Assessing the fall risks of community-dwelling stroke survivors using the Short-form Physiological Profile Assessment (S-PPA)

Abstract Introduction: Falls are multifactorial and are related to the aging process, reduced functional capacity, comorbidities, sensory deficits, muscle weakness, postural instability and decreased protective response. Objective: To verify the correlation between physiological risk of falls and physical and aerobic capacity of the community-dwelling elderly. Method: Participated elderly individuals from the community, aged ≥65 years, without distinction of sex, race, and/or social class. We excluded cognitive impairments, locomotion incapacity, neurological diseases or sequelae, and/or severe pain that prevented the performance of the tests. We evaluated risk of falls (Physiological Profile Assessment - PPA), physical capacity (Short Physical Performance Battery - SPPB) and aerobic capacity (Shuttle Walk Test - ISWT). Results: Participated 59 elderly (71.8±5.0 ys). The mean performance in PPA was 0.4±0.4; SPPB was 10.4±1.7 and ISWT was 281±111.7 meters. PPA presented a moderate and statistically significant correlation (P<0.001) for SPPB (r= -0.53) and ISWT (r= -0.46). Conclusion: There is a moderate correlation between the physiological risk of falls (PPA) and functional (SPPB) and aerobic capacity (ISWT). Preventive measures to reduce the risk of falls should include strategies to increase functional and aerobic capacity. It is suggested the systematic use of SPPB in clinical practice.

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ABILITY OF THE PHYSIOLOGICAL PROFILE ASSESSMENT TO CLASSIFY FALLER TYPE: A PROSPECTIVE COHORT STUDY

Innovation in Aging ◽

10.1093/geroni/igz038.1757 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S471-S471

Author(s):

Deborah A Jehu ◽

Jennifer C Davis ◽

Kristin Velsey ◽

Winnie Cheung ◽

Teresa Liu-Ambrose

Keyword(s):

Older Adults ◽

Risk Assessment ◽

Fall Prevention ◽

Fall Risk ◽

Vancouver General Hospital ◽

Community Dwelling ◽

Medical Attention ◽

Physiological Profile ◽

Fall Risk Assessment ◽

Physiological Profile Assessment

Abstract Accurately identifying older adults who will experience subsequent falls is important for the provision of secondary fall prevention. The purpose of this study was to determine the accuracy of the Physiological Profile Assessment (PPA) – a valid and reliable fall-risk assessment [1] – in predicting subsequent falls over a 12-month period in older adults who sought for medical attention after an index fall. Seven hundred thirty-seven community-dwelling adults, aged 70 years and older, who were seen at the Vancouver General Hospital Fall Prevention Clinic, completed the PPA at their initial visit. Falls over the subsequent 12 months were tracked prospectively via monthly falls calendars. All individuals received geriatric care at baseline. Binary logistic regressions were performed to determine the accuracy of classifying two prospective faller types: 1) no additional falls; 2) one or more additional fall(s). Baseline PPA, age, and sex were entered as independent variables. During the 12 month observation period, 345 participants had no additional falls (Age:81.3±6.6yrs;Female=251) and 392 fell one or more times (Age:82.3±6.5yrs;Female=230). The classification accuracy was 51.3% for those who had no additional falls and 64.8% for those with one or more additional fall(s) (Overall:58.5%;χ2=29.0;PPA:β=-0.21;Age:β=-0.01;Sex:β=-60). The PPA was not able to accurately differentiate between those who did and did not subsequently fall. Fall-risk assessment sensitivity and specificity should be improved in older adults seeking medical attention following an index fall to inform secondary fall prevention. [1] Lord SR, et al., 2003. Phys Ther.

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Development and Validation of the Activities of Daily Living Short Form for Community-Dwelling Korean Stroke Survivors

Evaluation & the Health Professions ◽

10.1177/0163278717695863 ◽

2017 ◽

Vol 41 (1) ◽

pp. 44-66 ◽

Cited By ~ 1

Author(s):

Ickpyo Hong ◽

Eun-Young Yoo ◽

Abby Swanson Kazley ◽

Danbi Lee ◽

Chih-Ying Li ◽

...

Keyword(s):

Activities Of Daily Living ◽

Daily Living ◽

Short Form ◽

Secondary Data ◽

Community Dwelling ◽

Stroke Survivors ◽

Health And Nutrition ◽

Euroqol 5D ◽

Good Internal Consistency ◽

Development And Validation

This study developed and validated a short form (SF) using activities of daily living (ADL) outcome measures from the Korea National Health and Nutrition Examination Survey (KNHANES) that can minimize survey administration burden for clinicians. This study utilized secondary data from the 2005 KNHANES with 422 community-dwelling stroke survivors. The KNHANES data were collected from April to June 2005 in South Korea. We created a 7-item SF from the 17 ADL questions in the survey using item response theory (IRT) methodologies. The precision and validity of the SF were compared to the full questionnaire of ADL items and the EuroQol-5D total score. Among the 17 ADL questions, 14 questions demonstrated unidimensional construct validity. Using IRT methodologies, a set of 7 items were selected from the full bank. The 7-item SF demonstrated good psychometric properties: high correlation with the full bank ( r = .975, p < .001), good internal consistency (Cronbach’s α = .93), and a high correlation with the EuroQol-5D total score ( r = .678, p < .001). These findings indicate that a well-developed SF can precisely measure ADL performance capacity for stroke survivors compared to the full item bank, which is expected to reduce the administration burden of the KNHANES.

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83 Trip Versus Slip: Implication of the Triggers of Falls on Physiological Fall Risk

Age and Ageing ◽

10.1093/ageing/afz164.83 ◽

2019 ◽

Vol 48 (Supplement_4) ◽

pp. iv18-iv27

Author(s):

Freddy M H Lam ◽

Dicky T K Choy ◽

Jason C S Leung ◽

Timothy C Y Kwok

Keyword(s):

Fall Risk ◽

Exercise Intervention ◽

Short Form ◽

Knee Extension ◽

Community Dwelling ◽

Walk Test ◽

Physiological Profile ◽

Knee Extension Strength ◽

The Difference ◽

10 Meter Walk Test

Abstract Introduction Early identification of fallers with intrinsic fall risk factors could facilitate the delivery of timely and appropriate treatment. This study aims to see if the two most common triggers of falls – trip and slip, have an implication on the physiological profile of older fallers. Methods One thousand one hundred and forty-one community-dwelling older adults aged 60 years or above who had a fall in the past year were recruited in Hong Kong. Details on the falls experienced by the elderly were recorded in an interview. Physiological fall risk of the participants was measured by the short-form Physiological Profile Assessment (PPA). It assesses vision, reaction time, proprioception, balance, and knee extension strength. Mobility was assessed by the 10-meter walk test at comfortable speed. Analysis of Co-variance (ANCOVA) was used to compare the assessment results between those who only experienced trip and falls (n=378; 316 female; mean age=70.4±7.2) and those who only experienced slip and falls (n=204; 159 female; mean age=70.1±7.1) while adjusting for gender proportion. Chi-square test was used to evaluate the difference in the proportion of recurrent fallers across groups. Results Elderly who experienced only trip and falls have a significantly lower knee extension strength (22.9±8.3kg) compare with those who experienced only slip and falls (25.0±9.18 kg; p=0.031). They also tend to take longer to complete the 10-meter walk test (Trip only: 10.17±2.88; Slip only: 9.72±2.63; p=0.085). A higher percentage of those who tripped were recurrent fallers but the difference was insignificant (Trip only: 11.6%; Slip only: 8.3%; p=0.214). No other outcome measure was found to be significantly different across groups (p≥0.418). Conclusion Elderly who tripped and fell have worse physical ability than those who slipped. They are potentially better candidates for fall prevention exercise intervention.

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Fall risk in Chinese community-dwelling older adults: A physiological profile assessment study

Geriatrics and Gerontology International ◽

10.1111/ggi.12463 ◽

2015 ◽

Vol 16 (2) ◽

pp. 259-265 ◽

Cited By ~ 2

Author(s):

Kar-Ho Siong ◽

Marcella Mun-San Kwan ◽

Stephen R Lord ◽

Andrew Kwok-Cheung Lam ◽

William Wai-Nam Tsang ◽

...

Keyword(s):

Older Adults ◽

Fall Risk ◽

Community Dwelling ◽

Chinese Community ◽

Physiological Profile ◽

Assessment Study ◽

Community Dwelling Older Adults ◽

Physiological Profile Assessment

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57 The Use of the Physiological Profile Assessment to Improve Prediction of Fragility Fractures in Community-Dwelling Older People

Age and Ageing ◽

10.1093/ageing/afz164.57 ◽

2019 ◽

Vol 48 (Supplement_4) ◽

pp. iv13-iv17

Author(s):

Lara Harvey ◽

Morag Taylor ◽

Kim Delbaere ◽

Stephen Lord ◽

Henry Brodaty ◽

...

Keyword(s):

Older People ◽

Fall Risk ◽

Fragility Fractures ◽

Community Dwelling ◽

Baseline Assessment ◽

Physiological Profile ◽

Visual Contrast ◽

Increased Risk ◽

Community Dwelling Older People ◽

Physiological Profile Assessment

Abstract Introduction The Physiological Profile Assessment (PPA) is a validated composite measure of sensorimotor function, known to predict falls with 75% accuracy. This work aimed to investigate whether PPA is also associated with fragility fractures. Method Participants were 489 community-dwelling older people (age=70-90) enrolled in the longitudinal population-based Sydney Memory and Ageing Study. Participants underwent comprehensive assessments at enrolment, including the 5-item PPA (visual contrast sensitivity, lower limb proprioception, knee extension strength, simple reaction time and postural sway). Participant records were linked to emergency department, hospital and death records (2005-2014) to identify fragility fractures following baseline assessment, with median follow-up duration of 7.5 years. Negative binomial regression, with observation time as the offset, was used to assess factors associated with fractures. Results At baseline assessment, 281 (57.5%) participants were assessed as having low/mild fall risk [PPA<1] and 208 (42.5%) as moderate/marked/very marked fall risk [PPA score >1]. Over the study period, 72 (14.7%) individuals sustained 1 fracture, and a further 39 (8.0%) sustained 2 or more fractures. Univariate analysis showed that increasing age (Incidence Rate Ratio (IRR) 1.1, 95%CI 1.0-1.1, p=0.0026), being female (IRR 1.8, 95%CI 1.3-2.8, p=0.0033), having osteoporosis (IRR 1.7, 95%CI 1.1-2.6, p=0.0340) and moderate/marked/very marked PPA (IRR 1.8, 95%CI 1.2-2.7, p=0.0025) were associated with fractures. In the multivariate analysis, only moderate/marked/very marked PPA (IRR 1.6, 95%CI 1.1-2.5, p=0.0159) and being female (IRR 1.8, 95%CI 1.1-2.8, p=0.0121) remained independently associated with fractures. Conclusion These findings show that people at increased risk of falls based on the Physiological Profile Assessment are also at increased risk of future fragility fractures regardless of the presence of osteoporosis. Early identification of this high risk population provides the opportunity to intervene with evidence based strategies to minimize falls risk as well as considering pharmacological management of bone health.

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Assessing elderly’s functional balance and mobility via analyzing data from waist-mounted tri-axial wearable accelerometers in timed up and go tests

BMC Medical Informatics and Decision Making ◽

10.1186/s12911-021-01463-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Lisha Yu ◽

Yang Zhao ◽

Hailiang Wang ◽

Tien-Lung Sun ◽

Terrence E. Murphy ◽

...

Keyword(s):

Predictive Models ◽

Cross Validation ◽

Motor Coordination ◽

Predictive Accuracy ◽

Short Form ◽

Community Dwelling ◽

Regularized Regression ◽

Balance Assessment ◽

Timed Up And Go ◽

Functional Balance

Abstract Background Poor balance has been cited as one of the key causal factors of falls. Timely detection of balance impairment can help identify the elderly prone to falls and also trigger early interventions to prevent them. The goal of this study was to develop a surrogate approach for assessing elderly’s functional balance based on Short Form Berg Balance Scale (SFBBS) score. Methods Data were collected from a waist-mounted tri-axial accelerometer while participants performed a timed up and go test. Clinically relevant variables were extracted from the segmented accelerometer signals for fitting SFBBS predictive models. Regularized regression together with random-shuffle-split cross-validation was used to facilitate the development of the predictive models for automatic balance estimation. Results Eighty-five community-dwelling older adults (72.12 ± 6.99 year) participated in our study. Our results demonstrated that combined clinical and sensor-based variables, together with regularized regression and cross-validation, achieved moderate-high predictive accuracy of SFBBS scores (mean MAE = 2.01 and mean RMSE = 2.55). Step length, gender, gait speed and linear acceleration variables describe the motor coordination were identified as significantly contributed variables of balance estimation. The predictive model also showed moderate-high discriminations in classifying the risk levels in the performance of three balance assessment motions in terms of AUC values of 0.72, 0.79 and 0.76 respectively. Conclusions The study presented a feasible option for quantitatively accurate, objectively measured, and unobtrusively collected functional balance assessment at the point-of-care or home environment. It also provided clinicians and elderly with stable and sensitive biomarkers for long-term monitoring of functional balance.

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Disability, Frailty and Depression in the community-dwelling older adults with Osteosarcopenia

BMC Geriatrics ◽

10.1186/s12877-021-02022-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ki-Soo Park ◽

Gyeong-Ye Lee ◽

Young-Mi Seo ◽

Sung-Hyo Seo ◽

Jun-Il Yoo

Keyword(s):

Older Adults ◽

Short Form ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Community Dwelling ◽

Normal Group ◽

World Health ◽

Common Disease ◽

Using Data ◽

Health Organization

Abstract Background The purpose of this study was to investigate the prevalence of osteosarcopenia in the over 60-year-old community and to evaluate whether osteosarcopenia is associated with disability, frailty and depression. Methods This study was performed using the baseline data of Namgaram-2, among the 1010 surveyed subjects, 885 study subjects who were 60 years or older and had all necessary tests performed were selected. The Kaigo-Yobo checklist (frailty), World Health Organization Disability Assessment Schedule (WHODAS) and Geriatric Depression Scale-Short Form-Korean (GDSSF-K) were used. The Asian Working Group for Sarcopenia (AWGS 2019) were applied in this study. Osteopenia was measured using data from dual energy X-ray absorptiometry (DEXA) and osteopenia was diagnosed when the T-score was less than − 1.0. The study subjects were divided into four groups: the normal group, in which both sarcopenia and osteopenia were undiagnosed, osteopenia only, sarcopenia only and the osteosarcopenia group, which was diagnosed with both sarcopenia and osteopenia. Results Of the 885 subjects over 60 years old evaluated, the normal group comprised 34.0%, the only osteopenia group 33.7%, the only sarcopenia group 13.1%, and the osteosarcopenia group 19.2%. WHODAS (17.5, 95% CI: 14.8-20.1), Kaigo-Yobo (3.0, 95% CI: 2.6-3.4), and GDSSF mean score (4.6, 95% CI: 3.9-5.4) were statistically significantly higher in the osteosarcopenia group compared the other groups. Partial eta squared (ηp2) of WHODAS (0.199) and Kaigo-Yobo (0.148) values according to Osteosarcopenia were large, and GDSSF (0.096) was medium Conclusions Osteosarcopenia is a relatively common disease group in the older adults community that may cause deterioration of health outcomes. Therefore, when evaluating osteopenia or sarcopenia in the older adults, management of those in both disease groups should occur together.

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Development and validation of a short version of the Sarcopenia Quality of Life questionnaire: the SF-SarQoL

Quality of Life Research ◽

10.1007/s11136-021-02823-3 ◽

2021 ◽

Author(s):

A. Geerinck ◽

C. Beaudart ◽

J.-Y. Reginster ◽

M. Locquet ◽

C. Monseur ◽

...

Keyword(s):

Quality Of Life ◽

Short Form ◽

Reduction Process ◽

Community Dwelling ◽

Short Version ◽

Second Phase ◽

Life Questionnaire ◽

Quality Of Life Questionnaire ◽

Two Phases

Abstract Purpose To facilitate the measurement of quality of life in sarcopenia, we set out to reduce the number of items in the previously validated Sarcopenia Quality of Life (SarQoL®) questionnaire, and to evaluate the clinimetric properties of this new short form. Methods The item reduction process was carried out in two phases. First, information was gathered through item-impact scores from older people (n = 1950), a Delphi method with sarcopenia experts, and previously published clinimetric data. In the second phase, this information was presented to an expert panel that decided which of the items to include in the short form. The newly created SFSarQoL was then administered to older, community-dwelling participants who previously participated in the SarcoPhAge study. We examined discriminative power, internal consistency, construct validity, test–retest reliability, structural validity and examined item parameters with a graded response model (IRT). Results The questionnaire was reduced from 55 to 14 items, a 75% reduction. A total of 214 older, community-dwelling people were recruited for the validation study. The clinimetric evaluation showed that the SF-SarQoL® can discriminate on sarcopenia status [EWGSOP2 criteria; 34.52 (18.59–43.45) vs. 42.86 (26.56–63.69); p = 0.043], is internally consistent (α = 0.915, ω = 0.917) and reliable [ICC = 0.912 (0.847–0.942)]. A unidimensional model was fitted (CFI = 0.978; TLI = 0.975; RMSEA = 0.108, 90% CI 0.094–0.123; SRMR = 0.055) with no misfitting items and good response category separation. Conclusions A new, 14-item, short form version of the Sarcopenia Quality of Life questionnaire has been developed and shows good clinimetric properties.

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Depression-related weight change and incident diabetes in a community sample

Scientific Reports ◽

10.1038/s41598-021-92963-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Eva Graham ◽

Tristan Watson ◽

Sonya S. Deschênes ◽

Kristian B. Filion ◽

Mélanie Henderson ◽

...

Keyword(s):

Type 2 Diabetes ◽

Weight Loss ◽

Weight Gain ◽

Weight Change ◽

Short Form ◽

Community Sample ◽

Overweight And Obesity ◽

Community Dwelling ◽

Increased Risk

AbstractThis cohort study aimed to compare the incidence of type 2 diabetes in adults with depression-related weight gain, depression-related weight loss, depression with no weight change, and no depression. The study sample included 59,315 community-dwelling adults in Ontario, Canada. Depression-related weight change in the past 12 months was measured using the Composite International Diagnostic Interview—Short Form. Participants were followed for up to 20 years using administrative health data. Cox proportional hazards models compared the incidence of type 2 diabetes in adults with depression-related weight change and in adults with no depression. Adults with depression-related weight gain had an increased risk of type 2 diabetes compared to adults no depression (HR 1.70, 95% CI 1.32–2.20), adults with depression-related weight loss (HR 1.62, 95% CI 1.09–2.42), and adults with depression with no weight change (HR 1.39, 95% CI 1.03–1.86). Adults with depression with no weight change also had an increased risk of type 2 diabetes compared to those with no depression (HR 1.23, 95% CI 1.04–1.45). Associations were stronger among women and persisted after adjusting for attained overweight and obesity. Identifying symptoms of weight change in depression may aid in identifying adults at higher risk of type 2 diabetes and in developing tailored prevention strategies.

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