{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T15:34:00Z","timestamp":1777304040628,"version":"3.51.4"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,2,3]],"date-time":"2016-02-03T00:00:00Z","timestamp":1454457600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geriatrics Gerontology Int"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>In an attempt to decrease the incidence of falls and fall\u2010related 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We enrolled 93 participants living in the community, 60 residents of an intermediate geriatric nursing home and 50 residents of the 100\u2010bed <jats:styled-content style=\"fixed-case\">K<\/jats:styled-content>andayama <jats:styled-content style=\"fixed-case\">Y<\/jats:styled-content>asuragien 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 \u201c<jats:styled-content style=\"fixed-case\">NY<\/jats:styled-content>\u2010mode\u201d diuretic therapy, namely, spironolactone 12.5\u2009mg orally once on alternate days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The incidence of falls fell from 53 in 2011 to 29 in 2012, and there were no fall\u2010related proximal femoral fractures for 3 years after the introduction of <jats:styled-content style=\"fixed-case\">NY<\/jats:styled-content>\u2010mode 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We found that reducing or replacing daily diuretics with <jats:styled-content style=\"fixed-case\">NY<\/jats:styled-content>\u2010mode therapy appeared to reduce the incidence of falls and fall\u2010related proximal femoral fracture, likely by preserving intracellular and extracellular body water volumes. Low\u2010dose spironolactone (12.5\u2009mg 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\u2010related fractures. <jats:bold>Geriatr Gerontol Int 2017; 17: 262\u2013269.<\/jats:bold><\/jats:p><\/jats:sec>","DOI":"10.1111\/ggi.12719","type":"journal-article","created":{"date-parts":[[2016,2,3]],"date-time":"2016-02-03T17:01:52Z","timestamp":1454518912000},"page":"262-269","source":"Crossref","is-referenced-by-count":15,"title":["Reduction of diuretics and analysis of water and muscle volumes to prevent falls and fall\u2010related fractures in older adults"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5161-8431","authenticated-orcid":false,"given":"Kosuke","family":"Okada","sequence":"first","affiliation":[{"name":"Hiroshima Atomic Bomb Survivors Nursing Home Kandayama Yasuragien  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Food and Dietetics Hiroshima Bunka Gakuen Two\u2010Year College  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nanao","family":"Kamada","sequence":"additional","affiliation":[{"name":"Hiroshima Atomic Bomb Survivors Relief Foundation  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yumiko","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Hiroshima Atomic Bomb Survivors Nursing Home Kurakake Nozomien  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masayuki","family":"Kakehashi","sequence":"additional","affiliation":[{"name":"Graduate School of Biomedical and Health Sciences Hiroshima University  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidemi","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Faculty of Nursing Hiroshima Bunka Gakuen University  Kure Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigeko","family":"Katoh","sequence":"additional","affiliation":[{"name":"Faculty of Nursing Hiroshima Bunka Gakuen University  Kure Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsuya","family":"Morita","sequence":"additional","affiliation":[{"name":"Faculty of Nursing Hiroshima Bunka Gakuen University  Kure Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,2,3]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afj056"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1999.tb01898.x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1999.tb01899.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/62.10.1172"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2009.357"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.2165\/11599460-000000000-00000"},{"key":"e_1_2_7_8_1","first-page":"1","volume-title":"Fall Prevention Medical Encyclopedia","author":"Society of Fall Preventive Medicine","year":"2008"},{"key":"e_1_2_7_9_1","first-page":"128","volume-title":"Edema: In Textbook of Geriatric Medicine","author":"Toba K","year":"2008"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-1-4160-6231-8.10040-6"},{"key":"e_1_2_7_11_1","first-page":"658","volume-title":"Todays Therapeutic Drugs 2015","author":"Urabe A","year":"2015"},{"key":"e_1_2_7_12_1","first-page":"101","article-title":"Studies on the reduction of diuretic for the prevention of falls and fall\u2010related fractures in the elderly","volume":"68","author":"Okada K","year":"2015","journal-title":"J Hiroshima Medical Association"},{"key":"e_1_2_7_13_1","first-page":"257","article-title":"Actual situation of falls in the elderly of an Atomic Bomb survivors nursing home","volume":"68","author":"Okada K","year":"2015","journal-title":"J Hiroshima Medical Association"},{"key":"e_1_2_7_14_1","first-page":"10","volume-title":"Fall Prevention Medical Encyclopedia","author":"Suzuki T","year":"2008"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1995.79.4.1316"},{"key":"e_1_2_7_16_1","first-page":"11","article-title":"Evaluation of segmented bioelectrical impedance analysis (SBIA) for measuring muscle distribution","volume":"1","author":"Cha K","year":"1997","journal-title":"J Int Council Health Phys Recreation Spor Dance"},{"key":"e_1_2_7_17_1","unstructured":"The Japanese Ministry of Health Labour and Welfare.(On line) The current situation and the future direction of long\u2010term care insurance system in Japan with a focus on the housing for the elderly.2013. 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