Using Functional Ability Measures to Assess Fall Risk in Acute Care

2020 ◽  
Vol 42 (12) ◽  
pp. 1050-1058
Author(s):  
Alaina M. Bassett ◽  
Ka-Chun Siu ◽  
Julie A. Honaker

Currently, it is not known whether integration of functional performance measures is sensitive and feasible for use in acute care settings. This cross-sectional study explored the subjective and objective measures of the risks of falling, falls efficacy, and functional abilities for inpatients in an adult acute care unit. The Morse Fall Scale ( n = 30) and Timed Up and Go (TUG; n = 10) had excellent sensitivity (100%) for identifying participants with prior fall histories, while the St. Thomas Risk Assessment Tool in Falling Elderly Inpatients only had good sensitivity (87.5%). Study findings suggest that implementation of feasible functional ability measures in conjunction with subjective fall risk measures could enhance accuracy and performance in identifying inpatient risks of falling in acute care settings.

2020 ◽  
Vol 10 (3) ◽  
pp. 12-15
Author(s):  
Jogmaya Limbu ◽  
Sunita Poudyal

Background: Falls in older people is a common serious health problem that has profound im­pact on overall health and quality of life of older people. The aim of this study was to assess the fall risk among older adults. Methods: The descriptive cross-sectional study was carried out among older adults residing in Bharatpur, Chitwan. A total of 98 older adults were selected by using simple random sampling technique. The data were collected by using structured interview schedule and fall risk was as­sessed by Timed Up and Go (TUG) test. Data were collected from 23rd June, 2019 to 7th July, 2019. Obtained data were analyzed using descriptive and inferential statistics. Results: The study findings revealed that more than half (60.2%) of the older adults were from the age group of ≤79 years, male (63.3%) and almost half (50%) were illiterate. Nearly all (96.9%) older adults were living with their family however, 50% were undernourished (BMI- <22.9). Ma­jorities (66.3%) were suffering from chronic diseases and had been taking medicine. Majority of older adults reported vision problem (64.3%) and hearing problem (60.2%). However, only 8.2% reported history of fall within last 6-12 months. More than half (59.2%) of the older adults had high risk of fall and found significant association with age (p=0.039) and vision problem (p=0.043). Conclusions: More than half of the older adults are in risk of falls. Therefore, more emphasis should be given in screening the older people for fall risk factors as preventive measures.


Author(s):  
Jian Wang ◽  
Xiuqin Chen ◽  
Xiaoming Sun ◽  
Huifen Ma ◽  
Yan Yu ◽  
...  

Background: We aimed to evaluate the predictive value of the 'Timed Up and Go' test (TUGT) for identifying fall risk in community-dwelling elderly. Methods: From Aug 2016 to Feb 2017, cluster sampling was conducted among residents aged over 60 from 15 communities in Songjiang district, Shanghai. Face-to-face questionnaire interviews and TUGT measures were conducted to collect data. Results: 6,014 participants were enrolled, with an average age 72.7±7.0 years. 637 (10.6%) elderly people had a fall experience in the past year. TUGT for the non-fall group, one-fall group and recurrent-fall group was 9.02±4.39, 10.00±5.26 and 10.78±4.51 seconds respectively (P<0.001). ROC analysis showed that the TUGT cut-off point for the elderly was 12.5 seconds and AUC was 0.573 for any-fall group and 0.613 for recurrent-fall group respectively. After adjusting for age and gender, the predictive value was not high for any-fall group (AUC=0.614) and recurrent-fall group (AUC=0.648). The TUGT cut-off point for the elderly aged below 65, 65-74, 75-84 and 85 and above was 13.52s, 12.51s, 12.51s, 12.00s, respectively. After adjustment of the confounding factors, the OR values for the risk of fall for the elderly men and women who completed TUGT longer than the cut-off point was 2.404 and 2.075 times higher than those who completed TUGT shorter than the cut-off point, respectively. Conclusion: TUGT with the cut-off score of 12.5s has limited capability in predicting fall risk in community-dwelling elderly.


2016 ◽  
Vol 36 (1) ◽  
pp. 71-78 ◽  
Author(s):  
Ozkan Ulutas ◽  
Janine Farragher ◽  
Ernest Chiu ◽  
Wendy L. Cook ◽  
Sarbjit V. Jassal

♦ BackgroundOlder in-center hemodialysis patients have a high burden of functional disability. However, little is known about patients on home chronic peritoneal dialysis (PD). As patients opting for home dialysis are expected to play a greater role in their own dialysis care, we hypothesized that a relatively low number of PD patients would require help with basic self-care tasks (ADL) and instrumental activities of daily living (IADL).♦ MethodsWe used a cross-sectional study design to measure the proportion of patients aged 65 years and older undergoing outpatient PD who needed help with day-to-day activities. Patients living in nursing homes were excluded from the study. Functional dependence in ADL and IADL tasks were measured by the Barthel and Lawton Scales. Physical performance measures used included the timed up-and-go (TUG) test, chair stands and Folstein mini-mental score (MMSE).♦ResultsA total of 74 of 76 (97%) eligible PD patients participated. Patients had a mean age of 76.2 ± 7.5 years. Thirty-six percent had impaired MMSE scores, 69% were unable to stand from a chair without the use of their arms and 51% had abnormal TUG scores. Only 8 patients (11%) were fully independent for both ADL and IADL activities. Dependence in one or more ADL activity was reported by 64% of participants, while 89% reported dependence in one or more IADL.♦ConclusionsImpaired physical and functional performance is common in older patients maintained on PD. Collaborative geriatric-renal programs may be beneficial within the dialysis community.


Geriatrics ◽  
2018 ◽  
Vol 3 (3) ◽  
pp. 51 ◽  
Author(s):  
Margaret Danilovich ◽  
Laura Diaz ◽  
Daniel Corcos ◽  
Jody Ciolino

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.


2020 ◽  
Vol 33 ◽  
Author(s):  
Maiara Gonçalves dos Santos ◽  
Pricila Damiani ◽  
Ana Carolina Zappe Marcon ◽  
Alessandro Haupenthal ◽  
Núbia Pereira Carelli de Avelar

Abstract Introduction: Knee osteoarthritis (KOA) is a common degenerative disease in older people, causing pain, stiffness and dysfunction. Objective: To determine the influence of KOA on functional performance (FP), quality of life (QoL) and pain in older women. Method: This is a cross-sectional study, in which 50 older women diagnosed with KOA and 51 without KOA participated. Participants were assessed using FP tests: Sit-to-stand (STS); Gait speed test (GST); Timed Up and Go (TUG); 6-minute walk test (6 MWT) and the Berg Balance Scale (BBS). Pain was assessed by the visual analog scale (VAS); quality of life by applying the SF-36; and self-perception of the disease by using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results: No intergroup statistical differences were found in the BBS (p: 0.42), STS (p: 0.59) and 6MWT (p: 0.97). However, the KOA group showed slower GS (p < 0.00) and longer time in TUG (p < 0.00). They also presented higher pain levels (p < 0.01), worse perceived health status regarding pain, stiffness and physical function (WOMAC) (p < 0.01), as well as worse QoL indices in functional capacity, physical limitations, pain and overall health status (p < 0.010). Conclusion: The results of the study demonstrate that older women with KOA showed a decline in FP, QoL and higher pain levels.


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