Research Article
Year 2021,
Volume: 8 Issue: 1, 73 - 81, 07.05.2021
Abstract
Purpose: The aim of this study was to determine the factors affecting the perceived and measured fall risk in the older adults.
Methods: A cross-sectional study was conducted in Urla State Hospital, Healthy Ageing School. Physical and sociodemographic characteristics of the elderly were questioned and recorded. Cognitive status, comorbidity, physical activity levels, walking speed, functional lower extremity strength, functional mobility, strength (knee extensors, ankle dorsiflexors, elbow flexors), hand grip strength, perceived fall risk were evaluated with Mini Mental State Test, Charlson Age-Added Comorbidity Index, Physical Activity Assessment Scale, 10 meters walking test, 30 seconds chair sit-up test, Timed Up&Go Test, hand-held dynamometer, sphygmomanometer, International Fall Efficiency Scale, respectively. Objective measurement of risk of falling were done by Dynamic Postural Stability Test (Tecnobody Pro-Kin balance device). Multiple linear regression analysis was used to determine possible factors associated with perceived and measured fall risk.
Results: The study included 36 (27 females, 9 males) older adults with a mean age of 70.06±4.46 years. Height, elbow flexor muscle strength and body mass index explained 42% of the variance (f2 =0.73) in perceived fall risk. The number of comorbidities, functional mobility and height explained 54% of the variance (f2 =1.15) in the measured fall risk.
Conclusion: Short height, lack of elbow flexors’ strength and high body mass index were associated with fear of falling in the elderly; as well as long height, high number of comorbidities and poor functional mobility may the predictors of fall risk in elderly patients.
Keywords
References
- 1. Sturnieks DL, St George R, Lord SR. Balance disorders in the elderly. Clin Neurophysiol. 2008;38:467-478.
- 2. Stevens JA, Olson S. Reducing falls and resulting hip fractures among older women. MMWR Recomm Rep. 2000;49:3-12.
- 3. Boyd R, Stevens J. Falls and fear of falling: Burden, beliefs and behaviours. Age Ageing 2009;38:423-428.
- 4. Evitt CP, Quigley PA. Fear of falling in older adults: a guide toits prevalence, risk factors, and consequences. Rehabil Nurs. 2004;29:207-210.
- 5. Friedman SM, Munoz B, West SK, et al. Falls and fear of falling: which comes first? A longitudinal prediction model suggests strategies for primary and secondary prevention. J Am Geriatr Soc. 2002;50:1329-1335.
- 6. Kumar A, Delbaere K, Zijlstra, GAR, et al. Exercise for reducing fear of falling in older people living in the community: Cochrane systematic review and meta-analysis. Age Ageing. 2016;45:345-352.
- 7. Binda SM, Culham EG, Brouwer B. Balance, muscle strength, and fear of falling in older adults. Exp Aging Res. 2003;29:205-219.
- 8. Delbaere K, Close JC, Brodaty H, et al. Determinants of disparities between perceived and physiological risk of falling among elderly people: cohort study. Bmj. 2010;341:c4165.
- 9. Güngen C, Ertan T, Eker E, et al. Standardize Mini Mental Test’in Türk toplumunda hafif demans tanısında geçerlik ve güvenilirliği. Türk Psikiyatr Derg. 2002;13:273-281.
- 10. Charlson M, Szatrowski TP, Peterson J, et al. Validation of a combined comorbidity index. J Clin Epidemiol. 1994;47:1245-1251.
- 11. Ayvat E, Kılınç M, Kırdı N. The Turkish version of the Physical Activity Scale for the Elderly (PASE): its cultural adaptation, validation, and reliability. Turk J Med Sci. 2017;47:908-915.
- 12. Altun AM, Özbek SE, Zarifoğlu M, et al. Assessment of gait and balance in Parkinson’s Disease. Parkinson Hastalığı ve Hareket Bozuklukları Dergisi. 2013;16:1-8.
- 13. Jones CJ, Rikli RE. Measuring functional fitness of older adults. J Active Aging. 2002;24-30.
- 14. Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls incommunity-dwelling older adults using the timed up&go test. Phys Ther. 2000;80:896-903.
- 15. Suzuki M, Yamada S, Inamura A, et al. Reliability and validity of measurements of knee extension strength obtained from nursing home residents with dementia. Am J Phys Med Rehabil. 2009;88:924-933.
- 16. Ishizaki T, Wantanabe S, Suzuki T, et al. Predictors for functional decline among nondisabled older Japanese living in a community during 3-year follow-up. J Am Geriatr Soc. 2000;48:1424-1429.
- 17. Hamilton GF, McDonald C, Chenier TC. Measurement of grip strength: Validity and reliability of the sphygmomanometer and Jamar grip dynamometer. J Orthop Sports Phys Ther. 1992;16:215-219.
- 18. Ulus Y, Durmus D, Akyol Y, et al. Reliability and validity of the Turkish version of the Falls Efficacy Scale International (FES-I) in community-dwelling older persons. Arch Gerontol Geriatr. 2012;54:429-433.
- 19. Arol P, Eroğlu KI. The effects of 8-week balance training on the kayaking performance of the beginners. Pedagogics, psychology, medical-biological problems of physical training and sports. 2018;22:170-176.
- 20. Scursatone I, Caire M, Cerrina V, et al. Influence of competitive experience on static postural balance in a group of rhythmic gymnastics of high level. Revista de Ciencias del Deporte. 2015;11:203-204.
- 21. Prosperini L, Sbardella E, Raz E, et al. Multiple Sclerosis: White and gray matter damage. Radiology. 2013;268:181-189.
- 22. George D, Mallery M. SPSS for Windows Step by Step: A Simple Guide and Reference, 17.0 update (10a ed.). Boston: Pearson; 2010.
- 23. Hayran M, Hayran M. Sağlık araştırmaları için temel istatistik. Ankara: Omega Araştırma; 2011.
- 24. Cohen, J. Statistical power analysis for the behavioral sciences. Routledge; 2013.
- 25. Harro CC, Garascia C. Reliability and validity of computerized force platform measures of balance function in healthy older adults. J Geriatr Phys Ther. 2019;42:E57-66.
- 26. Malini FM, Lourenço RA, Lopes CS. Prevalence of fear of falling in older adults, and its associations with clinical, functional and psychosocial factors: The Frailty in Brazilian Older People-Rio de Janeiro Study. Geriatr Gerontol Int. 2016;16:336-344.
- 27. Greenberg MR, Moore EC, Nguyen MC, et al. Perceived fall risk and functional decline: Gender differences in patient's willingness to discuss fall risk, fall history, or to have a home safety evaluation. Yale J Biol Med. 2016;89:261-267.
- 28. Hoang OTT, Jullamate P, Piphatvanitcha N, et al. Factors related to fear of falling among community‐dwelling older adults. J Clin Nurs. 2017;26:68-76.
- 29. Oh E, Hong GRS, Lee S, et al. Fear of falling and its predictors among community-living older adults in Korea. Aging Ment Health. 2017;21:369-378.
- 30. Lavedán A, Viladrosa M, Jürschik P, et al. Fear of falling in community-dwelling older adults: A cause of falls, a consequence, or both? PLoS one. 2018;13:e0194967.
- 31. Kocic M, Stojanovic Z, Lazovic M, et al. Relationship between fear of falling and functional status in nursing home residents aged older than 65 years. Geriatr Gerontol Int. 2017;17:1470-1476.
- 32. Kim J, Choi Y, Choi JW, et al. Impact of family characteristics by marital status of cohabitating adult children on depression among Korean older adults. Geriatr Gerontol Int. 2017;17:2527-2536.
- 33. Rakhshani T, Ansari MH, Ebrahimi M, et al. Fear of falling and its association with anxiety and depression disorders among community-dwelling older adults. Int J Health Promot Educ. 2019;57:303-315.
- 34. Carpenter CR, Avidan MS, Wildes T, et al. Predicting geriatric falls following an episode of emergency department care: a systematic review. Acad Emerg Med. 2014;21:1069-1082.
- 35. Deandrea S, Lucenteforte E, Bravi F et al. Risk factors for falls in community-dwelling older people:" a systematic review and meta-analysis". Epidemiology. 2010;658-668.
- 36. Austin N, Devine A, Dick I, et al. Fear of falling in older women: a longitudinal study of incidence, persistence, and predictors. J Am Geriatr Soc. 2007;55:1598-1603.
- 37. Lee J, Choi M, Kim CO. Falls, a fear of falling and related factors in older adults with complex chronic disease. J Clin Nurs. 2017;26:4964-4972.
- 38. Fletcher PC, Hirdes JP. Restriction in activity associated withfear of falling among community-based seniors using home care services. Age Ageing. 2004;33:273-279.
- 39. Liu JY. Fear of falling in robust community-dwelling older people: results of a cross-sectional study. J Clin Nurs. 2015;24:393-405.
- 40. Chamberlin ME, Fulwider BD, Sanders SL, et al. Does fear of falling influence spatial and temporal gait parameters in elderly persons beyond changes associated with normal aging? J Gerontol A Biol Sci Med Sci. 2005;60:1163-1167.
- 41. Maki BE. Gait changes in older adults: predictors of falls or indicators of fear. J Am Geriatr Soc. 1997;45:313-320.
- 42. Reelick MF, Van Iersel MB, Kessels RP, et al. The influence of fear of falling on gait and balance in older people. Age Ageing. 2009;38:435-440.
- 43. Piau A, Mattek N, Crissey R, et al. When will my patient fall? Sensor-based in-home walking speed identifies future falls in older adults. J Gerontol A Biol Sci Med Sci. 2020;75:968-973.
- 44. Park JH, Cho H, Shin JH, et al. Relationship among fear of falling, physical performance, and physical characteristics of the rural elderly. Am J Phys Med Rehabil. 2014;93:379-386.
Year 2021,
Volume: 8 Issue: 1, 73 - 81, 07.05.2021
Abstract
Amaç: Çalışmada toplumda yaşayan yaşlılarda algılanan ve ölçülen düşme riskini etkileyen faktörleri belirlemek amaçlandı.
Yöntem: Kesitsel planlanan çalışma Urla Devlet Hastanesi Sağlıklı Yaş Alma Okulu’nda yürütüldü. Yaşlıların fiziksel ve sosyodemografik özellikleri sorgulanıp kaydedildi. Çalışmada kognitif durum, Mini Mental Durum Testi; komorbidite, Charlson Yaş-ekli Komorbidite İndeksi; fiziksel aktivite seviyesi Fiziksel Aktivite Değerlendirme Ölçeği; yürüme hızı, 10 metre yürüme testi; alt ekstremite fonksiyonel kuvveti, 30 saniye sandalyede otur-kalk testi; fonksiyonel mobilite, Zamanlı Kalk-Yürü Testi; diz ekstansörlerinin, ayak bileği dorsifleksörlerinin ve dirsek fleksörlerinin kuvveti, el dinamometresi; el kavrama kuvveti, sfigmomanometre; algılanan düşme riski, Uluslararası Düşme Etkinlik Skalası; objektif düşme riski, Dinamik Postüral Stabilite Testi (Tecnobody Pro-Kin denge cihazı) ile değerlendirildi. Algılanan ve ölçülen düşme riski ile ilişkili olası belirteçlerin belirlenmesinde çoklu doğrusal regresyon analizi kullanıldı.
Bulgular: Çalışmaya yaş ortalaması 70,06±4,46 yıl olan 36 (27 kadın, 9 erkek) yaşlı dahil edildi. Algılanan düşme riskinde boy uzunluğu, dirsek fleksör kuvveti ve beden kütle indeksinin, varyansın %42’sini (f2=0,73); ölçülen düşme riskinde komorbidite puanı, fonksiyonel mobilite ve boy uzunluğunun, varyansın %54’ünü açıkladığı bulundu (f2=1,15).
Sonuç: Yaşlılarda kısa boy, düşük dirsek fleksör kuvveti ve yüksek beden kütle indeksi düşme korkusunun; uzun boy, yüksek komorbidite puanı ve kötü fonksiyonel mobilitenin ölçülen düşme riskinin belirteçleri arasında olabileceği göz önünde tutulmalıdır.
References
- 1. Sturnieks DL, St George R, Lord SR. Balance disorders in the elderly. Clin Neurophysiol. 2008;38:467-478.
- 2. Stevens JA, Olson S. Reducing falls and resulting hip fractures among older women. MMWR Recomm Rep. 2000;49:3-12.
- 3. Boyd R, Stevens J. Falls and fear of falling: Burden, beliefs and behaviours. Age Ageing 2009;38:423-428.
- 4. Evitt CP, Quigley PA. Fear of falling in older adults: a guide toits prevalence, risk factors, and consequences. Rehabil Nurs. 2004;29:207-210.
- 5. Friedman SM, Munoz B, West SK, et al. Falls and fear of falling: which comes first? A longitudinal prediction model suggests strategies for primary and secondary prevention. J Am Geriatr Soc. 2002;50:1329-1335.
- 6. Kumar A, Delbaere K, Zijlstra, GAR, et al. Exercise for reducing fear of falling in older people living in the community: Cochrane systematic review and meta-analysis. Age Ageing. 2016;45:345-352.
- 7. Binda SM, Culham EG, Brouwer B. Balance, muscle strength, and fear of falling in older adults. Exp Aging Res. 2003;29:205-219.
- 8. Delbaere K, Close JC, Brodaty H, et al. Determinants of disparities between perceived and physiological risk of falling among elderly people: cohort study. Bmj. 2010;341:c4165.
- 9. Güngen C, Ertan T, Eker E, et al. Standardize Mini Mental Test’in Türk toplumunda hafif demans tanısında geçerlik ve güvenilirliği. Türk Psikiyatr Derg. 2002;13:273-281.
- 10. Charlson M, Szatrowski TP, Peterson J, et al. Validation of a combined comorbidity index. J Clin Epidemiol. 1994;47:1245-1251.
- 11. Ayvat E, Kılınç M, Kırdı N. The Turkish version of the Physical Activity Scale for the Elderly (PASE): its cultural adaptation, validation, and reliability. Turk J Med Sci. 2017;47:908-915.
- 12. Altun AM, Özbek SE, Zarifoğlu M, et al. Assessment of gait and balance in Parkinson’s Disease. Parkinson Hastalığı ve Hareket Bozuklukları Dergisi. 2013;16:1-8.
- 13. Jones CJ, Rikli RE. Measuring functional fitness of older adults. J Active Aging. 2002;24-30.
- 14. Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls incommunity-dwelling older adults using the timed up&go test. Phys Ther. 2000;80:896-903.
- 15. Suzuki M, Yamada S, Inamura A, et al. Reliability and validity of measurements of knee extension strength obtained from nursing home residents with dementia. Am J Phys Med Rehabil. 2009;88:924-933.
- 16. Ishizaki T, Wantanabe S, Suzuki T, et al. Predictors for functional decline among nondisabled older Japanese living in a community during 3-year follow-up. J Am Geriatr Soc. 2000;48:1424-1429.
- 17. Hamilton GF, McDonald C, Chenier TC. Measurement of grip strength: Validity and reliability of the sphygmomanometer and Jamar grip dynamometer. J Orthop Sports Phys Ther. 1992;16:215-219.
- 18. Ulus Y, Durmus D, Akyol Y, et al. Reliability and validity of the Turkish version of the Falls Efficacy Scale International (FES-I) in community-dwelling older persons. Arch Gerontol Geriatr. 2012;54:429-433.
- 19. Arol P, Eroğlu KI. The effects of 8-week balance training on the kayaking performance of the beginners. Pedagogics, psychology, medical-biological problems of physical training and sports. 2018;22:170-176.
- 20. Scursatone I, Caire M, Cerrina V, et al. Influence of competitive experience on static postural balance in a group of rhythmic gymnastics of high level. Revista de Ciencias del Deporte. 2015;11:203-204.
- 21. Prosperini L, Sbardella E, Raz E, et al. Multiple Sclerosis: White and gray matter damage. Radiology. 2013;268:181-189.
- 22. George D, Mallery M. SPSS for Windows Step by Step: A Simple Guide and Reference, 17.0 update (10a ed.). Boston: Pearson; 2010.
- 23. Hayran M, Hayran M. Sağlık araştırmaları için temel istatistik. Ankara: Omega Araştırma; 2011.
- 24. Cohen, J. Statistical power analysis for the behavioral sciences. Routledge; 2013.
- 25. Harro CC, Garascia C. Reliability and validity of computerized force platform measures of balance function in healthy older adults. J Geriatr Phys Ther. 2019;42:E57-66.
- 26. Malini FM, Lourenço RA, Lopes CS. Prevalence of fear of falling in older adults, and its associations with clinical, functional and psychosocial factors: The Frailty in Brazilian Older People-Rio de Janeiro Study. Geriatr Gerontol Int. 2016;16:336-344.
- 27. Greenberg MR, Moore EC, Nguyen MC, et al. Perceived fall risk and functional decline: Gender differences in patient's willingness to discuss fall risk, fall history, or to have a home safety evaluation. Yale J Biol Med. 2016;89:261-267.
- 28. Hoang OTT, Jullamate P, Piphatvanitcha N, et al. Factors related to fear of falling among community‐dwelling older adults. J Clin Nurs. 2017;26:68-76.
- 29. Oh E, Hong GRS, Lee S, et al. Fear of falling and its predictors among community-living older adults in Korea. Aging Ment Health. 2017;21:369-378.
- 30. Lavedán A, Viladrosa M, Jürschik P, et al. Fear of falling in community-dwelling older adults: A cause of falls, a consequence, or both? PLoS one. 2018;13:e0194967.
- 31. Kocic M, Stojanovic Z, Lazovic M, et al. Relationship between fear of falling and functional status in nursing home residents aged older than 65 years. Geriatr Gerontol Int. 2017;17:1470-1476.
- 32. Kim J, Choi Y, Choi JW, et al. Impact of family characteristics by marital status of cohabitating adult children on depression among Korean older adults. Geriatr Gerontol Int. 2017;17:2527-2536.
- 33. Rakhshani T, Ansari MH, Ebrahimi M, et al. Fear of falling and its association with anxiety and depression disorders among community-dwelling older adults. Int J Health Promot Educ. 2019;57:303-315.
- 34. Carpenter CR, Avidan MS, Wildes T, et al. Predicting geriatric falls following an episode of emergency department care: a systematic review. Acad Emerg Med. 2014;21:1069-1082.
- 35. Deandrea S, Lucenteforte E, Bravi F et al. Risk factors for falls in community-dwelling older people:" a systematic review and meta-analysis". Epidemiology. 2010;658-668.
- 36. Austin N, Devine A, Dick I, et al. Fear of falling in older women: a longitudinal study of incidence, persistence, and predictors. J Am Geriatr Soc. 2007;55:1598-1603.
- 37. Lee J, Choi M, Kim CO. Falls, a fear of falling and related factors in older adults with complex chronic disease. J Clin Nurs. 2017;26:4964-4972.
- 38. Fletcher PC, Hirdes JP. Restriction in activity associated withfear of falling among community-based seniors using home care services. Age Ageing. 2004;33:273-279.
- 39. Liu JY. Fear of falling in robust community-dwelling older people: results of a cross-sectional study. J Clin Nurs. 2015;24:393-405.
- 40. Chamberlin ME, Fulwider BD, Sanders SL, et al. Does fear of falling influence spatial and temporal gait parameters in elderly persons beyond changes associated with normal aging? J Gerontol A Biol Sci Med Sci. 2005;60:1163-1167.
- 41. Maki BE. Gait changes in older adults: predictors of falls or indicators of fear. J Am Geriatr Soc. 1997;45:313-320.
- 42. Reelick MF, Van Iersel MB, Kessels RP, et al. The influence of fear of falling on gait and balance in older people. Age Ageing. 2009;38:435-440.
- 43. Piau A, Mattek N, Crissey R, et al. When will my patient fall? Sensor-based in-home walking speed identifies future falls in older adults. J Gerontol A Biol Sci Med Sci. 2020;75:968-973.
- 44. Park JH, Cho H, Shin JH, et al. Relationship among fear of falling, physical performance, and physical characteristics of the rural elderly. Am J Phys Med Rehabil. 2014;93:379-386.
There are 44 citations in total.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Articles |
| Authors | |
| Publication Date | May 7, 2021 |
| Submission Date | October 30, 2019 |
| Published in Issue | Year 2021 Volume: 8 Issue: 1 |
