scholarly journals Development and validation of a continuous fall risk score in community-dwelling older people: an ecological approach

2021 ◽  
Vol 21 (S2) ◽  
Author(s):  
Jorge Bravo ◽  
Hugo Rosado ◽  
Pablo Tomas-Carus ◽  
Cristina Carrasco ◽  
Nuno Batalha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Clinical Practice ◽  
Older People ◽  
Risk Score ◽  
Fall Risk ◽  
Community Dwelling ◽  
Fall Risk Assessment ◽  
Standardized Residuals ◽  
Community Dwelling Older People

Abstract Background Fall risk assessment in older people is of major importance for providing adequate preventive measures. Current predictive models are mainly focused on intrinsic risk factors and do not adjust for contextual exposure. The validity and utility of continuous risk scores have already been demonstrated in clinical practice in several diseases. In this study, we aimed to develop and validate an intrinsic-exposure continuous fall risk score (cFRs) for community-dwelling older people through standardized residuals. Methods Self-reported falls in the last year were recorded from 504 older persons (391 women: age 73.1 ± 6.5 years; 113 men: age 74.0 ± 6.1 years). Participants were categorized as occasional fallers (falls ≤1) or recurrent fallers (≥ 2 falls). The cFRs was derived for each participant by summing the standardized residuals (Z-scores) of the intrinsic fall risk factors and exposure factors. Receiver operating characteristic (ROC) analysis was used to determine the accuracy of the cFRs for identifying recurrent fallers. Results The cFRs varied according to the number of reported falls; it was lowest in the group with no falls (− 1.66 ± 2.59), higher in the group with one fall (0.05 ± 3.13, p < 0.001), and highest in the group with recurrent fallers (2.82 ± 3.94, p < 0.001). The cFRs cutoff level yielding the maximal sensitivity and specificity for identifying recurrent fallers was 1.14, with an area under the ROC curve of 0.790 (95% confidence interval: 0.746–0.833; p < 0.001). Conclusions The cFRs was shown to be a valid dynamic multifactorial fall risk assessment tool for epidemiological analyses and clinical practice. Moreover, the potential for the cFRs to become a widely used approach regarding fall prevention in community-dwelling older people was demonstrated, since it involves a holistic intrinsic-exposure approach to the phenomena. Further investigation is required to validate the cFRs with other samples since it is a sample-specific tool.

scholarly journals Fall-related efficacy is a useful and independent index to detect fall risk in Japanese community-dwelling older people: a 1-year longitudinal study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Naoto Kamide ◽  
Yoshitaka Shiba ◽  
Miki Sakamoto ◽  
Haruhiko Sato ◽  
Akie Kawamura
Keyword(s):  
Risk Factors ◽  
Older People ◽  
Physical Performance ◽  
Fall Risk ◽  
Community Dwelling ◽  
Confounding Factors ◽  
Potential Risk Factors ◽  
Community Dwelling Older People ◽  
Walking Time

Abstract Background Fall-related efficacy has been found to be associated with both falls and fall risk factors such as physical performance. The aim of the present study was to clarify whether fall-related efficacy is, independent of physical performance and other potential risk factors, associated with future falls in community-dwelling older people. Methods The study participants were 237 Japanese older people aged 65 years and over who were living independently in their community. Fall-related efficacy and physical performance were assessed at baseline using the short version of the Falls Efficacy Scale-International (short FES-I) and 5-m walking time, the Timed Up and Go Test, the 5 Times Sit to Stand Test, and grip strength. Physical performance was then again assessed at 1-year follow-up. The number of falls was obtained every 6 months for 1 year after the baseline survey. Instrumental activities of daily living (IADL), depression, fall history, current medications, medical history, and pain were also investigated as potential confounding factors that have possible associations with falls. The associations between the short FES-I, physical performance, and number of falls were analyzed using Poisson regression analysis adjusted for physical performance and potential confounding factors. Results The mean age of the participants (75.9% women) was 71.1 ± 4.6 years, and 92.8% could perform IADL independently. The total numbers of falls and fallers during the 1-year follow-up period were 70 and 42, respectively. On Poisson regression analysis adjusted for walking time and potential confounding factors, independent of physical performance, the short FES-I was found to be significantly associated with number of falls (relative risk = 1.09, p < 0.05). On the other hand, physical performance was not significantly associated with the number of falls. Conclusions The findings of the present study suggest that the short FES-I, independent of physical performance and other potential risk factors, is a useful index to detect fall risk in community-dwelling older people, and that fall-related efficacy is an important factor in terms of fall prevention.

scholarly journals 21 Fall Risk Assessment Outcomes in Community Dwelling Elderly Patients on Warfarin (FRAIL-W)

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv6-iv8
Author(s):  
Syarifah Nurul Ain ◽  
Liew Houng Bang ◽  
Premala Subramaniam ◽  
Ho Hee Kheen
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Elderly Patients ◽  
Fall Risk ◽  
Warfarin Therapy ◽  
Community Dwelling ◽  
Bleeding Complications ◽  
Fall Risk Assessment ◽  
Falls Risk ◽  
Severity Of Injury

Abstract Background Elderly patients on warfarin are prone to experience severe bleeding complications when they fall. In warfarin clinic, they are not routinely screened for falls risk before starting on warfarin therapy. The purpose of our study was to determine the incidence of fall and its associated factors, severity of injury following fall and grading of falls risk among community dwelling elderly patients on warfarin in two tertiary hospitals in Sabah. Methods This is a cross-sectional study conducted in warfarin outpatient clinic, Hospital Queen Elizabeth and Hospital Queen Elizabeth II for 10 weeks (Mac-May 2019). Inclusion; patients aged ≥60 years old, on lifelong warfarin therapy. Exclusion; dementia, psychosis, severe cognitive impairment, institutionalised, inability to stand. Face-to-face interviews were done using Falls Risk for Older People – Community (FROP-Com) and Timed Up and Go (TUG) test. Results Out of 162 patients, majority were males (65.4%), Chinese (50.6%), married (93.2%), stays with family (96.9%) and had secondary education (42.6%). Mean age was 70 years old. 82.1% of them had atrial fibrillation; 63.2% had low CHA2DS2VASC score (less than 4) and 91.7% had low HAS-BLED score (less than 3). 22 patients (13.6%) experienced actual fall in past 12 months; only 1 patient experienced major injury. FROP-Com showed majority 133 patients (82.1%) were at low risk of fall. Risk factors of fall include polypharmacy and comorbidity affecting balance and mobility. Mean TUG test score was high; 13.7 seconds. Conclusion Fall incidence among patients on warfarin is substantial. Risk factors include polypharmacy and comorbidity affecting balance and mobility. This interim analysis showed majority patients had low fall risk (82.1% on FROP-Com, 58.0% on TUG test). Among fallers, FROP-Com risk score was moderate-high in 10 patients (45.5%). Further analysis could reveal potential value of these tests in refining fall risk assessment in this group of patients.

Fall Risk Assessment and Risk Factors of Inpatients in Armed Forces Hospital

2016 ◽  
Vol 34 (1) ◽  
pp. 42-53
Author(s):  
Kyung-Wan Seo ◽  
Jeong-Ok Lee ◽  
Sun-Young Choi ◽  
Min-Jung Park
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Fall Risk ◽  
Armed Forces ◽  
Fall Risk Assessment

scholarly journals Comparison of Fall Risk Assessment Tools for Older Indonesian Adults in the Elderly Home and the Community

2019 ◽  
Vol 8 (3) ◽  
pp. 241
Author(s):  
Indri Hapsari Susilowati ◽  
Susiana Nugraha ◽  
Sabarinah Sabarinah ◽  
Bonardo Prayogo Hasiholan ◽  
Supa Pengpid ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Fall Risk ◽  
Assessment Tool ◽  
The Elderly ◽  
Risk Assessment Tool ◽  
Fall Risk Assessment ◽  
Elderly Home ◽  
Balance Confidence ◽  
Confidence Scale

Introduction: One of the causes of disability among elderly is falling. The ability to predict the risk of falls among this group is important so that the appropriate treatment can be provided to reduce the risk. The objective of this study was to compare the Stopping Elderly Accidents, Deaths, & Injuries (STEADI) Initiative from the Centers for Disease Control and Prevention (CDC) and The Johns Hopkins Fall Risk Assessment Tool (JHFRAT) from the Johns Hopkins University. Methods: This study used the STEADI tool, JHFRAT, Activities-Specific Balance Confidence Scale (ABC), and The Geriatric Depression Scale (GDS). The study areas were in community and elderly home in both public and private sectors and the samples were 427 after cleaning. Results: The results for the STEADI and JHFRAT tools were similar where the respondents at highest risk of falling among women (STEADI: 49%; JHFRAT: 3.4%), in Bandung area (63.5%; 5.4%), in private homes (63.3%; 4.4%), non-schools (54.6%; 6.2%), aged 80 or older (64.8%; 6.7%) and not working (48.9%;3.3%). The regression analysis indicated that there was a significant relationship between the risk factors for falls in the elderly determined by the JHFRAT and STEADI tools: namely, region, type of home, age, disease history, total GDS and ABC averages. Conclusion: Despite the similarity in the risk factors obtained through these assessments, there was a significant difference between the results for the STEADI tool and the JHFRAT. The test strength was 43%. However, STEADI is more sensitive to detect fall risk smong elderly than JHFRATKeywords: Activities-Specific Balance Confidence scale, elderly, fall risk,The Johns Hopkins Fall Risk Assessment Tool, the Stopping Elderly Accidents, Deaths, & Injuries

scholarly journals Nutritional Status and Risk Factors for Frailty in Community-Dwelling Older People: A Cross-Sectional Study

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 1041 ◽  
Author(s):  
Pilar Pérez-Ros ◽  
Rafael Vila-Candel ◽  
Lourdes López-Hernández ◽  
Francisco Miguel Martínez-Arnau
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Nutritional Status ◽  
Older People ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Sectional Study ◽  
Cross Sectional ◽  
Community Dwelling Older People ◽  
The Relationship

Objective: This study aims to assess the relationship that frailty has with nutritional status and functional risk factors in community-dwelling older adults. Methods: Cross-sectional study in community-dwelling older people, independent for walking and without impaired cognition. Frailty was assessed by Fried criteria. Nutritional status was analyzed by the Mini Nutritional Assessment Short Form (MNA-SF), biochemical markers (albumin, total proteins, cholesterol, lymphocytes, and hemoglobin); and anthropometric parameters (body mass index [BMI], body fat percentage, handgrip, and perimeters). A comprehensive geriatric assessment analyzed other risk factors: functionality, cognition, falls, comorbidity, polypharmacy, physical activity, and quality of life (QoL). Results: We included 564 elderly people with a mean age of 76.05 (standard deviation 3.97) years; 63.1% (n = 356) were women, and 83.9% (n = 473) were prefrail, and frail. The sample presented high functionality and a nutritional status with a predominance of overweight and obesity. Factors associated with frailty (R2 = 0.43) were age over 75 years (odds ratio [OR] 3.31, 95% confidence interval [CI] 1.76, 6.21; p < 0.001), female gender (OR 2.37, 95% CI 1.24, 4.52; p = 0.009), anemia (OR 2.45, 95% CI 1.19, 5.02; p = 0.015), falls (OR 1.94, 95% CI 1.12, 3.25; p = 0.016) and the fear of falling (OR 4.01: 95% CI 1.76, 9.16; p = 0.001). Performing more than 3 weekly hours of physical activity was found to be a protective factor (OR 0.23, 95% CI 0.15, 0.35; p < 0.001). Conclusions: The relationship between frailty and malnutrition in functionally independent community-dwelling older people is unclear. More studies are needed to know what nutritional markers are related to frailty, cognition, and functionality in order to discriminate the risk factors for community-dwelling older people at risk of malnutrition and dependency.

P2-299: INDIVIDUAL RISK FACTORS FOR POSSIBLE UNDETECTED DEMENTIA AMONGST COMMUNITY-DWELLING OLDER PEOPLE IN NEW ZEALAND

2006 ◽  
Vol 14 (7S_Part_15) ◽  
pp. P796-P797
Author(s):  
Adrian Martinez-Ruiz ◽  
Ying Huang ◽  
Susan Gee ◽  
Hamish Jamieson ◽  
Gary Cheung
Keyword(s):  
Risk Factors ◽  
New Zealand ◽  
Older People ◽  
Community Dwelling ◽  
Individual Risk ◽  
Community Dwelling Older People ◽  
Individual Risk Factors

scholarly journals Physical performance reflects cognitive function, fall risk, and quality of life in community-dwelling older people

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Shota Ikegami ◽  
Jun Takahashi ◽  
Masashi Uehara ◽  
Ryosuke Tokida ◽  
Hikaru Nishimura ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cognitive Function ◽  
Older People ◽  
Physical Performance ◽  
Fall Risk ◽  
Community Dwelling ◽  
Community Dwelling Older People

scholarly journals International classification of function, disability and health framework for fall risk stratification in community dwelling older adults

2017 ◽  
Vol 3 (1) ◽  
Author(s):  
Majumi M. Noohu ◽  
Aparajit B. Dey ◽  
Shashi Sharma ◽  
Mohammed E. Hussain
Keyword(s):  
Older Adults ◽  
Risk Assessment ◽  
Odds Ratio ◽  
Fall Risk ◽  
Adjusted Odds Ratio ◽  
Community Dwelling ◽  
Disability And Health ◽  
Fall Risk Assessment ◽  
Community Dwelling Older Adults

Falls is an important cause for mortality and morbidity in older adults. The fall risk assessment is an integral component of fall prevention in older adults. The international classification of function, disability and health (ICF) can be an ideal comprehensive model for fall risk assessment. There is lack of information relating ICF and fall risk assessment in community dwelling older adults. In this study we tried to assess the fall risk using different domains of ICF using various clinical tools. A total of 255 subjects were recruited through convenient sampling method from geriatric clinic (OPD) of All India Institute of Medical Sciences, New Delhi. The study was single session cross-section design. The body mass index (BMI), grip strength, depression score (Geriatric depression scale:short form; GDS-S) and co morbidities were used to assess body function and structure domain, timed up and go (TUG), Berg balance scale (BBS) and elderly fall screening test (EFST) scores were used for activity domain, selfreported cause of fall, medications and uses of assistive device for environmental factors. Then the association of body function and structure, activity and environmental factors were determined with falls. There was an association of fall in analysis in subjects with no fall and one or more falls for, BMI, grip strength (kg), GDS-S score, no. of co morbidities, chronic pain, TUG, BBS, TUG (s), BBS, EFST, slip/trip, walking cane, hypoglycemic and antihypertensives medications (unadjusted and adjusted odds ratio).The diabetes, and hyper tension showed association for adjusted odds ratio only. In subjects with one fall and more than one fall, TUG, BBS, EFST, GDS-S score, NSAIDS and antidepressants use showed a significant association with fall (unadjusted and adjusted odds ratio). The ICF may be used in routine for fall risk assessment in community dwelling older adults.

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