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4 Table 2 Physical functioning before and after the intervention Fig. 2 Changes in BMI Fig. 3 Changes in TUGT

1) Shumway-Cook A, Baldwin M, Polissar NL, Gruber W Predicting the probability for falls community-dwelling older adults. Phy Ther 1997 ; 77 : 812-819.

5 1) Shumway-Cook A, Baldwin M, Polissar NL, Gruber W Predicting the probability for falls community-dwelling older adults. Phy Ther 1997 ; 77 : ) Graafmans WC, Ooms ME, Hofstee HMA, Bezemer PD, Bouter LM, Lips P : Falls in the elderly : A prospective study of risk factors and risk profiles. Am J Epidemiol 1996 ; 143 : ) Koski K, Luukinen H, Laippala P, Kivela SL : Physiological factors and medications as predictors of injurious falls by elderly people : A prospective population-based study. Age and Ageing 1996 ; 25 : ) Nguyen TV, Eisman JA, Kelly PJ, Sambrook N : Risk factors for osteoporotic fractures in elderly men. Am J Epidemiol 1996 ; 144 : ) Tinetti ME, Mendes de Leon CF, Doucette JT, Doucette JT, Baker DI : Fear of falling and fall-related efficacy in relationship to functioning among community-living elders. J Gerontol Med Sci 1994 ; 49 : ) Myers AM, Powell LE, Maki BE, Holliday PJ, Brawley LR, Sherk W : Psychological indicators of balance confidence : relationship to actual and perceived abilities. J Gernntnl Merl Sri ) Yasumura S, Arai H, Haga H, Niino N, Nagai H, Suzuki T : Risk factors for falls among elderly people living in an

11) Tinetti ME, Baker DI, McAvay G, Claus EB, Garrett P, Gttschalk M, et al. : A multifactorial intervention to reduce the risk of falling among elderly people living in the community.

6 11) Tinetti ME, Baker DI, McAvay G, Claus EB, Garrett P, Gttschalk M, et al. : A multifactorial intervention to reduce the risk of falling among elderly people living in the community. NEJM 1994 ; 331 : ) Lord SR, Ward JA, Williams P, Strudwick M : The effect of a 12-month exercise trial on balance, strength, and falls in older women : a randomized controlled trial. J Am Geriatric Soc 1995 ; 43 : ) Yeasvage JA, Brink TL, Rose TL, Lum 0, Huang V, Adey M, et al. : Development and validation of a geriatric depression screening scale : a preliminary report. J Psychiatr Res 1982 ; 17 : ) Woo J, Ho SC, Sham A : Longitudinal changes in body mass index and body composition over 3 years and relationship to health outcomes in Hong Kong Chinese age 70 and older. J Am Geriatr Socl 2001 ; 49 : ) Allison DB, Zancolli R, Faith MS, Heo M, Pietrobelli A, Vanitallie TB, et al. : Weight loss increases and fat loss decreases all-cause mortality rate : results from two independent cohort studies. Int J Obes Relat Metab Disord 1999 ; 23 : ) Means KM, Rodell DE, 0' Sullivan PS, Cranford LA : Rehabilitation of elderly fallers : pilot study of a low to moderate intensity exercise program. Arch Phys Med rehabil 1996 ; 77 : ) Clark NM, Janz NK, Dodge JA : Changes in functional health status of older women with heart disease : Evaluation of a program based-on self-regulation. J Gerontol Soc Sci 2000 ; 55 : ) Tennstedt S, Howland J, Lachman M, Peterson E, Kasten L, Jette A : A randomized, controlled trial of a group intervention to reduce fear of falling and associated activity restriction in older adults. J Gerontol Psycho Sci 1998 ; 53 : Abstract Intervention study using a fall prevention program to prevent functional decline of old-old elderly in a rural community Yoshiharu Yokokawal), Ichiro Kai2), Yayoi Usui3), Fumitoshi Kosoda3), Taiki Furuta3) and Kazuki Konaka3) The purpose of this study was to determine the effects of a fall prevention program for old-old elderly in a rural community in Japan. The subjects were 71 inhabitants aged 75 and over who used community health and welfare services such as day services and social activity classes. They were divided into two groups : 34 in the experimental group, and 37 controls. Physical therapists and care staff instructed the experimental group in fall prevention exercises once per two weeks from December 2000 to March The control group utilized the usual services without any special instructions. All subjects were evaluated by physical performance tests and a self-administered questionnaire before and after 4 months following the intervention. Collected data were analyzed by two-way ANOVA using intervention and time as independent variables, and physical performance tests as dependent variables. Twenty-three of the experimental group and 26 of the control group completed both baseline and follow-up surveys. There were no significant differences in physical ability between the two groups at the time of the baseline survey. The experimental group showed excellent compliance and participated in all sessions during the intervention period. Interaction effects on body mass index and Timed Up and Go Test were shown to be significant (F = 5.623, P< 0.01 ; F = 6.541, P< 0.05). There were no changes in terms of other physical and psychological factors. Our results showed specific exercises could improve some aspects of physical performance. Since the group exercise program can be effective for old-old elderly, it might contribute to decreasing falls and prolong independent living. Key words : Falls, Old-old elderly, Physical activity, TUGT, BMI (Jpn J Geriat 2003 ; 40 : 47-52) 1) Department of Physical Therapy, Teikyo Medical Welfare College 2) School of Health Sciences and Nursing, University of Tokyo 3) Kakeyu Hospital Rehabilitation Center

Epidemiology and implications of falling among the elderly

Epidemiology and implications of falling among the elderly 3) Blake AJ, Morgan K, Bendall MJ : Falls by elderly people at home : prevalence and associated factors. Age Ageing 1988 ; 17 : 365-372.