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Fall Prevention and Geriatric Nursing
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Fall Prevention and Geriatric Nursing

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Preventive Medicine".

Deadline for manuscript submissions: 31 December 2025 | Viewed by 10124

Special Issue Editors

Dr. Cristina Lavareda Baixinho

E-Mail Website
Guest Editor
Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Community Nurse Department, Nursing School of Lisbon, 1900-160 Lisbon, Portugal
Interests: falls; transitional care; knowledge transfer; home security; musculoskeletal disorders
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Andreia Costa

E-Mail Website
Guest Editor
Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Community Nurse Department, Nursing School of Lisbon, 1900-160 Lisbon, Portugal
Interests: social prescribing; health literacy; healthy aging; complex interventions; falls
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Maria Adriana Henriques

E-Mail Website
Guest Editor
Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Community Nurse Department, Nursing School of Lisbon, 1900-160 Lisbon, Portugal
Interests: healthy aging; complex interventions; falls; community health interventions; public health interventions; fundamental care; chronic disease
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Falls are globally recognized as a public health problem for older persons due to the harmful consequences they have on functionality and quality of life, as well as increased resource consumption and healthcare costs.

A society with an increase in older people, many of them with various frailty factors, needs to rethink social, health and urban policies to enable healthy ageing. Fall prevention is above all an individual responsibility, but the low health literacy of this population, the emphasis of some health systems on secondary rather than primary prevention, the multidimensionality of risk and the complexity of some interventions make it difficult to reduce the prevalence, risk and fear of falling.

In this Special Issue, dedicated to Fall Prevention and Geriatric Nursing, we challenge nurses and other professionals to disseminate studies, systematic reviews and experience reports focused on new interventions for fall prevention in different contexts and the education and training of health professionals and caregivers to implement preventive measures and strategies to mitigate the fear of falling.

Dr. Cristina Lavareda Baixinho
Prof. Dr. Andreia Costa
Prof. Dr. Maria Adriana Henriques
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • accidental falls
  • aged
  • nursing
  • risk
  • health literacy
  • healthy ageing
  • complex interventions
  • health interventions
  • fundamental care
  • patient safety

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Published Papers (5 papers)

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Research

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11 pages, 263 KiB  
Article
One-Year Changes in Depressive Symptoms and Cognitive Function Among Brazilian Older Adults Attending Primary Care
by Fernanda Maria Silva Rivoli, Antonio Pedro Gabriel Monteiro Galhardo, Giancarlo Lucchetti, Lízia Abreu Esper, Yan Lyncon Ribeiro, Gerson de Souza Santos, Helena José, Luís Sousa, Gail Low and Luciano Magalhães Vitorino
Healthcare 2025, 13(7), 807; https://doi.org/10.3390/healthcare13070807 - 3 Apr 2025
Viewed by 316
Abstract
Background: Aging is a global phenomenon closely associated with changes in cognitive function and mental health. These conditions substantially burden public health systems and adversely affect the quality of life of older adults. This study aimed to examine changes in depressive symptoms [...] Read more.
Background: Aging is a global phenomenon closely associated with changes in cognitive function and mental health. These conditions substantially burden public health systems and adversely affect the quality of life of older adults. This study aimed to examine changes in depressive symptoms and cognitive function over a 12-month follow-up period in a cohort of Brazilian older adults attending primary care. Methods: This observational longitudinal study included a randomized sample of individuals aged ≥60 years residing in São Paulo, Brazil, and registered at a Primary Healthcare Unit (PHU). Data collection involved administering a sociodemographic and health questionnaire along with two validated instruments: the Geriatric Depression Scale-15 (GDS-15) and the Mini-Mental State Examination (MMSE). Linear regression models were used for the analyses. Results: A total of 368 older adults were included, with 63% being men and a mean age of 74.65 years. After one year, depressive symptoms showed a notable increase, with the mean GDS-15 score rising from 5.97 to 7.48 (Cohen-d = 0.542). Likewise, there was a decrease in the mean MMSE score ranging from 19.11 to 18.88 (Cohen-d = 0.216). Adjusted regression analyses revealed that depressive symptoms at baseline (B = 0.696; p = 0.048; R2 = 0.19) and cognitive function at baseline (B = 0.444; p < 0.001; R2 = 0.26) were predictive of their respective deteriorations over the follow-up period. Conclusions: Depressive symptoms and cognitive decline place a significant burden on public health systems in aging societies. These findings underscore the importance of continuous monitoring and early intervention strategies to mitigate their impact and enhance the quality of life for older adults. Full article
(This article belongs to the Special Issue Fall Prevention and Geriatric Nursing)
12 pages, 274 KiB  
Article
Association between Falls, Fear of Falling and Depressive Symptoms in Community-Dwelling Older Adults
by Maria Eduarda Armando Pereira, Gerson de Souza Santos, Clara Rabite de Almeida, Kethlyn Cristina Santos Nunes, Monalisa Claudia Maria da Silva, Helena José, Luís Sousa and Luciano Magalhães Vitorino
Healthcare 2024, 12(16), 1638; https://doi.org/10.3390/healthcare12161638 - 16 Aug 2024
Cited by 3 | Viewed by 2208
Abstract
Background: Longevity increases pose public health challenges, especially in managing falls and their psychological impacts on older adults. Limited evidence exists on the relationship between a fear of falling (FOF), previous falls, and depressive symptoms among community-dwelling older adults. Objective: To evaluate the [...] Read more.
Background: Longevity increases pose public health challenges, especially in managing falls and their psychological impacts on older adults. Limited evidence exists on the relationship between a fear of falling (FOF), previous falls, and depressive symptoms among community-dwelling older adults. Objective: To evaluate the association between falls, FOF, and depressive symptoms in community-dwelling older adults. Methods: This cross-sectional study, conducted in 2018, included 400 older adults from a Basic Health Unit in São Paulo, Brazil. The Geriatric Depression Scale (GDS-15) and the International Falls Efficacy Scale (FES-I) were used, along with self-report questionnaires on fall history. Linear and logistic regression were used to analyze the relationships between variables. Results: The mean age was 75.2 (SD = 8.53) years, with 63.2% being female. Depressive symptoms were observed in 18.3% of the participants, while 90.5% reported a fear of falling (FOF). More than half (63.0%) experienced falls, with 49.5% occurring in the last year. Factors such as the female gender, negative health perceptions, and functional dependence were associated with depressive symptoms. Adjusted analyses indicated that both a fear of falling (FOF) (B = 0.043; p = 0.012) and a history of falls (B = 0.725; p = 0.015) were associated with depressive symptoms. Conclusions: Falls, FOF, and depressive symptoms are interlinked among older adults, underscoring the need for targeted interventions to improve their mental and physical health. Full article
(This article belongs to the Special Issue Fall Prevention and Geriatric Nursing)
8 pages, 241 KiB  
Article
Association between Polypharmacy and Hospitalization among Older Adults Admitted to Emergency Departments for Falls in Guadeloupe: A Retrospective Cohort Study
by Nadine Simo-Tabue, Laurys Letchimy, Ludwig Mounsamy, Leila Rinaldo, Larissa Vainqueur, Marie-Josiane Ntsama-Essomba, Guillaume Mallet, Denis Boucaud-Maitre and Maturín Tabue Teguo
Healthcare 2024, 12(15), 1471; https://doi.org/10.3390/healthcare12151471 - 24 Jul 2024
Viewed by 1327
Abstract
Introduction: Falls are a common geriatric syndrome in older people. Falls are associated with adverse health events such as dependency, unplanned emergency admissions and death. This study aimed to identify the factors associated with fall severity, such as diabetes, hypertension, heart disease, cognitive [...] Read more.
Introduction: Falls are a common geriatric syndrome in older people. Falls are associated with adverse health events such as dependency, unplanned emergency admissions and death. This study aimed to identify the factors associated with fall severity, such as diabetes, hypertension, heart disease, cognitive decline and polypharmacy, as well as sociodemographic characteristics in patients aged 70 years and over admitted to the emergency department in Guadeloupe. Method: A single-center, observational, retrospective study of patients aged 70 years and over admitted to the emergency department (ED) of the University Hospital of Guadeloupe for a fall between 1 May 2018 and 30 April 2019 was conducted. Fall severity was defined as the need for hospitalization. Bivariate analysis was used to determine the associations between fall severity and sociodemographic characteristics, comorbidities, history of falls and polypharmacy (defined as the daily use of at least five drugs). Polypharmacy was analyzed as a binary variable (>5 drugs daily; yes or no) in categories (0–3 (ref.), 4–6, 7–9 and ≥10 drugs). Results: During the study period, 625 patients who attended the ED for a fall were included. The mean age was 82.6 ± 7.6 years, and 51.2% were women. Of these, 277 patients (44.3%) were admitted to the hospital, and 3 patients (0.5%) died. In the bivariate analysis, only polypharmacy was associated with hospitalization for a fall (OR: 1.63 [95% CI: 1.33–2.02]). The odds ratios for the polypharmacy categories were 1.46 [95% CI 0.99–2.14], 1.65 [1.09–2.50] and 1.48 [0.76–2.85] for 4–6, 7–9 and ≥10 drugs, respectively. Conclusions: Polypharmacy was associated with hospitalization as a proxy for fall severity. A regular review of drug prescriptions is essential to reduce polypharmacy in older adults. Full article
(This article belongs to the Special Issue Fall Prevention and Geriatric Nursing)
13 pages, 602 KiB  
Article
Predictive Validity of the Johns Hopkins Fall Risk Assessment Tool for Older Patients in Stroke Rehabilitation
by Seungho Hong, Ji-Sook Kim and Young-Ah Choi
Healthcare 2024, 12(7), 791; https://doi.org/10.3390/healthcare12070791 - 6 Apr 2024
Viewed by 3225
Abstract
The aim of this retrospective, cross-sectional, observational study was to assess the frequency of falls and evaluate the predictive validity of the Johns Hopkins Fall Risk Assessment Tool (JHFRAT) among patients aged ≥65 years, transferred to the rehabilitation ward of a university hospital. [...] Read more.
The aim of this retrospective, cross-sectional, observational study was to assess the frequency of falls and evaluate the predictive validity of the Johns Hopkins Fall Risk Assessment Tool (JHFRAT) among patients aged ≥65 years, transferred to the rehabilitation ward of a university hospital. The predictive ability was assessed using receiver operating characteristic curve analysis, and the optimal threshold was established using the Youden index. We analyzed the overall cohort (N = 175) with subacute stroke and the subgroup with a low unaffected handgrip strength (HGS; men: <28 kg, women: <18 kg). Overall, 135/175 patients (77.1%) had a low HGS. The fall rate was 6.9% overall and 5.9% for patients with a low HGS. The JHFRAT predictive value was higher for patients with a low HGS than that for the overall cohort, but acceptable in both. The optimal cutoff score for the overall cohort was 11 (sensitivity, 67%; specificity, 68%), whereas that for the subgroup was 12 (sensitivity, 75%; specificity: 72%). These results are expected to aid nurses working in rehabilitation wards in more effectively utilizing JHFRAT outcomes for post-stroke older patients with a low HGS and contribute to the development of more appropriate fall prevention strategies for high-risk patients in the future. Full article
(This article belongs to the Special Issue Fall Prevention and Geriatric Nursing)
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Review

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14 pages, 667 KiB  
Review
Fall Risk Assessment and Prevention Strategies in Nursing Homes: A Narrative Review
by Takeshi Miura and Yuka Kanoya
Healthcare 2025, 13(4), 357; https://doi.org/10.3390/healthcare13040357 - 7 Feb 2025
Viewed by 2221
Abstract
Abstract: Background/Objectives: Falls in nursing homes significantly affect residents’ health and quality of life. Although considerable progress has been made in fall prevention strategies in acute care settings and community environments, research on fall risk assessment methods and prevention strategies in nursing homes [...] Read more.
Abstract: Background/Objectives: Falls in nursing homes significantly affect residents’ health and quality of life. Although considerable progress has been made in fall prevention strategies in acute care settings and community environments, research on fall risk assessment methods and prevention strategies in nursing homes remains scarce. Nursing homes provide long-term care for residents with high levels of dependency, presenting unique challenges in managing fall risks. Nevertheless, unlike hospitals, nursing homes face operational constraints, such as limited resources and staffing. These factors necessitate a tailored approach to fall risk management. This study aimed to summarize the current knowledge of fall risk assessment and prevention methods in nursing homes, clarify practical insights for implementation, and identify research gaps based on studies published over the past five years. Methods: This narrative review targeted studies published between 2019 and 2024 on fall risk assessment and prevention methods in nursing homes. A literature search was conducted using the PubMed and CINAHL databases, combining keywords such as “Accident Prevention”, “Fall Risk Assessment”, “Nursing Homes”, “Long-Term Care”, and “Aged”. The inclusion criteria allowed the inclusion of peer-reviewed academic articles on fall risk assessment or prevention interventions in long-term care facilities published in English within the past five years. Studies focusing on community-dwelling older adults, hospitalized older adults, and review articles were excluded. Results: This review analyzed 55 studies; among them, 27 studies focused on fall risk assessment and 28 focused on fall prevention. Regarding fall risk assessment, widely used tools, such as the Morse Fall Scale, which is also utilized in medical settings, have been extensively examined. In addition, new predictive methods utilizing electronic health records (EHR) and wearable devices have been introduced. However, the limited number of reports highlights the potential challenges in developing indicators that consider the unique characteristics and feasibility of LTC facilities. Regarding fall prevention, studies have examined indirect approaches, such as environmental modifications, and direct interventions, such as exercise programs. Furthermore, staff education and organizational initiatives are crucial in implementing preventive measures. However, most studies have been conducted in experimental settings, with limited empirical research available to assess the practical applications of these strategies in real-world nursing home environments. Conclusions: Fall risk assessments in nursing homes lack practical indicators tailored to the specific characteristics of long-term care facilities. Although various digital technologies have been explored for fall prevention, empirical studies that validate their real-world applicability are lacking. Full article
(This article belongs to the Special Issue Fall Prevention and Geriatric Nursing)
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