Reduction of diuretics and analysis of water and muscle volumes to prevent falls and fall-related fractures in older adults
Autor: | Shigeko Katoh, Nanao Kamada, Masahiro Okada, Yumiko Yamaguchi, Hidemi Sasaki, Kosuke Okada, Katsuya Morita, Masayuki Kakehashi |
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Rok vydání: | 2016 |
Předmět: |
medicine.medical_specialty
Activities of daily living business.industry medicine.drug_class medicine.medical_treatment Body water Gerontological nursing 030204 cardiovascular system & hematology Loop diuretic medicine.disease 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine chemistry Heart failure Internal medicine Physical therapy Spironolactone Medicine 030212 general & internal medicine Diuretic business Bioelectrical impedance analysis |
Zdroj: | Geriatrics & Gerontology International. 17:262-269 |
ISSN: | 1444-1586 |
Popis: | AIM: In an attempt to decrease the incidence of falls and fall-related fractures at a special geriatric nursing home, we endeavored to reduce diuretic doses, and examined the relationship between the effectiveness of this approach with the body compositions and activities of daily living of the study cohort. METHODS: We enrolled 93 participants living in the community, 60 residents of an intermediate geriatric nursing home and 50 residents of the 100-bed Kandayama Yasuragien special geriatric nursing home. We recorded body composition using a multifrequency bioelectrical impedance analyzer. Daily loop diuretic and other diuretic regimens of those in the special geriatric nursing home were reduced or replaced with "NY-mode" diuretic therapy, namely, spironolactone 12.5 mg orally once on alternate days. RESULTS: The incidence of falls fell from 53 in 2011 to 29 in 2012, and there were no fall-related proximal femoral fractures for 3 years after the introduction of NY-mode diuretic therapy. We also found statistically significant differences in muscle and intracellular water volumes in our elderly participants: those with higher care requirements or lower levels of independence had lower muscle or water volumes. CONCLUSIONS: We found that reducing or replacing daily diuretics with NY-mode therapy appeared to reduce the incidence of falls and fall-related proximal femoral fracture, likely by preserving intracellular and extracellular body water volumes. Low-dose spironolactone (12.5 mg on alternate days) appears to be an effective means of treating elderly individuals with chronic heart failure or other edematous states, while preventing falls and fall-related fractures. Geriatr Gerontol Int 2016; ●●: ●●-●●. Language: en |
Databáze: | OpenAIRE |
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