , Jamjit Korawit , Suchart Pawaris , Ritdate Kittima 
Published: December 2019

Abstract

Introduction
Postural instability problem in the elderly is associated the cognitive impairment. The ageing process is directly linked to impairments in postural stability. Dual task activity is a commonplace to most activities of daily living. The elderly who has a postural instability and cognitive decline that are mechanisms which lead to an increased risk of falls in the elderly.

Objective
To investigate the effect of dual task training on postural stability in the healthy elderly.

Methods
The sixty-six healthy elderly were selected based on the inclusion criteria. With randomized 33 participants in each experimental and control group. The experimental group received dual task training for 6 weeks delivered three days per week. The control group received education for postural stability and aerobic exercise. Their postural stability was assessed using the Mini-BESTest in before and after training.

Results
The score of the Mini-BESTest compare between before and after 6 weeks were significantly different in postural stability and cognitive from that before in experimental group (p&lt;0.001).

Conclusions
The finding support the dual task training program can improve postural stability in the elderly. Therefore, the dual task training program should be implemented with the elderly to be a choice of exercises for the elderly with postural instability.
35 The Impact of Postural Hyperkyphosis on Postural Stability and Cognition
Authors: Burns Krista 
Published: December 2019

Abstract

Background
Postural Hyperkyphosis results from flexor dominant posture habits. Flexor dominance occurs due to dysfunction of the pontomedullary reticular formation (PMRF) of the brainstem and the vestibular system. The role of the PMRF is to inhibit anterior flexion above T6 spinal level, and the vestibular system stimulates upright postural extension and balance.
When patients present with flexor dominance they have a Postural Hyperkyphosis postural distortion pattern and abnormal muscle activation patterns. To correct flexor dominance, practitioners should perform brain-based exercises, not just structural exercises. Brain based stimulation of the vestibular system and the brainstem stimulates upright extension of the Posture System and inhibition of anterior flexion to reduce Postural Hyperkyphosis.
Postural Hyperkyphosis contributes to multiple health discrepancies. According to Cohen, Vasavada, and Wiest et al. (2016) in the Frontiers of Neuroscience, Postural Hyperkyphosis is associated with a lower state of cognition. According to Kado, Huang, and Nguyen et al. (2007) in the Journals of Gerontology hyperkyphosis is associated with poor balance and injurious falls in the elderly. Brainstem and vestibular activation reduces flexion and improves extension for better postural correction outcomes.

Results
Brain Based exercises reduce Postural Hyperkyphosis and improve postural stability and cognition of elderly patients. Brain Based exercises are safe for the elderly to perform and can be easily implemented into physical rehabilitation treatment plans for better postural correction results.

Conclusion
Correcting Postural Hyperkyphosis to improve Postural Stability and cognition requires a Brain Based treatment protocol.
38 Process Evaluation of the Praised 2, A Multi-Centre Randomised Controlled Trial (RCT) Testing the Clinical and Cost-Effectiveness of a Therapy Intervention Designed to Promote Activity and Independence Amongst People with Early Dementia or Mild Cognitive Impairment
Authors: Di Lorito Claudio , Pollock Kristian , Harwood Rowan , Booth Vicky , Goldberg Sarah , Van der Wardt Veronika 
Published: December 2019

Abstract

Introduction
The 'Promoting Activity, Independence and Stability in early dementia and cognitive impairment' (PrAISED 2) is a randomised controlled trial testing the effectiveness of an exercise and physical activity programme for people with mild cognitive impairment and early dementia. Parallel to the trial, our team is conducting a process evaluation, whose aims are to: 1. Determine the extent to which the programme is being delivered according to plan; 2. Gather feedback from the primary stakeholders on the quality of programme implementation. Here we present preliminary results from the PrAISED 2 process evaluation.

Methods
The process evaluation comprises two studies: 1. An implementation study, examining the extent to which the programme is being delivered according to plan, which investigates Fidelity (i.e. the consistency of what is implemented with the planned intervention), Adaptations (i.e. alterations made to achieve better contextual fit), Dose (i.e. how much intervention is delivered) and Reach (i.e. the extent to which agents come into contact with the intervention). 2. A study on the mechanisms of impact and context, gathering feedback on the quality of implementation thorugh qualitative interviews with participants with dementia and their carers (as dyads) and therapists delivering the intervention.

Results
The process evaluation is ongoing and results will be available in Autumn 2019.

Conclusion
Results from the PrAISED 2 process evaluation will: enable the identification of the active ingredients within the intervention and explain how they are exerting their effect; explain discrepancies between expected and observed outcomes; help to understand how context influences outcomes; provide crucial insights to aid implementation. Findings from this study will represent transferable knowledge for researchers interested in the mechanisms that affect the success of physical interventions for people with frailty.
50 Sociodemographic, Physical Performance and Fear of Falls Profile of Older Adult Fallers and Non Fallers: A Preliminary Study
Authors: Ibrahim Azianah , Hassan Nur Aimuni Abu , Hassan Halizahanim 
Published: December 2019

Abstract

Introduction
It is important to identify older adult fallers in order to implement early prevention management also prevent recurrent falls. This study aimed to explore the profiles of older adult fallers and non-fallers in regards to socio-demographic, physical performance, fear of falls that includes the activities that were feared in regard to falls.

Analysis
Descriptive and mean comparison test.

Methodology
Participants for this study were recruited among individuals aged 60 years and above, able to walk 3m, able to stand independently for longer than 1min and able to comprehend and follow instructions. Exclusion criteria include recent vertebral or lower limb fracture (less than 6months), unstable angina, unable to follow command and severe hearing and vision impairment. Design: Cross-sectional study.

Results
A number of 27 older adults were screened for falls. Based on Timed Up and Go test (cut off 11.18s), 8 (29.6%) of them were identified as fallers. Fallers were majority females (10, 37%), had visual impairment (4,14.8%), older (77.4±2.9years versus 68.4±5.7years) and had slightly higher in fear of falls score (13.2±5.5 versus 12.0±7.0). In view of physical performance, fallers were slower in Timed Up and Go test (13.6±2.4 versus 9.1±1.4), weaker in hand grip strength (14.3±2.5kg versus 21.5±19.3kg) and weaker in sit-to-stand performance (13.3±2.7s versus 10.7±2.7s). Age (p&lt;0.05) and sit-to-stand performance (p&lt;0.05) significantly differed between fallers and non-fallers. Among seven activities assessed using short Falls Efficacy Scale-International, non-fallers were found to have more fear during various activities compared to fallers.

Implication
Exploration of falls risk profiles in older adults will hopefully allow better understanding and further improvement in developing falls prevention management plans.
51 A Prospective Study on Falls Efficacy and Functional Outcomes after HIP Fracture Surgery in a Singapore Orthogeriatric Programme
Authors: Goh Kiat Sern , Serena Kiat Mun , Chandran Thulasi 
Published: December 2019

Abstract

Introduction
Fear of Falling (FoF) is common after hip fracture and associated with adverse outcomes including impaired functional recovery and recurrent falls. The objective of this study was to measure self-efficacy related to falls and its association with functional outcomes after hip fracture surgery.

Methods
A prospective cohort study was performed on 106 community-dwelling elderly aged ≥65 years without dementia, admitted to a community hospital for rehabilitation after surgery for fragility hip fracture in Singapore. They were managed in an integrated multidisciplinary orthogeriatric programme, transitioning from acute orthopaedic unit to the affiliated community hospital. Falls Efficacy Scale (FES; range 10-100) was assessed on discharge. Main outcomes measured included Parker Mobility Score (PMS) and Modified Barthel Index (MBI) at 3 months.

Results
Key characteristics of the cohort were: mean age 79.4(SD 6.38); female 74%, Chinese 83%, pre-fracture PMS 6.7(SD 2.7); pre-fracture MBI 81.1(SD 20.9); mean FES score 32.0(SD 23.7). At 3 months, mean PMS was 3.97(SD 2.51); mean MBI was 73(SD 20.1), demonstrating that the cohort overall did not regain their pre-morbid functional levels. FES was negatively correlated with both 3-month MBI and PMS with coefficients -0.592 and -0.523 respectively (p&lt;0.001). FES was negatively associated with 3-month MBI and PMS in the multiple linear regression model, having adjusted for demographics, comorbidities, pre-fracture MBI and PMS, MMSE, geriatric depression scale, and post-operative weight-bearing status, with corresponding βs -0.26(95%CI -0.49 to -0.02;p=0.032) and -0.03(95%CI -0.06 to -0.00;p=0.044).

Conclusion
FoF is a potentially modifiable factor linked to adverse functional outcomes in hip fracture rehabilitation, indicating the necessity to address falls self-efficacy as a major component of assessment and intervention, whilst further exploring the local validity and applicability of various instruments measuring FoF. Further studies need to be conducted on the evolving patterns of FoF over time and its impact on longer-term functional and psychosocial outcomes.