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Mu Y, Ge S, Du B. 1 km of living area: age differences in the association between neighborhood environment perception and self-rated health among Chinese people. BMC Public Health 2024; 24:584. [PMID: 38395814 PMCID: PMC10885538 DOI: 10.1186/s12889-024-18041-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
OBJECTIVES This study aimed to explore the age differences in the relationship between neighborhood environment perception and self-rated health among Chinese people. STUDY DESIGN This is cross-sectional study. METHODS The participants were 2,631 residents aged 18 and above from 2021 Chinese General Social Survey (CGSS). Self-rated health was reported by residents. Neighborhood environment was measured by respondents' subjective perception of 1 km living area. Ordered logit regression models were used to examine the relationship between neighborhood environment perception and self-rated health. RESULTS In summary, 42.08% were classified as young adults, and 57.92% were classified as middle-aged and older adults. Young adults with higher perception of neighborhood social environment were more likely to perceive good health. Neighborhood built environment was significantly associated with self-rated health among middle-aged and older adults. CONCLUSION The neighborhood environment is an important predictor of the health of its residents. Neighborhood environmental modifications should be tailored to meet the needs of different age groups, promoting health equity.
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Affiliation(s)
- Yuexuan Mu
- School of Public health, Soochow University, Jiangsu, China
| | - Shu Ge
- School of Sociology and Population Studies, Renmin University of China, Beijing, China
| | - Benfeng Du
- School of Sociology and Population Studies, Renmin University of China, Beijing, China.
- Special expert of Henan Provincial Government, Henan, China.
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Chippendale T, Albert SM, Mahmood A. Efficacy of the Stroll Safe Outdoor Fall Prevention Program: A Randomized Controlled Trial. THE GERONTOLOGIST 2023; 63:1556-1565. [PMID: 36148513 DOI: 10.1093/geront/gnac145] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Outdoor falls can negatively affect the independence and well-being of community-dwelling older adults. Although there is some overlap, there are also differences in risk factors for indoor and outdoor falls. There are no existing community-based fall prevention programs that specifically target outdoor fall prevention. To fill this gap, the Stroll Safe program was developed. RESEARCH DESIGN AND METHODS A cluster-randomized controlled trial design was used with randomization at the site level. Participants (N = 86) were aged 60 and older, with a history of an outdoor fall or who had a fear of falling outdoors. Eight naturally occurring retirement community program sites were randomly assigned to the treatment or wait list control group. Outcome measures included the Outdoor Falls Questionnaire, the Falls Behavioral Scale for the Older Person, and the Falls Efficacy Scale-International to examine knowledge of risks, safe strategy use, protective behaviors, and fear of falling. An Analysis of Covariance (ANCOVA) was used to compare change scores between groups with covariates included for any initial differences between groups. A linear mixed model was also conducted to account for any clustering effects. RESULTS Significant differences (ps < .05) were found between groups for knowledge of outdoor fall risks and safe strategy use. Effect sizes were large (Cohen's d = 1.2-1.9). Results were retained at 6-week follow-up. DISCUSSION AND IMPLICATIONS Stroll Safe is effective in improving knowledge of outdoor fall risks and increasing safe strategy use for community mobility. Stroll Safe fills a gap in outdoor fall prevention programs. Clinical Trials Registration Number: NCT03624777.
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Affiliation(s)
- Tracy Chippendale
- Department of Occupational Therapy, Steinhardt School of Culture, Education, and Human Development, New York University, New York City, New York, USA
| | - Steven M Albert
- Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Atiya Mahmood
- Gerontology Department, Simon Fraser University, Vancouver, British Columbia, Canada
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Vo MTH, Thonglor R, Moncatar TJR, Han TDT, Tejativaddhana P, Nakamura K. Fear of falling and associated factors among older adults in Southeast Asia: a systematic review. Public Health 2023; 222:215-228. [PMID: 36229238 DOI: 10.1016/j.puhe.2022.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 07/27/2022] [Accepted: 08/14/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVES The aim of this study was to provide a comprehensive overview of the prevalence, measurement scales, related factors and interventions for fear of falling (FOF) among older adults in Southeast Asia. STUDY DESIGN This was a systematic review. METHODS Published research studies on FOF among older adults were searched using the following databases: PubMed, Cochrane Library, Scopus, ASEAN Citation Index, Thai Journal Citation Index, Malaysian Journal Citation Report and Google Scholar. All observational and experimental studies investigating FOF among community-dwelling older adults in Southeast Asia were eligible. A narrative synthesis was used to describe the findings. The Joanna Briggs Institute checklist was used to assess the quality and risk of bias of the included studies. RESULTS A total of 15 observational studies and three experimental studies were included after screening 2112 titles and abstracts. These studies, published between 2011 and 2021, were conducted in Malaysia, Singapore, Thailand and Vietnam. The FOF prevalence ranged from 21.6% to 88.2%. The most commonly used FOF assessment tool was the Falls Efficacy Scale-International. Well-reported related factors of FOF were female sex, advanced age, balance impairment and fall history. All experimental studies utilising single- or multi-component interventions comprised an exercise approach. Limited studies have considered environmental factors. CONCLUSIONS Various related factors of FOF and the interventions implemented were revealed. Public health researchers and policymakers should consider the factors related to FOF in practical FOF intervention and prevention strategies. Further evidence on FOF issues is required to understand the multidimensional characteristics of FOF, specifically the environmental aspects of older adults in Southeast Asia.
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Affiliation(s)
- M T H Vo
- Department of Global Health Entrepreneurship, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; ASEAN Institute for Health Development, Mahidol University, 999 Salaya, Phutthamonthon, Nakhon Pathom 73170, Thailand
| | - R Thonglor
- Department of Global Health Entrepreneurship, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; Faculty of Public Health, Naresuan University, Phitsanulok 65000, Thailand
| | - T J R Moncatar
- College of Public Health, University of the Philippines Manila, Manila, Philippines
| | - T D T Han
- Faculty of Public Health, Hue University of Medicine and Pharmacy, Hue University, Hue 530000, Viet Nam
| | - P Tejativaddhana
- ASEAN Institute for Health Development, Mahidol University, 999 Salaya, Phutthamonthon, Nakhon Pathom 73170, Thailand
| | - K Nakamura
- Department of Global Health Entrepreneurship, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; WHO Collaborating Centre for Healthy Cities and Urban Policy Research, Tokyo, Japan.
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Wang Y, Zhang C, Hikichi H, Kawachi I, Li X. Longitudinal Associations Between Disaster Damage and Falls/Fear of Falling in Older Adults: 9-Year Follow-Up of Survivors of the 2011 Great East Japan Earthquake and Tsunami. Innov Aging 2023; 7:igad020. [PMID: 37056712 PMCID: PMC10089294 DOI: 10.1093/geroni/igad020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Indexed: 03/06/2023] Open
Abstract
Background and Objectives Fear of falling and falls are common in older adults. However, their associations with natural disaster exposures remain poorly understood. This study aims to examine longitudinal associations between disaster damage with fear of falling/falls among older disaster survivors. Research Design and Methods In this natural experiment study, the baseline survey (4,957 valid responses) took place 7 months before the 2011 Great East Japan Earthquake and Tsunami, and 3 follow-ups were conducted in 2013, 2016, and 2020. Exposures were different types of disaster damage and community social capital. Outcomes were fear of falling and falls (including incident and recurrent falls). We used lagged outcomes in logistic models adjusting for covariates and further examined instrumental activities of daily living (IADLs) as a mediator. Results The baseline sample had a mean (standard deviation) age of 74.8 (7.1) years; 56.4% were female. Financial hardship was associated with fear of falling (odds ratio (OR), 1.75; 95% confidence interval (CI) [1.33, 2.28]) and falls (OR, 1.29; 95% CI [1.05, 1.58]), especially recurrent falls (OR, 3.53; 95% CI [1.90, 6.57]). Relocation was inversely linked with fear of falling (OR, 0.57; 95% CI [0.34, 0.94]). Social cohesion was protectively associated with fear of falling (OR, 0.82; 95% CI [0.71, 0.95]) and falls (OR, 0.88; 95% CI [0.78, 0.98]) whereas social participation increased the risk of these issues. IADL partially mediated observed associations between disaster damage and fear of falling/falls. Discussion and Implications Experiences of material damage rather than psychological trauma were associated with falls and fear of falling, and the increased risk of recurrent falls revealed a process of cumulative disadvantage. Findings could inform targeted strategies for protecting older disaster survivors.
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Affiliation(s)
- Yuhang Wang
- Department of Sociology, Tsinghua University, Beijing, China
| | - Chenggang Zhang
- Department of Sociology, Tsinghua University, Beijing, China
| | - Hiroyuki Hikichi
- School of Medicine, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Ichiro Kawachi
- Department of Sociology, Tsinghua University, Beijing, China
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Xiaoyu Li
- Department of Sociology, Tsinghua University, Beijing, China
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5
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DiGuiseppi CG, Hyde HA, Betz ME, Scott KA, Eby DW, Hill LL, Jones VC, Mielenz TJ, Molnar LJ, Strogatz D, Li G. Association of falls and fear of falling with objectively-measured driving habits among older drivers: LongROAD study. JOURNAL OF SAFETY RESEARCH 2022; 83:96-104. [PMID: 36481041 PMCID: PMC10115437 DOI: 10.1016/j.jsr.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 02/28/2022] [Accepted: 08/09/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE Falls in older adults are associated with increased motor vehicle crash risk, possibly mediated by driving behavior. We examined the relationship of falls and fear of falling (FOF) with subsequent objectively measured driving habits. METHODS This multi-site, prospective cohort study enrolled 2990 active drivers aged 65-79 (53% female). At enrollment, we assessed falls in the past year and FOF (Short Falls Efficacy Scale-International). Driving outcomes included exposure, avoidance of difficult conditions, and unsafe driving during one-year follow-up, using in-vehicle Global Positioning System devices. RESULTS Past-year falls were associated with more hard braking events (HBE). High FOF was associated with driving fewer days, miles, and trips, driving nearer home and more HBE. Differences were attenuated and not significant after accounting for health, function, medications and sociodemographics. DISCUSSION Differences in objectively measured driving habits according to past-year fall history and FOF were largely accounted for by differences in health and medications. Rather than directly affecting driving, falls and FOF may serve as markers for crash risk and reduced community mobility due to age-related changes and poor health.
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Affiliation(s)
- Carolyn G DiGuiseppi
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Hailey A Hyde
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Marian E Betz
- Department of Emergency Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Kenneth A Scott
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - David W Eby
- University of Michigan Transportation Research Institute, University of Michigan, Ann Arbor, MI, USA; Center for Advancing Transportation Leadership and Safety (ATLAS Center), University of Michigan, Ann Arbor, MI, USA
| | - Linda L Hill
- School of Public Health, University of California San Diego, La Jolla, CA, USA
| | - Vanya C Jones
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Thelma J Mielenz
- Department of Epidemiology, Mailman School of Public Health, Columbia's Injury Control Research Center, Columbia University, New York, NY, USA
| | - Lisa J Molnar
- University of Michigan Transportation Research Institute, University of Michigan, Ann Arbor, MI, USA; Center for Advancing Transportation Leadership and Safety (ATLAS Center), University of Michigan, Ann Arbor, MI, USA
| | - David Strogatz
- Bassett Research Institute, Bassett Healthcare Network, Cooperstown, NY, USA
| | - Guohua Li
- Department of Epidemiology, Mailman School of Public Health, Columbia's Injury Control Research Center, Columbia University, New York, NY, USA; Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, NY, USA
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Melchiorre MG, D’Amen B, Quattrini S, Lamura G, Socci M. Health Emergencies, Falls, and Use of Communication Technologies by Older People with Functional and Social Frailty: Ageing in Place in Deprived Areas of Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14775. [PMID: 36429499 PMCID: PMC9691100 DOI: 10.3390/ijerph192214775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
Frail older people ageing alone in place need help to perform daily living activities, especially when functional limitations are increasing and formal/informal supports are lacking. This context represents a risk of experiencing health emergencies, in particular falls. It is thus important to understand how seniors manage these potential difficulties and who helps them. The present study aimed to explore these dimensions in Italy, where 120 qualitative interviews were carried out in 2019 within the "Inclusive ageing in place" (IN-AGE) research project, involving frail older people living alone at home. A content analysis was conducted. Results showed that seniors need to manage health emergencies regarding heart and breathing problems but mainly episodes of falls are reported, with consequent fractures and fear of falling again. In several cases, the use of a mobile phone was crucial in order to seek for help, and the first to intervene were children, in addition to some neighbors. Some seniors also referred their ability to call independently the General Practitioner (GP) or the emergency room, in order to not disturb family members. These findings highlight new useful insights for policy makers, regarding health emergencies prevention and management measures to put in place, especially concerning falls, and the support provided by communication technologies.
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A qualitative investigation exploring neighbourhood environment, risks and fear of falling, and fall prevention strategies among urban-dwelling older adults in a high-density city. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x22001209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Abstract
Falls in older adulthood can have serious consequences. It is therefore important to identify ways to prevent falls, particularly from the voice of older adults. Bottom-up qualitative exploration of the perspectives of older adults can provide rich insights that can help inform the development of effective fall prevention programmes. However, currently there is a dearth of such empirical data, especially among urban-dwelling older adults in high-density cities where fall rates are high. The current study aimed to examine qualitatively perceptions of neighbourhood physical environment in relation to falls, perceived risks and fear of falling, and strategies and behaviours for fall prevention in a sample of urban-dwelling older adults in the high-density city of Hong Kong. Face-to-face semi-structured in-depth interviews were conducted with 50 community-dwelling older adults. Interviews were transcribed verbatim and analysed using thematic analysis techniques. Five general themes were revealed: risks and circumstances of falls, consequences of falls, fear of falling and its consequences, neighbourhood environment, and strategies and behaviours of fall prevention. While older adults discussed the risks of falling and held a fear of falling, these beliefs were mixed. In addition to fall prevention strategies (e.g. keep balance), current findings highlighted the importance of establishing protective factors (e.g. flat and even walking paths) and reducing risk factors (e.g. neighbourhood clutter) in neighbourhood environments. For urban-dwelling older adults in high-density cities, current findings highlight the importance of focusing efforts at the built environment level in addition to strategies and behaviours of fall prevention at the individual level.
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8
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The association between tree canopy cover over streets and elderly pedestrian falls: A health disparity study in urban areas. Soc Sci Med 2022; 306:115169. [DOI: 10.1016/j.socscimed.2022.115169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/26/2022] [Accepted: 06/24/2022] [Indexed: 11/20/2022]
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Conroy B, Murphy N, Romero-Ortuno R, Cunningham C, Horgan F. Examining the factors associated with community ambulation in an older adult day hospital population. Eur Geriatr Med 2022; 13:1137-1147. [PMID: 35788972 DOI: 10.1007/s41999-022-00666-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 06/01/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE The ability of an older adult to walk independently in their community assists with maintaining independence, a healthy lifestyle and a good quality of life. In clinical practice, outdoor mobility is often one of the first activities, where a decline is observed. The aim of this study was to examine the factors associated with community ambulation in community dwelling older adults attending a day hospital. METHODS This was a cross-sectional observational study design. Inclusion criteria were community dwelling older adults, over 65 years, attending a day hospital and able to ambulate at least 10 m with or without an assistive device. The primary outcome measure was a community ambulation questionnaire. A range of other outcome measures were completed assessing motor, cognitive, executive function and behavioural domains. Multivariate logistic regression was employed to identify independent predictors of community ambulation. RESULTS 161 participants completed this study. The median age was 83 years (IQR 9), 64% were female and 49.1% lived alone. 55.3% of participants were classified as independent community ambulators. Mean gait speed was 0.8 m/s, median TUG score was 16.6 s and median frailty was 4 (IRQ 2) using the Clinical Frail Scale. Self-efficacy (p < 0.001) and gait speed (p = 0.030) were independently associated with community ambulation. CONCLUSIONS The findings demonstrate the complexity and multifactorial nature of community ambulation in older adults. This suggests the need to adopt a broader approach to the management of older adults, to promote the achievement of independent community ambulation.
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Affiliation(s)
- Bronagh Conroy
- Physiotherapy Department, St James's Hospital, Dublin 8, Ireland.
| | - Niamh Murphy
- Physiotherapy Department, St James's Hospital, Dublin 8, Ireland
| | - Roman Romero-Ortuno
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland.,Mercer's Institute for Successful Ageing (MISA), St James's Hospital, Dublin 8, Ireland
| | - Conal Cunningham
- Mercer's Institute for Successful Ageing (MISA), St James's Hospital, Dublin 8, Ireland
| | - Frances Horgan
- School of Physiotherapy, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin, Ireland
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Rico CLV, Curcio CL. Fear of Falling and Environmental Factors: A Scoping Review. Ann Geriatr Med Res 2022; 26:83-93. [PMID: 35673944 PMCID: PMC9271395 DOI: 10.4235/agmr.22.0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 05/29/2022] [Indexed: 12/02/2022] Open
Abstract
Fear of falling is a geriatric condition that must be understood from both a clinical perspective and from the environment in which older adults live. This review aimed to describe the scientific evidence reported in the last 5 years regarding the fear of falling in older adults and its relationship with environmental factors. The relationships between fear of falling and environmental factors are mainly evidenced in the built environment. Older adults with a fear of falling are described as perceiving the built environment as dangerous when they do not meet the requirements of safety, accessibility, and comfort; they also report the importance of living in communities with controlled crime levels and available social support for older adults to improve their insecurity and feelings of vulnerability.
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Affiliation(s)
- Claudia Liliana Valencia Rico
- Nursing Program, Catholic University of Manizales, Caldas, Colombia
- Faculty of Health Sciences, University of Caldas, Caldas, Colombia
- Corresponding Author Claudia Liliana Valencia Rico, RN, MSc Nursing Program, Catholic University of Manizales, Carrera 23 No. 60-63, Manizales, Caldas, Colombia E-mail:
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de Souza Moreira B, Cristina de Souza Andrade A, Xavier CC, Proietti FA, Braga LDS, Friche AADL, Teixeira Caiaffa W. Perceived neighborhood and fall history among community-dwelling older adults living in a large Brazilian urban area: a multilevel approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:522-534. [PMID: 32568556 DOI: 10.1080/09603123.2020.1782354] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 06/10/2020] [Indexed: 06/11/2023]
Abstract
Few studies have examined the neighborhood features related to falls in the older population in low-and-middle-income countries, including Brazil. This study aimed to evaluate if perceived neighborhood features are related to falls among older Brazilian adults living in a large urban area. This cross-sectional study was conducted using data from 834 participants (≥60 years) from a multistage household survey in Belo Horizonte, Brazil. The association between fall history in the previous year and perceived neighborhood features (quality of services, physical and social disorder, and safety) was examined using multilevel logistic regression. The fall prevalence was 13.6%. Older adults living in neighborhoods with a higher physical disorder were more likely to report fall in the previous year, even after controlling for demographic, clinical and social variables (OR = 2.59; 95% CI = 1.14-5.87). The other neighborhood features investigated were not associated with a fall history. Our findings suggest that improving the physical environment represents an important strategy to prevent falls in the Brazilian urban older population.
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Affiliation(s)
- Bruno de Souza Moreira
- Graduate Program in Public Health, Faculty of Medicine, Observatory for Urban Health in Belo Horizonte (OSUBH), Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | | | - Luciana de Souza Braga
- Department of Preventive and Social Medicine, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Amélia Augusta de Lima Friche
- Graduate Program in Public Health, Faculty of Medicine, Observatory for Urban Health in Belo Horizonte (OSUBH), Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Waleska Teixeira Caiaffa
- Graduate Program in Public Health, Faculty of Medicine, Observatory for Urban Health in Belo Horizonte (OSUBH), Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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12
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MacKay S, Ebert P, Harbidge C, Hogan DB. Fear of Falling in Older Adults: A Scoping Review of Recent Literature. Can Geriatr J 2021; 24:379-394. [PMID: 34912493 PMCID: PMC8629501 DOI: 10.5770/cgj.24.521] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Fear of falling (FOF) is prevalent among older adults and associated with adverse health outcomes. Over recent years a substantial body of research has emerged on its epidemiology, associated factors, and consequences. This scoping review summarizes the FOF literature published between April 2015 and March 2020 in order to inform current practice and identify gaps in the literature. Methods A total of 439 articles related to FOF in older adults were identified, 56 selected for full-text review, and 46 retained for data extraction and synthesis. Results The majority of included studies were cross-sectional. Older age, female sex, previous falls, worse physical performance, and depressive symptoms were the factors most consistently associated with FOF. Studies that measured FOF with a single question reported a significantly lower prevalence of FOF than those using the Falls Efficacy Scale, a continuous measure. FOF was associated with higher likelihoods of future falls, short-term mortality, and functional decline. Conclusions Comparisons between studies were limited by inconsistent definition and measurement of FOF, falls, and other characteristics. Consensus on how to measure FOF and which participant characteristics to evaluate would address this issue. Gaps in the literature include clarifying the relationships between FOF and cognitive, psychological, social, and environmental factors.
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Affiliation(s)
- Scott MacKay
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary
| | - Patricia Ebert
- Department of Psychology, University of Calgary, Calgary.,Hotchkiss Brain Institute, University of Calgary, Calgary.,Specialized Geriatric Services, Calgary Regional Health Authority, Calgary
| | - Cathy Harbidge
- Specialized Geriatric Services, Calgary Regional Health Authority, Calgary
| | - David B Hogan
- Division of Geriatric Medicine, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB
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Schmitt AC, Baudendistel ST, Lipat AL, White TA, Raffegeau TE, Hass CJ. Walking indoors, outdoors, and on a treadmill: Gait differences in healthy young and older adults. Gait Posture 2021; 90:468-474. [PMID: 34619613 DOI: 10.1016/j.gaitpost.2021.09.197] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 09/16/2021] [Accepted: 09/26/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Although human gait is typically studied in a laboratory environment, the findings of laboratory-based gait assessments are often applied to daily life scenarios. Assessing gait in varied conditions may offer a better understanding of the influence of environment on gait performance. RESEARCH QUESTIONS How do spatiotemporal gait measures differ between indoor overground walking, outdoor walking, and treadmill walking in healthy adults? Do different walking environments exaggerate age-related alterations in gait performance in older compared to young adults? METHODS 30 young (18-30yrs) and 28 older adults (60-80yrs) completed four randomized conditions at their typical, comfortable walking pace: 1) 8 m of indoor walking, 2) continuous indoor walking, 3) treadmill walking, and 4) outdoor walking on a sidewalk. Wearable inertial sensors recorded gait data and the magnitudes and variability (in standard deviations) of the following gait measures were computed: cadence, percent double support, stride length (with sample entropy), and gait velocity. RESULTS Despite the lack of significant univariate interactions between group and walking condition, significant main effects for condition and group were observed in both the magnitude and variability analyses. Treadmill walking resulted in a slower gait with shorter, less variable strides (p < .001), while walking outdoors resulted in faster gait with longer strides (p < .001) compared to other walking conditions. Stride length regularity was reduced when walking outdoors compared to treadmill walking (p = .019). SIGNIFICANCE The results showed that the effects of walking condition on gait measures were more dramatic than participant age, and gait performance differs between walking environments in both older and younger adults. Since daily life gait encompasses both tightly controlled and unconstrained, free-living walking, researchers and clinicians should use caution when generalizing gait performance across walking conditions. Measures of gait performance typically used in laboratory gait analyses may not adequately characterize daily life gait in indoor and outdoor environments.
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Affiliation(s)
- Abigail C Schmitt
- Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, AR, USA; Applied Neuromechanics Laboratory, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA.
| | - Sidney T Baudendistel
- Applied Neuromechanics Laboratory, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA
| | - Ania L Lipat
- Applied Neuromechanics Laboratory, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA
| | - Tatiana A White
- Applied Neuromechanics Laboratory, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA
| | - Tiphanie E Raffegeau
- Department of Health, Kinesiology, and Recreation at the University of Utah in Salt Lake City, UT, USA; Present address: Division of Execise Physiology, School of Applied Health Sciences and Wellness, Ohio University, Athens, OH, USA
| | - Chris J Hass
- Applied Neuromechanics Laboratory, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA
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Abe T, Okuyama K, Hamano T, Kamada M, Isomura M, Nabika T, Miyazaki R. Association between hilliness and walking speed in community-dwelling older Japanese adults: A cross-sectional study. Arch Gerontol Geriatr 2021; 97:104510. [PMID: 34487955 DOI: 10.1016/j.archger.2021.104510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/18/2021] [Accepted: 08/23/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE This cross-sectional study investigated the association between hilliness and walking speed in community-dwelling older adults, and whether it varied according to their car-driving status. METHODS Data were collected from 590 participants aged 65 and older living in Okinoshima Town, Shimane prefecture, Japan, in 2018. Comfortable walking speed (m/s) was objectively assessed. Hilliness was measured by the mean land slope (degree) within a 500-m or 1000-m network buffer around each participant's home using a geographic information system. A multiple linear regression examined whether the land slope was associated with walking speed, adjusted for sex, age, body mass index, smoking habits, alcohol consumption habits, exercise habits, chronic disease, and living arrangements. A stratified analysis by car-driving status was also conducted. RESULTS After adjusting for all confounders, the land slope within the 500-m or 1000-m network buffer was negatively associated with walking speed (B = -0.007, 95% CI [-0.011, -0.002]; B = -0.007, 95% CI [-0.011, -0.003], respectively). The stratified analysis by car-driving status showed that living in a hilly area was negatively associated with walking speed among non-drivers in the 500-m or 1000-m network buffer (B = -0.011, 95% CI [-0.017, -0.004]; B = -0.012, 95% CI [-0.019, -0.006]), though there were no associations among drivers. CONCLUSIONS A hilly environment is positively associated with slow walking speed in community-dwelling older adults in Japan. Moreover, car-driving status potentially modifies the relationship between living in a hilly environment and slow walking speed.
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Affiliation(s)
- Takafumi Abe
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, 223-8 Enya-cho, Izumo-shi, Shimane 693-8501, Japan.
| | - Kenta Okuyama
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, 223-8 Enya-cho, Izumo-shi, Shimane 693-8501, Japan; Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Jan Waldenströms gata 35, Malmö 20502, Sweden
| | - Tsuyoshi Hamano
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, 223-8 Enya-cho, Izumo-shi, Shimane 693-8501, Japan; Department of Sports Sociology and Health Sciences, Faculty of Sociology, Kyoto Sangyo University, Motoyama, Kamigamo, Kita-ku, Kyoto 603-8555, Japan
| | - Masamitsu Kamada
- Department of Health Education and Health Sociology, School of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Minoru Isomura
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, 223-8 Enya-cho, Izumo-shi, Shimane 693-8501, Japan; Faculty of Human Sciences, Shimane University, 1060 Nishikawatsu-cho, Matsue-shi, Shimane 690-8504, Japan
| | - Toru Nabika
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, 223-8 Enya-cho, Izumo-shi, Shimane 693-8501, Japan; Department of Functional Pathology, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo-shi, Shimane 693-8501, Japan
| | - Ryo Miyazaki
- Center for Community-Based Healthcare Research and Education (CoHRE), Head Office for Research and Academic Information, Shimane University, 223-8 Enya-cho, Izumo-shi, Shimane 693-8501, Japan; Faculty of Human Sciences, Shimane University, 1060 Nishikawatsu-cho, Matsue-shi, Shimane 690-8504, Japan
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15
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Yao Q, Jin W, Li Y. Associations between fear of falling and activity restriction and late life depression in the elderly population: Findings from the Irish longitudinal study on ageing (TILDA). J Psychosom Res 2021; 146:110506. [PMID: 34010733 DOI: 10.1016/j.jpsychores.2021.110506] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 04/29/2021] [Accepted: 05/01/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The effect of Fear of Falling (FOF) and fear-related Activity Restriction (AR) on Late Life Depression (LLD) remains unstudied in older adults. In this study, we aimed to clarify associations between FOF, AR and the prevalence and incidence of LLD in a large cohort of community-dwelling older adults. METHODS In this prospective study, participants (n = 4230; 52.1% female) aged ≥50 years completed the survey on whether they had FOF and AR at baseline. In addition, the Centre for Epidemiological Studies Depression (CESD) scale was used to evaluate LLD at baseline and after 2 years of follow-up. Moreover, LLD was defined by a CES-D score ≥ 16, at follow-up. RESULTS The results showed that the prevalence and incidence of LLD were 6.9% (n = 293) and 4.2% (n = 167), respectively. In addition, most of the respondents with LLD were female (64.9% vs 55.4%) and 50-59 years of age (50.9% vs 42.8%, all P < 0.05). Analysis of data from Wave 1 and 2 using logistic regression also demonstrated that the levels of FOF/AR was associated with 82.2% and 62.7% higher odds of prevalence [OR = 1.822, 95%CI: 1.272-2.612] and incidence [OR = 1.627, 95%CI: 1.085-2.440] of LLD, respectively in the fully adjusted models. CONCLUSION FOF and AR may be associated with the prevalence and incidence of LLD. Additionally, the study highlighted the importance of assessing LLD in older adults with FOF and AR.
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Affiliation(s)
- Qian Yao
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, China
| | - Wenyi Jin
- Department of Orthopedics, Renmin Hospital of Wuhan University, China.
| | - Yan Li
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, China.
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Viviano NA, Galik E, Resnick B. Racial differences in physical activity in nursing home residents with cognitive impairment. Appl Nurs Res 2021; 60:151445. [PMID: 34247786 DOI: 10.1016/j.apnr.2021.151445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/31/2021] [Accepted: 05/16/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Nursing home (NH) residents with moderate-to-severe cognitive impairment experience mostly sedentary lifestyles. AIM Previous research has examined racial differences in physical activity (PA) levels in community-dwelling older adults but not in NH residents with cognitive impairment, and the current study aimed to examine these differences. METHODS This was a secondary data analysis of baseline data from the Function and Behavior Focused Care Intervention (FBFC) study. The sample included 247 cognitively impaired residents from 12 NHs who wore an ActiGraph to measure PA. RESULTS The residents' mean age was 82.6 (SD = 10.1) and had an average MMSE score of 7.8 (SD = 5.0). The sample (N = 247) was 41% African American and 59% White. African American and White residents engaged in only 50.6 and 46.2 min of light- and 1.5 and 1.1 min of moderate-level PA, respectively. Based on a multivariate analysis of covariance (MANCOVA), there was not a statistically significant difference between African American and White residents on combined dependent PA measures [F (8, 237) = 1.067, p = .387, Wilks' Λ = 0.962]. There was a trend that direct care providers subjectively reported that White residents engaged in more PA than their African American counterparts [F(8, 237) = 2.741, p = .09]. CONCLUSIONS These findings are not consistent with prior research. However, these findings indicate severely low levels of PA in NH residents, regardless of racial group. Future research should prioritize PA interventions that make accommodations for all NH residents, and especially consider their underlying physical comorbidities and cognitive function.
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Affiliation(s)
- Nicole A Viviano
- University of Maryland School of Medicine, Department of Epidemiology and Public Health, Division of Gerontology, 660 W. Redwood Street, Howard Hall 222, Baltimore, MD 21201, United States of America.
| | - Elizabeth Galik
- University of Maryland School of Nursing, 655 West Lombard Street, Baltimore, MD 21210, United States of America
| | - Barbara Resnick
- University of Maryland School of Nursing, 655 West Lombard Street, Baltimore, MD 21210, United States of America
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17
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Is the self-perception of the built neighborhood associated with fear of falling in community-dwelling older adults? Arch Gerontol Geriatr 2021; 95:104395. [PMID: 33765655 DOI: 10.1016/j.archger.2021.104395] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/12/2021] [Accepted: 03/13/2021] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Characteristics of a built neighborhood may aggravate agravett to fear of falling in older adults and this knowledge are important to contribute to developing strategies aimed at reducing fear of falling and their consequences. OBJECTIVE To verify the association between self-perception of built neighborhood characteristics and fear of falling in community-dwelling older adults. MATERIALS AND METHODS This was a cross-sectional study including 308 community-dwelling older adults. The outcome was fear of falling evaluated through Falls Efficacy Scale International. Older adults were classified with high fear of falling when they obtained values ≥ 23 points and classified as low fear of falling with score < 23 point. The built neighborhood variables were evaluated by the adapted Neighborhood Environment Walkability Scale. Multivariable logistic regression was performed to verify associations between the variables. RESULTS The prevalence of fear of falling was 48.40%. Significant negative associations were observed between residing near a bus stop, outdoor gyms, safe places to walk during the day, and positive associations between garbage accumulation and/or open sewers and high crime rates and fear of falling. CONCLUSION The association between self-perceived characteristics of built neighborhoods and fear of falling points to the need for improvements in urban infrastructure, especially public spaces, in order to reduce fear of falling in community-dwelling older adults.
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Lee S, Lee C, Rodiek S. Outdoor exposure and perceived outdoor environments correlated to fear of outdoor falling among assisted living residents. Aging Ment Health 2020; 24:1968-1976. [PMID: 31364392 DOI: 10.1080/13607863.2019.1647139] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Fear of falling is a major health concern among older adults. Although several studies have addressed general fear of falling in relation to personal factors, little is known about the specific relationship between fear of outdoor falling and perceptions of the outdoor environments. PURPOSE This study is to identify perceived environmental factors and outdoor exposure associated with fear of outdoor falling among assisted living residents aged 65 or older stratified by the amount of time spent outdoors. METHODS This study used survey data collected from a multiregional study conducted in 2007 that surveyed residents in 68 assisted living facilities in Houston, Texas; Chicago, Illinois; and Seattle, Washington. Out of 1,043 total participants, this study used a subset of 907 residents who used outdoor areas at least five minutes a day. Multivariate logistic regression was used after controlling for covariates. RESULTS Approximately 31% of the participants reported having worried about falling while using the outdoor areas in their assisted living community. Multivariate analyses showed that adequately designed walkways (OR = 0.614, 95% CI = 0.405-0.931), comfort levels in using outdoor areas (OR = 0.657, 95% CI = 0.437-0.989), and frequency of outdoor usage (OR = 0.538, 95% CI = 0.368-0.787) were associated with decreased fear of outdoor falling after adjusting for individual factors (i.e. age, sex, health condition, fall history, vision problems, mobility aids). CONCLUSION Improved walkways and comfort levels when using outdoor areas, as well as the amount of time spent outdoors, would be helpful in reducing fear of outdoor falling, which can help promote healthy lifestyle among assisted living residents.
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Affiliation(s)
- Sungmin Lee
- Department of Plant Science and Landscape Architecture, College of Agriculture, Health and Natural Resources, University of Connecticut, Storrs, CT, USA
| | - Chanam Lee
- Department of Landscape Architecture & Urban Planning, College of Architecture, Texas A&M University, College Station, TX, USA
| | - Susan Rodiek
- Department of Architecture, College of Architecture, Texas A&M University, College Station, TX, USA
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Portegijs E, Keskinen KE, Eronen J, Saajanaho M, Rantakokko M, Rantanen T. Older Adults' Physical Activity and the Relevance of Distances to Neighborhood Destinations and Barriers to Outdoor Mobility. Front Public Health 2020; 8:335. [PMID: 32850580 PMCID: PMC7426456 DOI: 10.3389/fpubh.2020.00335] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 06/16/2020] [Indexed: 12/30/2022] Open
Abstract
Aim: To determine the relevance of features located close to home and further away, our aim was to study associations between older adults' physical activity and self-reported neighborhood destinations and barriers to outdoor mobility categorized by presence and maximal distance from home. Methods: Cross-sectional analyses comprising men and women 79-94 years old (57%) living independently in Central Finland (n = 185). Self-reported physical activity was categorized into lower (≤3 h moderate activity a week) and higher (≥4 h moderate or intense activity a week) activity. Assisted by interviewers, participants located on an interactive map destinations perceived to facilitate and barriers perceived to hinder outdoor mobility in their neighborhood. Participants' home addresses were geolocated. Euclidean distances between home and reported locations were computed, and the maximal distance from home to neighborhood destinations and barriers, respectively, was categorized based using four common buffer distances, i.e., 250 m, 500 m, 750 m, and 1 km. Participants reporting destinations or barriers within and beyond the respective distance were compared with those reporting none. Results: About 80% of participants reported neighborhood destinations and 55% neighborhood barriers to outdoor mobility. Barriers were generally located closer to home than destinations [median 166 m (range 25 m-6.10 km) vs. 492 m (5 m-2.7 km)]. Logistic regression analyses adjusted for age, sex, and physical performance showed that neighborhood destinations increased the odds for higher physical activity when located beyond 500 m from home [OR 2.95, 95% confidence interval (CI) 1.02-8.54], but not when located solely within 500 m (OR 1.70, 95% CI 0.30-9.61), in comparison with when reporting no destinations. In contrast, neighborhood barriers decreased the odds for higher physical activity when solely located within 500 m (OR 0.31, 95% CI 0.14-0.72), but not when any barrier was located beyond 500 m (OR 0.96, 95% CI 0.23-3.99), compared with when reporting no barriers. Associations were similar for 250-m buffer distances, but not robust for 750-m and 1,000-m buffers because of lower prevalence. Conclusion: Neighborhood barriers to outdoor mobility located close to home were associated with lower physical activity of older adults, whereas barriers further away were not. Attractive destinations for outdoor mobility located further away from home correlated with higher physical activity, potentially by motivating one to go out and be physically active. Temporal relationships warrant further study.
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Affiliation(s)
- Erja Portegijs
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| | - Kirsi E. Keskinen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| | - Johanna Eronen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| | - Milla Saajanaho
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| | - Merja Rantakokko
- School of Health and Social Studies, JAMK University of Applied Sciences, Jyväskylä, Finland
| | - Taina Rantanen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
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Experiences of the Built Environment, Falls and Fear of Falling Outdoors among Older Adults: An Exploratory Study and Future Directions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041224. [PMID: 32074960 PMCID: PMC7068602 DOI: 10.3390/ijerph17041224] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 02/09/2020] [Accepted: 02/12/2020] [Indexed: 11/16/2022]
Abstract
Falls can have serious impacts on the health, wellbeing and daily mobilities of older adults. Falls are a leading cause of injury and death amongst older adults and outdoor falls comprise a substantial proportion of pedestrian injuries. As well as physical injuries, the psychological impacts of experiencing a fall can result in older adults getting out of the house less often, resulting in lower levels of physical activity and social connection. Despite the known consequences of falls, relatively little research considers the impact of the urban built environment on falls among older adults. This research aimed to explore the experiences of older adults in the urban environment, falling and the fear of falling outdoors. We conducted an online survey with adults aged 50+ using a participatory mapping survey tool and a convenience sample. The study area was Greater Christchurch, New Zealand. Results suggest that both perceived accessibility and neighbourhood conditions are independently associated with fear of falling, after controlling for frequency of falling, gender and activities of daily living. Our findings demonstrate the need for much better understandings of the relationships between the urban environment, outdoor mobility, fear of falling and falling among older adults and we propose suggestions for future research.
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21
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Qiu H, Rehman RZU, Yu X, Xiong S. Application of Wearable Inertial Sensors and A New Test Battery for Distinguishing Retrospective Fallers from Non-fallers among Community-dwelling Older People. Sci Rep 2018; 8:16349. [PMID: 30397282 PMCID: PMC6218502 DOI: 10.1038/s41598-018-34671-6] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 10/22/2018] [Indexed: 11/09/2022] Open
Abstract
Considering the challenge of population ageing and the substantial health problem among the elderly population from falls, the purpose of this study was to verify whether it is possible to distinguish accurately between older fallers and non-fallers, based on data from wearable inertial sensors collected during a specially designed test battery. A comprehensive but practical test battery using 5 wearable inertial sensors for multifactorial fall risk assessment was designed. This was followed by an experimental study on 196 community-dwelling Korean older women, categorized as fallers (N1 = 82) and non-fallers (N2 = 114) based on prior history of falls. Six machine learning models (logistic regression, naïve bayes, decision tree, random forest, boosted tree and support vector machine) were proposed for faller classification. Results indicated that compared with non-fallers, fallers performed significantly worse on the test battery. In addition, the application of sensor data and support vector machine for faller classification achieved an overall accuracy of 89.4% with 92.7% sensitivity and 84.9% specificity. These findings suggest that wearable inertial sensor based systems show promise for elderly fall risk assessment, which could be implemented in clinical practice to identify "at-risk" individuals reliably to promote proactive fall prevention.
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Affiliation(s)
- Hai Qiu
- Human Factors and Ergonomics Laboratory, Department of Industrial & Systems Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea
| | - Rana Zia Ur Rehman
- Human Factors and Ergonomics Laboratory, Department of Industrial & Systems Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea
| | - Xiaoqun Yu
- Human Factors and Ergonomics Laboratory, Department of Industrial & Systems Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea
| | - Shuping Xiong
- Human Factors and Ergonomics Laboratory, Department of Industrial & Systems Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, South Korea.
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