scholarly journals Implementation and initial evaluation of falls risk reduction resources in a rural Native American Community

2021 ◽  
Vol 8 (S2) ◽  
Author(s):  
Kyle M. Knight
Keyword(s):  
Native American ◽  
Risk Reduction ◽  
Integrated Approach ◽  
Health Care Facilities ◽  
Falls Prevention ◽  
Timed Up And Go ◽  
Falls Risk ◽  
Functional Reach ◽  
Increased Risk ◽  
Serious Injury

Abstract Background Although falls are common and can cause serious injury to older adults, many health care facilities do not have falls prevention resources available. Falls prevention resources can reduce injury and mortality rates. Using the Centers for Disease Control and Prevention’s (CDC) Stopping Elderly Accidents, Deaths & Injuries (STEADI) model, a falls risk clinic was implemented in a rural Indian Health Service (IHS) facility. Methods A Fall Risk Questionnaire was created and implemented into the Provider’s Electronic Health Records system interface to streamline provider screening and referral of patients who may be at risk for falls to a group falls risk reduction class. Results Participants exhibited average improvements in the Timed Up and Go (6.8 s) (P = 0.0001), Five-Time Sit-to-Stand (5.1 s) (P = 0.0002), and Functional Reach (3.6 inches) (P = 1.0) tests as compared to their own baseline. Results were analyzed via paired t test. 71% of participants advanced out of an “increased risk for falls” category in at least one outcome measure. Of the participants to complete the clinic, all were successfully contacted and three (18%) reported one or more falls at the 90-day mark, of which one (6%) required a visit to the Emergency Department but did not require hospital admission. Conclusions In regards to reducing falls in the community, per the CDC STEADI model, an integrated approach is best. All clinicians can play a part in reducing elder falls.

scholarly journals Age suit simulation replicates in healthy young adults the functional challenges to balance experienced by older adults: an observational study

2021 ◽  
pp. bmjstel-2021-000867
Author(s):  
Carole Anne Watkins ◽  
Ellie Higham ◽  
Michael Gilfoyle ◽  
Charley Townley ◽  
Sue Hunter
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Berg Balance Scale ◽  
Normative Values ◽  
Timed Up And Go ◽  
Falls Risk ◽  
Functional Reach ◽  
Functional Reach Test ◽  
Age Simulation ◽  
Positive Effect

BackgroundAge simulation can have a positive effect on empathic understanding and perception of ageing. However, there is limited evidence for its ability to replicate objectively the physical and functional challenges of ageing.ObjectiveTo observe whether age suit simulation can replicate in healthy young adults the physical and physiological balance disturbance and falls risk experienced by older adults.MethodologyHealthy young adults aged 20–40 years (16 male) were recruited to the study using convenience sampling from a student population. Participants performed three validated balance tests—Functional Reach Test (FRT), Timed Up and Go (TUG) and Berg Balance Scale (BBS)—first without the age suit and then with the age suit, using a standardised protocol, following the same sequence.Results30 participants completed all tests. Statistically significant differences between without-age-suit and with-age-suit performance were recorded for FRT distance (p<0.000005), time taken to complete the TUG (p<0.0005) and BBS score (p<0.001). A comparison of participant scores with normative FRT and TUG scores identified that the suit had ‘aged’ the majority of participants to the normative values for older adults (60+), with some reaching the values for individuals aged 70–89. However, no scores achieved the values indicative of increased falls risk.ConclusionsThe age suit is a valid educational tool that extends the value of age simulation beyond a more general empathising role, enabling those working with an older population to experience and understand the functional challenges to balance experienced by older adults as part of their training.

scholarly journals COMPARISON OF PROPENSITY TO FALLS IN MALE AND FEMALE ELDERLY AND ITS CORRELATION BETWEEN THE BALANCE AND COGNITION LEVEL

2020 ◽  
pp. 1-6
Author(s):  
Élcio Alves Guimarães ◽  
Kennedy Rodrigues Lima ◽  
Flávia Fernandes Oliveira ◽  
Renato Mota da Silva ◽  
Lucas Resende Sousa ◽  
...  
Keyword(s):  
Mental State ◽  
Mini Mental State Examination ◽  
The Elderly ◽  
The Other ◽  
Timed Up And Go ◽  
Functional Changes ◽  
Functional Reach ◽  
Increased Risk ◽  
Risk Of Fall ◽  
State Examination

Background: Aging is a dynamic, progressive and physiological process, accompanied by morphological and functional changes, as well as biochemical and psychological changes, resulting in a decrease in the functional reserve of organs and system. With aging, functional losses occur, so the elderly have a greater predisposition to falls. Objective: To compare the propensity to falls between elderly men and women correlating with the level of cognition and balance. Methods: The sample consisted of 60 elderly people, of which 30 were male and 30 were female both aged 65 to 80 years. The propensity to falls was assessed using the “Timed Up and Go” and “Functional Reach” tests, and the state of cognition was assessed by the test “Mini-Mental State Examination”. Results: The results obtained with Time Up and Go, Functional Reach and the Mini-Mental State Examination, indicated that, as the values of one of the variables increase, the values of the other variable increase too; as the values of one of the variables decrease, the values of the other variable increase too. Conclusions: It can be concluded that there was no increased risk of fall when compared the genders; but the female presented altered cognitive deficit.

scholarly journals Exercise, Health, and Falls Risks among Older African American Women

2017 ◽  
Vol 5 (3) ◽  
pp. 16 ◽  
Author(s):  
Maria Kosma ◽  
Jan M. Hondzinski ◽  
David R. Buchanan
Keyword(s):  
African American ◽  
Risk Reduction ◽  
Falls Prevention ◽  
Exercise Behavior ◽  
Active Group ◽  
Health Conditions ◽  
Falls Risk ◽  
Muscle Strengthening ◽  
Group D

Background of Study: Although exercise has many benefits, older African American (AA) women are less active than older Caucasian women and older AA men. Balance and muscle-strengthening activities are typically recommended for decreased falls, whereas the role of aerobic training alone on falls prevention is controversial. Objective: This was a mixed methods phronetic (pragmatic) study – without an intervention – including quantitative data (falls risks) and qualitative data on exercise behavior and its importance to health and falls prevention; therefore, the studied phenomenon was thoroughly and pragmatically investigated. The first purpose of the study was to examine differences in falls risks based on exercise type (aerobics vs. combination of aerobics, muscle training, and balance activities) and exercise level (active people vs. somewhat active people). Secondly, participants’ exercise values were examined in relation to their health, falls-risk prevention, exercise behavior, and falls risks. Method: Interviews and falls risk assessments were conducted among 12 older AA women in an inner-city community center. Results: ANCOVA and ANOVA showed that the aerobics group performed better in Dynamic Gait Index (DGI) and Timed Up and Go than the combination group (d =0.85, -0.97); the latter surpassed the former in Functional Reach (d = 2.27). The active group (met the 150 minutes/week exercise recommendation) performed better in DGI and Six-Minute Walk than the somewhat active group (d =0.62.,50); the latter outperformed the former in balance-eyes open (d = -0.52). Emerging themes about lifestyle values included: a) reasons for health conditions and staying healthy and b) falls prevention. Conclusion: Exercise programs for fall risk reduction should include not only muscle strengthening and balance activities, but also aerobic exercises. Meeting minimum exercise recommendations is key to falls risk reduction. Beyond healthy diet, the role of exercise on the prevention of health conditions needs to be emphasized.

scholarly journals SENSOR-BASED ASSESSMENT OF FALLS RISK OF THE TIMED UP AND GO IN REAL-WORLD SETTINGS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S10-S10
Author(s):  
Charlene C Quinn ◽  
Barry R Greene ◽  
Killian McManus ◽  
Stephen J Redmond ◽  
Brian Caulfield
Keyword(s):  
Fall Risk ◽  
Population Based ◽  
Falls Prevention ◽  
Sensor Data ◽  
Gait Velocity ◽  
Community Settings ◽  
Mobility Impairment ◽  
Timed Up And Go ◽  
Falls Risk ◽  
Slow Walking Speed

Abstract Falls are the leading cause of older adult injury and cost $50bn annually. New digital technologies can quantitatively measure falls risk. Objective is to report on a validated wearable sensor-based Timed Up and Go (QTUG) assessment detailing 11 measures of falls risk, frailty and mobility impairment in older adults in six countries in 38 clinical and community settings. Second objective is to generate individual targeted falls prevention programs. 14,611 QTUG records from 8,521 participants (63% female) (72.7±10.7 years) available for analysis. QTUG time was 13.9±7.4 s; gait velocity was 101.9±32.5 cm/s. 25.8% of patients reported falling in previous 12 months; 26.2% of patients were at high fall risk. 21.5% not reporting a fall, were high fall risk. Participants had slow walking speed (29.8%); high gait variability (19.8%); problems with transfers (17.5%). Easily captured and interpreted sensor data is useful in a population-based approach to quantify falls risk stratification.

scholarly journals Digital assessment of falls risk, frailty, and mobility impairment using wearable sensors

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Barry R. Greene ◽  
Killian McManus ◽  
Stephen J. Redmond ◽  
Brian Caulfield ◽  
Charlene C. Quinn
Keyword(s):  
Risk Assessment ◽  
Fall Risk ◽  
Falls Prevention ◽  
Sensor Data ◽  
Emergency Department Utilization ◽  
Mobility Impairment ◽  
Timed Up And Go ◽  
Falls Risk ◽  
Assessment Protocol ◽  
Risk Of Falls

AbstractFalls are among the most frequent and costly population health issues, costing $50bn each year in the US. In current clinical practice, falls (and associated fall risk) are often self-reported after the “first fall”, delaying primary prevention of falls and development of targeted fall prevention interventions. Current methods for assessing falls risk can be subjective, inaccurate, have low inter-rater reliability, and do not address factors contributing to falls (poor balance, gait speed, transfers, turning). 8521 participants (72.7 ± 12.0 years, 5392 female) from six countries were assessed using a digital falls risk assessment protocol. Data consisted of wearable sensor data captured during the Timed Up and Go (TUG) test along with self-reported questionnaire data on falls risk factors, applied to previously trained and validated classifier models. We found that 25.8% of patients reported a fall in the previous 12 months, of the 74.6% of participants that had not reported a fall, 21.5% were found to have a high predicted risk of falls. Overall 26.2% of patients were predicted to be at high risk of falls. 29.8% of participants were found to have slow walking speed, while 19.8% had high gait variability and 17.5% had problems with transfers. We report an observational study of results obtained from a novel digital fall risk assessment protocol. This protocol is intended to support the early identification of older adults at risk of falls and inform the creation of appropriate personalized interventions to prevent falls. A population-based approach to management of falls using objective measures of falls risk and mobility impairment, may help reduce unnecessary outpatient and emergency department utilization by improving risk prediction and stratification, driving more patients towards clinical and community-based falls prevention activities.

29 Association between Risk of Falling and History of a Previous Falls over Four Years’ Annual Follow-up

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv6-iv8
Author(s):  
Guo Jeng Tan ◽  
Sumaiyah Mat ◽  
Maw Pin Tan
Keyword(s):  
Depression Scale ◽  
Resource Planning ◽  
Timed Up And Go ◽  
The Third ◽  
Functional Reach ◽  
Increased Risk ◽  
Annual Visit ◽  
Risk Of Falls ◽  
History Of

Abstract Introduction Falls in older persons lead to psychological as well as physical effects resulting in loss of quality of life, functional impairment and institutionalization. Previous studies have established falls in the previous 12 months as a risk factor for subsequent falls, but few have evaluated sequentially. This study aims to determine the sequential trend of 12-month retrospective fall recall over a four-year follow-up period. Methods The Promoting Independence in our Seniors with Arthritis (PISA) study recruited individuals aged &gt;=60 years followed up over four year. Participants were asked about presence of any fall in the preceding 12 months during each annual visit. Assessment performed during each visit included weight and the Knee Injury and Osteoarthritis Outcome Score (KOOS), hand grip strength, timed-up-and-go test, functional reach and Hospital Anxiety and Depression Scale. Results Falls data were available for 218, 156, 117 and 100 individuals with 22.5%, 23.1%, 24.7% and 29.3% reporting falls at the first, second, third and fourth visits respectively. The mean age (standard deviation) at recruitment was 66.9 (7.1) years and 166 (74.1%) were women. The odds ratio (OR) (95% confidence interval, CI) for falls in the first, second and third years for fallers at recruitment were 2.45 (1.07-5.59), 3.55 (1.49-8.84) and 1.14 (0.43-3.05) respectively. Fallers at the second follow-up, were more likely to falls during second [OR (95%CI) = 2.41(1.94-12.90)] and third years [5.20 (1.91-14.13)]. Faller at the third visit for falls were more likely to fall in the third yaer [OR (95%CI) = 3.88(1.55-9.69)]. Conclusion Falls in the preceding 12 months was associated with increased risk of falls in the subsequent two years. Faller at recruitment, however. were no longer at increased risk of falls at the third year of follow-up. This has implications for resource planning in terms to determine whether intervention is still useful with long waiting lists in overcrowded public health facilities.

scholarly journals Non-Pharmacological Interventions towards Preventing the Triad Osteoporosis-Falls Risk-Hip Fracture, in Population Older than 65. Scoping Review

2020 ◽  
Vol 9 (8) ◽  
pp. 2329
Author(s):  
Alba Peraza-Delgado ◽  
María Begoña Sánchez-Gómez ◽  
Juan Gómez-Salgado ◽  
Macarena Romero-Martín ◽  
Mercedes Novo-Muñoz ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Scoping Review ◽  
Functional Disability ◽  
Adult Population ◽  
Falls Prevention ◽  
Medical Expenditure ◽  
Mineral Density ◽  
Pharmacological Interventions ◽  
Falls Risk ◽  
Increased Risk

Osteoporosis leads to increased risk of falls, and thus an increase in fractures, highlighting here hip fractures, that result in high mortality, functional disability, and high medical expenditure. The aim is to summarise the available evidence on effective non-pharmacological interventions to prevent the triad osteoporosis/falls risk/hip fracture. A scoping review was conducted consulting the Scientific Electronic Library Online (Scielo), National Institute for Health and Care Excellence (NICE), Cumulative Index to Nursing & Allied Health Literature (CINAHL) y PubMed.databases. Inclusion criteria were articles published between 2013 and 2019, in Spanish or English. In addition, publications on a population over 65 years of age covering non-pharmacological interventions aimed at hip fracture prevention for both institutionalised patients in long-stay health centres or hospitals, and patients cared for at home, both dependent and non-dependent, were included. Sixty-six articles were selected and 13 non-pharmacological interventions were identified according to the Nursing Interventions Classification taxonomy, aimed at preventing osteoporosis, falls, and hip fracture. The figures regarding the affected population according to the studies are alarming, reflecting the importance of preventing the triad osteoporosis, falls risk, and hip fracture among the population over 65 years of age. The most effective interventions were focused on increasing Bone Mineral Density through diet, exercise, and falls prevention. As a conclusion, primary prevention should be applied to the entire adult population, with special emphasis on people with osteoporosis.

scholarly journals Predicting Fall Counts Using Wearable Sensors: A Novel Digital Biomarker for Parkinson’s Disease

Sensors ◽  
2021 ◽  
Vol 22 (1) ◽  
pp. 54
Author(s):  
Barry R. Greene ◽  
Isabella Premoli ◽  
Killian McManus ◽  
Denise McGrath ◽  
Brian Caulfield
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Inertial Sensor ◽  
Wearable Sensors ◽  
Strong Association ◽  
Sensor Data ◽  
Clinical Population ◽  
Timed Up And Go ◽  
Falls Risk ◽  
Serious Injury

People with Parkinson’s disease (PD) experience significant impairments to gait and balance; as a result, the rate of falls in people with Parkinson’s disease is much greater than that of the general population. Falls can have a catastrophic impact on quality of life, often resulting in serious injury and even death. The number (or rate) of falls is often used as a primary outcome in clinical trials on PD. However, falls data can be unreliable, expensive and time-consuming to collect. We sought to validate and test a novel digital biomarker for PD that uses wearable sensor data obtained during the Timed Up and Go (TUG) test to predict the number of falls that will be experienced by a person with PD. Three datasets, containing a total of 1057 (671 female) participants, including 71 previously diagnosed with PD, were included in the analysis. Two statistical approaches were considered in predicting falls counts: the first based on a previously reported falls risk assessment algorithm, and the second based on elastic net and ensemble regression models. A predictive model for falls counts in PD showed a mean R2 value of 0.43, mean error of 0.42 and a mean correlation of 30% when the results were averaged across two independent sets of PD data. The results also suggest a strong association between falls counts and a previously reported inertial sensor-based falls risk estimate. In addition, significant associations were observed between falls counts and a number of individual gait and mobility parameters. Our preliminary research suggests that the falls counts predicted from the inertial sensor data obtained during a simple walking task have the potential to be developed as a novel digital biomarker for PD, and this deserves further validation in the targeted clinical population.

scholarly journals Anemia, sarcopenia, physical activity, and the risk of tuberculosis in the older population: a nationwide cohort study

2021 ◽  
Vol 12 ◽  
pp. 204062232110159
Author(s):  
Jung Eun Yoo ◽  
Dahye Kim ◽  
Hayoung Choi ◽  
Young Ae Kang ◽  
Kyungdo Han ◽  
...  
Keyword(s):  
Physical Activity ◽  
Screening Program ◽  
Chronic Obstructive ◽  
Older Population ◽  
Timed Up And Go ◽  
Obstructive Pulmonary Disease ◽  
Mild Anemia ◽  
Increased Risk ◽  
Male Sex

Background: The aim of this study was to investigate whether physical activity, sarcopenia, and anemia are associated an with increased risk of tuberculosis (TB) among the older population. Methods: We included 1,245,640 66-year-old subjects who participated in the National Screening Program for Transitional Ages for Koreans from 2009 to 2014. At baseline, we assessed common health problems in the older population, including anemia and sarcopenia. The subjects’ performance in the timed up-and-go (TUG) test was used to predict sarcopenia. The incidence of TB was determined using claims data from the National Health Insurance Service database. Results: The median follow-up duration was 6.4 years. There was a significant association between the severity of anemia and TB incidence, with an adjusted hazard ratio (aHR) of 1.28 [95% confidence interval (CI), 1.20–1.36] for mild anemia and 1.69 (95% CI, 1.51–1.88) for moderate to severe anemia. Compared with those who had normal TUG times, participants with slow TUG times (⩾15 s) had a significantly increased risk of TB (aHR 1.19, 95% CI, 1.07–1.33). On the other hand, both irregular (aHR 0.88, 95% CI 0.83–0.93) and regular (aHR 0.84, 95% CI, 0.78–0.92) physical activity reduced the risk of TB. Male sex, lower income, alcohol consumption, smoking, diabetes, and asthma/chronic obstructive pulmonary disease increased the risk of TB. Conclusion: The risk of TB among older adults increased with worsening anemia, sarcopenia, and physical inactivity. Physicians should be aware of those modifiable predictors for TB among the older population.

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