Sensorimotor performance and reference values for fall risk assessment in community-dwelling adults: The Yishun Study

2021 ◽  
Author(s):  
Benedict Wei Jun Pang ◽  
Shiou-Liang Wee ◽  
Lay Khoon Lau ◽  
Khalid Abdul Jabbar ◽  
Wei Ting Seah ◽  
...  
Keyword(s):  
Reaction Time ◽  
Muscle Strength ◽  
Reference Values ◽  
Representative Sample ◽  
Fall Risk ◽  
Age Groups ◽  
Community Dwelling ◽  
Risk Scores ◽  
Younger Adults ◽  
Sensorimotor Performance

ABSTRACT Objective What are the reference values of sensorimotor performance for fall risk in community-dwelling adults? How do our population norms compare to that of other populations? Are younger adults at risk of falls? Methods In a cross-sectional study design, sensorimotor functions and fall risk scores of community-dwelling adults were assessed and calculated to derive corresponding fall risk categories. Reference values were determined using the average scores by age-group. A total of 542 community-dwelling adults were recruited (21-90 years old) across 10-year (21-60 years) and 5-year age-groups (>60 years) to obtain a representative sample of community-dwelling adults in Singapore. We assessed five physiological domains: vision, proprioception, muscle strength, reaction time and postural balance, according to the Physiological Profile Assessment (PPA). Fall risk scores and the corresponding fall risk profiles were generated from an online calculator. Results Sensorimotor performance and PPA fall risk scores were significantly worse for increasing age categories (p < .01). Females had significantly slower reaction time (p < .001), lower muscle strength (p < .001) and higher fall risk (p = .008). Our representative sample of older adults (≥65 years) performed poorer in postural sway (z = −0.50) and reaction time (z = −0.55), but better in proprioception (z = 0.29) and vision (z = 0.23) compared to Caucasian norms. Among younger adults (21-59 years), 36.8% appeared to exhibit higher fall risk. Conclusions Our study presents important reference data and compared sensorimotor functions and physiological fall risk across the age groups of community-dwelling adults in a South-East Asian population. Poor sensorimotor performance and fall risk appear already pertinent in younger adults. Further studies are warranted to improve our understanding of fall risk among younger adults. Impact Statement In physical therapy practice, PPA reference values can aid clinicians in the development of targeted interventions tailored towards an individual’s physiological risk profile, addressing specific physiological systems that require particular attention.

scholarly journals USEFUL FIELD OF VIEW AND DRIVING SIMULATION ACROSS TWO AGE GROUPS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S968-S969
Author(s):  
Rebecca A Dunterman ◽  
Robert C Intrieri ◽  
Marisa Guernsey
Keyword(s):  
Older Adults ◽  
Digit Span ◽  
Age Groups ◽  
Reaction Times ◽  
Community Dwelling ◽  
Older Drivers ◽  
Field Of View ◽  
Driving Simulation ◽  
Risk Scores ◽  
Useful Field Of View

Abstract The Insurance Information Institute (2017) reports that drivers aged 65 and older have the second highest rate of fatal car crashes. Research with the useful field of view (UFOV) assessment has predicted crashes in older drivers (Ball, 2006). “UFOV is defined as the area from which an individual can extract information quickly without head or eye movement” (Posit Science, 2019). Research demonstrates that older drivers are limited by poorer vision, divided attention and the inability to ignore distractions, and slower reaction time to critical stimuli (Owsley et al. 1998). As a result UFOV is an effective variable in assessing driver safety. We hypothesized that older compared to younger drivers would be less likely to inhibit attention to task irrelevant visual stimuli while engaged in a simulated driving task. Participants were community dwelling older adults and students recruited from a research pool and through word of mouth. Participants completed a series of demographic and health questions, Snellen visual acuity test a series of cognitive measures (e. g., Trails 1 and 2, digit symbol, digit span) and the UFOV assessment. Participants completed a driving simulation task while information on driving performance: number of collisions, speed limit deviations, turn signal use, time spent tailgating another vehicle, and braking reaction times. ANOVA demonstrated that as hypothesized, younger participants had significantly lower UFOV risk scores (p = .000). Older adults’ (M = 2.15, SD = .945) and younger adults’ (M = 1, SD = 0).

Fear of Alzheimer's disease in the French population: impact of age and proximity to the disease

2011 ◽  
Vol 24 (1) ◽  
pp. 108-116 ◽  
Author(s):  
Inge Cantegreil-Kallen ◽  
Stéphanie Pin
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Age Groups ◽  
The Elderly ◽  
Community Dwelling ◽  
French Population ◽  
Cross Sectional ◽  
Younger Adults ◽  
Substantial Impact ◽  
Negative Image

ABSTRACTBackground: The negative image of Alzheimer's disease (AD) in our society has a substantial impact on treating, caring for and integrating those suffering from the disease and their relatives. Little research has been conducted on social perception of AD in the community.Methods: The aim of this study was to investigate the perception, knowledge, opinions and beliefs about AD in the French population. A cross-sectional telephone survey of 2013 randomly selected community-dwelling people aged 18 years and over was conducted. Multivariate logistic regressions were used for identifying predictors of the personal fear of developing AD, both for the global sample and for different age groups.Results: Sixty percent of the sample reported personal fear of developing AD. This attitude was strongly related to age, becoming predominant among the elderly. In the middle-aged group, personal fear of developing AD was highest in women with poor self-perceived health and, in particular, those who cared for someone with AD. Being a caregiver or knowing someone with the disease was also strongly associated with fear among younger adults aged 18–34.Conclusions: These results serve as an incentive for developing special education and prevention programs focused on different age groups and caregivers of AD.

scholarly journals Fall risk in people with MS: A Physiological Profile Assessment study

2016 ◽  
Vol 2 ◽  
pp. 205521731664113 ◽  
Author(s):  
Phu D Hoang ◽  
Meryem Baysan ◽  
Hilary Gunn ◽  
Michelle Cameron ◽  
Jenny Freeman ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Reaction Time ◽  
Contrast Sensitivity ◽  
Fall Risk ◽  
Quadriceps Strength ◽  
Risk Scores ◽  
Future Research ◽  
Reference Database ◽  
Physiological Profile ◽  
Physiological Profile Assessment

Introduction The Physiological Profile Assessment (PPA) is used in research and clinical practice for assessing fall risk. We compared PPA test performance between people with multiple sclerosis (MS) and healthy controls, determined the fall-risk profile for people with MS and developed a reference database for people with MS. Methods For this study, 416 ambulant people with MS (51.5 ± 12.0 years) and 352 controls (52.8 ± 12.2 years) underwent the PPA (tests of contrast sensitivity, proprioception, quadriceps strength, reaction time and sway) with composite fall-risk scores computed from these measures. MS participants were followed prospectively for falls for 3 months. Results The MS participants performed significantly worse than controls in each PPA test. The average composite fall-risk score was also significantly elevated, indicating a “marked” fall risk when compared with controls. In total, 155 MS participants (37.3%) reported 2 + falls in the follow-up period. Frequent fallers performed significantly worse than non-frequent fallers in the contrast sensitivity, reaction time and sway tests and had higher PPA composite scores. Conclusions In line with poor PPA test performances, falls incidence in people with MS was high. This study provides comprehensive reference data for the PPA measures for people with MS that could be used to inform future research and clinical practice.

scholarly journals Decreased Muscle Strength Relates to Self-Reported Stooping, Crouching, or Kneeling Difficulty in Older Adults

2010 ◽  
Vol 90 (1) ◽  
pp. 67-74 ◽  
Author(s):  
Manuel E. Hernandez ◽  
Allon Goldberg ◽  
Neil B. Alexander
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Fall Risk ◽  
Knee Extensor ◽  
Community Dwelling ◽  
Functional Mobility ◽  
Plantar Flexor ◽  
Cross Sectional ◽  
Muscle Groups ◽  
Flexor Strength

Background Bending down and kneeling are fundamental tasks of daily living, yet nearly a quarter of older adults report having difficulty performing or being unable to perform these movements. Older adults with stooping, crouching, or kneeling (SCK) difficulty have demonstrated an increased fall risk. Strength (force-generating capacity) measures may be useful for determining both SCK difficulty and fall risk. Objective The purposes of this study were: (1) to examine muscle strength differences in older adults with and without SCK difficulty and (2) to examine the relative contributions of trunk and leg muscle strength to SCK difficulty. Design This was a cross-sectional observational study. Methods Community-dwelling older adults (age [X̅±SD]=75.5±6.0 years) with SCK difficulty (n=27) or without SCK difficulty (n=21) were tested for leg and trunk strength and functional mobility. Isometric strength at the trunk, hip, knee, and ankle also was normalized by body weight and height. Results Compared with older adults with no SCK difficulty, those with SCK difficulty had significant decreases in normalized trunk extensor, knee extensor, and ankle dorsiflexor and plantar-flexor strength. In 2 separate multivariate analyses, raw ankle plantar-flexor strength (odds ratio [OR]=0.97, 95% confidence interval [CI]=0.95–0.99) and normalized knee extensor strength (OR=0.61, 95% CI=0.44–0.82) were significantly associated with SCK difficulty. Stooping, crouching, and kneeling difficulty also correlated with measures of functional balance and falls. Limitations Although muscle groups that were key to rising from SCK were examined, there are other muscle groups that may contribute to safe SCK performance. Conclusions Decreased muscle strength, particularly when normalized for body size, predicts SCK difficulty. These data emphasize the importance of strength measurement at multiple levels in predicting self-reported functional impairment.

scholarly journals Frailty Prevalence in Younger End-Stage Kidney Disease Patients Undergoing Dialysis and Transplantation

2020 ◽  
Vol 51 (7) ◽  
pp. 501-510
Author(s):  
Nadia M. Chu ◽  
Xiaomeng Chen ◽  
Silas P. Norman ◽  
Jessica Fitzpatrick ◽  
Stephen M. Sozio ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Age Groups ◽  
Wald Test ◽  
Community Dwelling ◽  
End Stage Kidney Disease ◽  
Frailty Phenotype ◽  
Younger Adults ◽  
Younger Patients ◽  
End Stage ◽  
Community Dwelling Older Adults

Background: Frailty, originally characterized in community-dwelling older adults, is increasingly being studied and implemented for adult patients with end-stage kidney disease (ESKD) of all ages (>18 years). Frailty prevalence and manifestation are unclear in younger adults (18–64 years) with ESKD; differences likely exist based on whether the patients are treated with hemodialysis (HD) or kidney transplantation (KT). Methods: We leveraged 3 cohorts: 378 adults initiating HD (2008–2012), 4,304 adult KT candidates (2009–2019), and 1,396 KT recipients (2008–2019). The frailty phenotype was measured within 6 months of dialysis initiation, at KT evaluation, and KT admission. Prevalence of frailty and its components was estimated by age (≥65 vs. <65 years). A Wald test for interactions was used to test whether risk factors for frailty differed by age. Results: In all 3 cohorts, frailty prevalence was higher among older than younger adults (HD: 71.4 vs. 47.3%; candidates: 25.4 vs. 18.8%; recipients: 20.8 vs. 14.3%). In all cohorts, older patients were more likely to have slowness and weakness but less likely to report exhaustion. Among candidates, older age (odds ratio [OR] = 1.79, 95% CI: 1.47–2.17), non-Hispanic black race (OR = 1.30, 95% CI: 1.08–1.57), and dialysis type (HD vs. no dialysis: OR = 2.06, 95% CI: 1.61–2.64; peritoneal dialysis vs. no dialysis: OR = 1.78, 95% CI: 1.28–2.48) were associated with frailty prevalence, but sex and Hispanic ethnicity were not. These associations did not differ by age (pinteractions > 0.1). Similar results were observed for recipients and HD patients. Conclusions: Although frailty prevalence increases with age, younger patients have a high burden. Clinicians caring for this vulnerable population should recognize that younger patients may experience frailty and screen all age groups.

scholarly journals Multi-System Physical Exercise Intervention for Fall Prevention and Quality of Life in Pre-Frail Older Adults: A Randomized Controlled Trial

2020 ◽  
Vol 17 (9) ◽  
pp. 3102 ◽  
Author(s):  
Jiraporn Chittrakul ◽  
Penprapa Siviroj ◽  
Somporn Sungkarat ◽  
Ratana Sapbamrer
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Reaction Time ◽  
Muscle Strength ◽  
Physical Exercise ◽  
Fall Prevention ◽  
Fall Risk ◽  
Postural Sway ◽  
Frail Older Adults

Effective interventions for indicated fall prevention are necessary for older adults with frailty. We aimed to determine the effectiveness of a Multi-system Physical Exercise (MPE) for fall prevention and Health-Related Quality of Life (HRQOL) in pre-frail older adults. This randomized control trial with allocation concealment included 72 adults aged 65 and above, identified as pre-frailty and with mild and moderate fall risk scores measured by the Physiological Profile Assessment (PPA). Randomly, using block randomization, participants were divided into two groups: an MPE group (n = 36) and a control group (n = 36). The intervention consisted mainly of proprioception, muscle strengthening, reaction time, and balance training and was carried out three days per week for 12 weeks. The primary outcome was fall risk assessed using PPA at 12 weeks post-baseline and at a 24 week follow-up. Significant differences were found in the improvement in fall risk, proprioception, muscle strength, reaction time and postural sway, and fear of fall scores in the MPE group compared with controls at week 12 and 24. In addition, HRQOL had increased significantly in the MPE group in comparison to controls. The MPE program significantly increased muscle strength and improved proprioception, reaction time, and postural sway leading to fall risk reduction in older adults with pre-frailty. Therefore, the MPE program is recommended for used in day-to-day primary care practice in the pre-frail population.

scholarly journals Is functional fitness performance a useful predictor of risk of falls among community-dwelling older adults?

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Hsin-Hung Ho ◽  
I-Yao Fang ◽  
Yi-Chien Yu ◽  
Yi-Ping Huang ◽  
I-Ling Kuo ◽  
...  
Keyword(s):  
Older Adults ◽  
Fall Risk ◽  
Public Health Problem ◽  
Community Dwelling ◽  
Risk Scores ◽  
Functional Fitness ◽  
Risk Of Falling ◽  
Cross Sectional ◽  
Risk Of Falls ◽  
Community Dwelling Older Adults

Abstract Background Falls among older adults are a serious public health problem. Many studies indicate that positive functional fitness performance decreases the risk of falls. A limited amount of previous study has investigated the association between broad functional fitness and the fall risk. This study examines the associations between functional fitness and the risk of falling among community-dwelling older adults. Methods Three waves of cross-sectional data were collected from 2017 to 2019 in Taipei City, Taiwan. Six hundred sixty-five participants aged ≥65 years were randomly recruited from 12 districts of Taipei. Eight functional fitness tests (i.e., back scratch, chair-sit and-reach, 8-ft up-and-go, 30-s sit-to-stand, 30-s arm curl, 30-s single-leg stance, 2-min step, and hand grip strength tests) were performed to record the physical performance of older subjects. A Chinese version of the fall-risk questionnaire (FRQ) was used to calculate the fall risk scores. Linear regression and logistic regression were utilized to estimate the relationships of each functional fitness and fall risk. Result The results showed that 37.45% of older adults had a high risk of falling. It was found for each functional fitness that performance was linearly associated with the risk of falling. Moreover, older adults with low-performance levels in all functional fitness except back-scratching were more likely to have a higher risk of falling. Conclusions Our study indicated that functional fitness performance appears to provide valid predictive guidance for reducing the risk of falling among the older population.

scholarly journals Enhanced Gait Variability Index in Older Asian Adults and Increased Physiological Fall Risk: Results from the Yishun Study

2020 ◽  
Author(s):  
Khalid Abdul Jabbar ◽  
Wei-Ting Seah ◽  
Lay Khoon Lau ◽  
Benedict Wei-Jun Pang ◽  
Daniella Hui-Min Ng ◽  
...  
Keyword(s):  
Older Adults ◽  
Reference Values ◽  
Gait Speed ◽  
Fall Risk ◽  
Asian Population ◽  
Risk Groups ◽  
Gait Variability ◽  
Community Dwelling ◽  
Spatiotemporal Parameters ◽  
Variability Index

Abstract Background: Gait variability (GV) of various spatiotemporal parameters has been investigated in association with falls as well as physical and cognitive decline. However, the lack of consensus regarding the best approach to quantify GV as well as the lack of a composite score to represent the variabilities of the various spatiotemporal gait parameters, had dampened the reporting and acceptance of GV, especially among Asian researchers. The main objective of this study was to derive an Enhanced Gait Variability Index (EGVI) and reference values in an Asian population and to evaluate its validity as an indicator of physiological fall risk.Methods: This cross-sectional study was conducted in a large residential town of Yishun in Singapore. Random sample of community-dwelling adults (N = 511, 21 – 90 years old) categorized into 3 groups – reference group (N = 268, 21 – 64 years), low fall-risk (N = 182, ≥ 65 years) and high fall-risk (N = 61, ≥ 65 years). Physiological Profile Assessment (PPA) score of ≥ 2.0 was used to differentiate high fall-risk and low fall-risk groups. EGVI were derived from 5 spatiotemporal parameters: step length(cm), step time(s), stance time(s), single support time(s) and stride velocity(cm/s), with reference values from among participation less than 65 years of age.Results: Our Asian population showed greater overall gait variability than the European cohort in which the original EGVI was derived. This Asian EGVI displayed a non-linear relationship with both ageing and gait speed – significant changes in the EGVI were observed for those older than 60 years of age and in those whose habitual gait speed was lesser than 120cm/s. The EGVI discriminated between older adults with and without high fall risk and showed weak to moderate correlation with a number of the functional mobility and balance tests in both high and low fall risk groups.Conclusion: We derived an Asian Enhanced Gait Variability Index and reference values and validated its performance to discriminate high fall-risk and low fall-risk among older adults.

scholarly journals Key factor cutoffs and interval reference values for stratified fall risk assessment in community-dwelling older adults: the role of physical fitness, body composition, physical activity, health condition, and environmental hazards

2021 ◽  
Vol 21 (S2) ◽  
Author(s):  
Catarina Pereira ◽  
Guida Veiga ◽  
Gabriela Almeida ◽  
Ana Rita Matias ◽  
Ana Cruz-Ferreira ◽  
...  
Keyword(s):  
Older Adults ◽  
High Risk ◽  
Physical Fitness ◽  
Reference Values ◽  
Fall Risk ◽  
Community Dwelling ◽  
Low Risk ◽  
Moderate Risk ◽  
Community Dwelling Older Adults ◽  
Very High

Abstract Background Fall risk assessment and determination of older adults’ individual risk profiles are crucial elements in fall prevention. As such, it is essential to establish cutoffs and reference values for high and low risk according to key risk factor outcomes. This study main objective was to determine the key physical fitness, body composition, physical activity, health condition and environmental hazard risk outcome cutoffs and interval reference values for stratified fall risk assessment in community-dwelling older adults. Methods Five-hundred community-dwelling Portuguese older adults (72.2 ± 5.4 years) were assessed for falls, physical fitness, body composition, physical (in) activity, number of health conditions and environmental hazards, and sociodemographic characteristics. Results The established key outcomes and respective cutoffs and reference values used for fall risk stratification were multidimensional balance (low risk: score > 33, moderate risk: score 32–33, high risk: score 30–31, and very high: score < 30); lean body mass (low risk: > 44 kg, moderate risk: 42–44 kg, high risk: 39–41 kg, and very high: < 39 kg); fat body mass (low risk: < 37%, moderate risk: 37–38%, high risk: 39–42%, and very high: > 42%); total physical activity (low risk: > 2800 Met-min/wk., moderate risk: 2300–2800 Met-min/wk., high risk: 1900–2300 Met-min/wk., and very high: < 1900 Met-min/wk); rest period weekdays (low risk: < 4 h/day, moderate risk: 4–4.4 h/day, high risk: 4.5–5 h/day, and very high: > 5 h/day); health conditions (low risk: n < 3, moderate risk: n = 3, high risk: n = 4–5, and very high: n > 5); and environmental hazards (low risk: n < 5, moderate risk: n = 5, high risk: n = 6–8, and very high: n > 8). Conclusions Assessment of community-dwelling older adults’ fall risk should focus on the above outcomes to establish individual older adults’ fall risk profiles. Moreover, the design of fall prevention interventions should manage a person’s identified risks and take into account the determined cutoffs and respective interval values for fall risk stratification.

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