Frailty Status and Increased Risk for Falls

Study Overview
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Brief Summary
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We hypothesized that the use of anticholinergic medications may precipitate falls differently by frailty status in older adults. Community-dwelling older subjects admitted to the Geriatrics Outpatient Clinic prospectively enter into the study. Frailty status is defined according to the Physical Frailty Phenotype. The drugs are categorized according to the ACB scale

Detailed Description
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Previous studies have found that the use of drugs with anticholinergic properties relate to increased prevalence of falls in older women and men. Frailty is associated with serious health outcomes including falls, hip fractures, and death. Frailty can be a relevant target to investigate its association with the risk of falls among the users of drugs with anticholinergic properties. A recent evidence suggests that the interaction between being frail and adverse outcomes in older adults receiving polypharmacy or centrally acting drugs is complex and not straightforward across all frailty phenotypes. We classify the participants frail if they met at least three of five criteria, while those having one or two criteria were pre-frail, and others were non-frail. We determine the anticholinergic burden by using the Anticholinergic Cognitive Burden (ACB) Scale developed by Boustani et al.

Official Title
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Frailty Status and Increased Risk for Falls: The Role of Anticholinergic Burden

Conditions
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Frailty, Fall, Anticholinergic Toxicity

Intervention / Treatment
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* Diagnostic Test: Fall assessment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Community-dwelling older adults Exclusion Criteria: a history of dementia, current delirium or psychotic symptoms, taking antipsychotic medications, being functionally dependent to others, difficulty in communicating with the interviewer, terminal illness, being bedridden or wheelchair bound (≥2 weeks), difficulty in standing or walking, incomplete data

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Fallers<br>Participants who reported one or more falls within the 12 months preceding the study consist the group of ''fallers''. | Diagnostic Test: Fall assessment<br>* Through a comprehensive geriatric assessment carried out by our geriatrician led multidisciplinary team we gather information about fall recalls consistent with the definition of landing on the floor or ground.<br>|
| Non-fallers<br>Participants with no fall history consist the group of ''non-fallers'' | Diagnostic Test: Fall assessment<br>* Through a comprehensive geriatric assessment carried out by our geriatrician led multidisciplinary team we gather information about fall recalls consistent with the definition of landing on the floor or ground.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Fall assessment | We will assess the association between anticholinergic burden (ACB) and falls based on frailty status among older adults. | 1-2 hours |