scholarly journals Relationship Between Dynamic Balance Measures and Functional Performance in Community-Dwelling Elderly People

2010 ◽  
Vol 90 (5) ◽  
pp. 748-760 ◽  
Author(s):  
Ankur Desai ◽  
Valerie Goodman ◽  
Naaz Kapadia ◽  
Barbara L. Shay ◽  
Tony Szturm
Keyword(s):  
Older Adults ◽  
Elderly People ◽  
Dynamic Balance ◽  
Community Dwelling ◽  
Standing Balance ◽  
Self Report ◽  
Clinical Test ◽  
Balance Assessment ◽  
Test Protocol ◽  
Community Dwelling Older Adults

BackgroundPoor balance control, mobility restrictions, and fall injuries are serious problems for many older adults.ObjectiveThe purpose of this study was to evaluate a new dynamic standing balance assessment test for identifying individuals at risk for falling in a group of community-dwelling older adults.DesignThis was a cross-sectional observational study of 72 community-dwelling older adults who were receiving rehabilitation in a geriatric day hospital.MethodA Dynamic Balance Assessment (DBA) test protocol was developed based on the concept of the Sensory Organization Test and the Clinical Test of Sensory Interaction and Balance. The DBA consists of 6 tasks performed on a normal floor surface and repeated on a sponge surface. A flexible pressure mat was used to record the foot's center of pressure (COP) on both surfaces, and loss of balance was recorded. Balance performance also was evaluated using the Berg Balance Scale, the Timed “Up & Go” Test, gait speed, and the Six-Minute Walk Test. Participants were classified as “fallers” or “nonfallers” based on a self-report.ResultsNo significant differences were noted between the faller group (n=47) and the nonfaller group (n=25) for demographic variables or medications. The DBA composite scores, which were derived from analysis of COP excursions of the 6 tasks performed on the sponge surface, were able to distinguish between fallers and nonfallers. Of the clinical tests, only the Timed “Up & Go” Test was able to differentiate between the faller and nonfaller groups.LimitationsA prospective study is needed to confirm the current findings and to expand testing to a larger and more diverse sample.ConclusionsThe findings indicate that analysis of the extent and amount of COP displacements during selected tasks and under different surface conditions is an appropriate method to assess dynamic standing balance controls and can discriminate between fallers and nonfallers among community-dwelling elderly people.

Association between childhood socioeconomic status and subjective memory complaints among older adults: results from the Japan Gerontological Evaluation Study 2010

2019 ◽  
Vol 31 (12) ◽  
pp. 1699-1707 ◽  
Author(s):  
Toshinori Nishizawa ◽  
Ayako Morita ◽  
Takeo Fujiwara ◽  
Katsunori Kondo
Keyword(s):  
Older Adults ◽  
Socioeconomic Status ◽  
Evaluation Study ◽  
Community Dwelling ◽  
Self Report ◽  
Subjective Memory Complaints ◽  
Subjective Memory ◽  
Memory Complaints ◽  
Childhood Socioeconomic Status ◽  
Community Dwelling Older Adults

ABSTRACTBackground:Subjective memory complaints (SMC) have been suggested as an early marker of mild cognitive impairment and dementia. However, there is a paucity of evidence on the effects of early life conditions on the development of SMC in old age. This study is aimed at investigating the association between childhood socioeconomic status (SES) and SMC in community-dwelling older adults.Methods:We used the data of the Japan Gerontological Evaluation Study, a population-based cohort study of people aged 65 years or older enrolled from 28 municipalities across Japan. Childhood SES and SMC in everyday life were assessed from the self-report questionnaire administered in 2010 (n = 16,184). Poisson regression was performed to determine their association, adjusted for potential confounders and life-course mediators and examined cohort effects.Results:We identified SMC in 47.4% of the participants. After adjusting for sex, age, and number of siblings, low and middle childhood SES were associated with 29% (prevalence ratio [PR]: 1.29, 95% confidence interval [CI]: 1.22, 1.36) and 10% higher prevalence of SMC (PR: 1.10, 95%CI: 1.04, 1.17), respectively, compared with high childhood SES (p for trend <.001). The interaction terms between childhood SES and age groups were not statistically significant.Conclusion:Childhood SES is significantly associated with SMC among community-dwelling older adults. Efforts to minimize childhood poverty may diminish or delay the onset of SMC and dementia in later life.

scholarly journals The Modified Gait Efficacy Scale: Establishing the Psychometric Properties in Older Adults

2012 ◽  
Vol 92 (2) ◽  
pp. 318-328 ◽  
Author(s):  
Alaina M. Newell ◽  
Jessie M. VanSwearingen ◽  
Elizabeth Hile ◽  
Jennifer S. Brach
Keyword(s):  
Older Adults ◽  
Correlation Coefficient ◽  
Internal Consistency ◽  
Intraclass Correlation ◽  
Community Dwelling ◽  
Self Report ◽  
Retest Reliability ◽  
And Performance ◽  
Test Retest Reliability ◽  
Community Dwelling Older Adults

BackgroundPerceived ability or confidence plays an important role in determining function and behavior. The modified Gait Efficacy Scale (mGES) is a 10-item self-report measure used to assess walking confidence under challenging everyday circumstances.ObjectiveThe purpose of this study was to determine the reliability, internal consistency, and validity of the mGES as a measure of gait in older adults.DesignThis was a cross-sectional study.MethodsParticipants were 102 community-dwelling older adults (mean [±SD] age=78.6±6.1 years) who were independent in ambulation with or without an assistive device. Participants were assessed using the mGES and measures of confidence and fear, measures of function and disability, and performance-based measures of mobility. In a subsample (n=26), the mGES was administered twice within a 1-month period to establish test-retest reliability through the intraclass correlation coefficient (ICC [2,1]). The standard error of measure (SEM) was determined from the ICC and standard deviation. The Cronbach α value was calculated to determine internal consistency. To establish the validity of the mGES, the Spearman rank order correlation coefficient was used to examine the association with measures of confidence, fear, gait, and physical function and disability.ResultsThe mGES demonstrated test-retest reliability within the 1-month period (ICC=.93, 95% confidence interval=.85, .97). The SEM of the mGES was 5.23. The mGES was internally consistent across the 10 items (Cronbach α=.94). The mGES was related to measures of confidence and fear (r=.54–.88), function and disability (Late-Life Function and Disability Instrument, r=.32–.88), and performance-based mobility (r=.38–.64).LimitationsThis study examined only community-dwelling older adults. The results, therefore, should not be generalized to other patient populations.ConclusionThe mGES is a reliable and valid measure of confidence in walking among community-dwelling older adults.

scholarly journals Association ankle function and balance in community-dwelling older adults

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247885
Author(s):  
David Hernández-Guillén ◽  
Catalina Tolsada-Velasco ◽  
Sergio Roig-Casasús ◽  
Elena Costa-Moreno ◽  
Irene Borja-de-Fuentes ◽  
...  
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Dynamic Balance ◽  
Weight Bearing ◽  
Community Dwelling ◽  
Plantar Flexor ◽  
Flexor Muscle ◽  
Ankle Mobility ◽  
Ankle Function ◽  
Community Dwelling Older Adults

Background and purpose Ankle function declines with age. The objective of this study was to investigate the association between ankle function and balance in older adults, with a focus on range of motion (ROM) and strength. Methods This was a cross-sectional study that included 88 healthy community-dwelling older adults. Ankle mobility was measured while bearing weight (lunge test) and not bearing weight. The plantar-flexor muscle strength was assessed using a hand-held dynamometer. Balance was measured in terms of dynamic balance and mobility (timed up and go test), monopodal and bipodal static balance with open and closed eyes (single-leg stand test and platform measures), and margins of stability (functional reach test). Linear correlation and multiple regression analyses were conducted with a 95% CI. Results and discussion Most participants had limited ankle mobility (n = 75, 86%). Weight-bearing ankle dorsiflexion ROM was the strongest predictor of dynamic balance and included general mobility and stability (Radj2 = [0.34]; β = [-0.50]). In contrast, plantar-flexor muscle strength was a significant predictor of static standing balance with open eyes (Radj2 = [0.16–0.2]; β = [0.29–0.34]). Overall, weight-bearing ankle dorsiflexion ROM was a more representative measure of balance and functional performance; however, a non-weight-bearing mobility assessment provides complementary information. Therefore, both measures can be used in clinical practice. Conclusion This study supports the concept that ankle mobility contributes to the performance of dynamic tasks, while the plantar-flexor muscle strength helps to develop a standing static balance. Identification of alterations in ankle function is warranted and may assist in the design of tailored interventions. These interventions can be used in isolation or to augment conventional balance training in order to improve balance performance in community-dwelling older adults.

scholarly journals Psychometric Properties of the Taiwanese Version of the Tilburg Frailty Indicator for Community-Dwelling Older Adults

Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1193
Author(s):  
Chia-Hui Lin ◽  
Chieh-Yu Liu ◽  
Jiin-Ru Rong
Keyword(s):  
Older Adults ◽  
Psychometric Properties ◽  
Roc Curve ◽  
Goodness Of Fit ◽  
Community Dwelling ◽  
Self Report ◽  
Youden Index ◽  
Tilburg Frailty Indicator ◽  
Community Dwelling Older Adults ◽  
Frailty Indicator

Screening the frailty level of older adults is essential to avoid morbidity, prevent falls and disability, and maintain quality of life. The Tilburg Frailty Indicator (TFI) is a self-report instrument developed to assess frailty for community-dwelling older adults. The aim of this study was to explore the psychometric properties of the Taiwanese version of TFI (TFI-T). The sample consisted of 210 elderly participants living in the community. The scale was implemented to conduct a confirmatory factor analysis (CFA) test for validity. The models were evaluated through sensitivity, specificity, area under the curve, and receiving operating characteristic (ROC) curve. CFA was performed to evaluate construct validity, and the TFI-T has a goodness of fit with the three-factor structure of the TFI. Totally, the 15 items of TFI-T have acceptable internal consistency (Cronbach’s alpha = 0.78), and test–retest reliability (r = 0.88, p < 0.001). The criterion-related validity was examined, the TFI-T correlation with the Kihon Checklist (KCL) score (r = 0.74; p < 0.001). The cutoff of 5.5 based on the Youden index was considered optimal. The area under the ROC curve analysis indicated that the TFI-T has good accuracy in frailty screening. The TFI-T exhibits good reliability and validity and can be used as a sensitive and accurate instrument, which is highly applicable to screen frailty in Taiwan among older adults.

Can Insoles Be Used to Improve Static and Dynamic Balance of Community-Dwelling Older Adults? A Systematic Review on Recent Advances and Future Perspectives

2020 ◽  
Vol 28 (6) ◽  
pp. 971-986
Author(s):  
Christina Zong-Hao Ma ◽  
Wing-Kai Lam ◽  
Bao-Chi Chang ◽  
Winson Chiu-Chun Lee
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Postural Balance ◽  
Dynamic Balance ◽  
Community Dwelling ◽  
Good Knowledge ◽  
Medical Conditions ◽  
Future Perspectives ◽  
Dynamic Conditions ◽  
Community Dwelling Older Adults

This systematic review investigated the effects of orthopedic, vibrating, and textured insoles on the postural balance of community-dwelling older adults. Articles published in English from 1999 to 2019 investigating the effects of (a) orthopedic, (b) vibrating, and (c) textured insoles on static and dynamic balance in community-dwelling older adults were considered. Twenty-four trials with a total of 634 older adults were identified. The information gathered generally supported the balance-improving effects of orthopedic, vibrating, and textured insoles in both static and dynamic conditions among community-dwelling older adults. Further examination found that rigidity, texture patterns, vibration thresholds, and components like arch supports and heel cups are important factors in determining whether insoles can improve balance. This review highlights the potential of insoles for improving the static and dynamic balance of community-dwelling older adults. Good knowledge in insole designs and an understanding of medical conditions of older adults are required when attempts are made to improve postural balance using insoles.

scholarly journals Automatic Quantification of Tandem Walking Using a Wearable Device: New Insights Into Dynamic Balance and Mobility in Older Adults

2020 ◽  
Vol 76 (1) ◽  
pp. 101-107
Author(s):  
Natalie Ganz ◽  
Eran Gazit ◽  
Nir Giladi ◽  
Robert J Dawe ◽  
Anat Mirelman ◽  
...  
Keyword(s):  
Older Adults ◽  
Postural Control ◽  
Dynamic Balance ◽  
Principal Component ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Sensor Data ◽  
Quiet Standing ◽  
Mobility Disability ◽  
Community Dwelling Older Adults

Abstract Background Wearable sensors are increasingly employed to quantify diverse aspects of mobility. We developed novel tandem walking (TW) metrics, validated these measures using data from community-dwelling older adults, and evaluated their association with mobility disability and measures of gait and postural control. Methods Six hundred ninety-three community-dwelling older adults (age: 78.69 ± 7.12 years) wore a 3D accelerometer on their lower back while performing 3 tasks: TW, usual-walking, and quiet standing. Six new measures of TW were extracted from the sensor data along with the clinician’s conventional assessment of TW missteps (ie, trip other loss of balance in which recovery occurred to prevent a fall) and duration. Principal component analysis transformed the 6 new TW measures into 2 summary TW composite factors. Logistic regression models evaluated whether these TW factors were independently associated with mobility disability. Results Both TW factors were moderately related to the TW conventional measures (r &lt; 0.454, p &lt; .001) and were mildly correlated with usual-walking (r &lt; 0.195, p &lt; .001) and standing, postural control (r &lt; 0.119, p &lt; .001). The TW frequency composite factor (p = .008), but not TW complexity composite factor (p = .246), was independently associated with mobility disability in a model controlling for age, sex, body mass index, race, conventional measures of TW, and other measures of gait and postural control. Conclusions Sensor-derived TW metrics expand the characterization of gait and postural control and suggest that they reflect a relatively independent domain of mobility. Further work is needed to determine if these metrics improve risk stratification for other adverse outcomes (eg, falls and incident disability) in older adults.

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