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Last month Rob Morris from Queen’s Nottingham produced a succinct primer for oncologists on falls.
I’m going to attempt to reduce his 6 pages of wisdom to just 10 tweets https://www.clinicaloncologyonline.net/article/S0936-6555(20)30150-3/fulltext">https://www.clinicaloncologyonline.net/article/S...
I’m going to attempt to reduce his 6 pages of wisdom to just 10 tweets https://www.clinicaloncologyonline.net/article/S0936-6555(20)30150-3/fulltext">https://www.clinicaloncologyonline.net/article/S...
2. Falls are important.
The most common cause of accidental death in >75s
Each year 1 in 3 adults >65 will fall
20% of those who have fallen require medical attention
Incidence in older patients with cancer may be high as 50%
https://academic.oup.com/ageing/article/30/suppl_4/3/39672">https://academic.oup.com/ageing/ar...
The most common cause of accidental death in >75s
Each year 1 in 3 adults >65 will fall
20% of those who have fallen require medical attention
Incidence in older patients with cancer may be high as 50%
https://academic.oup.com/ageing/article/30/suppl_4/3/39672">https://academic.oup.com/ageing/ar...
3. Falls are an important part of geriatric syndromes where older adults are “vulnerable to situational changes and poor outcomes”
4. Older cancer patients are more likely to die in hospital after a fall than elders without cancer
https://pubmed.ncbi.nlm.nih.gov/25403592/
Falls">https://pubmed.ncbi.nlm.nih.gov/25403592/... have a negative impact on QoL for cancer survivors https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4871754/">https://www.ncbi.nlm.nih.gov/pmc/artic...
https://pubmed.ncbi.nlm.nih.gov/25403592/
Falls">https://pubmed.ncbi.nlm.nih.gov/25403592/... have a negative impact on QoL for cancer survivors https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4871754/">https://www.ncbi.nlm.nih.gov/pmc/artic...
5. We fall in part because we lose muscle (after age 30 muscle strength declines at rate of 3-8% every decade, accelerating to 10-15% after 50)
https://pubmed.ncbi.nlm.nih.gov/7825481/
Sarcopenia">https://pubmed.ncbi.nlm.nih.gov/7825481/&... may be present in up to 40% of cancer patients
https://pubmed.ncbi.nlm.nih.gov/28734552 ">https://pubmed.ncbi.nlm.nih.gov/28734552&...
https://pubmed.ncbi.nlm.nih.gov/7825481/
Sarcopenia">https://pubmed.ncbi.nlm.nih.gov/7825481/&... may be present in up to 40% of cancer patients
https://pubmed.ncbi.nlm.nih.gov/28734552 ">https://pubmed.ncbi.nlm.nih.gov/28734552&...
6. If patients fall then they will fear another fall – the post fall syndrome leading to inactivity (and ironically increased risk of falls)
https://pubmed.ncbi.nlm.nih.gov/8169336/ ">https://pubmed.ncbi.nlm.nih.gov/8169336/&...
https://pubmed.ncbi.nlm.nih.gov/8169336/ ">https://pubmed.ncbi.nlm.nih.gov/8169336/&...
7. Falls are more common in the presence of cognitive impairment
Orthostatic hypotension more common in dementia
Impairment of executive function (such as in ‘chemo brain’) also associated with increased falls risk https://pubmed.ncbi.nlm.nih.gov/23712088/ ">https://pubmed.ncbi.nlm.nih.gov/23712088/...
Orthostatic hypotension more common in dementia
Impairment of executive function (such as in ‘chemo brain’) also associated with increased falls risk https://pubmed.ncbi.nlm.nih.gov/23712088/ ">https://pubmed.ncbi.nlm.nih.gov/23712088/...
8. Peripheral neuropathy may affect over 20% of over 60s.
Falls are 2-3x more likely in those with chemo induced peripheral neuropathy https://ascopubs.org/doi/full/10.1200/jco.2016.71.3552">https://ascopubs.org/doi/full/...
Falls are 2-3x more likely in those with chemo induced peripheral neuropathy https://ascopubs.org/doi/full/10.1200/jco.2016.71.3552">https://ascopubs.org/doi/full/...
9. The (likely) most useful intervention to reduce/prevent falls in older adults is exercise although evidence of high quality is lacking (Cochrane review, 11RCTs only one on falls)
https://www.cochrane.org/CD011687/SYMPT_exercise-reducing-falls-people-living-and-beyond-cancer">https://www.cochrane.org/CD011687/...
https://www.cochrane.org/CD011687/SYMPT_exercise-reducing-falls-people-living-and-beyond-cancer">https://www.cochrane.org/CD011687/...
