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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 signs and symptoms 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.
RETINAL DYSTROPHY, EARLY-ONSET SEVERE, LRAT-RELATED
MedGen UID:
412868
Concept ID:
C2750064
Disease or Syndrome
RETINITIS PIGMENTOSA, JUVENILE, LRAT-RELATED
MedGen UID:
442376
Concept ID:
C2750065
Disease or Syndrome
MYOCLONUS, FAMILIAL CORTICAL
MedGen UID:
761667
Concept ID:
C3539916
Disease or Syndrome

Recent clinical studies

Etiology

Barker W
Nurs Older People 2014 Jul;26(6):18-24. doi: 10.7748/nop.26.6.18.e586. PMID: 24975078
Sarter M, Albin RL, Kucinski A, Lustig C
Exp Neurol 2014 Jul;257:120-9. Epub 2014 May 5 doi: 10.1016/j.expneurol.2014.04.032. [Epub ahead of print] PMID: 24805070
Rafiq M, McGovern A, Jones S, Harris K, Tomson C, Gallagher H, de Lusignan S
J Clin Epidemiol 2014 Aug;67(8):877-86. Epub 2014 Apr 29 doi: 10.1016/j.jclinepi.2014.03.008. [Epub ahead of print] PMID: 24786593
Taylor ME, Delbaere K, Lord SR, Mikolaizak AS, Brodaty H, Close JC
J Gerontol A Biol Sci Med Sci 2014 Aug;69(8):987-95. Epub 2013 Oct 22 doi: 10.1093/gerona/glt166. [Epub ahead of print] PMID: 24149433
Murphy MP, Carmine H, Kolakowsky-Hayner S
Rehabil Nurs 2014 May-Jun;39(3):113-22. Epub 2013 May 29 doi: 10.1002/rnj.89. [Epub ahead of print] PMID: 23720011

Diagnosis

Rafiq M, McGovern A, Jones S, Harris K, Tomson C, Gallagher H, de Lusignan S
J Clin Epidemiol 2014 Aug;67(8):877-86. Epub 2014 Apr 29 doi: 10.1016/j.jclinepi.2014.03.008. [Epub ahead of print] PMID: 24786593
Barbour KE, Stevens JA, Helmick CG, Luo YH, Murphy LB, Hootman JM, Theis K, Anderson LA, Baker NA, Sugerman DE; Centers for Disease Control and Prevention (CDC)
MMWR Morb Mortal Wkly Rep 2014 May 2;63(17):379-83. PMID: 24785984
To KG, Meuleners LB, Fraser ML, Do DV, Duong DV, Huynh VA, To QG, Phi TD, Tran HH, Nguyen ND
Ophthalmic Epidemiol 2014 Apr;21(2):79-85. Epub 2014 Feb 25 doi: 10.3109/09286586.2014.885058. [Epub ahead of print] PMID: 24568591
Aziz O, Park EJ, Mori G, Robinovitch SN
Gait Posture 2014;39(1):506-12. Epub 2013 Sep 23 doi: 10.1016/j.gaitpost.2013.08.034. [Epub ahead of print] PMID: 24148648
Gunn H, Creanor S, Haas B, Marsden J, Freeman J
Arch Phys Med Rehabil 2014 Mar;95(3):538-45. Epub 2013 Sep 18 doi: 10.1016/j.apmr.2013.08.244. [Epub ahead of print] PMID: 24055784

Therapy

Rafiq M, McGovern A, Jones S, Harris K, Tomson C, Gallagher H, de Lusignan S
J Clin Epidemiol 2014 Aug;67(8):877-86. Epub 2014 Apr 29 doi: 10.1016/j.jclinepi.2014.03.008. [Epub ahead of print] PMID: 24786593
Stone KL, Blackwell TL, Ancoli-Israel S, Cauley JA, Redline S, Marshall LM, Ensrud KE; Osteoporotic Fractures in Men Study Group
J Am Geriatr Soc 2014 Feb;62(2):299-305. Epub 2014 Jan 15 doi: 10.1111/jgs.12649. [Epub ahead of print] PMID: 24428306Free PMC Article
Yip JL, Khawaja AP, Broadway D, Luben R, Hayat S, Dalzell N, Bhaniani A, Wareham N, Khaw KT, Foster PJ
Br J Ophthalmol 2014 Mar;98(3):377-82. Epub 2013 Dec 12 doi: 10.1136/bjophthalmol-2013-304179. [Epub ahead of print] PMID: 24338086Free PMC Article
Muhaidat J, Kerr A, Evans JJ, Pilling M, Skelton DA
Arch Phys Med Rehabil 2014 Jan;95(1):58-64. Epub 2013 Sep 23 doi: 10.1016/j.apmr.2013.07.027. [Epub ahead of print] PMID: 24071555
Mille ML, Johnson-Hilliard M, Martinez KM, Zhang Y, Edwards BJ, Rogers MW
J Gerontol A Biol Sci Med Sci 2013 Dec;68(12):1540-8. Epub 2013 May 17 doi: 10.1093/gerona/glt062. [Epub ahead of print] PMID: 23685768Free PMC Article

Prognosis

Sarter M, Albin RL, Kucinski A, Lustig C
Exp Neurol 2014 Jul;257:120-9. Epub 2014 May 5 doi: 10.1016/j.expneurol.2014.04.032. [Epub ahead of print] PMID: 24805070
Rafiq M, McGovern A, Jones S, Harris K, Tomson C, Gallagher H, de Lusignan S
J Clin Epidemiol 2014 Aug;67(8):877-86. Epub 2014 Apr 29 doi: 10.1016/j.jclinepi.2014.03.008. [Epub ahead of print] PMID: 24786593
Stone KL, Blackwell TL, Ancoli-Israel S, Cauley JA, Redline S, Marshall LM, Ensrud KE; Osteoporotic Fractures in Men Study Group
J Am Geriatr Soc 2014 Feb;62(2):299-305. Epub 2014 Jan 15 doi: 10.1111/jgs.12649. [Epub ahead of print] PMID: 24428306Free PMC Article
Tiernan C, Lysack C, Neufeld S, Goldberg A, Lichtenberg PA
Arch Gerontol Geriatr 2014 Jan-Feb;58(1):88-94. Epub 2013 Aug 23 doi: 10.1016/j.archger.2013.08.005. [Epub ahead of print] PMID: 24063870Free PMC Article
Gunn H, Creanor S, Haas B, Marsden J, Freeman J
Arch Phys Med Rehabil 2014 Mar;95(3):538-45. Epub 2013 Sep 18 doi: 10.1016/j.apmr.2013.08.244. [Epub ahead of print] PMID: 24055784

Clinical prediction guides

Sarter M, Albin RL, Kucinski A, Lustig C
Exp Neurol 2014 Jul;257:120-9. Epub 2014 May 5 doi: 10.1016/j.expneurol.2014.04.032. [Epub ahead of print] PMID: 24805070
Rafiq M, McGovern A, Jones S, Harris K, Tomson C, Gallagher H, de Lusignan S
J Clin Epidemiol 2014 Aug;67(8):877-86. Epub 2014 Apr 29 doi: 10.1016/j.jclinepi.2014.03.008. [Epub ahead of print] PMID: 24786593
Stone KL, Blackwell TL, Ancoli-Israel S, Cauley JA, Redline S, Marshall LM, Ensrud KE; Osteoporotic Fractures in Men Study Group
J Am Geriatr Soc 2014 Feb;62(2):299-305. Epub 2014 Jan 15 doi: 10.1111/jgs.12649. [Epub ahead of print] PMID: 24428306Free PMC Article
Taylor ME, Delbaere K, Lord SR, Mikolaizak AS, Brodaty H, Close JC
J Gerontol A Biol Sci Med Sci 2014 Aug;69(8):987-95. Epub 2013 Oct 22 doi: 10.1093/gerona/glt166. [Epub ahead of print] PMID: 24149433
Stenhagen M, Ekström H, Nordell E, Elmståhl S
Arch Gerontol Geriatr 2014 Jan-Feb;58(1):95-100. Epub 2013 Aug 8 doi: 10.1016/j.archger.2013.07.006. [Epub ahead of print] PMID: 23993268

Recent systematic reviews

Stubbs B, Binnekade T, Eggermont L, Sepehry AA, Patchay S, Schofield P
Arch Phys Med Rehabil 2014 Jan;95(1):175-187.e9. Epub 2013 Sep 10 doi: 10.1016/j.apmr.2013.08.241. [Epub ahead of print] PMID: 24036161
Batchelor FA, Dow B, Low MA
Australas J Ageing 2013 Dec;32(4):211-6. Epub 2013 Jun 4 doi: 10.1111/ajag.12047. [Epub ahead of print] PMID: 24373039
Young B, Wynn PM, He Z, Kendrick D
Accid Anal Prev 2013 Nov;60:158-71. Epub 2013 Aug 16 doi: 10.1016/j.aap.2013.08.001. [Epub ahead of print] PMID: 24080473
Silva RB, Eslick GD, Duque G
J Am Med Dir Assoc 2013 Sep;14(9):685-9.e2. Epub 2013 Jul 13 doi: 10.1016/j.jamda.2013.05.015. [Epub ahead of print] PMID: 23860265
Zijlstra GA, van Haastregt JC, Du Moulin MF, de Jonge MC, van der Poel A, Kempen GI
Gerontologist 2013 Oct;53(5):839-49. Epub 2012 Nov 6 doi: 10.1093/geront/gns142. [Epub ahead of print] PMID: 23135419

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