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Falls

MedGen UID:
39084
Concept ID:
C0085639
Finding
Synonyms: [X]Falls; Fall; FALL
SNOMED CT: [X]Falls (1912002); Falls (161898004); Fall (1912002)
 
HPO: HP:0002527

Definition

A fall can change your life. If you're elderly, it can lead to disability and a loss of independence. If your bones are fragile from osteoporosis, you could break a bone, often a hip. But aging alone doesn't make people fall. Diabetes and heart disease affect balance. So do problems with circulation, thyroid or nervous systems. Some medicines make people dizzy. Eye problems or alcohol can be factors. Any of these things can make a fall more likely. Babies and young children are also at risk of falling - off of furniture and down stairs, for example. Falls and accidents seldom just happen. Taking care of your health by exercising and getting regular eye exams and physicals may help reduce your chance of falling. Getting rid of tripping hazards in your home and wearing nonskid shoes may also help. To reduce the chances of breaking a bone if you do fall, make sure that you get enough calcium and vitamin D. . NIH: National Institute on Aging.  [from MedlinePlus]

Conditions with this feature

Progressive supranuclear ophthalmoplegia
MedGen UID:
21026
Concept ID:
C0038868
Disease or Syndrome
The clinical manifestations of MAPT-related disorders (MAPT-related tauopathies) are most typically those of frontotemporal dementia (FTDP-17), but also include progressive supranuclear palsy (PSP), corticobasal degeneration (CBD), mild late-onset parkinsonism, and dementia with epilepsy. Clinical presentation of frontotemporal dementia (FTD) is variable: some present with slowly progressive behavioral changes, language disturbances, and/or extrapyramidal signs, whereas others present with rigidity, bradykinesia, supranuclear palsy, and saccadic eye movement disorders. Onset is usually between ages 40 and 60 years, but may be earlier or later. The disease progresses over a few years into profound dementia with mutism. PSP is characterized by progressive vertical gaze palsy in combination with a prominent loss of balance at early stages of the disease. With progression, axial rigidity, dysarthria, and dysphagia become prominent, often in combination with a frontal dysexecutive syndrome. CBD is a progressive neurodegenerative disorder which affects both the frontoparietal cortex and the basal ganglia, resulting in a mild to moderate dementia in combination with asymmetric parkinsonism, ideomotor apraxia, aphasia, and an alien-hand syndrome.
Supranuclear palsy, progressive, 2
MedGen UID:
324446
Concept ID:
C1836148
Disease or Syndrome
Progressive supranuclear palsy is a brain disorder that affects movement, vision, speech, and thinking ability (cognition). The signs and symptoms of this disorder usually become apparent in mid- to late adulthood, most often in a person's 60s. Most people with progressive supranuclear palsy survive 5 to 9 years after the disease first appears, although a few affected individuals have lived for more than a decade.Loss of balance and frequent falls are the most common early signs of progressive supranuclear palsy. Affected individuals have problems with walking, including poor coordination and an unsteady, lurching gait. Other movement abnormalities develop as the disease progresses, including unusually slow movements (bradykinesia), clumsiness, and stiffness of the trunk muscles. These problems worsen with time, and most affected people ultimately require wheelchair assistance.Progressive supranuclear palsy is also characterized by abnormal eye movements, which typically develop several years after the other movement problems first appear. Restricted up-and-down eye movement (vertical gaze palsy) is a hallmark of this disease. Other eye movement problems include difficulty opening and closing the eyelids, infrequent blinking, and pulling back (retraction) of the eyelids. These abnormalities can lead to blurred vision, an increased sensitivity to light (photophobia), and a staring gaze.Additional features of progressive supranuclear palsy include slow and slurred speech (dysarthria) and trouble swallowing (dysphagia). Most affected individuals also experience changes in personality and behavior, such as a general loss of interest and enthusiasm (apathy). They develop problems with cognition, including difficulties with attention, planning, and problem solving. As the cognitive and behavioral problems worsen, affected individuals increasingly require help with personal care and other activities of daily living.
Spastic ataxia Charlevoix-Saguenay type
MedGen UID:
338620
Concept ID:
C1849140
Disease or Syndrome
ARSACS (autosomal recessive spastic ataxia of Charlevoix-Saguenay) is characterized in individuals born in Quebec Province by early-onset (age 12-18 months) difficulty in walking and gait unsteadiness. In individuals with ARSACS born outside the Province of Quebec, onset is often delayed until later childhood and even adulthood. Ataxia, dysarthria, spasticity, extensor plantar reflexes, distal muscle wasting, a distal sensorimotor neuropathy predominant in the legs, and horizontal gaze-evoked nystagmus constitute the most frequent progressive neurologic signs. Increased demarcation of the retinal nerve fibers located near the vessels close to the optic disc (formerly designated as yellow streaks of hypermyelinated fibers) is very common in individuals with ARSACS who originate from Quebec but may be absent in non-Quebec born individuals. Individuals with ARSACS born in the Province of Quebec become wheelchair bound at the average age of 41 years; cognitive skills are preserved in the long term as individuals remain able to perform daily living tasks late into adulthood. Death commonly occurs in the sixth decade.
Leber congenital amaurosis 14
MedGen UID:
442375
Concept ID:
C2750063
Disease or Syndrome
Leber congenital amaurosis (LCA), a severe dystrophy of the retina, typically becomes evident in the first year of life. Visual function is usually poor and often accompanied by nystagmus, sluggish or near-absent pupillary responses, photophobia, high hyperopia, and keratoconus. Visual acuity is rarely better than 20/400. A characteristic finding is Franceschetti's oculo-digital sign, comprising eye poking, pressing, and rubbing. The appearance of the fundus is extremely variable. While the retina may initially appear normal, a pigmentary retinopathy reminiscent of retinitis pigmentosa is frequently observed later in childhood. The electroretinogram (ERG) is characteristically "nondetectable" or severely subnormal.
Myoclonus, familial cortical
MedGen UID:
761667
Concept ID:
C3539916
Disease or Syndrome
Familial cortical myoclonus is an autosomal dominant neurologic condition characterized by adult onset of cortical myoclonus manifest as involuntary jerks or movements affecting the face and limbs. Affected individuals can also experience falls without seizure activity or loss of consciousness (summary by Russell et al., 2012).

Recent clinical studies

Etiology

Wong H, Heuberger R, Logomarsino J, Hewlings S
Nurs Older People 2016 Feb;28(1):30-6. doi: 10.7748/nop.28.1.30.s22. PMID: 26938609
Hwang HF, Chen SJ, Lee-Hsieh J, Chien DK, Chen CY, Lin MR
J Am Geriatr Soc 2016 Mar;64(3):518-25. Epub 2016 Feb 11 doi: 10.1111/jgs.13952. [Epub ahead of print] PMID: 26865039
Bhangu J, McMahon CG, Hall P, Bennett K, Rice C, Crean P, Sutton R, Kenny RA
Heart 2016 May;102(9):681-6. Epub 2016 Jan 28 doi: 10.1136/heartjnl-2015-308706. [Epub ahead of print] PMID: 26822427
Lipsitz LA, Tchalla AE, Iloputaife I, Gagnon M, Dole K, Su ZZ, Klickstein L
J Am Geriatr Soc 2016 Feb;64(2):365-8. Epub 2016 Jan 19 doi: 10.1111/jgs.13708. [Epub ahead of print] PMID: 26783046
Cramer H, Sibbritt D, Adams J, Lauche R
Maturitas 2016 Feb;84:38-41. Epub 2015 Oct 28 doi: 10.1016/j.maturitas.2015.10.010. [Epub ahead of print] PMID: 26547236

Diagnosis

Bhangu J, McMahon CG, Hall P, Bennett K, Rice C, Crean P, Sutton R, Kenny RA
Heart 2016 May;102(9):681-6. Epub 2016 Jan 28 doi: 10.1136/heartjnl-2015-308706. [Epub ahead of print] PMID: 26822427
Lipsitz LA, Tchalla AE, Iloputaife I, Gagnon M, Dole K, Su ZZ, Klickstein L
J Am Geriatr Soc 2016 Feb;64(2):365-8. Epub 2016 Jan 19 doi: 10.1111/jgs.13708. [Epub ahead of print] PMID: 26783046
Prizer LP, Smith ML, Housman J, Ory MG
Aging Ment Health 2016;20(1):13-21. Epub 2015 Mar 20 doi: 10.1080/13607863.2015.1021748. [Epub ahead of print] PMID: 25793572
Clynes MA, Edwards MH, Buehring B, Dennison EM, Binkley N, Cooper C
Calcif Tissue Int 2015 Nov;97(5):445-52. Epub 2015 Jul 30 doi: 10.1007/s00223-015-0044-z. [Epub ahead of print] PMID: 26223791Free PMC Article
Bischoff-Ferrari HA, Orav JE, Kanis JA, Rizzoli R, Schlögl M, Staehelin HB, Willett WC, Dawson-Hughes B
Osteoporos Int 2015 Dec;26(12):2793-802. Epub 2015 Jun 12 doi: 10.1007/s00198-015-3194-y. [Epub ahead of print] PMID: 26068298

Therapy

Wong H, Heuberger R, Logomarsino J, Hewlings S
Nurs Older People 2016 Feb;28(1):30-6. doi: 10.7748/nop.28.1.30.s22. PMID: 26938609
Hwang HF, Chen SJ, Lee-Hsieh J, Chien DK, Chen CY, Lin MR
J Am Geriatr Soc 2016 Mar;64(3):518-25. Epub 2016 Feb 11 doi: 10.1111/jgs.13952. [Epub ahead of print] PMID: 26865039
Zia A, Kamaruzzaman S, Myint PK, Tan MP
Maturitas 2016 Feb;84:32-7. Epub 2015 Oct 23 doi: 10.1016/j.maturitas.2015.10.009. [Epub ahead of print] PMID: 26531071
Prizer LP, Smith ML, Housman J, Ory MG
Aging Ment Health 2016;20(1):13-21. Epub 2015 Mar 20 doi: 10.1080/13607863.2015.1021748. [Epub ahead of print] PMID: 25793572
Fu AS, Gao KL, Tung AK, Tsang WW, Kwan MM
Arch Phys Med Rehabil 2015 Dec;96(12):2096-102. Epub 2015 Sep 7 doi: 10.1016/j.apmr.2015.08.427. [Epub ahead of print] PMID: 26360975

Prognosis

Wong H, Heuberger R, Logomarsino J, Hewlings S
Nurs Older People 2016 Feb;28(1):30-6. doi: 10.7748/nop.28.1.30.s22. PMID: 26938609
Haines TP, Hill KD, Vu T, Clemson L, Finch CF, Day L
Arch Gerontol Geriatr 2016 May-Jun;64:151-61. Epub 2016 Feb 8 doi: 10.1016/j.archger.2016.02.003. [Epub ahead of print] PMID: 26900893
Fu AS, Gao KL, Tung AK, Tsang WW, Kwan MM
Arch Phys Med Rehabil 2015 Dec;96(12):2096-102. Epub 2015 Sep 7 doi: 10.1016/j.apmr.2015.08.427. [Epub ahead of print] PMID: 26360975
Bischoff-Ferrari HA, Orav JE, Kanis JA, Rizzoli R, Schlögl M, Staehelin HB, Willett WC, Dawson-Hughes B
Osteoporos Int 2015 Dec;26(12):2793-802. Epub 2015 Jun 12 doi: 10.1007/s00198-015-3194-y. [Epub ahead of print] PMID: 26068298
Mansfield A, Wong JS, McIlroy WE, Biasin L, Brunton K, Bayley M, Inness EL
Physiotherapy 2015 Dec;101(4):373-80. Epub 2015 Mar 25 doi: 10.1016/j.physio.2015.01.009. [Epub ahead of print] PMID: 26050134

Clinical prediction guides

Wong H, Heuberger R, Logomarsino J, Hewlings S
Nurs Older People 2016 Feb;28(1):30-6. doi: 10.7748/nop.28.1.30.s22. PMID: 26938609
Haines TP, Hill KD, Vu T, Clemson L, Finch CF, Day L
Arch Gerontol Geriatr 2016 May-Jun;64:151-61. Epub 2016 Feb 8 doi: 10.1016/j.archger.2016.02.003. [Epub ahead of print] PMID: 26900893
Bhangu J, McMahon CG, Hall P, Bennett K, Rice C, Crean P, Sutton R, Kenny RA
Heart 2016 May;102(9):681-6. Epub 2016 Jan 28 doi: 10.1136/heartjnl-2015-308706. [Epub ahead of print] PMID: 26822427
McKechnie D, Fisher MJ, Pryor J
J Clin Nurs 2016 Jan;25(1-2):213-22. Epub 2015 Dec 1 doi: 10.1111/jocn.13087. [Epub ahead of print] PMID: 26621788
Zia A, Kamaruzzaman S, Myint PK, Tan MP
Maturitas 2016 Feb;84:32-7. Epub 2015 Oct 23 doi: 10.1016/j.maturitas.2015.10.009. [Epub ahead of print] PMID: 26531071

Recent systematic reviews

Stubbs B, Stubbs J, Gnanaraj SD, Soundy A
Int Psychogeriatr 2016 Jan;28(1):23-9. Epub 2015 Aug 3 doi: 10.1017/S104161021500126X. [Epub ahead of print] PMID: 26234532
Teh RC, Mahajan N, Visvanathan R, Wilson A
Int J Evid Based Healthc 2015 Dec;13(4):213-23. doi: 10.1097/XEB.0000000000000029. PMID: 26630361
Park H, Satoh H, Miki A, Urushihara H, Sawada Y
Eur J Clin Pharmacol 2015 Dec;71(12):1429-40. Epub 2015 Sep 26 doi: 10.1007/s00228-015-1955-3. [Epub ahead of print] PMID: 26407688
Ambrose AF, Cruz L, Paul G
Maturitas 2015 Sep;82(1):85-93. Epub 2015 Jun 26 doi: 10.1016/j.maturitas.2015.06.035. [Epub ahead of print] PMID: 26255681
Gunn H, Markevics S, Haas B, Marsden J, Freeman J
Arch Phys Med Rehabil 2015 Oct;96(10):1898-912. Epub 2015 Jun 10 doi: 10.1016/j.apmr.2015.05.018. [Epub ahead of print] PMID: 26070975

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