The Oklahoma Falls Prevention Program Targeting Rural Community-Dwelling Older Adults

Abstract The Oklahoma Healthy Aging Initiative is a statewide health promotion program for older adults based at the University of Oklahoma. Seven staff educators and 32 volunteers delivered 2 community-based fall prevention programs, Staying Active and Independent for Life (SAIL) and Tai Chi Quan: Moving for Better Balance (TCBB) to 763 older Oklahomans in 71 sites across the state over 9 months. For both programs, twenty-four 60-90 minute classes were delivered over 12 weeks with pre and post assessments completed at the first and last class, respectively. Two hundred ninety eight participants (39%) completed at least 75% of class sessions and to date 140 completed a posttest evaluation and were included in the evaluation. Participants were mostly older (87% ≥60 years), female (86%), college educated (45%), white (87%), and most participated in TCBB (89%). Participants improved in 2 physical performance measures: mean 30-second chair stands increased from 11.5 (SD3.8) to 13.1 (SD3.4) stands (p<0.0001); and mean timed up and go time decreased from 10.0 (SD2.9) to 9.4 (SD2.9) seconds (p=0.004 ). More participants reported vigorous or moderate activity at least 3 times per week after program completion, 134 (96%) vs. 114 (81%), p=0.0001. There was no difference in measures of global health, satisfaction with social roles and activities, or companionship with participant mean scores near the upper range of these scales at baseline. Older Oklahomans participating in community-based exercise report good overall health and report high social connection. Future efforts will focus on more socially isolated older adults and diverse communities.

Download Full-text

Tai Chi: Moving for Better Balance—Development of a Community-Based Falls Prevention Program

Journal of Physical Activity and Health ◽

10.1123/jpah.5.3.445 ◽

2008 ◽

Vol 5 (3) ◽

pp. 445-455 ◽

Cited By ~ 33

Author(s):

Fuzhong Li ◽

Peter Harmer ◽

Karin A. Mack ◽

David Sleet ◽

K. John Fisher ◽

...

Keyword(s):

Older Adults ◽

Pacific Northwest ◽

Program Implementation ◽

Prevention Program ◽

Tai Chi ◽

Falls Prevention ◽

Community Based ◽

Participant Satisfaction ◽

The Pacific ◽

Instructor's Manual

Background:This study was designed to develop an evidence- and community-based falls prevention program—Tai Chi: Moving for Better Balance.Methods:A mixed qualitative and quantitative approach was used to develop a package of materials for program implementation and evaluation. The developmental work was conducted in 2 communities in the Pacific Northwest. Participants included a panel of experts, senior service program managers or activity coordinators, and older adults. Outcome measures involved program feasibility and satisfaction.Results:Through an iterative process, a program package was developed. The package contained an implementation plan and class training materials (ie, instructor’s manual, videotape, and user’s guidebook). Pilot testing of program materials showed that the content was appropriate for the targeted users (community-living older adults) and providers (local senior service organizations). A feasibility survey indicated interest and support from users and providers for program implementation. A 2-week pilot evaluation showed that the program implementation was feasible and evidenced good class attendance, high participant satisfaction, and interest in continuing Tai Chi.Conclusions:The package of materials developed in this study provides a solid foundation for larger scale implementation and evaluation of the program in community settings.

Download Full-text

Exercise for falls prevention in community-dwelling older adults: trial and participant characteristics, interventions and bias in clinical trials from a systematic review

BMJ Open Sport & Exercise Medicine ◽

10.1136/bmjsem-2019-000663 ◽

2019 ◽

Vol 5 (1) ◽

pp. e000663 ◽

Cited By ~ 3

Author(s):

Christopher A C M Ng ◽

Nicola Fairhall ◽

Geraldine Wallbank ◽

Anne Tiedemann ◽

Zoe A Michaleff ◽

...

Keyword(s):

Older Adults ◽

Tai Chi ◽

Allocation Concealment ◽

Community Dwelling ◽

Falls Prevention ◽

Intervention Programme ◽

Exercise Interventions ◽

Participant Characteristics ◽

Randomised Controlled ◽

Community Dwelling Older Adults

IntroductionThere is strong evidence that exercise prevents falls in community-dwelling older people. This review summarises trial and participant characteristics, intervention contents and study quality of 108 randomised trials evaluating exercise interventions for falls prevention in community-dwelling older adults.MethodsMEDLINE, EMBASE, CENTRAL and three other databases sourced randomised controlled trials of exercise as a single intervention to prevent falls in community-dwelling adults aged 60+ years to May 2018.Results108 trials with 146 intervention arms and 23 407 participants were included. Trials were undertaken in 25 countries, 90% of trials had predominantly female participants and 56% had elevated falls risk as an inclusion criterion. In 72% of trial interventions attendance rates exceeded 50% and/or 75% of participants attended 50% or more sessions. Characteristics of the trials within the three types of intervention programme that reduced falls were: (1) balance and functional training interventions lasting on average 25 weeks (IQR 16–52), 39% group based, 63% individually tailored; (2) Tai Chi interventions lasting on average 20 weeks (IQR 15–43), 71% group based, 7% tailored; (3) programmes with multiple types of exercise lasting on average 26 weeks (IQR 12–52), 54% group based, 75% tailored. Only 35% of trials had low risk of bias for allocation concealment, and 53% for attrition bias.ConclusionsThe characteristics of effective exercise interventions can guide clinicians and programme providers in developing optimal interventions based on current best evidence. Future trials should minimise likely sources of bias and comply with reporting guidelines.

Download Full-text

FALL PREVENTION PROGRAMS FOR RURAL COMMUNITY DWELLING OLDER ADULTS RESULTS IN IMPROVED BALANCE

Innovation in Aging ◽

10.1093/geroni/igz038.3149 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S856-S857

Author(s):

Robin E McAtee ◽

Ronni Chernoff ◽

Kathryn Packard ◽

Whitney Thomasson ◽

Laura Spradley ◽

...

Keyword(s):

Older Adults ◽

Fall Prevention ◽

Tai Chi ◽

Tracking System ◽

Financial Burden ◽

Community Dwelling ◽

Evidence Based ◽

Community Based ◽

Severe Injuries ◽

Significant Difference

Abstract More than one in four older adults (OA) in the US fall each year and 20 to 30% suffer moderate to severe injuries such as head trauma or hip fractures. Falls are both a medical and financial burden that can be significantly reduced by lifestyle interventions. One of the main strategies to help reduce these statistics is evidence-based fall prevention classes which help to build muscle, improve balance, and increase participants’ confidence in fall control. A goal of the Arkansas Geriatric Workforce Enhancement Program (HRSA grant U1QHP28723) is to deliver community-based programs that improve health outcomes and quality of life. Evidence-based preventive health training is a major way to meet this goal. Two of these evidence-based trainings are Tai Chi (TC) and A Matter of Balance (AMOB), multi-week classes that help to improve balance and reduce fall risk. This study took place at scheduled community-based classes, where demographic and balance data were obtained. The aim was to determine the difference in the balance of community-dwelling OA as measured by Balance Tracking System® before and after AMOB and TC courses. Both groups showed positive changes in their mean balance percentage with the AMOB class having a higher Mean ± SD (24.3 ± 21.0) vs. the TC participants (4.0 ± 29.7). The One-Way Analysis of Variance showed statistically significant difference in the AMOB class over those in the TC class, F (1, 32) = 5.280, p < 0.05. The Cohen’s d = 0.789 indicates a large effect between the two groups.

Download Full-text

Characteristics Associated with Improved Physical Performance among Community-Dwelling Older Adults in a Community-Based Falls Prevention Program

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17072509 ◽

2020 ◽

Vol 17 (7) ◽

pp. 2509

Author(s):

Gabrielle Scronce ◽

Wanqing Zhang ◽

Matthew Lee Smith ◽

Vicki Stemmons Mercer

Keyword(s):

Older Adults ◽

Physical Performance ◽

Prevention Program ◽

Community Dwelling ◽

Falls Prevention ◽

Initial Visit ◽

Cognitive Screening ◽

Community Based ◽

Community Dwelling Older Adults

This was a retrospective analysis of quasi-longitudinal data from an ongoing, community-based falls prevention program. The purpose was to identify participant characteristics predicting improvement on physical performance measures associated with falls risk. Community-dwelling older adults ≥60 years old participated in a community-based implementation of the Otago Exercise Program (OEP). Participants with increased falls risk (n = 353) were provided with individualized exercises from OEP and were invited to return for monthly follow-up. One hundred twenty-eight participants returned for at least two follow-up visits within 6 months of their initial visit (mean time to second follow-up = 93 days with standard deviation = 43 days). Outcome measures assessed at initial and all follow-up visits included Four Stage Balance Test (4SBT), Timed Up and Go test (TUG), and Chair Rise Test (CRT). Distributions were examined, and results were categorized to depict improvement from initial visit (IVT) to second follow-up visit (F2). Key predictor variables were included in multivariable linear or logistic regression models. Improved 4SBT performance was predicted by greater balance confidence. Better TUG performance at F2 was predicted by no use of assistive device for walking, higher scores on cognitive screening, and better IVT TUG performance. Improvement on CRT was predicted by younger age and lower scores on cognitive screening. While improvements on each of the three measures were predicted by a unique combination of variables, these variables tended to be associated with less frailty.

Download Full-text

Long-term participation in community group exercise improves lower extremity muscle strength and delays age-related declines in walking speed and physical function in older adults

European Review of Aging and Physical Activity ◽

10.1186/s11556-021-00260-2 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Chisato Hayashi ◽

Soshiro Ogata ◽

Tadashi Okano ◽

Hiromitsu Toyoda ◽

Sonoe Mashino

Keyword(s):

Older Adults ◽

Muscle Strength ◽

Physical Exercise ◽

Lower Extremity ◽

Physical Function ◽

Community Dwelling ◽

Group Exercise ◽

Community Based ◽

Lower Extremity Muscle

Abstract Background The effects of group exercise on the physical function of community-dwelling older adults remain unclear. The changes in lower extremity muscle strength, timed up and go (TUG) time, and the motor fitness scale (MFS), over time, among older adults who expressed a willingness to participate in community-based physical exercise groups, were determined using multilevel modelling. Methods We analyzed data of 2407 older adults between April 2010 and December 2019 from the registry of physical tests of community-based physical exercise groups. We conducted a retrospective cohort study to assess the effect of physical exercise on lower extremity muscle strength, TUG time, and MFS scores. The durations of the exercises were evaluated by frequency of physical test’s participate. Results A deterioration in lower extremity muscle strength was found in the short-term participant group only. However, in the mid-term and long-term participation groups, lower extremity muscle strength showed a trend of improvement. The TUG time and the MFS score were negatively correlated with increasing age in both groups divided by the duration of participation. However, there was a slower rate of deterioration in the long-term participation group. Discussion Lower extremity muscle strength, TUG time, and MFS scores decline with increasing age and there were differences in the slope of deterioration that depended on the duration of participation in community-based group exercise. Conclusion Participation in group exercise improved lower extremity muscle strength, TUG time, and MFS scores of older adults living in a community. The positive effects of group exercise were dependent on long-term participation.

Download Full-text

Impact of Malnutrition Status on Muscle Parameter Changes over a 5-Year Follow-Up of Community-Dwelling Older Adults from the SarcoPhAge Cohort

Nutrients ◽

10.3390/nu13020407 ◽

2021 ◽

Vol 13 (2) ◽

pp. 407

Author(s):

Laetitia Lengelé ◽

Olivier Bruyère ◽

Charlotte Beaudart ◽

Jean-Yves Reginster ◽

Médéa Locquet

Keyword(s):

Older Adults ◽

Muscle Strength ◽

Physical Performance ◽

Community Dwelling ◽

Timed Up And Go ◽

P Values ◽

Student’S T ◽

The Impact ◽

Community Dwelling Older Adults

This study aimed to assess the impact of malnutrition on the 5-year evolution of physical performance, muscle mass and muscle strength in participants from the SarcoPhAge cohort, consisting of community-dwelling older adults. The malnutrition status was assessed at baseline (T0) according to the “Global Leadership Initiatives on Malnutrition” (GLIM) criteria, and the muscle parameters were evaluated both at T0 and after five years of follow-up (T5). Lean mass, muscle strength and physical performance were assessed using dual X-ray absorptiometry, handgrip dynamometry, the short physical performance battery test and the timed up and go test, respectively. Differences in muscle outcomes according to nutritional status were tested using Student’s t-test. The association between malnutrition and the relative 5-year change in the muscle parameters was tested using multiple linear regressions adjusted for several covariates. A total of 411 participants (mean age of 72.3 ± 6.1 years, 56% women) were included. Of them, 96 individuals (23%) were diagnosed with malnutrition at baseline. Their muscle parameters were significantly lower than those of the well-nourished patients both at baseline and after five years of follow-up (all p-values < 0.05), except for muscle strength in women at T5, which was not significantly lower in the presence of malnutrition. However, the 5-year changes in muscle parameters of malnourished individuals were not significantly different than those of well-nourished individuals (all p-values > 0.05).

Download Full-text

Impact of a Community-Based Falls Prevention Program on Maintenance of Physical Activity Among Older Adults

Journal of Aging and Health ◽

10.1177/0898264308328988 ◽

2009 ◽

Vol 21 (3) ◽

pp. 480-500 ◽

Cited By ~ 6

Author(s):

Sophie Laforest ◽

Anne Pelletier ◽

Lise Gauvin ◽

Yvonne Robitaille ◽

Michel Fournier ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Prevention Program ◽

Falls Prevention ◽

Community Based

Download Full-text

Multisensory integration involved in the body perception of community-dwelling older adults

Scientific Reports ◽

10.1038/s41598-021-81121-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

M. Hide ◽

Y. Ito ◽

N. Kuroda ◽

M. Kanda ◽

W. Teramoto

Keyword(s):

Older Adults ◽

Multisensory Integration ◽

Fall Risk ◽

Community Dwelling ◽

The Body ◽

Risk Of Falling ◽

Body Perception ◽

Rubber Hand ◽

Timed Up And Go ◽

Community Dwelling Older Adults

AbstractThis study investigates how the multisensory integration in body perception changes with increasing age, and whether it is associated with older adults’ risk of falling. For this, the rubber hand illusion (RHI) and rubber foot illusion (RFI) were used. Twenty-eight community-dwelling older adults and 25 university students were recruited. They viewed a rubber hand or foot that was stimulated in synchrony or asynchrony with their own hidden hand or foot. The illusion was assessed by using a questionnaire, and measuring the proprioceptive drift and latency. The Timed Up and Go Test was used to classify the older adults into lower and higher fall-risk groups. No difference was observed in the RHI between the younger and older adults. However, several differences were observed in the RFI. Specifically, the older adults with a lower fall-risk hardly experienced the illusion, whereas those with a higher fall-risk experienced it with a shorter latency and no weaker than the younger adults. These results suggest that in older adults, the mechanism of multisensory integration for constructing body perception can change depending on the stimulated body parts, and that the risk of falling is associated with multisensory integration.

Download Full-text

Digital Health Interventions for Healthy Aging: A Qualitative User Evaluation and Ethical Assessment

10.21203/rs.3.rs-121871/v1 ◽

2020 ◽

Author(s):

Marcello Ienca ◽

Christophe Schneble ◽

Reto Kressig ◽

Tenzin Wangmo

Keyword(s):

Older Adults ◽

Older People ◽

Healthy Aging ◽

Ethical Issues ◽

Digital Health ◽

Functional Independence ◽

Community Dwelling ◽

Healthy Ageing ◽

Health Technologies ◽

Community Dwelling Older Adults

Abstract BackgroundDigital health technologies are being increasingly developed with the aim of allowing older adults to maintain functional independence throughout the old age, a process known as healthy ageing. Such digital health technologies for healthy ageing are expected to mitigate the socio-economic effects of population ageing and improve the quality of life of older people. However, little is known regarding the views and needs of older people regarding these technologies. AimThe aim of this study is to explore the views, needs and perceptions of community-dwelling older adults regarding the use of digital health technologies for healthy ageing. MethodFace-to-face, in-depth qualitative interviews were conducted with community-dwelling older adults (median age 79.6 years). The interview process involved both abstract reflections and practical demonstrations. The interviews were transcribed verbatim and analyzed according to inductive content analysis. ResultsThree main themes and twelve sub-themes emerged. The three main themes revolved around the following thematic areas: favorable views and perceptions on technology-assisted living, usability evaluations and ethical considerations. ConclusionsOur study reveals a generally positive attitude towards digital health technologies as participants believed digital tools could positively contribute to improving their overall wellbeing, especially if designed in a patient-centered manner. Safety concerns and ethical issues related to privacy, empowerment and lack of human contact also emerged as key considerations.

Download Full-text

Prevalence and Multidimensional Risk Factors of Physical Frailty in Korean Community-Dwelling Older Adults: Findings from Korean Frailty and Aging Cohort Study

10.20944/preprints202009.0423.v1 ◽

2020 ◽

Author(s):

Heeeun Jung ◽

Miji Kim ◽

Yunhwan Lee ◽

Chang Won Won

Keyword(s):

Risk Factors ◽

Older Adults ◽

Cohort Study ◽

Medical Condition ◽

Glycosylated Hemoglobin ◽

Community Dwelling ◽

National Standard ◽

Timed Up And Go ◽

Frailty Phenotype ◽

Community Dwelling Older Adults

Frailty is defined as a state of increased vulnerability to stressors, and it predicts the disability and mortality in the older population. This study aimed to investigate standardized prevalence and multidimensional risk factors associated with frailty among the Korean community-dwelling older adults. We analyzed the baseline data of 2,907 adults aged 70–84 years (mean age 75.8±3.9 years, 57.8% women) in the Korean Frailty and Aging Cohort Study. The Fried frailty phenotype was used to define frailty. Analyzed data included sociodemographic, physical, physical function, biological, lifestyle, health condition, medical condition, psychological, and social domains. Data were standardized using the national standard population composition ratio based on the Korean Population and Housing Census. The standardized prevalence of frailty and pre-frailty was 7.9% (95% confidence interval [CI] 6.8–8.9%) and 57.2% (95% CI 45.1–48.8%), respectively. The following 14 risk factors had a significant association with frailty: at risk of malnutrition, sarcopenia, severe mobility limitation, poor social capital, rural dwellers, depressive, poor self-perceived health, polypharmacy, elevated high-sensitivity C-reactive protein, elevated glycosylated hemoglobin, low 25-hydroxy vitamin D level, longer timed up and go, and low short physical performance battery score (p<0.05). Physico-nutritional, psychological, sociodemographic, and medical factors are strongly associated with frailty.

Download Full-text