scholarly journals The Role of Functional Risk and Fear of Falling in Older Adults’ Everyday Walking Activity

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 302-302
Author(s):  
Carl-Philipp Jansen ◽  
Jochen Klenk ◽  
Corinna Nerz ◽  
Sarah Labudek ◽  
Franziska Kramer ◽  
...  

Abstract Some persons have low functional risk (FR) but also high levels of fear of falling (FOF), in some it may be the exact opposite; in others, FOF matches actual functional risk. In order to characterise older persons in this respect, Delbaere et al. (2010) defined four groups: ‘vigorous’ (low FR/FOF), ‘anxious’ (low FR/high FOF), ‘stoic’ (high FR/low FOF), and ‘aware’ (high FR/FOF). We examined how the proposed group model translates into actual walking behaviour and explored whether group differences in walking occur due to FR level rather than the amount of FOF. Group allocation of N=294 participants was determined based on previously published cut-offs for FR (high vs. low Timed Up-and-Go) and FOF (high vs. low Short Falls-Efficacy Scale International). Walking activity was operationalised as mean number of steps per day over one week, assessed using ‘activPAL4™ micro’ accelerometers. Number of steps in the four groups were 6,335 (‘vigorous’), 5,782 (‘anxious’), 4,851 (‘stoic’), and 4,627 (‘aware’). Linear regression results showed that in the two low FR groups, those with high FOF did not differ significantly from the reference group with low FOF (anxious - vigorous: B=-645.3 steps, p=.157); however, the two groups with high FR showed a significantly different number of steps than the ‘vigorous’ group, irrespective of their FOF (aware-vigorous: B=-1536.1 steps, p=.002; stoic-vigorous: B=-1314.8 steps, p=.005). This means that FR outperformed FOF in their association with walking behaviour, i.e., participants can be better separated in their daily walking behaviour by FR than by FOF.

2021 ◽  
Author(s):  
Carl-Philipp Jansen ◽  
Jochen Klenk ◽  
Corinna Nerz ◽  
Chris Todd ◽  
Sarah Labudek ◽  
...  

Abstract Background older persons can be grouped according to their objective risk of falling (ORF) and perceived risk of falling (PRF) into ‘vigorous’ (low ORF/PRF), ‘anxious’ (low ORF/high PRF), ‘stoic’ (high ORF/low PRF) and ‘aware’ (high ORF/PRF). Sensor-assessed daily walking activity of these four groups has not been investigated, yet. Objective we examined everyday walking activity in those four groups and its association with ORF and PRF. Design cross-sectional. Setting community. Subjects N = 294 participants aged 70 years and older. Methods ORF was determined based on multiple independent risk factors; PRF was determined based on the Short Falls Efficacy Scale-International. Subjects were allocated to the four groups accordingly. Linear regression was used to quantify the associations of these groups with the mean number of accelerometer-assessed steps per day over 1 week as the dependent variable. ‘Vigorous’ was used as the reference group. Results average number of steps per day in the four groups were 6,339 (‘vigorous’), 5,781 (‘anxious’), 4,555 (‘stoic’) and 4,528 (‘aware’). Compared with the ‘vigorous’, ‘stoic’ (−1,482; confidence interval (CI): −2,473; −491) and ‘aware’ (−1,481; CI: −2,504; −458) participants took significantly less steps, but not the ‘anxious’ (−580 steps; CI: −1,440; 280). Conclusion we have integrated a digital mobility outcome into a fall risk categorisation based on ORF and PRF. Steps per day in this sample of community-dwelling older persons were in accordance with their ORF rather than their PRF. Whether this grouping approach can be used for the specification of participants’ needs when taking part in programmes to prevent falls and simultaneously promote physical activity remains to be answered in intervention studies.


2020 ◽  
Vol 51 (3) ◽  
pp. 795-806 ◽  
Author(s):  
Elizabeth J. Short ◽  
Rachael Cooper Schindler ◽  
Rita Obeid ◽  
Maia M. Noeder ◽  
Laura E. Hlavaty ◽  
...  

Purpose Play is a critical aspect of children's development, and researchers have long argued that symbolic deficits in play may be diagnostic of developmental disabilities. This study examined whether deficits in play emerge as a function of developmental disabilities and whether our perceptions of play are colored by differences in language and behavioral presentations. Method Ninety-three children participated in this study (typically developing [TD]; n = 23, developmental language disorders [DLD]; n = 24, attention-deficit/hyperactivity disorder [ADHD]; n = 26, and autism spectrum disorder [ASD]; n = 20). Children were videotaped engaging in free-play. Children's symbolic play (imagination, organization, elaboration, and comfort) was scored under conditions of both audible language and no audible language to assess diagnostic group differences in play and whether audible language impacted raters' perception of play. Results Significant differences in play were evident across diagnostic groups. The presence of language did not alter play ratings for the TD group, but differences were found among the other diagnostic groups. When language was audible, children with DLD and ASD (but not ADHD) were scored poorly on play compared to their TD peers. When language was not audible, children with DLD were perceived to play better than when language was audible. Conversely, children with ADHD showed organizational deficits when language was not available to support their play. Finally, children with ASD demonstrated poor play performance regardless of whether language was audible or not. Conclusions Language affects our understanding of play skills in some young children. Parents, researchers, and clinicians must be careful not to underestimate or overestimate play based on language presentation. Differential skills in language have the potential to unduly influence our perceptions of play for children with developmental disabilities.


Author(s):  
Alessandra Marengoni ◽  
Clare Tazzeo ◽  
Amaia Calderón-Larrañaga ◽  
Albert Roso-Llorach ◽  
Graziano Onder ◽  
...  
Keyword(s):  

Urban Forum ◽  
2021 ◽  
Author(s):  
Alexandra Panman ◽  
Ian Madison ◽  
Nyambiri Nanai Kimacha ◽  
Jean-Benoît Falisse

AbstractThis paper explores the role of savings groups in resilience to urban climate-related disasters. Savings groups are a rapidly growing phenomenon in Africa. They are decentralized, non-institutional groups that provide millions of people excluded from the formal banking sector with a trusted, accessible, and relatively simple source of microfinance. Yet there is little work on the impacts of savings groups on resilience to disasters. In this paper, we use a combination of quantitative and qualitative evidence from Dar es Salaam (Tanzania) to shed new light on the role that savings groups play in helping households cope with climate-related shocks. Drawing on new data, we show that approximately one-quarter of households have at least one member in a group, and that these households recover from flood events faster than those who do not. We further argue that the structure of savings groups allows for considerable group oversight, reducing the high costs of monitoring and sanctioning that often undermine cooperative engagement in urban areas. This makes the savings group model a uniquely flexible form of financing that is well adapted to helping households cope with shocks such as repeated flooding. In addition to this, we posit that they may provide a foundation for community initiatives focusing on preventative action.


2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
BV Silva ◽  
T Rodrigues ◽  
N Cunha ◽  
J Brito ◽  
P Alves Da Silva ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. Background During the COVID-19 pandemic many countries have imposed lockdown restrictions to movement. Since the 18th of March in Portugal, thousands of people have been confined to their homes. While hospital admissions for COVID-19 patients increased exponentially, admissions for non-COVID-19 patients decreased dramatically. However, it remains unclear whether lockdown-related immobility can contribute to the increased incidence of pulmonary embolism. Purpose To compare the incidence of pulmonary embolism (PE) during the lockdown period (Abril 1 to May 31, 2020) compared to the reference period in 2019. Methods Retrospective study of consecutive outpatients who presented to the emergency department and underwent computed tomography pulmonary angiography (CTPA) due to suspicion of PE. Results Compared to the same period of 2019, the lockdown period was associated with a significant increase in PE diagnosis (29 versus 18 patients). PE patients during lockdown were older (median age 71 years; interquartile range [IQR][60-85] versus 59 years [44-76]; p = 0.046) and have lower prevalence of active cancer (14% versus 33% in the reference period). Women represent 55% (n = 16) of patients in lockdown group (versus 50% in 2019 group). Clinical probability (GENEVA score) was similar in both groups (median score 2.72 in lockdown group and 2.50 in reference group, p = 0.452). None of the patients with PE was diagnosed with COVID-19. Conclusion We have observed a marked increase (62%) in PE diagnosis during lockdown period compared to the reference period, which can be explained by the reduction in physical activity due to teleworking and closure of gyms and sports activities. These data reinforce the importance of promoting physical activity programs at home. The role of pharmacological or mechanical thromboprophylaxis in this scenario remains unclear.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 588-588
Author(s):  
Anne Blawert ◽  
Ellen Freiberger ◽  
Susanne Wurm

Abstract For older adults, a hospital stay can lead to loss of physical function and frailty. It is therefore important to investigate factors for recovery after hospitalization. Recent studies suggest negative self-perceptions of aging (SPA) as a potential risk factor in the context of serious health events. This ongoing longitudinal study investigates how negative SPA might contribute to worse physical recovery (assessed with the Short Physical Performance Battery) after hospital stay in a sample of 244 German adults aged 75 to 96. Preliminary mediation analysis based on available data of the first 50 participants indicate that negative SPA is related to increased fear of falling after 6 months, which predicts worse physical function one year after hospitalization (indirect effect: B = -0.70, SE = 0.41, p = .09). The results stress the importance of SPA for health recovery in old age and introduce fear of falling as a psychological pathway.


Author(s):  
Debanjan Banerjee ◽  
Kiran Rabheru ◽  
Carlos Augusto de Mendonca Lima ◽  
Gabriel Ivbijaro

2020 ◽  
Vol Volume 15 ◽  
pp. 645-654 ◽  
Author(s):  
Simone Chantal Gafner ◽  
Caroline Henrice Germaine Bastiaenen ◽  
Serge Ferrari ◽  
Gabriel Gold ◽  
Andrea Trombetti ◽  
...  

2002 ◽  
Vol 10 (2) ◽  
pp. 71-77 ◽  
Author(s):  
Rainer Rauramaa ◽  
Raimo Kuhanen ◽  
Timo A. Lakka ◽  
Sari B. Väisänen ◽  
Pirjo Halonen ◽  
...  

We investigated the role of the angiotensinogen (AGT) gene M235T polymorphism in determining blood pressure (BP) response to moderate intensity exercise in a 6-yr randomized controlled trial in 140 middle-aged men. Sitting, supine, and standing blood pressures were measured annually. Of the randomized men, 86% participated in the trial for 6 yr. Submaximal cardiorespiratory fitness increased by 16% in the exercise group. In the M homozygotes, sitting systolic BP decreased by 1.0 mmHg in the exercise but increased by 14.6 mmHg in the reference group ( P = 0.007 for net effect). Sitting and supine diastolic BP decreased by 6.2 and 3.3 mmHg in the exercise but increased by 2.8 and 3.2 mmHg in the reference group ( P = 0.026 and 0.024 for net effects), respectively. Regular moderate intensity exercise attenuates aging-related increase in systolic BP and decreases diastolic BP among the M homozygotes of the AGT gene M235T polymorphism.


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