scholarly journals 01 Prediction of Falls in Community-Dwelling Older People using an Accelerometer: The Results of a 1-Year Prospective Study

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv1-iv2
Author(s):  
Hiroshi Osaka ◽  
Daisuke Fujita ◽  
Kenichi Kobara ◽  
Yosuke Yoshimura ◽  
Hiromi Matsumoto ◽  
...  
Keyword(s):  
Older People ◽  
Fall Risk ◽  
Walking Speed ◽  
Exercise Duration ◽  
Community Dwelling ◽  
Gait Parameters ◽  
Weight Shift ◽  
Trunk Acceleration ◽  
History Of ◽  
Community Dwelling Older People

Abstract Background Fall preventive exercise for community-dwelling older people in Japan has a certain effect. The purpose of this study was to examine the predictors of fall risk in older people engaging in preventive exercise. Methods In this prospective study, we recruited 162 community-dwelling older people. We had them complete a self-report questionnaire containing items on weekly exercise frequency, exercise duration, exercise efficacy, amount of pain, number of diagnosis chronic diseases, health anxiety level, vision impairment, difficulty using the stairs, insomnia, fear of falling, history of falls, and forgetfulness, as well as the Falls Efficacy Scale. Walking speed and trunk acceleration during walking were also measured in all participants. From trunk acceleration, we calculated five gait parameters: fluctuation, weight shift, lateral balance, anteroposterior balance, and rhythm. Participants were classified as fallers or non-fallers according to the incidence of falls over a 1-year period from baseline assessment. Results Of all participants, 19 (11.7%) were classified as fallers and 143 (88.3%) as non-fallers. In comparing the fallers and non-fallers, we found significant differences in their exercise duration, exercise efficacy, amount of pain, history of falls, walking speed, and the gait parameters of weight shift and anteroposterior balance. A logistic regression analysis revealed that walking speed (odds ratio: 0.049, 95% confidence interval [CI]: 0.005-0.265, p=0.008) and weight shift (odds ratio: 0.021, 95%CI: 0.000-0.877, p=0.043) were predictors of falls. Conclusion The gait parameter of weight shift is the amplitude ratio of the auto-correlation function from vertical acceleration. This gait parameter is an original metrics and might show the temporal structure around the terminal stance. Measurement of gait parameters, in addition to physical performance, using an accelerometer seems beneficial for fall risk identification among community-dwelling older people engaged in fall preventive exercise.

Association between a history of falls and the ability to multi-task in community-dwelling older people

2010 ◽  
Vol 22 (5-6) ◽  
pp. 427-432 ◽  
Author(s):  
Hyuma Makizako ◽  
Taketo Furuna ◽  
Hiroyuki Shimada ◽  
Hikaru Ihira ◽  
Mika Kimura ◽  
...  
Keyword(s):  
Older People ◽  
Community Dwelling ◽  
History Of ◽  
Community Dwelling Older People

scholarly journals Fall-related efficacy is a useful and independent index to detect fall risk in Japanese community-dwelling older people: a 1-year longitudinal study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Naoto Kamide ◽  
Yoshitaka Shiba ◽  
Miki Sakamoto ◽  
Haruhiko Sato ◽  
Akie Kawamura
Keyword(s):  
Risk Factors ◽  
Older People ◽  
Physical Performance ◽  
Fall Risk ◽  
Community Dwelling ◽  
Confounding Factors ◽  
Potential Risk Factors ◽  
Community Dwelling Older People ◽  
Walking Time

Abstract Background Fall-related efficacy has been found to be associated with both falls and fall risk factors such as physical performance. The aim of the present study was to clarify whether fall-related efficacy is, independent of physical performance and other potential risk factors, associated with future falls in community-dwelling older people. Methods The study participants were 237 Japanese older people aged 65 years and over who were living independently in their community. Fall-related efficacy and physical performance were assessed at baseline using the short version of the Falls Efficacy Scale-International (short FES-I) and 5-m walking time, the Timed Up and Go Test, the 5 Times Sit to Stand Test, and grip strength. Physical performance was then again assessed at 1-year follow-up. The number of falls was obtained every 6 months for 1 year after the baseline survey. Instrumental activities of daily living (IADL), depression, fall history, current medications, medical history, and pain were also investigated as potential confounding factors that have possible associations with falls. The associations between the short FES-I, physical performance, and number of falls were analyzed using Poisson regression analysis adjusted for physical performance and potential confounding factors. Results The mean age of the participants (75.9% women) was 71.1 ± 4.6 years, and 92.8% could perform IADL independently. The total numbers of falls and fallers during the 1-year follow-up period were 70 and 42, respectively. On Poisson regression analysis adjusted for walking time and potential confounding factors, independent of physical performance, the short FES-I was found to be significantly associated with number of falls (relative risk = 1.09, p < 0.05). On the other hand, physical performance was not significantly associated with the number of falls. Conclusions The findings of the present study suggest that the short FES-I, independent of physical performance and other potential risk factors, is a useful index to detect fall risk in community-dwelling older people, and that fall-related efficacy is an important factor in terms of fall prevention.

scholarly journals Physical performance reflects cognitive function, fall risk, and quality of life in community-dwelling older people

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Shota Ikegami ◽  
Jun Takahashi ◽  
Masashi Uehara ◽  
Ryosuke Tokida ◽  
Hikaru Nishimura ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cognitive Function ◽  
Older People ◽  
Physical Performance ◽  
Fall Risk ◽  
Community Dwelling ◽  
Community Dwelling Older People

scholarly journals Association between toe flexor strength and spatiotemporal gait parameters in community-dwelling older people

2014 ◽  
Vol 11 (1) ◽  
pp. 143 ◽  
Author(s):  
Shogo Misu ◽  
Takehiko Doi ◽  
Tsuyoshi Asai ◽  
Ryuichi Sawa ◽  
Kota Tsutsumimoto ◽  
...  
Keyword(s):  
Older People ◽  
Community Dwelling ◽  
Gait Parameters ◽  
Toe Flexor Strength ◽  
Community Dwelling Older People ◽  
Flexor Strength

scholarly journals Development and internal validation of a risk prediction model for falls among older people using primary care electronic health records

2021 ◽  
Author(s):  
Noman Dormosh ◽  
Martijn C Schut ◽  
Martijn W Heymans ◽  
Nathalie van der Velde ◽  
Ameen Abu-Hanna
Keyword(s):  
Primary Care ◽  
High Risk ◽  
Older People ◽  
Prediction Model ◽  
Community Dwelling ◽  
Receiver Operating Curve ◽  
Free Text ◽  
Medical Conditions ◽  
History Of ◽  
Community Dwelling Older People

Abstract Background Currently used prediction tools have limited ability to identify community-dwelling older people at high risk for falls. Prediction models utilizing Electronic Heath Records (EHR) provide opportunities but up to now showed limited clinical value as risk stratification tool; because of among others the underestimation of falls prevalence. The aim of this study was to develop a fall prediction model for community-dwelling older people using a combination of structured data and free text of primary care EHR and to internally validate its predictive performance. Methods EHR data of individuals aged 65 or over. Age, sex, history of falls, medications and medical conditions were included as potential predictors. Falls were ascertained from the free text. We employed the Bootstrap-enhanced penalized logistic regression with the least absolute shrinkage and selection operator to develop the prediction model. We used 10-fold cross-validation to internally validate the prediction strategy. Model performance was assessed in terms of discrimination and calibration. Results Data of 36,470 eligible participants were extracted from the dataset. The number of participants who fell at least once was 4,778 (13.1%). The final prediction model included age, sex, history of falls, two medications and five medical conditions. The model had a median area under the receiver operating curve of 0.705 (IQR 0.700-0.714) . Conclusions Our prediction model to identify older people at high risk for falls achieved fair discrimination, and had reasonable calibration. It can be applied in clinical practice as it relies on routinely collected variables and does not require mobility assessment tests.

scholarly journals Development and validation of a continuous fall risk score in community-dwelling older people: an ecological approach

2021 ◽  
Vol 21 (S2) ◽  
Author(s):  
Jorge Bravo ◽  
Hugo Rosado ◽  
Pablo Tomas-Carus ◽  
Cristina Carrasco ◽  
Nuno Batalha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Clinical Practice ◽  
Older People ◽  
Risk Score ◽  
Fall Risk ◽  
Community Dwelling ◽  
Fall Risk Assessment ◽  
Standardized Residuals ◽  
Community Dwelling Older People

Abstract Background Fall risk assessment in older people is of major importance for providing adequate preventive measures. Current predictive models are mainly focused on intrinsic risk factors and do not adjust for contextual exposure. The validity and utility of continuous risk scores have already been demonstrated in clinical practice in several diseases. In this study, we aimed to develop and validate an intrinsic-exposure continuous fall risk score (cFRs) for community-dwelling older people through standardized residuals. Methods Self-reported falls in the last year were recorded from 504 older persons (391 women: age 73.1 ± 6.5 years; 113 men: age 74.0 ± 6.1 years). Participants were categorized as occasional fallers (falls ≤1) or recurrent fallers (≥ 2 falls). The cFRs was derived for each participant by summing the standardized residuals (Z-scores) of the intrinsic fall risk factors and exposure factors. Receiver operating characteristic (ROC) analysis was used to determine the accuracy of the cFRs for identifying recurrent fallers. Results The cFRs varied according to the number of reported falls; it was lowest in the group with no falls (− 1.66 ± 2.59), higher in the group with one fall (0.05 ± 3.13, p < 0.001), and highest in the group with recurrent fallers (2.82 ± 3.94, p < 0.001). The cFRs cutoff level yielding the maximal sensitivity and specificity for identifying recurrent fallers was 1.14, with an area under the ROC curve of 0.790 (95% confidence interval: 0.746–0.833; p < 0.001). Conclusions The cFRs was shown to be a valid dynamic multifactorial fall risk assessment tool for epidemiological analyses and clinical practice. Moreover, the potential for the cFRs to become a widely used approach regarding fall prevention in community-dwelling older people was demonstrated, since it involves a holistic intrinsic-exposure approach to the phenomena. Further investigation is required to validate the cFRs with other samples since it is a sample-specific tool.

scholarly journals The effect of the interaction between fall-related self-efficacy and gait function on the occurrence of falls in community-dwelling older people

2021 ◽  
Author(s):  
Naoto Kamide ◽  
Haruhiko Sato ◽  
Miki Sakamoto ◽  
Yoshitaka Shiba
Keyword(s):  
Older People ◽  
Self Efficacy ◽  
Pressure Sensors ◽  
Community Dwelling ◽  
Short Version ◽  
Elderly Persons ◽  
Gait Parameters ◽  
Maximum Effort ◽  
Community Dwelling Older People ◽  
Gait Function

Abstract Background Fall-related self-efficacy and gait function are known to be associated. However, whether the interaction between fall-related self-efficacy and gait function affects future falls has not been investigated. Aim The aim of this study was to investigate the effect of the interaction between fall-related self-efficacy and spatiotemporal gait parameters on the occurrence of falls in community-dwelling older people. Methods A total of 265 elderly persons (age ≥ 65 years) living independently in the community were recruited. For gait function, spatiotemporal gait parameters at usual and maximum effort paces were measured using a 2.4-m walkway system with embedded pressure sensors. Furthermore, changes in gait parameters between usual and maximum paces were calculated (Δgait parameters). Fall-related self-efficacy was assessed using the short version of the Falls Efficacy Scale International (Short FES-I). The occurrence of falls was prospectively investigated 6 months later. The effect of the interaction between short FES-I and gait parameters on falls was analyzed using logistic regression analysis adjusted for confounding factors. Results Several gait parameters were significantly different by self-efficacy level. As for the effect of the interaction of fall-related self-efficacy and gait parameters on falls, smaller Δgait parameters in those with high efficacy were associated with higher odds ratios of falls, whereas Δgait parameters in those with low efficacy were not associated with falls. Discussion and conclusions The interaction between fall-related self-efficacy and gait function appeared to affect future falls. Assessments combining fall-related self-efficacy and gait function may improve the accuracy of prediction of future falls.

scholarly journals The effect of the interaction between fall-related self-efficacy and gait function on the occurrence of falls in community-dwelling older people

2021 ◽  
Author(s):  
Naoto Kamide ◽  
Haruhiko Sato ◽  
Miki Sakamoto ◽  
Yoshitaka Shiba
Keyword(s):  
Older People ◽  
Self Efficacy ◽  
Pressure Sensors ◽  
Community Dwelling ◽  
Short Version ◽  
Elderly Persons ◽  
Gait Parameters ◽  
Maximum Effort ◽  
Community Dwelling Older People ◽  
Gait Function

Abstract Background Fall-related self-efficacy and gait function are known to be associated. However, whether the interaction between fall-related self-efficacy and gait function affects future falls has not been investigated.Aim The aim of this study was to investigate the effect of the interaction between fall-related self-efficacy and spatiotemporal gait parameters on the occurrence of falls in community-dwelling older people. Methods A total of 265 elderly persons (age ≥65 years) living independently in the community were recruited. For gait function, spatiotemporal gait parameters at usual and maximum effort paces were measured using a 2.4-m walkway system with embedded pressure sensors. Furthermore, changes in gait parameters between usual and maximum paces were calculated (Δgait parameters). Fall-related self-efficacy was assessed using the short version of the Falls Efficacy Scale International (Short FES-I). The occurrence of falls was prospectively investigated 6 months later. The effect of the interaction between Short FES-I and gait parameters on falls was analyzed using logistic regression analysis adjusted for confounding factors.Results Several gait parameters were significantly different by self-efficacy level. As for the effect of the interaction of fall-related self-efficacy and gait parameters on falls, smaller Δgait parameters in those with high efficacy were associated with higher odds ratios of falls, whereas Δgait parameters in those with low efficacy were not associated with falls.Discussion and conclusions The interaction between fall-related self-efficacy and gait function appeared to affect future falls. Assessments combining fall-related self-efficacy and gait function may improve the accuracy of prediction of future falls.

57 The Use of the Physiological Profile Assessment to Improve Prediction of Fragility Fractures in Community-Dwelling Older People

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv13-iv17
Author(s):  
Lara Harvey ◽  
Morag Taylor ◽  
Kim Delbaere ◽  
Stephen Lord ◽  
Henry Brodaty ◽  
...  
Keyword(s):  
Older People ◽  
Fall Risk ◽  
Fragility Fractures ◽  
Community Dwelling ◽  
Baseline Assessment ◽  
Physiological Profile ◽  
Visual Contrast ◽  
Increased Risk ◽  
Community Dwelling Older People ◽  
Physiological Profile Assessment

Abstract Introduction The Physiological Profile Assessment (PPA) is a validated composite measure of sensorimotor function, known to predict falls with 75% accuracy. This work aimed to investigate whether PPA is also associated with fragility fractures. Method Participants were 489 community-dwelling older people (age=70-90) enrolled in the longitudinal population-based Sydney Memory and Ageing Study. Participants underwent comprehensive assessments at enrolment, including the 5-item PPA (visual contrast sensitivity, lower limb proprioception, knee extension strength, simple reaction time and postural sway). Participant records were linked to emergency department, hospital and death records (2005-2014) to identify fragility fractures following baseline assessment, with median follow-up duration of 7.5 years. Negative binomial regression, with observation time as the offset, was used to assess factors associated with fractures. Results At baseline assessment, 281 (57.5%) participants were assessed as having low/mild fall risk [PPA&lt;1] and 208 (42.5%) as moderate/marked/very marked fall risk [PPA score &gt;1]. Over the study period, 72 (14.7%) individuals sustained 1 fracture, and a further 39 (8.0%) sustained 2 or more fractures. Univariate analysis showed that increasing age (Incidence Rate Ratio (IRR) 1.1, 95%CI 1.0-1.1, p=0.0026), being female (IRR 1.8, 95%CI 1.3-2.8, p=0.0033), having osteoporosis (IRR 1.7, 95%CI 1.1-2.6, p=0.0340) and moderate/marked/very marked PPA (IRR 1.8, 95%CI 1.2-2.7, p=0.0025) were associated with fractures. In the multivariate analysis, only moderate/marked/very marked PPA (IRR 1.6, 95%CI 1.1-2.5, p=0.0159) and being female (IRR 1.8, 95%CI 1.1-2.8, p=0.0121) remained independently associated with fractures. Conclusion These findings show that people at increased risk of falls based on the Physiological Profile Assessment are also at increased risk of future fragility fractures regardless of the presence of osteoporosis. Early identification of this high risk population provides the opportunity to intervene with evidence based strategies to minimize falls risk as well as considering pharmacological management of bone health.

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