Predictors of Future Walking Speed: A 12-Month Monitoring Program

2021 ◽  
pp. 009141502110665
Author(s):  
Ayelet Dunsky ◽  
Aviva Zeev ◽  
Yael Netz
Keyword(s):  
Older Adults ◽  
Reaction Time ◽  
Older Adult ◽  
Walking Speed ◽  
Monitoring Program ◽  
Community Dwelling ◽  
Adult Women ◽  
Balance Performance ◽  
Adult Men ◽  
Community Dwelling Older Adults

The purpose of the current study was to identify significant predictors of walking speed (WS) among community-dwelling older adults, as it is one of the most representative measures of functioning in their daily lives. Seventy-seven (24 adult men, 26 adult women, and 27 older-adult women) community-dwelling older adults (73.7 ± 4.9 years) performed two assessments, over a 12-month period. Several physical, cognitive, and psychological tests were performed, as well as assessing the preferred WS. Multiple linear regression, stratified by gender, was used to identify significant predictors of future WS. For the adult men, walking and functional performances at the first assessment predicted 71.9%; for adult women, reaction time, walking, and balance performance predicted 64.4%; and, for the older-adult women, fast walking and reaction time predicted 48.2% of the variance of future WS. Clinicians should consider including different exercises for each group of older adults to evaluate and preserve functional abilities.

scholarly journals Increasing Older Adult Involvement in Geriatric Assessment: A Mixed-Methods Process Evaluation

2021 ◽  
pp. 089826432199332
Author(s):  
Wanda Rietkerk ◽  
Jannet de Jonge-de Haan ◽  
Joris P. J. Slaets ◽  
Sytse U. Zuidema ◽  
Debby L. Gerritsen
Keyword(s):  
Older Adults ◽  
Behavior Change ◽  
Older Adult ◽  
Goal Setting ◽  
Geriatric Assessment ◽  
Well Being ◽  
Community Dwelling ◽  
Implementation Processes ◽  
Adult Involvement ◽  
Community Dwelling Older Adults

Objectives: Goal setting and motivational interviewing (MI) may increase well-being by promoting healthy behavior. Since we failed to show improved well-being in a proactive assessment service for community-dwelling older adults applying these techniques, we studied whether implementation processes could explain this. Methods: Goals set during the comprehensive geriatric assessment were evaluated on their potential for behavior change. MI and goal setting adherence wasassessed by reviewing audiotaped interactions and interviewing care professionals. Results: Among the 280 goals set with 230 frail older adults (mean age 77 ± 6.9 years, 59% women), more than 90% had a low potential for behavior change. Quality thresholds for MI were reached in only one of the 11 interactions. Application was hindered by the context and the limited proficiency of care professionals. Discussion: Implementation was suboptimal for goal setting and MI. This decreased the potential for improved well-being in the participating older adults.

scholarly journals Comparison of Lateral Perturbation-Induced Step Training and Hip Muscle Strengthening Exercise on Balance and Falls in Community-Dwelling Older Adults: A Blinded Randomized Controlled Trial

2021 ◽  
Author(s):  
Mark W Rogers ◽  
Robert A Creath ◽  
Vicki Gray ◽  
Janice Abarro ◽  
Sandy McCombe Waller ◽  
...  
Keyword(s):  
Older Adults ◽  
Controlled Trial ◽  
Step Length ◽  
Community Dwelling ◽  
Controlled Study ◽  
Balance Performance ◽  
Muscle Strengthening ◽  
Hip Muscle ◽  
Hip Abduction ◽  
Community Dwelling Older Adults

Abstract Background This factorial, assessor-blinded, randomized, and controlled study compared the effects of perturbation-induced step training (lateral waist-pulls), hip muscle strengthening, and their combination, on balance performance, muscle strength, and prospective falls among older adults. Methods Community-dwelling older adults were randomized to 4 training groups. Induced step training (IST, n = 25) involved 43 progressive perturbations. Hip abduction strengthening (HST, n = 25) utilized progressive resistance exercises. Combined training (CMB, n = 25) included IST and HST, and the control performed seated flexibility/relaxation exercises (SFR, n = 27). The training involved 36 sessions for a period of 12 weeks. The primary outcomes were the number of recovery steps and first step length, and maximum hip abduction torque. Fall frequency during 12 months after training was determined. Results Overall, the number of recovery steps was reduced by 31% and depended upon the first step type. IST and CMB increased the rate of more stable single lateral steps pre- and post-training than HST and SFR who used more multiple crossover and sequential steps. The improved rate of lateral steps for CMB exceeded the control (CMB/SFR rate ratio 2.68). First step length was unchanged, and HST alone increased hip torque by 25%. Relative to SFR, the fall rate ratios (falls/person/year) [95% confidence interval] were CMB 0.26 [0.07–0.90], IST 0.44 [0.18–1.08], and HST 0.30 (0.10–0.91). Conclusions Balance performance through stepping was best improved by combining perturbation and strength training and not strengthening alone. The interventions reduced future falls by 56%–74% over the control. Lateral balance perturbation training may enhance traditional programs for fall prevention.

scholarly journals 94 Association between Dual-Task Timed “UP and GO” Test and Occurrence of Falls According to Age Group (Young-Older or Old-Older Adults): A Longitudinal Observation Study

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv18-iv27
Author(s):  
Tsuyoshi Asai ◽  
Kensuke Oshima ◽  
Yoshihiro Fukumoto ◽  
Shogo Misu
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Dual Task ◽  
Community Dwelling ◽  
Age Group ◽  
Adult Group ◽  
Observation Study ◽  
Timed Up And Go ◽  
Community Dwelling Older Adults

Abstract Aim To elucidate the association between the occurrence of falls and timed “up and go” (TUG) test score in a dual-task condition among community-dwelling older adults by age group. Methods This longitudinal observation study included 987 community-dwelling older adults at baseline. A TUG test (single-TUG) and a TUG test while counting aloud backward from 100 (dual-TUG) were conducted at baseline. The dual-task cost (DTC) value was computed from these results. Data on fall history were obtained using a self-administered questionnaire at the 1-year follow-up. At follow-up, 322 participants had dropped out and six participants had missing data for falls. The final analysis included 658 individuals (follow-up rate: 658/987, 67%) divided into a young-older adult group (aged 60–74 years) and an old-older adult group (aged 75 years or older). Associations between the occurrence of falls and TUG-related values were analyzed by age group using multivariate logistic regression models. Results For old-older adults, there were significant associations between the occurrence of falls and DTC value (odds ratio [OR] 0.981, 95% confidence interval [CI]: 0.963–0.999, p = 0.040) and single-TUG score (OR 1.129, 95% CI: 1.006–1.268, p = 0.039). However, no significant associations were observed for young-older adults. Conclusions Slower single-TUG test score and lower DTC value are associated with the occurrence of falls among old-older adults but not among young-older adults. Dual task assessment is useful for predicting falls in TUG fall assessment for old-older adults.

Transfer Effects of Fall Training on Balance Performance and Spatiotemporal Gait Parameters in Healthy Community-Dwelling Older Adults: A Pilot Study

2014 ◽  
Vol 22 (3) ◽  
pp. 324-333 ◽  
Author(s):  
Lars Donath ◽  
Oliver Faude ◽  
Stephanie A. Bridenbaugh ◽  
Ralf Roth ◽  
Martin Soltermann ◽  
...  
Keyword(s):  
Older Adults ◽  
Dual Task ◽  
Stride Length ◽  
Fear Of Falling ◽  
Community Dwelling ◽  
Stride Time ◽  
Balance Performance ◽  
Transfer Effects ◽  
Gait Parameters ◽  
Community Dwelling Older Adults

This study examined transfer effects of fall training on fear of falling (Falls Efficacy Scale—International [FES–I]), balance performance, and spatiotemporal gait characteristics in older adults. Eighteen community-dwelling older adults (ages 65–85) were randomly assigned to an intervention or control group. The intervention group completed 12 training sessions (60 min, 6 weeks). During pre- and posttesting, we measured FES–I, balance performance (double limb, closed eyes; single limb, open eyes; double limb, open eyes with motor-interfered task), and gait parameters (e.g., velocity; cadence; stride time, stride width, and stride length; variability of stride time and stride length) under single- and motor-interfered tasks. Dual tasks were applied to appraise improvements of cognitive processing during balance and gait. FES–I (p = .33) and postural sway did not significantly change (0.36 < p < .79). Trends toward significant interaction effects were found for step width during normal walking and stride length variability during the motor dual task (p = .05, ηp2 = .22). Fall training did not sufficiently improve fear of falling, balance, or gait performance under single- or dual-task conditions in healthy older adults.

scholarly journals Self-Selected Walking Speed Is Predictive of Daily Ambulatory Activity in Older Adults

2016 ◽  
Vol 24 (2) ◽  
pp. 214-222 ◽  
Author(s):  
Addie Middleton ◽  
George D. Fulk ◽  
Michael W. Beets ◽  
Troy M. Herter ◽  
Stacy L. Fritz
Keyword(s):  
Older Adults ◽  
Linear Regression ◽  
Functional Status ◽  
Walking Speed ◽  
Activity Monitoring ◽  
Community Dwelling ◽  
Ambulatory Activity ◽  
Steps Per Day ◽  
Community Dwelling Older Adults ◽  
Insight Into

Daily ambulatory activity is associated with health and functional status in older adults; however, assessment requires multiple days of activity monitoring. The objective of this study was to determine the relative capabilities of self-selected walking speed (SSWS), maximal walking speed (MWS), and walking speed reserve (WSR) to provide insight into daily ambulatory activity (steps per day) in community-dwelling older adults. Sixty-seven older adults completed testing and activity monitoring (age 80.39 [6.73] years). SSWS (R2 = .51), MWS (R2 = .35), and WSR calculated as a ratio (R2 = .06) were significant predictors of daily ambulatory activity in unadjusted linear regression. Cutpoints for participants achieving < 8,000 steps/day were identified for SSWS (≤ 0.97 m/s, 44.2% sensitivity, 95.7% specificity, 10.28 +LR, 0.58 −LR) and MWS (≤ 1.39 m/s, 60.5% sensitivity, 78.3% specificity, 2.79 +LR, 0.50 −LR). SSWS may be a feasible proxy for assessing and monitoring daily ambulatory activity in older adults.

scholarly journals Building Trust in Ethnically Diverse Older Adults Using Technology-Based Physio-Feedback

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 562-562
Author(s):  
Ladda Thiamwong
Keyword(s):  
Older Adults ◽  
Ethnically Diverse ◽  
Community Dwelling ◽  
Test Results ◽  
Balance Performance ◽  
Specific Objective ◽  
Objective Feedback ◽  
And Migration ◽  
Changes Over Time ◽  
Community Dwelling Older Adults

Abstract There is no research exploring how to build trust in the context of falls risk assessment and prevention. This study describes strategies to build trust in ethnically diverse older adults using technology-based physio-feedback from two studies. The technology includes a portable BTrackS balance plate and BTrackS Balance Software running on a computer device. Participants were provided instant playback showing their static balance performance with a scale from 0 to 100. Sixty-seven community-dwelling older adults participated in the first study, and 41 of them (61.2%) participated again in the second study using the same procedures. 70% were women, 43% were immigrants, 34% Hispanics, 15% African Americans, and 9% Asians. Three reasons for participation were reported: 1) specific objective feedback on the test results that supported by technology, 2) ability to record changes over time; and 3) ability to access the fall risk technology-based test at a place of their convenience. Part of a symposium sponsored by the International Aging and Migration Interest Group.

scholarly journals Longitudinal Association of Executive Function and Balance in Community-Dwelling Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 700-700
Author(s):  
Jennifer Blackwood ◽  
Reza Amini ◽  
Gerry Conti ◽  
Quinn Hanses ◽  
Rebekah Taylor ◽  
...  
Keyword(s):  
Older Adults ◽  
Executive Function ◽  
Best Practice ◽  
Secondary Data ◽  
Community Dwelling ◽  
Balance Performance ◽  
Cross Sectional ◽  
Clock Drawing Test ◽  
Single Leg Stance ◽  
Community Dwelling Older Adults

Abstract Declines in Executive Function (EF) are associated with balance in community-dwelling older adults with Mild Cognitive Impairment (MCI). While this has been examined in cross-sectional studies, no longitudinal studies describe change over time. The purpose of this study was to examine how performance on the components of the Short Physical Performance Battery (SPPB) are associated with EF in community-dwelling older adults who transition into MCI. This secondary data analysis employed eight years of data from the National Health and Aging Trends Study dataset (2011 – 2018) with 1,225 participants in all eight waves (balanced). EF was measured with the Clock Drawing Test and SPPB balance tests included side-by-side, semi-tandem, full tandem, and single leg stance with eyes open or closed. Longitudinal ordered logistic regression was used to examine associations between each balance measure and EF while controlling for comorbidity, function, depression, gender, age, and ethnicity. EF was significantly associated with tandem, semi-tandem, and single leg stance after controlling for covariates. One point increase in SPPB can reduce the risk of EF impairment by 8.2% (Odds Ratio (OR)=0.918, p&lt;0.001). Among SPPB components, semi-tandem (OR=0.468) and side-by-side (OR=0.472) were the strongest predictors of EF impairment. Declines in both EF and balance performance occurred over an eight-year period in adults. This may reflect common neural processes shared between the cognitive and motor areas of the central nervous system. Best practice suggests screening both balance (tandem, semi-tandem, or single leg stance) and EF in the clinical assessment of community-dwelling older adults.

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