The Association of Falls Risk in Older Adults and Their Living Environment: A Case Study of Rural Area, Thailand

Falls in older adults have become a serious problem and a major cause of home injuries and even deaths. The increasing number of older people that will enter the “older adults” category in a few years’ time calls for an effective plan to mitigate the risk factors to falling. This article reported on our study of the relationship between living environment hazards and fall risk in older adults to reduce and prevent the risk of falling using a specific case of a rural area in Thailand. A site investigation together with a questionnaire survey were conducted in a total of 950 homes of older people who were interviewed in conjunction with authorities from Banphaeo district of Samutsakorn Province, Thailand. Using a multinomial logistic regression model, this research found the following risk of falls based on the categorizations of the calculated risk factors among socio-economic characteristics (sex, age, marital status, income), health status (congenital diseases), and living environment characteristics (toilet availability in bedroom). The analysis identified a multifactorial relationship involving intrinsic and extrinsic factors that determined fall risk among older adults. Based on the findings of the research, risk factors associated with socioeconomic determinants in term of poverty were found as a key barrier in promoting the health and well-being of older adults. We recommend interventions for fall prevention and fall risk-reduction strategies through improvement of the physical environment in the homes of older adults as a proactive measure to lessen the causes of home injuries from falls.

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Prediction of Balance Perturbations and Falls on Stairs in Older People Using a Biomechanical Profiling Approach: A 12-Month Longitudinal Study

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa130 ◽

2020 ◽

Author(s):

Thijs Ackermans ◽

Natasha Francksen ◽

Carolyn Lees ◽

Fyllis Papatzika ◽

Adamantios Arampatzis ◽

...

Keyword(s):

Risk Factors ◽

Older Adults ◽

Older People ◽

Fall Risk ◽

Assessment Tool ◽

Cox Regression ◽

Screening Tools ◽

Major Health Problem ◽

Cox Regression Analysis ◽

Psychological Parameters

Abstract Background Stair falls are a major health problem for older people, but presently, there are no specific screening tools for stair fall prediction. The purpose of the present study was to investigate whether stair fallers could be differentiated from nonfallers by biomechanical risk factors or physical/psychological parameters and to establish the biomechanical stepping profile posing the greatest risk for a stair fall. Methods Eighty-seven older adults (age: 72.1 ± 5.2 years) negotiated an instrumented seven-step staircase and performed a range of physical/psychological tasks. k-Means clustering was used to profile the overall stair negotiation behavior with biomechanical parameters indicative of fall risk as input. Falls and events of balance perturbation (combined “hazardous events”) were then monitored during a 12-month follow-up. Cox-regression analysis was performed to examine whether physical/psychological parameters or biomechanical outcome measures could predict future hazardous events. Kaplan–Meier survival curves were obtained to identify the stepping strategy posing a risk for a hazardous event. Results Physical/psychological parameters did not predict hazardous events and the commonly used Fall Risk Assessment Tool classified only 1/17 stair fallers at risk for a fall. Single biomechanical risk factors could not predict hazardous events on stairs either. On the contrary, two particular clusters identified by the stepping profiling method in stair ascent were linked with hazardous events. Conclusion This highlights the potential of the stepping profiling method to predict stair fall risk in older adults against the limited predictability of single-parameter approaches currently used as screening tools.

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The Relationship Between Fear of Falling and Functional Fitness among Older Adults Living in Rest Home

10.35262/jiag.v16i1.5-10 ◽

2020 ◽

Vol 16 (1) ◽

Author(s):

H Tuna ◽

Ö Bozan ◽

B Gürpınar ◽

N İlçin

Keyword(s):

Risk Factors ◽

Older Adults ◽

Fall Risk ◽

Fear Of Falling ◽

Dynamic Balance ◽

Upper Body ◽

Functional Fitness ◽

Fall Risk Factors ◽

Rest Home ◽

History Of

Objective: This study aimed to report the fear of falling and assess its associations with several fall-related characteristics and functional fitness parameters among older adults living in the rest home. Methods: Seventy-eight older adults aged between 65-94 years were included in the study. History of falling and the number of risk factors for falling were recorded. Fear of falling was evaluated with The Falls Efficacy ScaleInternational. Functional fitness was assessed with Senior Fitness Test, including tests for the functional measurement of strength, flexibility, aerobic endurance and dynamic balance. Result: The mean age of participants was 78.46±7.16 years. There were correlations exist between fear of falling and number of fall risk factors, dynamic balance, upper body flexibility and aerobic endurance (p<0.05). Multiple linear regression analysis showed that the parameters with the highest determinants of fear of falling were the dynamic balance and history of falling (p<0.05). Conclusions: In our study, history of falling, number of fall risk factors, flexibility for the upper body, aerobic endurance and dynamic balance were parameters related to fear of falling among older adults, but the most influential factors in fear of falling were dynamic balance and history of falling.

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Association of self-perceived income sufficiency with cognitive impairment among older adults: a population-based study in India

BMC Psychiatry ◽

10.1186/s12888-021-03257-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

T. Muhammad ◽

Shobhit Srivastava ◽

T. V. Sekher

Keyword(s):

Risk Factors ◽

Older Adults ◽

Cognitive Impairment ◽

Activities Of Daily Living ◽

Psychological Health ◽

Daily Living ◽

Basic Needs ◽

Well Being ◽

Asset Ownership ◽

Increased Risk

Abstract Background Greater cognitive performance has been shown to be associated with better mental and physical health and lower mortality. The present study contributes to the existing literature on the linkages of self-perceived income sufficiency and cognitive impairment. Study also provides additional insights on other socioeconomic and health-related variables that are associated with cognitive impairment in older ages. Methods Data for this study is derived from the 'Building Knowledge Base on Population Ageing in India'. The final sample size for the analysis after removing missing cases was 9176 older adults. Descriptive along with bivariate analyses were presented to show the plausible associations of cognitive impairment with potential risk factors using the chi-square test. Also, binary logistic regression analysis was performed to provide the relationship between cognitive impairment and risk factors. The software used was STATA 14. Results About 43% of older adults reported that they had no source of income and 7.2% had income but not sufficient to fulfil their basic needs. Older adults with income but partially sufficient to fulfil their basic needs had 39% significantly higher likelihood to suffer from cognitive impairment than older adults who had sufficient income [OR: 1.39; OR: 1.21–1.59]. Likelihood of cognitive impairment was low among older adults with asset ownership than older adults with no asset ownership [OR: 0.83; CI: 0.72–0.95]. Again, older adults who work by compulsion (73.3%) or felt mental or physical stress due to work (57.6%) had highest percentage of cognitive impairment. Moreover, older adults with poor self-rated health, low instrumental activities of daily living, low activities of daily living, low subjective well-being and low psychological health were at increased risk for cognitive impairment. Conclusion The study highlights the pressing need for care and support and especially financial incentives in the old age to preserve cognitive health. Further, while planning geriatric health care for older adults in India, priority must be given to financially backward, with no asset ownership, with poor health status, older-older, widowed, and illiterate older individuals, as they are more vulnerable to cognitive impairment.

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The economic recession and subjective well-being in older adults in the Republic of Ireland

Irish Journal of Psychological Medicine ◽

10.1017/ipm.2016.21 ◽

2016 ◽

Vol 36 (2) ◽

pp. 99-104 ◽

Cited By ~ 1

Author(s):

R. M. Duffy ◽

K. Mullin ◽

S. O’Dwyer ◽

M. Wrigley ◽

B. D. Kelly

Keyword(s):

Older Adults ◽

Older People ◽

Urban Areas ◽

Economic Recession ◽

Well Being ◽

Poor Health ◽

Future Research ◽

Subjective Well Being ◽

Physical And Mental Health ◽

Future Health

ObjectiveSubjective well-being in older people is strongly associated with emotional, physical and mental health. This study investigates subjective well-being in older adults in Ireland before and after the economic recession that commenced in 2008.MethodsCross-sectional data from the biennial European Social Survey (2002–2012) were analysed for two separate groups of older adults: one sampled before the recession and one after. Stratification and linear regression modelling were used to analyse the association between subjective well-being, the recession and multiple potential confounders and effect modifiers.ResultsData were analysed on 2013 individuals. Overall, subjective well-being among older adults was 1.30 points lower after the recession compared with before the recession (s.e. 0.16; 95% confidence interval 1.00–1.61; p<0.001) [pre-recession: 16.1, out of a possible 20 (s.d. 3.24); post-recession:14.8 (s.d. 3.72)]. Among these older adults, the pre- and post-recession difference was especially marked in women, those with poor health and those living in urban areas.ConclusionsSubjective well-being was significantly lower in older adults after the recession compared with before the recession, especially in women with poor health in urban areas. Policy-makers need proactively to protect these vulnerable cohorts in future health and social policy. Future research could usefully focus on older people on fixed incomes whose diminished ability to alter their economic situation might make them more vulnerable to reduced subjective well-being during a recession.

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Prevalence and Risk Factors of Postprandial Hypotension Among Japanese Older Adults in a Facility

Innovation in Aging ◽

10.1093/geroni/igaa057.716 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 222-222

Author(s):

Noriko Suzuki ◽

Masahiko Hashizume ◽

Hideyuki Shiotani

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Older Adults ◽

Older People ◽

Future Research ◽

Baseline Body Mass Index ◽

Term Care ◽

Postprandial Hypotension ◽

Before And After ◽

Japanese Older Adults

Abstract Postprandial hypotension (PPH) is an unrecognized sudden drop of blood pressure (BP) after meals and a hidden problem among older people including those living in long-term care facilities (LTCFs). Though PPH causes dizziness, falls, and syncope, it has received little attention from¬¬¬ healthcare workers (HCW) including caregivers, nurses and physicians, and risk factors of PPH should be carefully assessed to improve quality of life. Therefore, we aimed to examine the prevalence and risk factors of PPH in a LTCF in Japan. Participants were 114 older adults living in a LTCF in Japan (mean age 85.9 years old; 85 female (74%)). To examine PPH, blood pressure (BP) was measured before and after lunch. BP after meal was measured four times every 30 minutes. PPH is defined as a BP drop of 20 mmHg or more and we also defined a BP drop within a range of 19 to 15 mmHg as potential-PPH. As risk factors, we compared systolic and diastolic BP at baseline, body mass index, pulse rate, disease and complications between groups with/without PPH. The prevalence of PPH was 41% (47/114) and 52% with potential-PPH; 11% (13/114) added. Among risk factors, systolic BP was significantly higher in those with PPH (142.6 vs 123.5 mmHg, p <0.001). This study revealed that PPH & potential-PPH occurred in half of the subjects in a LTCF in Japan. HCW need to focus on high systolic BP to predict PPH and future research is necessary to prevent and cope with PPH for older people.

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Comparison of The Risk Factors For Falls Among Older Adults Between Urban and Rural Areas of Shantou City, China

10.21203/rs.3.rs-72830/v1 ◽

2020 ◽

Author(s):

Xiaodong Chen ◽

Zeting Lin ◽

Ran Gao ◽

Yijian Yang ◽

Liping Li

Keyword(s):

Risk Factors ◽

Older Adults ◽

Fall Prevention ◽

Rural Areas ◽

Urban Areas ◽

Multivariable Analysis ◽

Living Environment ◽

Balance Function ◽

Urban And Rural Areas ◽

Risk Factors For Falls

Abstract Background: To investigate the prevalence of falls and risk factors among older adults in urban and rural areas and to facilitate the design of fall prevention interventions.Methods: We used cluster random sampling to investigate the sociodemographic information, living habits, medical history, and falls among 649 older adult participants. Univariable and multivariable logistic regression was used to examine fall risk factors in urban and rural areas.Results: The fall rate and rate of injury from falls among older adults in urban areas were 27.3% and 18.6%, respectively, which were higher than those in rural areas (17.0% and 12.2%; P<0.05). Multivariable analysis showed that the risk factors for falls among urban older adults included a high school or below education level (OR=3.737, 95% CI: 1.503~9.291); diabetes medicine use (OR=4.518, 95% CI: 1.228~16.626); incontinence (OR=8.792, 95% CI: 1.894~40.824); lack of fall prevention education (OR = 11.907, 95% CI: 1.321～107.354); and reduced balance function (OR = 3.901, 95% CI: 1.894~7.815). The risk factors among rural older adults included a previous nonfarming occupation (OR=2.496, 95% CI: 1.416~4.398); incontinence (OR =11.396, 95% CI: 1.901~68.327); poor living environment (OR=3.457, 95% CI: 1.488~8.033); and reduced balance function (OR =4.260, 95% CI: 2.361~7.688).Discussion: The rate of falls among older adults in urban areas is higher than that in rural areas of Shantou City. Fall prevention in urban areas should target older adults with low education and modify the diabetes medication use. Interventions should focus on improving the home environment of older adults in rural areas.

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Using Tai Chi to Reduce Fall Risk Factors Among Older Adults: An Evaluation of a Community-Based Implementation

Journal of Applied Gerontology ◽

10.1177/0733464817703004 ◽

2017 ◽

Vol 38 (7) ◽

pp. 983-998 ◽

Cited By ~ 5

Author(s):

Mary P. Gallant ◽

Meaghan Tartaglia ◽

Susan Hardman ◽

Kara Burke

Keyword(s):

Risk Factors ◽

Older Adults ◽

Fall Risk ◽

Tai Chi ◽

Community Based ◽

Fall Risk Factors

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Features of Rural Communities in Latin America and Sub-Saharan Africa That Influence Well-Being of Older Persons

Innovation in Aging ◽

10.1093/geroni/igab046.1622 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 420-421

Author(s):

Andrew Banda ◽

Norah Keating ◽

Jaco Hoffman ◽

Jose Parodi ◽

Nereide Curreri

Keyword(s):

Older Adults ◽

Latin America ◽

Rural Communities ◽

Older People ◽

Scoping Review ◽

Older Persons ◽

Subjective Wellbeing ◽

Well Being ◽

Sub Saharan Africa ◽

Sub Saharan

Abstract In their recent volume, Critical Rural Gerontology, Skinner et al (2021) challenge us to set aside unidimensional notions of rural communities as bypassed vs very supportive; and to identify the elements of rurality that empower or exclude older people and how these differ across cultures and settings. Covid-19 has highlighted the need for safe and inclusive communities. Given that LMIC will be home to the majority of older adults (Gonzales et al. 2015), we undertook a scoping review of features of rural communities that influence wellbeing of older people in countries across Latin America and Sub-Saharan Africa. The review included literature in English, French, Spanish and Portuguese, using search engines MEDLINE, CINAHL Complete, PsycInfo, SocINDEX, SciELO, AJOL (Africa Journals Online), LILACS, Redalyc, LatinIndex and Clacso. Findings illustrate diversity in how community features including remoteness, infrastructure and belonging influence material, social and subjective wellbeing of older residents.

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ADVANCING AN INTERDISCIPLINARY SCIENCE OF AGING THROUGH A PRACTICE-BASED DATA SCIENCE APPROACH

Innovation in Aging ◽

10.1093/geroni/igz038.1786 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S480-S480

Author(s):

Robert Lucero ◽

Ragnhildur Bjarnadottir

Keyword(s):

Machine Learning ◽

Risk Factors ◽

Older Adults ◽

Text Mining ◽

Language Processing ◽

Fall Risk ◽

Data Science ◽

Care Quality ◽

Science Approach ◽

Hospitalized Older Adults

Abstract Two hundred and fifty thousand older adults die annually in United States hospitals because of iatrogenic conditions (ICs). Clinicians, aging experts, patient advocates and federal policy makers agree that there is a need to enhance the safety of hospitalized older adults through improved identification and prevention of ICs. To this end, we are building a research program with the goal of enhancing the safety of hospitalized older adults by reducing ICs through an effective learning health system. Leveraging unique electronic data and healthcare system and human resources at the University of Florida, we are applying a state-of-the-art practice-based data science approach to identify risk factors of ICs (e.g., falls) from structured (i.e., nursing, clinical, administrative) and unstructured or text (i.e., registered nurse’s progress notes) data. Our interdisciplinary academic-clinical partnership includes scientific and clinical experts in patient safety, care quality, health outcomes, nursing and health informatics, natural language processing, data science, aging, standardized terminology, clinical decision support, statistics, machine learning, and hospital operations. Results to date have uncovered previously unknown fall risk factors within nursing (i.e., physical therapy initiation), clinical (i.e., number of fall risk increasing drugs, hemoglobin level), and administrative (i.e., Charlson Comorbidity Index, nurse skill mix, and registered nurse staffing ratio) structured data as well as patient cognitive, environmental, workflow, and communication factors in text data. The application of data science methods (i.e., machine learning and text-mining) and findings from this research will be used to develop text-mining pipelines to support sustained data-driven interdisciplinary aging studies to reduce ICs.

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EXAMINING DISCREPANCIES IN SOCIAL ROBOT VERSUS HUMAN ASSESSMENTS OF GERIATRIC WELL-BEING

Innovation in Aging ◽

10.1093/geroni/igz038.1199 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S329-S329

Author(s):

Erin Harrington ◽

Ha Do ◽

Alex J Bishop ◽

Celinda Reese-Melancon ◽

and Weihua Sheng

Keyword(s):

Older Adults ◽

Fall Risk ◽

Social Connectedness ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Well Being ◽

Falls Prevention ◽

Assessment Tools ◽

Assessment Scores ◽

Loneliness Scale

Abstract Socially assistive robotic (SAR) technologies represent a viable tool for monitoring the safety and health of older adults. However, it is unclear whether SARs can comprehensively screen geriatric well-being as effectively as trained human clinicians. The purpose of this study was to compare SAR versus human assessment of geriatric well-being. Participants included 30 older adults (Mage = 73.40, SD = 7.88) who completed a robot-administered well-being assessment session during which human-administered evaluation was simultaneously performed. Standardized clinical screening assessment tools common in geriatric care were administered (e.g., Short Blessed Test (SBT), UCLA Loneliness Scale, Geriatric Depression Scale, PHQ-4, Iowa Fatigue Scale, Fall Risk). Multiple dependent sample t-tests were used to explore variability in assessment scores between SAR and human evaluation. Assessment scores significantly differed on several measures, including the SBT (t(29) = -9.33, p < .001), UCLA Loneliness scale (t(19) = 2.37, p < . 05), and fall risk assessment (t(29) = 3.03, p < .01). Specifically, the SAR indicated that older adults were significantly more cognitively impaired, less lonely, and more likely to fall compared to the human administrator. Other observed differences and hypothesized explanations will be discussed in greater detail. The current study indicates that there is a divergence in geriatric assessment outcomes based on human versus SAR administration. Findings have implications relative to further developing SAR technology to align with human-based evaluations to enhance cognitive well-being, social connectedness, and falls prevention.

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