Falls from Tractors in Older Age: Risky Behaviors in a Group of Swedish and Italian Farmers Over 65

Poor postural balance is one of the major risk factors for falling. A great number of reports have analyzed the risk factors and predictors of falls but the results have for the most part been unclear and partly contradictory. Objective data on these matters are thus urgently needed. The force platform technique has widely been used as a tool to assess balance. However, the ability of force platform measures to predict falls remains unknown. The purpose of this systematic review was to extract and critically review the findings of prospective studies where force platform measurements have been used as predictors of falls among elderly populations. The study was done as a systematic literature review. PubMed, the Cochrane Central Register of Controlled Trials, and CINAHL databases from 1950 to April 2005 were used. The review includes prospective follow-up studies using the force platform as a tool to measure postural balance. Nine original prospective studies were included in the final analyses. In five studies fall-related outcomes were associated with some force platform measures and in the remaining four studies associations were not found. For the various parameters derived on the basis of the force platform data, the mean speed of the mediolateral (ML) movement of the center of pressure (COP) during normal standing with the eyes open and closed, the mean amplitude of the ML movement of the COP with the eyes open and closed, and the root-mean-square value of the ML displacement of COP were the indicators that showed significant associations with future falls. Measures related to dynamic posturography (moving platforms) were not predictive of falls. Despite a wide search only a few prospective follow-up studies using the force platform technique to measure postural balance and a reliable registration of subsequent falls were found. The results suggest that certain aspects of force platform data may have predictive value for subsequent falls, especially various indicators of the lateral control of posture. However, the small number of studies available makes it difficult to draw definitive conclusions. Copyright 2006 S. Karger AG, Basel.

The aims of this study were: (i) to determine the relation between chronological and functional age; (ii) to examine the association between chronological age and work outcomes; and (iii) to examine the association between functional age and work outcomes. An overview of the most reported work outcomes is outlined. Chronological age refers to the calendar age; functional age was measured with perceived health status (SF-36) and the presence of a chronic health condition. Perspectives on experienced problems, barriers, facilitators and support needs due to ageing and the Work Ability Index were gathered out as work outcomes. The association of chronological and functional age of workers aged ≥45 years (n = 2971) on work outcomes were significant but small, except for the presence of a chronic health condition. The presence of a chronic health condition was not related to chronological age. Older workers (60-64 years) reported better scores on social functioning, mental health and vitality compared with workers aged 45-59 years. Most reported problems due to ageing were energy decline, muscle function decline, concentration lapses and memory deterioration. Experienced barriers were concentration, work pace problems and mobility; facilitators were support from colleagues, informal relations at work and supervisors. Individual agreement had to be met to continue working life. This study confirmed that both chronological and functional age were associated with a decrease in work outcomes. Workers >60 years did not experience more problems and barriers compared with workers between 45 and 49 years of age.