human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The eight FICSIT ( Frailty and Injuries : Cooperative Studies of Intervention Techniques ) sites test different intervention strategies in selected target groups of older adults . To compare the relative potential of these interventions to reduce frailty and fall-related injuries , all sites share certain descriptive ( risk-adjustment ) measures and outcome measures . This article describes the shared measures , which are referred to as the FICSIT Common Data Base ( CDB ) . The description is divided into four sections according to the four FICSIT committees responsible for the CDB : ( 1 ) psychosocial health and demographic measures ; ( 2 ) physical health measures ; ( 3 ) fall-related measures ; and ( 4 ) cost and cost-effectiveness measures . Because the structure of the FICSIT trial is unusual , the CDB should expedite secondary analyses of various research questions dealing with frailty and falls OBJECTIVES To test the hypothesis that scores on 4 falls risk measures  will differ significantly in patients reporting recurrent falls compared with those who do not ; and to explore the validity of each measure to predict such falls status . DESIGN A convenience sample was tested to establish the sensitivity and specificity of the  Functional Reach Test , Timed Up & Go test , one-leg stance test ( OLST )  , and  balance subsection of the Performance Oriented Mobility Assessment ( B-POMA ) . A 12-month retrospective falls history was used to identify recurrent fallers . SETTING A day hospital for the elderly . PARTICIPANTS Convenience sample of 30 day hospital patients . The inclusion criteria were : ability to rise from a chair and walk 6 m ; no severe cognitive impairment or blindness ; age 65 years or older . INTERVENTIONS Not applicable . MAIN OUTCOME MEASURES Scores on the 4 tests and retrospective falls histories . RESULTS Scores on the B-POMA and OLST showed significant differences between fallers and nonfallers ( P<.05 ) . An  OLST time of 1.02 seconds or less ( odds ratio [OR]=15.2 ; 95 % confidence interval [ CI ] , 1.72 - 133.95 ) and B-POMA score of 11 or less ( OR=18.5 ; 95 % CI , 2.05 - 167.79 ) were predictive of day hospital patients having a history of recurrent falls . CONCLUSIONS OLST and B-POMA both have potential as screening tools for risk of falls , but this observation requires confirmation in a prospect i ve study Objective To determine the efficacy of a targeted multifactorial falls prevention programme in elderly care wards with relatively short lengths of stay . Design Cluster r and omised trial . Setting 24 elderly care wards in 12 hospitals in Sydney , Australia . Participants 3999 patients , mean age 79 years , with a median hospital stay of seven days . Interventions A nurse and physiotherapist each worked for 25 hours a week for three months in all intervention wards . They provided a targeted multifactorial intervention that included a risk assessment of falls , staff and patient education , drug review , modification of bedside and ward environments , an exercise programme , and alarms for selected patients . Main outcome measure Falls during hospital stay . Results Intervention and control wards were similar at baseline for previous rates of falls and individual patient characteristics . Overall , 381 falls  occurred during the study . No difference was found in fall rates during follow-up between intervention and control wards : respectively , 9.26 falls per 1000 bed days and 9.20 falls per 1000 bed days ( P=0.96 ) . The incidence rate ratio adjusted for individual lengths of stay and previous fall rates in the ward was 0.96 ( 95 % confidence interval 0.72 to 1.28 ) . Conclusion A targeted multifactorial falls prevention programme was not effective among older people in hospital wards with relatively short lengths of stay . Trial registration Australian New Zeal and Clinical Trials Registry ACTRNO 12605000467639 BACKGROUND Executive function ( EF ) deficits may increase fall risk , even among older adults with no overt cognitive impairment . Indeed , the effects of dual tasking ( DT ) on gait , a challenge to executive control , are more exaggerated in persons with a history of falls . Prospect i ve evidence is , however , lacking . METHODS We prospect ively evaluated whether EF predicts falls over a 2-year period among 262 community-living , healthy , and well-functioning older adults , focusing on the 201 who reported no falls during the previous year . At baseline , participants completed a computerized cognitive battery that generated an index of EF and other cognitive domains .  Gait was assessed using performance-based tests and by quantifying walking during single- and dual-task conditions . RESULTS The 262 participants ( mean age : 76.3 ± 4.3 years , 60.3 % women ) had intact cognitive function on testing , a low comorbidity index , and good mobility . The EF index predicted future falls . Among those who reported no previous falls , participants in the worst EF quartile were three times more likely to fall during the 2 years of follow-up , and they were more likely to transition from nonfaller to faller sooner . DT gait variability also predicted future falls and multiple falls , whereas other measures of cognitive function , gait , and mobility did not . CONCLUSIONS Among healthy older adults , individuals with poorer EF are more prone to falls . Higher-level cognitive functions such as those regulated by the frontal lobes are apparently needed for safe everyday navigation that dem and s multitasking . Optimal screening , early detection , and treatment of falls should , apparently , also target this cognitive domain Background Falling is a common problem in the fast-growing elderly population .  Multitasking or engaging in two or more activities at the same time is common in daily living . Objective To determine the usefulness of the  trail-walking test ( TWT ) for predicting a fall in community-dwelling elderly individuals . Methods This was a prospect i ve study in which the TWT was used to evaluate the risk of falling among a group of community-dwelling elderly individuals ( n = 171 ) with a mean age of 80.5 ± 5.6 years . The following tests were conducted :  TWT , trail-making test ( TMT ) , timed-up- and -go test ( TUG ) , functional reach ( FR ) test , one-leg st and ing ( OLS ) test , and 10-m walking time test . Test – retest reliability was assessed by repeating the TWT within 2 weeks of the first trial , and there was a 1-year follow-up . Stepwise logistic regression analysis was used to analyze whether the TWT , TMT , TUG , FR , OLS , or 10-m walking tests predicted falling . Results The test – retest reliability  of TWT was high ( intraclass correlation coefficient 0.945 , p < 0.001 ) . Fifty-nine participants ( 34.5 % ) had reported a fall during the year preceding the 1-year follow-up . The stepwise logistic regression analysis revealed that only the TWT was significantly related to falling ( odds ratio 1.160 , 95 % confidence interval 1.107–1.214 ; p < 0.001 ) . In total , 77.8 % of cases were correctly classified . Conclusion When reliability and validity were considered , the TWT was most useful test of those evaluated for assessing the risk of fall among our elderly cohort OBJECTIVE To establish whether changes in a spoken verbal task performance while walking compared with being at rest could predict falls among older adults . DESIGN Prospect i ve cohort study of 12 months ' duration . SETTING Twenty-seven senior housing facilities . PARTICIPANTS Sample of 187 subjects aged 75 - 100 ( mean age 84.8 + /- 5.2 ) . During enrollment , participants were asked to count aloud backward from 50 , both at rest and while walking and were divided into two groups according to their counting performance . Information on incident falls during the follow-up year was monthly collected . MEASUREMENTS The number of enumerated figures while sitting on a chair and while walking  , and the first fall that occurred during the follow up year . RESULTS The number of enumerated figures under dual-task as compared to  single task  increased among 31.5 % of the tested subjects ( n = 59 ) and was associated with lower scores in MMSE ( P = 0.034 ) , and higher scores in Geriatric Depression Scale ( P = 0.007 ) and Timed Up & Go ( P = 0.005 ) . During the 12 months follow-up , 54 subjects ( 28.9 % ) fell . After adjusting for these variables , the increase in counting performance was significantly associated with falls ( adjusted OR = 53.3 , P < 0.0001 ) . Kaplan-Meier distributions of falls differed significantly between subjects who either increased or decreased their counting performance ( P < 0.0001 ) . CONCLUSIONS Faster counting while walking was strongly associated with falls , suggesting that better performance in an additional verbal counting task while walking might represent a new way to predict falls among older adults Background and aims The aim of this study was to describe the prevalence of falls  in a general older population , especially among the most elderly , and the risk markers associated with falls . Methods This is a cross-sectional study in which 38 fall risk markers were analysed in non- , occasional- and frequent-fallers . The population was 2,865 individuals ( aged 60–93 ) , r and omly selected from the general population register . The risk of falling was calculated as age-adjusted odds ratios . The relation between the number of risk markers  for an individual and falls was also analysed . Results About one in ten reported falling during the past 6 months , 35 % of which were over 90 years old . Twenty-one risk markers were significantly related to falls confirming falling as a multifactorial problem . These included a variety of diseases , symptoms , medical and physical functions , life-style factors and the taking of certain drugs . The five risk markers with the highest odds ratio in frequent fallers were ‘ tendency to fall ’ ( 37.9 ) , ‘ low walking speed ’ ( 12.8 ) , consumption of ‘ neuroleptics ’ ( 10.9 ) , ‘ impaired mobility ’ ( 10.0 ) and ‘ dementia ’ ( 5.4 ) . Subjects with more than four and seven risk markers showed a 9- respectively 28-fold increase in the risk of falling , especially among frequent fallers and those aged over 90 years . Conclusion Falls are common in the elderly population and the risk is multifactorial . The results imply that there is an overrepresentation of fallers in a distinct subgroup of the very elderly and those with multiple risk markers . The self-perceived clinical sign ‘ tendency to fall ’ seems highly sensitive as indicator of individuals at risk . Several risk markers may be treatable . Fall risk seems to increase in a non-linear , almost exponential way with increasing number of risk markers OBJECTIVES To compare the practicality , reliability , validity , and responsiveness of the timed up and go ( TUG ) , one-leg st and ( OLS ) , functional reach ( FR ) , and Tinetti balance ( TB ) performance measures in people aged 65 and older . DESIGN A prospect i ve study . SETTING Shin-Sher Township of Taichung County , west- central Taiwan . PARTICIPANTS Twelve hundred community-dwelling older people . MEASUREMENTS During an initial assessment at their residences , participants were interviewed for demographics , cognition , fall history , use of a walking aid , and activities of daily living ( ADLs )  , in addition to completing the four balance tests . Falls were ascertained by telephone every 3 months for a 1-year follow-up ; the four balance measures and ADLs were also reassessed at the end of the follow-up year . RESULTS Of the four balance measures , the OLS had the lowest participation rate , and participation of people who were cognitively impaired had fallen in the previous year , used a walking aid , or suffered from an ADL disability was lower than for their counterparts . The time to complete the tests ranged from 58 seconds for OLS , to 160 seconds for the TB . All four balance measures exhibited excellent test-retest reliability and discriminant validity but poor responsiveness to fall status . The TB showed better discriminant , convergent , and predictive validities and responsiveness to ADL changes than the other three tests . CONCLUSION According to psychometric properties , the most suitable performance measure for evaluating balance in community-dwelling older people was the TB , followed by the TUG OBJECTIVE To determine the accuracy of the Timed Up and Go Test ( TUGT ) for screening the risk of falls among community-dwelling elderly individuals . METHOD This is a prospect i ve cohort study with a r and omly by lots without reposition sample stratified by proportional partition in relation to gender involving 63 community-dwelling elderly individuals . Elderly individuals who reported having Parkinson 's disease , a history of transitory ischemic attack , stroke and with a Mini Mental State Exam lower than the expected for the education level , were on a wheelchair and that reported a single fall in the previous six months were excluded . The TUGT , a mobility test , was the measure of interested and the occurrence of falls was the outcome . The performance of basic activities of daily living ( ADL ) and instrumental activities of daily living ( IADL ) was determined through the Older American Re sources and Services , and the socio-demographic and clinical data were determined through the use of additional question naires . Receiver Operating Characteristic Curves were used to analyze the sensitivity and specificity of the TUGT . RESULTS Elderly individuals who fell had greater difficulties in ADL and IADL ( p<0.01 ) and a slower performance on the TUGT ( p=0.02 ) . No differences were found in socio-demographic and clinical characteristics between fallers and non-fallers . Considering the different sensitivity and specificity , the best predictive value for discriminating elderly individuals who fell was 12.47 seconds [ ( RR=3.2 ) 95%CI : 1.3 - 7.7 ] . CONCL 
    Output:
    
agent
Conclusion The Timed Up and Go test has limited ability to predict  falls in community dwelling elderly and should not be used in isolation to identify individuals at high risk of falls in this setting
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The eight FICSIT ( Frailty and Injuries : Cooperative Studies of Intervention Techniques ) sites test different intervention strategies in selected target groups of older adults . To compare the relative potential of these interventions to reduce frailty and fall-related injuries , all sites share certain descriptive ( risk-adjustment ) measures and outcome measures . This article describes the shared measures , which are referred to as the FICSIT Common Data Base ( CDB ) . The description is divided into four sections according to the four FICSIT committees responsible for the CDB : ( 1 ) psychosocial health and demographic measures ; ( 2 ) physical health measures ; ( 3 ) fall-related measures ; and ( 4 ) cost and cost-effectiveness measures . Because the structure of the FICSIT trial is unusual , the CDB should expedite secondary analyses of various research questions dealing with frailty and falls OBJECTIVES To test the hypothesis that scores on 4 falls risk measures  will differ significantly in patients reporting recurrent falls compared with those who do not ; and to explore the validity of each measure to predict such falls status . DESIGN A convenience sample was tested to establish the sensitivity and specificity of the  Functional Reach Test , Timed Up & Go test , one-leg stance test ( OLST )  , and  balance subsection of the Performance Oriented Mobility Assessment ( B-POMA ) . A 12-month retrospective falls history was used to identify recurrent fallers . SETTING A day hospital for the elderly . PARTICIPANTS Convenience sample of 30 day hospital patients . The inclusion criteria were : ability to rise from a chair and walk 6 m ; no severe cognitive impairment or blindness ; age 65 years or older . INTERVENTIONS Not applicable . MAIN OUTCOME MEASURES Scores on the 4 tests and retrospective falls histories . RESULTS Scores on the B-POMA and OLST showed significant differences between fallers and nonfallers ( P<.05 ) . An  OLST time of 1.02 seconds or less ( odds ratio [OR]=15.2 ; 95 % confidence interval [ CI ] , 1.72 - 133.95 ) and B-POMA score of 11 or less ( OR=18.5 ; 95 % CI , 2.05 - 167.79 ) were predictive of day hospital patients having a history of recurrent falls . CONCLUSIONS OLST and B-POMA both have potential as screening tools for risk of falls , but this observation requires confirmation in a prospect i ve study Objective To determine the efficacy of a targeted multifactorial falls prevention programme in elderly care wards with relatively short lengths of stay . Design Cluster r and omised trial . Setting 24 elderly care wards in 12 hospitals in Sydney , Australia . Participants 3999 patients , mean age 79 years , with a median hospital stay of seven days . Interventions A nurse and physiotherapist each worked for 25 hours a week for three months in all intervention wards . They provided a targeted multifactorial intervention that included a risk assessment of falls , staff and patient education , drug review , modification of bedside and ward environments , an exercise programme , and alarms for selected patients . Main outcome measure Falls during hospital stay . Results Intervention and control wards were similar at baseline for previous rates of falls and individual patient characteristics . Overall , 381 falls  occurred during the study . No difference was found in fall rates during follow-up between intervention and control wards : respectively , 9.26 falls per 1000 bed days and 9.20 falls per 1000 bed days ( P=0.96 ) . The incidence rate ratio adjusted for individual lengths of stay and previous fall rates in the ward was 0.96 ( 95 % confidence interval 0.72 to 1.28 ) . Conclusion A targeted multifactorial falls prevention programme was not effective among older people in hospital wards with relatively short lengths of stay . Trial registration Australian New Zeal and Clinical Trials Registry ACTRNO 12605000467639 BACKGROUND Executive function ( EF ) deficits may increase fall risk , even among older adults with no overt cognitive impairment . Indeed , the effects of dual tasking ( DT ) on gait , a challenge to executive control , are more exaggerated in persons with a history of falls . Prospect i ve evidence is , however , lacking . METHODS We prospect ively evaluated whether EF predicts falls over a 2-year period among 262 community-living , healthy , and well-functioning older adults , focusing on the 201 who reported no falls during the previous year . At baseline , participants completed a computerized cognitive battery that generated an index of EF and other cognitive domains .  Gait was assessed using performance-based tests and by quantifying walking during single- and dual-task conditions . RESULTS The 262 participants ( mean age : 76.3 ± 4.3 years , 60.3 % women ) had intact cognitive function on testing , a low comorbidity index , and good mobility . The EF index predicted future falls . Among those who reported no previous falls , participants in the worst EF quartile were three times more likely to fall during the 2 years of follow-up , and they were more likely to transition from nonfaller to faller sooner . DT gait variability also predicted future falls and multiple falls , whereas other measures of cognitive function , gait , and mobility did not . CONCLUSIONS Among healthy older adults , individuals with poorer EF are more prone to falls . Higher-level cognitive functions such as those regulated by the frontal lobes are apparently needed for safe everyday navigation that dem and s multitasking . Optimal screening , early detection , and treatment of falls should , apparently , also target this cognitive domain Background Falling is a common problem in the fast-growing elderly population .  Multitasking or engaging in two or more activities at the same time is common in daily living . Objective To determine the usefulness of the  trail-walking test ( TWT ) for predicting a fall in community-dwelling elderly individuals . Methods This was a prospect i ve study in which the TWT was used to evaluate the risk of falling among a group of community-dwelling elderly individuals ( n = 171 ) with a mean age of 80.5 ± 5.6 years . The following tests were conducted :  TWT , trail-making test ( TMT ) , timed-up- and -go test ( TUG ) , functional reach ( FR ) test , one-leg st and ing ( OLS ) test , and 10-m walking time test . Test – retest reliability was assessed by repeating the TWT within 2 weeks of the first trial , and there was a 1-year follow-up . Stepwise logistic regression analysis was used to analyze whether the TWT , TMT , TUG , FR , OLS , or 10-m walking tests predicted falling . Results The test – retest reliability  of TWT was high ( intraclass correlation coefficient 0.945 , p < 0.001 ) . Fifty-nine participants ( 34.5 % ) had reported a fall during the year preceding the 1-year follow-up . The stepwise logistic regression analysis revealed that only the TWT was significantly related to falling ( odds ratio 1.160 , 95 % confidence interval 1.107–1.214 ; p < 0.001 ) . In total , 77.8 % of cases were correctly classified . Conclusion When reliability and validity were considered , the TWT was most useful test of those evaluated for assessing the risk of fall among our elderly cohort OBJECTIVE To establish whether changes in a spoken verbal task performance while walking compared with being at rest could predict falls among older adults . DESIGN Prospect i ve cohort study of 12 months ' duration . SETTING Twenty-seven senior housing facilities . PARTICIPANTS Sample of 187 subjects aged 75 - 100 ( mean age 84.8 + /- 5.2 ) . During enrollment , participants were asked to count aloud backward from 50 , both at rest and while walking and were divided into two groups according to their counting performance . Information on incident falls during the follow-up year was monthly collected . MEASUREMENTS The number of enumerated figures while sitting on a chair and while walking  , and the first fall that occurred during the follow up year . RESULTS The number of enumerated figures under dual-task as compared to  single task  increased among 31.5 % of the tested subjects ( n = 59 ) and was associated with lower scores in MMSE ( P = 0.034 ) , and higher scores in Geriatric Depression Scale ( P = 0.007 ) and Timed Up & Go ( P = 0.005 ) . During the 12 months follow-up , 54 subjects ( 28.9 % ) fell . After adjusting for these variables , the increase in counting performance was significantly associated with falls ( adjusted OR = 53.3 , P < 0.0001 ) . Kaplan-Meier distributions of falls differed significantly between subjects who either increased or decreased their counting performance ( P < 0.0001 ) . CONCLUSIONS Faster counting while walking was strongly associated with falls , suggesting that better performance in an additional verbal counting task while walking might represent a new way to predict falls among older adults Background and aims The aim of this study was to describe the prevalence of falls  in a general older population , especially among the most elderly , and the risk markers associated with falls . Methods This is a cross-sectional study in which 38 fall risk markers were analysed in non- , occasional- and frequent-fallers . The population was 2,865 individuals ( aged 60–93 ) , r and omly selected from the general population register . The risk of falling was calculated as age-adjusted odds ratios . The relation between the number of risk markers  for an individual and falls was also analysed . Results About one in ten reported falling during the past 6 months , 35 % of which were over 90 years old . Twenty-one risk markers were significantly related to falls confirming falling as a multifactorial problem . These included a variety of diseases , symptoms , medical and physical functions , life-style factors and the taking of certain drugs . The five risk markers with the highest odds ratio in frequent fallers were ‘ tendency to fall ’ ( 37.9 ) , ‘ low walking speed ’ ( 12.8 ) , consumption of ‘ neuroleptics ’ ( 10.9 ) , ‘ impaired mobility ’ ( 10.0 ) and ‘ dementia ’ ( 5.4 ) . Subjects with more than four and seven risk markers showed a 9- respectively 28-fold increase in the risk of falling , especially among frequent fallers and those aged over 90 years . Conclusion Falls are common in the elderly population and the risk is multifactorial . The results imply that there is an overrepresentation of fallers in a distinct subgroup of the very elderly and those with multiple risk markers . The self-perceived clinical sign ‘ tendency to fall ’ seems highly sensitive as indicator of individuals at risk . Several risk markers may be treatable . Fall risk seems to increase in a non-linear , almost exponential way with increasing number of risk markers OBJECTIVES To compare the practicality , reliability , validity , and responsiveness of the timed up and go ( TUG ) , one-leg st and ( OLS ) , functional reach ( FR ) , and Tinetti balance ( TB ) performance measures in people aged 65 and older . DESIGN A prospect i ve study . SETTING Shin-Sher Township of Taichung County , west- central Taiwan . PARTICIPANTS Twelve hundred community-dwelling older people . MEASUREMENTS During an initial assessment at their residences , participants were interviewed for demographics , cognition , fall history , use of a walking aid , and activities of daily living ( ADLs )  , in addition to completing the four balance tests . Falls were ascertained by telephone every 3 months for a 1-year follow-up ; the four balance measures and ADLs were also reassessed at the end of the follow-up year . RESULTS Of the four balance measures , the OLS had the lowest participation rate , and participation of people who were cognitively impaired had fallen in the previous year , used a walking aid , or suffered from an ADL disability was lower than for their counterparts . The time to complete the tests ranged from 58 seconds for OLS , to 160 seconds for the TB . All four balance measures exhibited excellent test-retest reliability and discriminant validity but poor responsiveness to fall status . The TB showed better discriminant , convergent , and predictive validities and responsiveness to ADL changes than the other three tests . CONCLUSION According to psychometric properties , the most suitable performance measure for evaluating balance in community-dwelling older people was the TB , followed by the TUG OBJECTIVE To determine the accuracy of the Timed Up and Go Test ( TUGT ) for screening the risk of falls among community-dwelling elderly individuals . METHOD This is a prospect i ve cohort study with a r and omly by lots without reposition sample stratified by proportional partition in relation to gender involving 63 community-dwelling elderly individuals . Elderly individuals who reported having Parkinson 's disease , a history of transitory ischemic attack , stroke and with a Mini Mental State Exam lower than the expected for the education level , were on a wheelchair and that reported a single fall in the previous six months were excluded . The TUGT , a mobility test , was the measure of interested and the occurrence of falls was the outcome . The performance of basic activities of daily living ( ADL ) and instrumental activities of daily living ( IADL ) was determined through the Older American Re sources and Services , and the socio-demographic and clinical data were determined through the use of additional question naires . Receiver Operating Characteristic Curves were used to analyze the sensitivity and specificity of the TUGT . RESULTS Elderly individuals who fell had greater difficulties in ADL and IADL ( p<0.01 ) and a slower performance on the TUGT ( p=0.02 ) . No differences were found in socio-demographic and clinical characteristics between fallers and non-fallers . Considering the different sensitivity and specificity , the best predictive value for discriminating elderly individuals who fell was 12.47 seconds [ ( RR=3.2 ) 95%CI : 1.3 - 7.7 ] . CONCL 
    Output:
    