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 Multisensory integration involved in the body perception of community-dwelling older adults

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
M. Hide ◽  
Y. Ito ◽  
N. Kuroda ◽  
M. Kanda ◽  
W. Teramoto
Keyword(s):  
Older Adults ◽  
Multisensory Integration ◽  
Fall Risk ◽  
Community Dwelling ◽  
The Body ◽  
Risk Of Falling ◽  
Body Perception ◽  
Rubber Hand ◽  
Timed Up And Go ◽  
Community Dwelling Older Adults

AbstractThis study investigates how the multisensory integration in body perception changes with increasing age, and whether it is associated with older adults’ risk of falling. For this, the rubber hand illusion (RHI) and rubber foot illusion (RFI) were used. Twenty-eight community-dwelling older adults and 25 university students were recruited. They viewed a rubber hand or foot that was stimulated in synchrony or asynchrony with their own hidden hand or foot. The illusion was assessed by using a questionnaire, and measuring the proprioceptive drift and latency. The Timed Up and Go Test was used to classify the older adults into lower and higher fall-risk groups. No difference was observed in the RHI between the younger and older adults. However, several differences were observed in the RFI. Specifically, the older adults with a lower fall-risk hardly experienced the illusion, whereas those with a higher fall-risk experienced it with a shorter latency and no weaker than the younger adults. These results suggest that in older adults, the mechanism of multisensory integration for constructing body perception can change depending on the stimulated body parts, and that the risk of falling is associated with multisensory integration.

scholarly journals Reliability of HOME FAST BRAZIL—Self-Reported Version for Community-Dwelling Older Adults

2021 ◽  
Vol 9 ◽  
Author(s):  
Karina Stella Aoki Ferreira ◽  
Tamires Terezinha Gallo da Silva ◽  
Jarbas Melo Filho ◽  
Natacha Verônica Bazanella ◽  
Audrin Said Vojciechowski ◽  
...  
Keyword(s):  
Older Adults ◽  
Cross Sectional Study ◽  
Environmental Risks ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Rater Reliability ◽  
Risk Of Falls ◽  
History Of ◽  
Spearman Test ◽  
Community Dwelling Older Adults

Objective: Verify the intra- and inter-rater reliability of the HOME FAST BRAZIL—Self-reported version and correlate household environmental risks with the history of falls by community-dwelling older adults.Method: Cross sectional study with 50 community-dwelling older adults who were screened by the cut-off point of the Mini Mental State Exam and replied to the HOME FAST BRAZIL—Self-reported version using two evaluators, on three occasions. The reliability analysis was determined by the Intra-class Correlation Coefficient (ICC), considering ICC > 0.70 as adequate. To test the correlations, the Spearman test was used.Results: The mean age of the participants was 73.2 ± 5.8 years. The inter- rater reliability of HOME FAST BRAZIL—Self-reported version was ICC 0.83 (IC95%, 0.70–0.90) and the Intra- reliability ICC 0.85 (IC95%, 0.74–0.91). A risk of falls was verified in 88% of the sample and four environmental risks presented significant correlations with the history of falls.Conclusions: The HOME FAST BRAZIL—Self-reported version presented adequate reliability for the evaluation of household environmental risks for community-dwelling older adults. Risks such as inadequate armchairs/ sofas, the absence of anti-slip mats in the shower recess, the presence of pets and inadequate beds require attention in the evaluation of household risks, due to their correlation with the occurrence of falls.

scholarly journals Risk-of-falling related outcomes improved in community-dwelling older adults after a 6-week sideways walking intervention: a feasibility and pilot study

2020 ◽  
Author(s):  
Andreas Skiadopoulos ◽  
Nick Stergiou
Keyword(s):  
Older Adults ◽  
Pilot Study ◽  
Fall Risk ◽  
Exercise Intervention ◽  
Community Dwelling ◽  
Recruitment Strategy ◽  
Large Trial ◽  
Risk Of Falling ◽  
Walking Intervention ◽  
Community Dwelling Older Adults

Abstract BackgroundAging increases fall risk and alters gait mechanics and control. Our previous work has identified sideways walking as a potential training regimen to decrease fall risk by improving frontal plane control in older adults’ gait. The purposes of this pilot study were to test the feasibility of sideways walking as an exercise intervention and to explore its preliminary effects on risk-of-falling related outcomes.MethodsWe conducted a 6-week single-arm intervention pilot study. Participants were community-dwelling older adults ≥ 65 years old with walking ability. Key exclusion criteria were neuromusculoskeletal and cardiovascular disorders that affect gait. Individualized sideways walking intervention carried out under close supervision in a 200 m indoor walking track (3 days∙week− 1). Recruitment and retention capability, safety, and fidelity of intervention delivery were recorded. We also collected (open-label) walking speed, gait variability, self-reported and performance-based functional measures to assess participants’ risk-of-falling at baseline and post-intervention: immediate, and 6 weeks after the completion of the intervention.ResultsOver a 7-month period, 42 individuals expressed interest, 21 assessed for eligibility (21/42), and 15 consented to participate (15/21). Most of the potential participants were reluctant to commit to a 6-week intervention. Desired recruitment rate was achieved after revising the recruitment strategy. One participant dropped out (1/15). Remaining participants demonstrated excellent adherence to the protocol. Participants improved on most outcomes and the effects remained at follow-up. No serious adverse events were recorded during the intervention.ConclusionOur 6-week sideways walking training was feasible to deliver and demonstrated strong potential as an exercise intervention to improve risk-of-falling outcomes in community-dwelling older adults. In a future trial, alternative clinical tools should be considered to minimize the presence of ceiling/floor effects. A future large trial is needed to confirm sideways walking as a fall prevention intervention.Trial registrationClinicalTrials.gov identifier: NCT04505527. Retrospectively registered 10 August 2020.Trial fundingCenter for Research in Human Movement Variability, National Institutes for Health, University of Nebraska Collaboration Initiative.

scholarly journals A novel model to quantify balance alterations in older adults based on the center of pressure (CoP) measurements with a cross-sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256129
Author(s):  
Ángel Gabriel Estévez-Pedraza ◽  
Lorena Parra-Rodríguez ◽  
Rigoberto Martínez-Méndez ◽  
Otniel Portillo-Rodríguez ◽  
Zoraida Ronzón-Hernández
Keyword(s):  
Older Adults ◽  
Fall Risk ◽  
Center Of Pressure ◽  
Low Cost ◽  
Area Under The Curve ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Mean Velocity ◽  
Cross Sectional

Background The timely detection of fall risk or balance impairment in older adults is transcendental because, based on a reliable diagnosis, clinical actions can be taken to prevent accidents. This study presents a statistical model to estimate the fall risk from the center of pressure (CoP) data. Methods This study is a cross-sectional analysis from a cohort of community-dwelling older adults aged 60 and over living in Mexico City. CoP balance assessments were conducted in 414 older adults (72.2% females) with a mean age of 70.23 ± 6.68, using a modified and previously validated Wii Balance Board (MWBB) platform. From this information, 78 CoP indexes were calculated and analyzed. Multiple logistic regression models were fitted in order to estimate the relationship between balance alteration and the CoP indexes and other covariables. Results The CoP velocity index in the Antero-Posterior direction with open eyes (MVELAPOE) had the best value of area under the curve (AUC) to identify a balance alteration (0.714), and in the adjusted model, AUC was increased to 0.827. Older adults with their mean velocity higher than 14.24 mm/s had more risk of presenting a balance alteration than those below this value (OR (Odd Ratio) = 2.94, p<0.001, 95% C.I.(Confidence Interval) 1.68–5.15). Individuals with increased age and BMI were more likely to present a balance alteration (OR 1.17, p<0.001, 95% C.I. 1.12–1.23; OR 1.17, p<0.001, 95% C.I. 1.10–1.25). Contrary to what is reported in the literature, sex was not associated with presenting a balance alteration (p = 0.441, 95% C.I. 0.70–2.27). Significance The proposed model had a discriminatory capacity higher than those estimated by similar means and resources to this research and was implemented in an embedded standalone system which is low-cost, portable, and easy-to-use, ideal for non-laboratory environments. The authors recommend using this technology to support and complement the clinical tools to attend to the serious public health problem represented by falls in older adults.

scholarly journals Risk‐of‐falling related outcomes improved in community‐dwelling older adults after a 6-week sideways walking intervention: a feasibility and pilot study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Andreas Skiadopoulos ◽  
Nick Stergiou
Keyword(s):  
Older Adults ◽  
Pilot Study ◽  
Fall Risk ◽  
Exercise Intervention ◽  
Recruitment Rate ◽  
Community Dwelling ◽  
Recruitment Strategy ◽  
Risk Of Falling ◽  
Walking Intervention ◽  
Community Dwelling Older Adults

Abstract Background Aging increases fall risk and alters gait mechanics and control. Our previous work has identified sideways walking as a potential training regimen to decrease fall risk by improving frontal plane control in older adults’ gait. The purposes of this pilot study were to test the feasibility of sideways walking as an exercise intervention and to explore its preliminary effects on risk-of-falling related outcomes. Methods We conducted a 6-week single-arm intervention pilot study. Participants were community-dwelling older adults ≥ 65 years old with walking ability. Key exclusion criteria were neuromusculoskeletal and cardiovascular disorders that affect gait. Because initial recruitment rate through University of Nebraska at Omaha and Omaha community was slower than expected (3 participants∙week− 1), we expanded the recruitment pool through the Mind & Brain Health Labs registry of the University of Nebraska Medical Center. Individualized sideways walking intervention carried out under close supervision in a 200 m indoor walking track (3 days∙week− 1). Recruitment and retention capability, safety, and fidelity of intervention delivery were recorded. We also collected (open-label) walking speed, gait variability, self-reported and performance-based functional measures to assess participants’ risk-of-falling at baseline and post-intervention: immediate, and 6 weeks after the completion of the intervention. Results Over a 7-month period, 42 individuals expressed interest, 21 assessed for eligibility (21/42), and 15 consented to participate (15/21). Most of the potential participants were reluctant to commit to a 6-week intervention. Desired recruitment rate was achieved after revising the recruitment strategy. One participant dropped out (1/15). Remaining participants demonstrated excellent adherence to the protocol. Participants improved on most outcomes and the effects remained at follow-up. No serious adverse events were recorded during the intervention. Conclusions Our 6-week sideways walking training was feasible to deliver and demonstrated strong potential as an exercise intervention to improve risk-of-falling outcomes in community-dwelling older adults. In a future trial, alternative clinical tools should be considered to minimize the presence of ceiling/floor effects. A future large trial is needed to confirm sideways walking as a fall prevention intervention. Trial registration ClinicalTrials.gov identifier: NCT04505527. Retrospectively registered 10 August 2020.

scholarly journals Development of Taiwan Risk Score for Sarcopenia (TRSS) for Sarcopenia Screening among Community-Dwelling Older Adults

2020 ◽  
Vol 17 (8) ◽  
pp. 2859
Author(s):  
Tzyy-Guey Tseng ◽  
Chun-Kuan Lu ◽  
Yu-Han Hsiao ◽  
Shu-Chuan Pan ◽  
Chi-Jung Tai ◽  
...  
Keyword(s):  
Older Adults ◽  
Working Group ◽  
Handgrip Strength ◽  
Community Setting ◽  
Community Dwelling ◽  
Risk Scores ◽  
Stepwise Logistic Regression ◽  
Cross Sectional ◽  
European Working ◽  
Community Dwelling Older Adults

The SARC-F questionnaire has been suggested by the European Working Group on Sarcopenia in Older People (EWGSOP) as a first-step screening tool for sarcopenia. However, the sensitivity to SARC-F is low among community-dwelling older adults. Therefore, this study aimed to develop a new prediction model for sarcopenia screening in the community setting. We conducted a cross-sectional analysis of data from the Taiwan Integration of Health and Welfare (TIHW) study. Covariates including comorbidities, socioeconomic status, social support, health behaviors, body composition, and serum biomarkers were collected for analysis. Sarcopenia was defined using handgrip strength and gait speed cut-off values suggested by the Asian Working Group for Sarcopenia. Risk scores for sarcopenia were estimated by stepwise logistic regression. Among 1025 participants (mean age, 71.95 ± 6.89 years), 179 (17.5%) had sarcopenia. Seven items, including age, female sex, receiving social assistance pension, absence of exercise, being underweight, abnormal fasting glucose levels, and abnormal creatinine levels were selected for the Taiwan Risk Scores for Sarcopenia (TRSS) with a cutoff value of 76 (sensitivity, 71.8%; specificity, 71.1%) and area under the curve (AUC) of 0.757. Our results suggested that the TRSS model could be applied cost-effectively in the community for early detection of sarcopenia.

scholarly journals A Description of Handgrip Strength in the Very Older Adult People Living in Rural Vietnam and Its Association with Daily Functions

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Nga Thi Thuy Nguyen ◽  
Thanh Xuan Nguyen ◽  
Anh Trung Nguyen ◽  
Thu Thi Hoai Nguyen ◽  
Tam Ngoc Nguyen ◽  
...  
Keyword(s):  
Older Adults ◽  
Rural Communities ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Handgrip Strength ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Low Education ◽  
Risk Of Falls ◽  
Community Dwelling Older Adults

Objective. To describe handgrip strength (HGS) and identify associated factors in community-dwelling older adults in rural Vietnam. Methods. A cross-sectional study was conducted in community-dwelling older adults 80 years and over in five rural communities in Hanoi, Vietnam. Age-gender-BMI stratified HGS values were reported as means and standard deviations. Demographic characteristics, malnutrition, risk of fall, basic activities of daily living (ADL), and instrumental activities of daily living (IADL) were investigated. Multivariate linear regression explored the association between HGS and these factors. Results. In 308 participants, mean age was 85.4 ± 4.2 years. Mean HGS was 21.6 ± 6.1  kg for males and 15.3 ± 4.3  kg for females. HGS in our sample was generally lower than that in other European countries and Asian threshold. Low HGS was correlated with older age ( β = − 0.196 , p < 0.001 ), female ( β = − 0.443 , p < 0.001 ), low education ( β = − 0.130 , p < 0.05 ), risk of falls ( β = − 0.114 , p < 0.05 ), and lower IADL ( β = 0.153 , p = 0.001 ). Conclusions. The age-gender-BMI stratified HGS values of 80 years and over community-dwellers in rural Vietnam were described. HGS decreased with advanced age, female, low education, high risk of falls, and impaired IADLs. The results could provide useful reference data for further investigations and measures in clinical practice.

scholarly journals Accuracy of clinical-functional tools to identify risk of falls among community-dwelling older adults

2019 ◽  
Vol 32 ◽  
Author(s):  
Raphaela Xavier Sampaio ◽  
Amanda Maria Santos Abreu ◽  
Cristiane Almeida Nagata ◽  
Patrícia Azevedo Garcia
Keyword(s):  
Older Adults ◽  
Risk Assessment ◽  
Predictive Value ◽  
Fall Risk ◽  
Community Dwelling ◽  
Methodological Study ◽  
Risk Of Falls ◽  
One Year ◽  
Sensitivity Specificity ◽  
Community Dwelling Older Adults

Abstract Introduction: The identification of older adults who present greater chances of falling is the first step in the prevention of falls. Clinical instruments have been shown to be able to differentiate fallers from non-fallers, but their predictive validity remains controversial. Objective: To investigate the accuracy of the Short Physical Performance Battery (SPPB) and Quick Screen Clinical Fall Risk Assessment (QuickScreen) instruments to identify risk of falls in community-dwelling older adults. Method: This is a prospective methodological study with 81 older adults (≥ 60 years), assessed at baseline by SPPB and QuickScreen and monitored after one year to identify the occurrence of falls. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under the ROC curve (AUC) were calculated. Results: 28.4% of the sample reported falls. QuickScreen presented 52.2% sensitivity, 74.1% specificity, 44.4% PPV, 79.6% NPV and 0.656 AUC. The AUC for SPPB was not significant (p = 0.087). Conclusion: QuickScreen presented poor accuracy when predicting falls and SPPB was unable to identify community-dwelling older adults at risk of falls. The QuickScreen instrument stood out for its high potential to identify true negatives.

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