Given the rising numbers of older adults in Canada experiencing falls, evidence-based identification of fall risks and plans for prevention across the continuum of care is a significant priority for health care providers. A scoping review was conducted to synthesize published international clinical practice guidelines (CPGs) and recommendations for fall risk screening and assessment in older adults (defined as 65 years of age and older). Of the 22 CPGs, 6 pertained to multiple settings, 9 pertained to community-dwelling older adults only, 2 each pertained to acute care and long-term care settings only, and 3 did not specify setting. Two criteria, prior fall history and gait and balance abnormalities, were applied either independently or sequentially in 19 CPG fall risk screening algorithms. Fall risk assessment components were more varied across CPGs but commonly included: detailed fall history; detailed evaluation of gait, balance, and/or mobility; medication review; vision; and environmental hazards assessment. Despite these similarities, more work is needed to streamline assessment approaches for heterogeneous and complex older adult populations across the care continuum. Support is also needed for sustainable implementation of CPGs in order to improve health outcomes.

Despite the hypothesized importance of the tropics in the global climate system, few tropical paleoclimatic records extend to periods earlier than the last glacial maximum (LGM), about 20,000 years before present. We present a well-dated 170,000-year time series of hydrologic variation from the southern hemisphere tropics of South America that extends from modern times through most of the penultimate glacial period. Alternating mud and salt units in a core from Salar de Uyuni, Bolivia reflect alternations between wet and dry periods. The most striking feature of the sequence is that the duration of paleolakes increased in the late Quaternary. This change may reflect increased precipitation, geomorphic or tectonic processes that affected basin hydrology, or some combination of both. The dominance of salt between 170,000 and 140,000 yr ago indicates that much of the penultimate glacial period was dry, in contrast to wet conditions in the LGM. Our analyses also suggest that the relative influence of insolation forcing on regional moisture budgets may have been stronger during the past 50,000 years than in earlier times.

Women experience a rapid rise in the incidence of wrist fracture after age 50. Accordingly, this study aimed to (1) determine the internal and environmental fall-related circumstances resulting in a wrist fracture, and (2) examine the relationship of functional status to these circumstances. Women aged 50 to 94 years reported on the nature of the injury (n = 99) and underwent testing for physical activity status, balance, strength, and mobility (n = 72). The majority of falls causing wrist fracture occurred outdoors, during winter months, as a result of a slip or trip while walking. Half of these falls resulted in other injuries including head, neck, and spine injuries. Faster walking speed, lower grip strength, and higher balance confidence were significantly associated with outdoor versus indoor falls and slips and trips versus other causes. This study provides insights into potential screening and preventive measures for fall-related wrist fractures in women.