爱豆传媒

Fall-related hip fractures are among the most sinister outcomes of falls in elderly populations, causing detrimental effects on functional capacity and independence, and leading to mortality. To understand the complexity of circumstances surrounding falls that lead to fractures, examination with a comprehensive and multidisciplinary approach is needed. In this study, we collaborated with specialists in medicine, architecture, urban engineering, and welfare engineering, with an aim to explore the mechanism of falls by examining ［1］ intrinsic factors (decline in muscular strength and capacity to maintain balance), ［2］ environmental characteristics of fall-related fractures (location of the fall, surrounding circumstances) and ［3］ movement leading to the fall. Findings of our comprehensive investigation help suggest strategies for fall prevention and reduction of fracture incidence. Moreover, we proposed designs of living environments to sustain life after fractures and prevent post-fall home confinement.

　In 2014, a cross-sectional survey was conducted, and self-administered questionnaires were distributed to 15,000 community-dwelling adults in Japan. We assessed characteristics of falls and fall-related fractures in the last 3 years based on physical factors (age, sex, history of diseases) and environmental factors (house type and barrier-free housing). In September 2016, bedside interviews were conducted with patients hospitalized as emergency cases for femoral fractures caused by falling. Through semi-structured interviews, details of circumstances of the event of the fall (e.g., location, time, history of previous falls), home environment, physical abilities, and daily motions were assessed. Medical records were reviewed for background diseases and medication. At 6-9 months after bedside interviews, home-visit interviews were conducted to examine the site of falls and environmental hazards, along with comparisons of photographs of the house and floor plans. Recently, we found that multiple turns are critical movements for falls/femoral fractures related to toilets, and that tracking movement on a photograph and floor plan of the home may be a feasible method to assess turning in the living environment.

　Through such action research, we provided suggestions for fall prevention and further sustainable home designs to facilitate successful elderly lives.

- Takehiro Matsubara Department of Orthopaedic Surgery, Graduate School of Medicine, The University of Tokyo

Article(pre-reviewed)
- [1] Son BK, Akishita M, Uchiyama E, Imaeda S, Taniguchi S, Sumikawa Y, Unyaporn S, Matsubara T, Tanaka S, Tanaka T, Otsuki T, Okata J, Iijima K. Multiple turns: potential risk factor for falls on the way to the toilet. Geriatr Gerontol Int 12:1293-1295, 2019 doi: 10.1111/ggi.13806.
- [2] Uchiyama E, Takano W, Nakamura Y, Son BK, Imaeda S, Tanaka T, Iijima K, Matsubara T. Constructing a fall risk classifier by statistical normalization of questionnaire results. The 37th annual conference of the Robotics Society of Japan (RSJ2019) 2019.9.3-7.
- [3] Imaeda S, Son BK, Uchiyama E, Tanaka T, Taniguchi, Unyaporn S, Miyoshi T, Nishino A, Tanaka T, Iijima K, Tanaka S, Matsubara T, Nishide K, Otsuki T. Combined Bedside and Home-Visit Interview Clarifies Exact Fall Situations Causing Femoral Fracture. AIJ Proceedings of the Housing Studies Symposium 2018, Vol.13, pp.65-70.
- [4] Imaeda S, Son BK, Uchiyama E, Tanaka T, Taniguchi S, Unyaporn S, Miyoshi Y, Tanaka T, Iijima K, Otsuki T. The Architectural Factors in Continuity of Living for the Elderly After Falls and Fractures. The 12th International Symposium on Architectural Interchanges in Asia, 420-424, 2018.
- [5] Tanaka T, Matsumoto H, Son BK, Imaeda S, Uchiyama E, Taniguchi S, Nishino A, Miura T, Tanaka T, Otsuki T, Nishide K, Iijima K, Okata J. Environmental and physical factors predisposing middle-aged and older Japanese adults to falls and fall-related fractures in the home. Geriatr Gerontol Int 18:1372-1377, 2018.
- [6] Imaeda S, Uchiyama E, Tanaka T, Taniguchi S, Kim KM, Choki M, Takada R, Miura T, Son BK, Nishino A, Tanaka T, Iijima K, Nishide K, Otsuki T. Modeling of Fall-Mechanism Based on Actual Conditions of Falls for the Elderly Living in Their Residence - A Qualitative Study in Bunkyo Ward, Yokohama City and Kashiwa City― AIJ Proceedings of the Housing Studies Symposium 2017, Vol.12, pp.217-226, 2017.12.
- Academic conference presentation
- [1] Son BK, Uchiyama E, Imaeda S, Sumikawa Y, Baba J, Unyaporn S, Matsubara T, Akishita M, Otsuki T, Tanaka T, Iijima K. Importance of turns by investigation the movement leading to falls in elderly persons who had experienced femoral fracture on the way to the toilet. 6th scientific conference, The Japanese Society for Fall Prevention. 2019.11.9-10.
- [2] Son BK, Uchiyama E, Imaeda S, Taniguchi S, Tanaka T, Sumikawa Y, Baba J, Unyaporn S, Matsubara T, Akishita M, Otsuki T, Tanaka T, Iijima K. Characteristics of the movement leading to fall/ hip fracture in the elderly by multidisciplinary examination 6th scientific conference, The Japanese Society for Fall Prevention. 2019.10.5-6.
- [3] Imaeda S, Son BK, Uchiyama E, Taniguchi S, Unyaporn S, Baba J, Sumikawa Y, Tanaka T, Tanaka T, Iijima K, Matsubara T, Otsuki T. Changes in Residential Environment of Elderly Patients Who Experienced Falls and Fractures by Home-Visit Interview. 6th scientific conference, The Japanese Society for Fall Prevention. 2019.10.5-6.
- [4] Son BK, Uchiyama E, Imaeda S, Taniguchi S, Unyaporn S, Sumikawa Y, Matsubara T, Otsuki T, Tanaka T, Iijima K . Investigation of intrinsic and environmental factors leading to fall/hip fracture by multidisciplinary examination. 61th Annual Meeting of Japan Geriatics Society. 2019.6.6-8.
- [5] Uchiyama E, Son BK, Imaeda S, Tanaka T, Matsumoto H, Morita K, Miyoshi T, Unyaporn S, Tanaka T, Iijima K, Matsubara T, Okata J. Quantitative analysis of environmental factors of fallings based on a bedside interview research for patients who have experienced femoral neck fractures. 5th scientific conference, The Japanese Society for Fall Prevention. 2018.10.7.
- [6] Imaeda S, Son BK, Uchiyama E, Tanaka T, Taniguchi S, Miyoshi T, Unyaporn S, Baba J, Sumikawa Y, Matsubara T, Otsuki T, Tanaka T, Iijima K, Okata J. Combined Bedside and Home-Visit Interview Clarifies Exact Fall Situations Causing Femoral Fracture. 5th scientific conference, The Japanese Society for Fall Prevention. 2018.10.7.
- [7] Unyaporn S, Son BK, Tanaka T, Imaeda S, Uchiyama E, Matsumoto H, Morita K, Matsubara T, Nishino A, Akishita M, Nakajima K, Tanaka S, Otsuki T, Nishide K, Tanaka T, Iijima K, Okata J. Characteristics of the elderly who have experienced fall/hip fracture focusing on medical history, medication and locomotive syndrom. 4th scientific conference, The Japanese Society for Fall Prevention. 2017.10.8.
- [8] Imaeda S, Son BK, Uchiyama E, Matsumoto H, Tanaka T, Taniguchi S, Kim KM, Takada R, Miura T, Nishino A, Nishide K, Otsuki T, Tanaka T, Iijima K, Okata J. Architectural Fall Prevention Measures Based on Falls at Residential Area and Home by the Elderly Who Live in Their House. 4th scientific conference, The Japanese Society for Fall Prevention. 2017.10.8.
- [9] Uchiyama E, Son BK, Imaeda S, Tanaka T, Matsumoto H, Morita K, Unyaporn S, Matsubara T, Nishino A, Akishita M, Otsuki T, Nishide K, Tanaka T, Iijima K, Okata J. Interview survey about falling situations to patients who have experienced and been in hospital due to femoral neck fracture. 4th scientific conference, The Japanese Society for Fall Prevention. 2017.10.8.
- [10] Imaeda S, Tanaka T, Taniguchi S, Kim KM, Matsumoto H, Uchiyama E, Nishino A, Son BK, Miura T, Iijima K, Tanaka T, Otsuki T, Nishide K, Okata J. Environmental Factors That the Elderly Could Dwell their Residence after Fall-Related Fracture: A Qualitative Study in Yokohama City. 3rd scientific conference, The Japanese Society for Fall Prevention. 2016.10.2.
- [11] Tanaka T, Imaeda S, Taniguchi S, Kim KM, Matsumoto H, Uchiyama E, Nishino A, Son BK, Miura T, Otsuki T, Nishide K, Tanaka T, Iijima K, Okata J. Internal and external factors associated with falls and fall-related fractures in community dwelling elderly population: a cross-sectional study. 3rd scientific conference, The Japanese Society for Fall Prevention. 2016.10.2.
- [12] Imaeda S, Tanaka T, Taniguchi S, Uchiyama E, Matsumoto H, Kim KM, Choki M, Takada R, Morita K, Unyaporn S, Nishino A, Son BK. Actual conditions of falls in elderly Japanese living in single-family house: A qualitative study. The 3rd IARU aging, Longevity and health Graduate Student Conference 2016.11.3-5.
- [13] Matsumoto H, Uchiyama E, Yoshida S, Kim K, Miki K, Son BK, Nishino A. Designing built environments to prevent falls, fall-related fractures, and post-fall home confinement. the Annunal meeting of Gerontological Society of America 2015.11.18-22, Orlando, Florida, USA