scholarly journals How 4Ms Age-Friendly Care Led to Improved Compliancy of Older Adult Fall Screenings in Rural Primary Care Clinics

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 827-827
Author(s):  
Leah Tobey ◽  
Robin McAtee
Keyword(s):  
Older Adult ◽  
Fall Risk ◽  
Healthy Aging ◽  
Fear Of Falling ◽  
Safety Education ◽  
Timed Up And Go ◽  
Rural Primary Care ◽  
Mobility Factor ◽  
History Of ◽  
Will Force

Abstract Past medical history of falls and fear of falling are reliable indicators of future fall risk of an older adult (OA). As one of the HRSA funded Geriatric Workforce Enhancement recipients, the AR Geriatric Education Collaborative (AGEC) worked with a rural federally qualified healthcare clinic system to help incorporate fall screens to satisfy the Mobility factor in the 4Ms age-friendly care framework. After consultation with the practitioners, it was decided to use the Timed-Up-And-Go (TUAG) screen because it is evidence-based and appropriate for OAs. Training on the use of the TUAG was completed next as was the addition of the screen into the EMR. Fall screens in one clinic were only completed 7% before training and 7 months after the training, this rose to almost 100%. In a second clinic, the screens were completed 22% of the time and this was increased to 66% after training. Training on mobility continues to occur on a regular basis as staff turns over and as new priorities arise, but the use of the TUAG as a mobility screen has been a critical component in the process of these rural clinics providing age-friendly care. Next steps with improving fall risks will be the development of flags within the EMR that will force practitioners to complete a full falls plan of care if the OA scored within the moderate or high fall risk categories. The plan will include home safety education and/or evaluation, PT or OT referrals to further support healthy aging for the OA.

The Relationship Between Fear of Falling and Functional Fitness among Older Adults Living in Rest Home

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
H Tuna ◽  
Ö Bozan ◽  
B Gürpınar ◽  
N İlçin
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Dynamic Balance ◽  
Upper Body ◽  
Functional Fitness ◽  
Fall Risk Factors ◽  
Rest Home ◽  
History Of

Objective: This study aimed to report the fear of falling and assess its associations with several fall-related characteristics and functional fitness parameters among older adults living in the rest home. Methods: Seventy-eight older adults aged between 65-94 years were included in the study. History of falling and the number of risk factors for falling were recorded. Fear of falling was evaluated with The Falls Efficacy ScaleInternational. Functional fitness was assessed with Senior Fitness Test, including tests for the functional measurement of strength, flexibility, aerobic endurance and dynamic balance. Result: The mean age of participants was 78.46±7.16 years. There were correlations exist between fear of falling and number of fall risk factors, dynamic balance, upper body flexibility and aerobic endurance (p<0.05). Multiple linear regression analysis showed that the parameters with the highest determinants of fear of falling were the dynamic balance and history of falling (p<0.05). Conclusions: In our study, history of falling, number of fall risk factors, flexibility for the upper body, aerobic endurance and dynamic balance were parameters related to fear of falling among older adults, but the most influential factors in fear of falling were dynamic balance and history of falling.

scholarly journals COGNITIVE APPRAISAL AND KNOWLEDGE AS RISK FACTORS FOR HIGH FEAR OF FALLING IN OLDER AND MIDDLE-AGED ADULTS IN SINGAPORE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S473-S473
Author(s):  
Pey June Tan ◽  
Reuben Ng ◽  
Angelique Chan ◽  
Jagadish U Mallya ◽  
Noor Hafizah Ismail ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Fall Risk ◽  
Cognitive Appraisal ◽  
Fear Of Falling ◽  
Age Groups ◽  
Fall Risk Factors ◽  
History Of ◽  
Middle Aged Adults ◽  
Balance Problems

Abstract Fear-of-falling (FOF) can be adaptive or maladaptive depending on one’s appraisal of knowledge and beliefs, but few have elucidated this cognitive process in older adults surrounding falls. We aim to identify risk factors for high FOF amongst community-dwelling older adults (OA) and middle-aged adults (MA) in Singapore. This was a cross-sectional survey of a nationally-representative sample of OA (≥60 years) and MA (40-59 years) identified by stratified random sampling. Primary outcome was high FOF measured by a single-item (4-point scale). Independent variables were history-of-falls, quality-of-life, fall-related cognitive appraisal (balance problems, importance to restrict activities to prevent falls) and knowledge indicators (knowledge of other OA who fell, ability to identify out of 13 fall risk factors). MA were also asked if they’re caregivers. Multiple logistic regressions identified risk factors for high FOF separately by age-groups, adjusting for socio-demographics and comorbidities. The final analysis included 549 OA (70.6±6.88 years) and 309 MA (49.7±5.89 years). No differences in high FOF was found among OA and MA (37% vs. 38%, p=0.305), but there were more falls among OA (19% vs 12%, p=0.010). Higher knowledge of fall risk factors and self-reported balance problems were significant risk factors for high FOF among OA only, while a history-of-falls and being a caregiver were significant among MA only. Perceived importance to restrict activities was associated with high FOF in both age-groups. Although findings suggest differences in the mechanism of high FOF between OA and MA, both age-groups have maladaptive appraisal tendencies related to restrict activities to prevent falls.

scholarly journals Relationship between SHARE-FI Frailty Scores and Physical Performance Measures in Older Adult Medicaid Recipients

Geriatrics ◽  
2018 ◽  
Vol 3 (3) ◽  
pp. 51 ◽  
Author(s):  
Margaret Danilovich ◽  
Laura Diaz ◽  
Daniel Corcos ◽  
Jody Ciolino
Keyword(s):  
Older Adult ◽  
Physical Performance ◽  
Performance Measures ◽  
Gait Speed ◽  
Fall Risk ◽  
Assessment Tool ◽  
Performance Measure ◽  
Self Report ◽  
Timed Up And Go ◽  
Cross Sectional

The Survey of Health, Ageing and Retirement in Europe-Frailty Instrument (SHARE-FI) is a frailty assessment tool designed for primary care settings comprised of four self-report questions and grip strength measurement, yet it is not known how SHARE-FI scores relate to objective physical performance measures that assess physical functioning, fall risk, and disability. This cross-sectional, observational study examined the association between SHARE-FI scores and a battery of physical performance measures in a sample of older adult, Medicaid waiver recipients (n = 139, mean age = 74.19 ± 8.36 years). We administered the SHARE-FI, Timed Up and Go (TUG), gait speed, and Short Physical Performance Battery (SPPB) in participants’ homes. Among clients, 45% were frail, 35% pre-frail, and 20% non-frail. There were significant differences in all physical performance measure scores with respect to SHARE-FI category. SHARE-FI continuous scores significantly predicted TUG time, all domains of the SPPB, gait speed, and inability to complete the chair rise test. Self-reported walking difficulty and objectively measured gait speed were significantly correlated. The SHARE-FI continuous frailty score predicts scores on a variety of validated physical performance measures. Given the fast administration time, the SHARE-FI could potentially be used to serve as a surrogate for physical performance measures with known association with physical function, fall risk, and disability.

scholarly journals Prevalence of fear of falling, in a sample of elderly adults in the community

2017 ◽  
Vol 20 (3) ◽  
pp. 309-318 ◽  
Author(s):  
Danielle Teles da Cruz ◽  
Raphaela Ornellas Duque ◽  
Isabel Cristina Gonçalves Leite
Keyword(s):  
Functional Capacity ◽  
Healthy Aging ◽  
Fear Of Falling ◽  
Perceived Health ◽  
Assistive Device ◽  
Elderly Persons ◽  
Cross Sectional ◽  
Significance Level ◽  
History Of ◽  
Difficulty Walking

Abstract Objectives: To investigate the prevalence of fear of falling among a sample of elderly persons in the community, and to analyze its correlation with age, self-perceived health, difficulty walking, use of an assistive device for walking, history of falls, and functional capacity. Method: A cross-sectional study of 314 non-institutionalized elderly individuals, living in the city of Juiz de Fora in the state of Minas Gerais) in 2015, was carried out. A household survey was conducted and fear of falling was assessed using the Falls Efficacy Scale - International - Brazil (FES-I-BRASIL). The Spearman correlation was used to verify the correlation of the independent variables with the fear of falling. The significance level for the study was 5%. Results: The prevalence of fear of falling among the elderly was 95.2% (95% CI= 92.3; 97.3). Fear of falling was significantly correlated with all the variables analyzed: age (r= 0.199), self-perceived health (r=0.299), difficulty walking (r= -0.480), use of an assistive device for walking (r=0.337), history of falls (r= -0.177), and functional capacity (r = -0.476) . Conclusions: A high prevalence of fear of falling was observed, with a significant correlation between the outcome and the variables studied. These findings point to the need for rehabilitation, prevention, and health promotion strategies that enable healthy aging.

scholarly journals Fear of falling associated with sociodemographic and lifestyle variables and clinical conditions in elderly people registered with the Family Health Strategy in Campo Grande, Mato Grosso do Sul

2016 ◽  
Vol 19 (3) ◽  
pp. 441-452 ◽  
Author(s):  
Karina Ayumi Martins Utida ◽  
Mariana Bogoni Budib ◽  
Adriane Pires Batiston
Keyword(s):  
Linear Correlation ◽  
Fear Of Falling ◽  
Family Health ◽  
The Elderly ◽  
Elderly Persons ◽  
Timed Up And Go ◽  
Cross Sectional ◽  
Mato Grosso ◽  
History Of ◽  
Mato Grosso Do Sul

Abstract Objective: To investigate the prevalence of fear of falling among the elderly and its association with sociodemographic and lifestyle variables, morbidities, balance, mobility and a history of falls (HF). Method: A cross-sectional study was performed in nine family health units in the southern district of Campo Grande, Mato Grosso do Sul. An interview was conducted to obtain data relating to the sociodemographic and clinical variables and the history of falls. The Falls Efficacy Scale-International-Brazil (FES-I-Brazil) and the Timed Up and Go (TUG) test were also applied. Statistical analysis was performed using the Pearson linear correlation test (FES-I-Brazil related to TUG score), the Student's t-test (FES-I-Brazil related to lifestyle, comorbidities and HF) and ANOVA one way, followed by Tukey post-hoc (FES-I-Brazil related to HF and TUG score). Results: Two hundred and one elderly persons with an average age of 70.85 (±7.72) years were included. On the FES-I-Brazil scale, the overall score was 28.80 (±0.82) points. The average TUG time was 12.00 (±0.57) seconds. There was a significant positive linear correlation between the FES-I-Brazil score and the TUG time (p<0.001) and the variables of gender (p=0.008), hypertension (p=0.002), FH (p=0.005) and frequency of falls (p=0.011). Conclusion: There is a high frequency of fear of falling among the studied population, as the majority reported fear of falling in at least one of the sixteen FES-I-Brazil tasks. Such fear was significantly associated with hypertension, diabetes mellitus, history of falls, perception of always suffering falls and low scores for mobility and balance.

scholarly journals The Relationship between Specific Cognitive Domains, Fear of Falling, and Falls in People with Multiple Sclerosis

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Alon Kalron
Keyword(s):  
Fall Risk ◽  
Fear Of Falling ◽  
Cognitive Testing ◽  
Cognitive Test ◽  
Walking Ability ◽  
Cognitive Domains ◽  
Cognitive Component ◽  
Fall Risk Factors ◽  
History Of ◽  
The Relationship

The primary aim was to examine the relationship between seven definite aspects of cognition measured by a computerized cognitive testing tool on the history falls in people with mild to moderate MS (PwMS). Secondary aims focused on whether cognition performance is correlated to fear of falling, walking velocity, and a patient-rated measure of walking ability. One hundred and one PwMS were included in the study analysis. Fifty-two had a history of at least one fall during the past year. Outcome measures included a computerized cognitive test battery designed to evaluate multiple cognitive domains, gait speed, and self-reported questionnaires; 12-item MS walking scale (MSWS-12); and Falls Efficacy Scale International. Significant differences between fallers and nonfallers were exhibited in attention and verbal function, scoring 7.5% (P=0.013) and 6.2% (P=0.05), respectively, below the parallel scores of the nonfallers. Attention was the only cognitive component significantly correlated with the MSWS-12 self-reported questionnaire. Fear of falling was significantly correlated with 6 (out of 7) definite cognitive variables. The present findings support the concept that when evaluating and attempting to reduce fall risk, emphasis should be placed not only on traditional fall risk factors like muscle strength and motor function, but also on cognitive function.

scholarly journals 122 3OLLIN: APP to Assess the Risk of Falls in Older Adults

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv28-iv33
Author(s):  
Lorena Parra-Rodríguez
Keyword(s):  
Older Adults ◽  
Fall Risk ◽  
Cognitive Status ◽  
Community Dwelling ◽  
Percentage Error ◽  
Functional Evaluation ◽  
Timed Up And Go ◽  
Registration System ◽  
History Of ◽  
The Mean

Abstract Objective To develop an app for Android smartphones (named 3Ollin) that assess the fall risk through the automated analysis of three physical performance (PP) tests and the history of falls of the participant. Design Cross-sectional design. Setting Community-dwelling older adults studied at the Functional Evaluation Laboratory at the National Institute of Geriatrics in Mexico. Participants Older adults (n=223) living in Mexico City were included. The participants were recruited from groups of pensioners from the National Autonomous University of Mexico, church groups, and other community programs. Measurements Data were collected about demographics, comorbidities, cognitive status, nutritional status, dependency and PP variables. The 3Ollin app evaluates the PP of the participants through the history of falls, the Timed Up and Go, the 30-second chair stand, and the 4-stage balance tests. The app incorporates them into the CDC’s Algorithm for Fall Risk Screening, Assessment, and Intervention. Methods All participants were evaluated by trained staff. The app has a registration system for users and patients, allows to perform the PP tests, acquires the data from the sensors signals, and sends and stores the information in the server of the National Institute of Geriatrics in Mexico. Results The mean age of the studied population was 73.5±7.0 years, 77.6% were women, and 37.2% did not complete the 4-stage balance test. The mean percentage error (MPE) between the gait speed measured through the GAITRite walkway (ms=103.5±26.1 cm/s) and the 3Ollin app (ms=100.0±30.3 cm/s) was 10.7%. The MPE between the number of chair lifts in 30 s according to the evaluator's observations (mCL=15±6 repetitions), and the 3Ollin app (mCL=19±6 repetitions) was 23.4%. Additionally, 87% were correctly classified according to the 3Ollin app. Conclusions This design first step of the 3Ollin app probed to offer a valid, efficient, costless performance evaluation, without the need of a laboratory environment.

Fear of falling and associated activity curtailment among middle aged and older adults with multiple sclerosis

2007 ◽  
Vol 13 (9) ◽  
pp. 1168-1175 ◽  
Author(s):  
E.W. Peterson ◽  
C.C. Cho ◽  
M.L. Finlayson
Keyword(s):  
Multiple Sclerosis ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Factors Associated ◽  
Telephone Interviews ◽  
History Of ◽  
Realistic Appraisal ◽  
Walking Aid

The purpose of this study was to identify factors associated with increased likelihood of reporting fear of falling (FoF) among people with multiple sclerosis (MS) and factors associated with activity curtailment among the subset of individuals reporting FoF. Cross-sectional data from telephone interviews with 1064 individuals with MS, aged 45—90 years living in the Midwestern United States were used. Logistic regression models examined factors associated with FoF and with activity curtailment among individuals reporting FoF. Of the participants, 63.5% reported FoF. Increased likelihood of reporting FoF was associated with being female, experiencing greater MS symptom interference during everyday activities, history of a fall in the past 6 months, and using a walking aid. Among participants reporting FoF, 82.6% reported curtailing activity. Increased likelihood of activity curtailment among people reporting FoF was associated with using a walking aid, needing moderate or maximum assistance with instrumental activities of daily living, and having less than excellent self-reported mental health. We concluded that FoF and associated activity curtailment are common among people aged 45—90 with MS. While FoF and associated activity curtailment may be appropriate responses to fall risk, the findings suggest that factors beyond realistic appraisal of fall risk may be operating. Multiple Sclerosis 2007; 13: 1168—1175. http://msj.sagepub.com

scholarly journals Minimal shoes improve stability and mobility in persons with a history of falls

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Tomasz Cudejko ◽  
James Gardiner ◽  
Asangaedem Akpan ◽  
Kristiaan D’Août
Keyword(s):  
Fall Prevention ◽  
Postural Stability ◽  
Center Of Pressure ◽  
Stability Margin ◽  
Timed Up And Go ◽  
Balance Test ◽  
Margin Of Stability ◽  
Eyes Open ◽  
History Of ◽  
Falls In Older Adults

AbstractPostural and walking instabilities contribute to falls in older adults. Given that shoes affect human locomotor stability and that visual, cognitive and somatosensory systems deteriorate during aging, we aimed to: (1) compare the effects of footwear type on stability and mobility in persons with a history of falls, and (2) determine whether the effect of footwear type on stability is altered by the absence of visual input or by an additional cognitive load. Thirty participants performed standing and walking trials in three footwear conditions, i.e. conventional shoes, minimal shoes, and barefoot. The outcomes were: (1) postural stability (movement of the center of pressure during eyes open/closed), (2) walking stability (Margin of Stability during normal/dual-task walking), (3) mobility (the Timed Up and Go test and the Star Excursion Balance test), and (4) perceptions of the shoes (Monitor Orthopaedic Shoes questionnaire). Participants were more stable during standing and walking in minimal shoes than in conventional shoes, independent of visual or walking condition. Minimal shoes were more beneficial for mobility than conventional shoes and barefoot. This study supports the need for longitudinal studies investigating whether minimal footwear is more beneficial for fall prevention in older people than conventional footwear.

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