Frailty Markers and Falls Among US Clergy

Studies examining frailty, physical performance, and falls among the clergy are limited. The objective of the study was to analyze sociodemographic profiles, gait, strength, and falls between diocesan and religious clergy. Participants included eighty-eight male Catholic clergy primarily in the northeast United States. Participants completed a demographic profile and gait velocity and strength measures. Results noted that more diocesan priests were retired (p = .02). Participants with a fall history demonstrated slower gait (p = .001) and weaker grip strength (p = .017) and were more likely to have a fear of falling (p = .009). Findings underscore the importance of fall screening among clergy.

Factors influencing physical activity levels in elderly community-dwelling convalescent stroke survivors: A cross-sectional study

AIM

This study aimed to investigate factors affecting physical activity (PA) among elderly stroke survivors living in the community and assess the mediating role of exercise planning in the relationship between exercise self-efficacy and PA.

METHODS

300 participants were surveyed using questionnaires and scales, with data analyzed using SPSS 26.0.

RESULTS

Univariate analysis identified sociological, disease-related factors, exercise self-efficacy, and exercise planning as influencing PA. Ordered logistic regression showed significant associations between PA, exercise self-efficacy (OR 1.093, 95 % CI 1.055-1.133, P < 0.001), and exercise planning (OR 1.296, 95 % CI 1.202-1.398, P < 0.001). Exercise planning partially mediated the relationship between exercise self-efficacy and PA, accounting for 64.86 % of the total effect.

CONCLUSIONS

Multiple factors, including sociological and disease-related ones, as well as exercise self-efficacy and planning, influence PA in elderly stroke survivors. Exercise planning partially mediates the relationship between exercise self-efficacy and PA.

Stabilization after postural transitions in the elderly: Experimental study on community-dwelling subjects and nursing home residents

BACKGROUND

Postural transitions have been identified as presenting challenging situations for the elderly.

RESEARCH QUESTION

This study hypothesizes a relationship between age-related factors and postural stabilization performance after a transition movement. In particular, the controlled factors in the experiment are: 1) assistance in living (independent living for community-dwelling subjects vs. assisted living for institutionalized subjects in nursing homes); 2) age of institutionalized individuals, by comparing groups with different age ranges.

METHODS

Sixty-three institutionalized individuals in nursing homes were recruited (17 in the age range 64-79; 46, including 6 drop-outs, in the age range 80-95). Moreover, seventeen (one drop out) community dwelling subjects (64-79 years) were enlisted. The study focuses on the postural stabilization phase after a "step forward" task.

RESULTS

When comparing age-matched subjects from the two groups, the residents in nursing homes were characterised by a worse stabilization performance: the stabilization time more than doubled, Instability increased by 39 %, and Promptness decreased by 77 %, although there was no significant difference in the quiet erect posture between the groups. No difference was observed when comparing the two age groups of residents in the nursing homes, however a potential confounding effect has been identified in the unequal mortality rates between the two groups.

SIGNIFICANCE

It is hypothesized that an individual identification of abnormal values of Instability and/or Promptness may inform different rehabilitation approaches.

Engineering Improved Balance Confidence in Older Adults With Complex Health Care Needs: Learning From the Muscling Up Against Disability Study

OBJECTIVE

To investigate the associations of balance confidence with physical and cognitive markers of well-being in older adults receiving government-funded aged care services and whether progressive resistance plus balance training could positively influence change.

DESIGN

Intervention study.

SETTING

Community-based older adult-specific exercise clinic.

PARTICIPANTS

Older adults (N=245) with complex care needs who were receiving government-funded aged care support.

INTERVENTIONS

Twenty-four weeks of twice weekly progressive resistance plus balance training carried out under the supervision of accredited exercise physiologists.

MAIN OUTCOME MEASURES

The primary measure was the Activity-specific Balance Confidence Scale. Secondary measures included the Short Physical Performance Battery; fall history gathered as part of the health history questionnaire; hierarchical timed balance tests; Geriatric Anxiety Index; Geriatric Depression Scale; Fatigue, Resistance, Ambulation, Illness, Loss of Weight scale; and EuroQoL-5 dimension 3 level.

RESULTS

At baseline, better physical performance (r=.54; P<.01) and quality of life (r=.52; P<.01) predicted better balance confidence. In contrast, at baseline, higher levels of frailty predicted worse balance confidence (r=-.55; P<.01). Change in balance confidence after the exercise intervention was accompanied by improved physical performance (+12%) and reduced frailty (-11%). Baseline balance confidence was identified as the most consistent negative predictor of change scores across the intervention.

CONCLUSIONS

This study shows that reduced physical performance and quality of life and increased frailty are predictive of worse balance confidence in older adults with aged care needs. However, when a targeted intervention of resistance and balance exercise is implemented that reduces frailty and improves physical performance, balance confidence will also improve. Given the influence of balance confidence on a raft of well-being determinants, including the capacity for positive physical and cognitive change, this study offers important insight to those looking to reduce falls in older adults.

Biopsychosocial Measures Related to Chronic Low Back Pain Postural Control in Older Adults

This study examined the biopsychosocial measures related to postural control in the growing population of older adults (i.e., 60 years and older). The sample of the study consisted of 129 older adults (M = 74.45, SD = 6.95), with 34 males and 95 females; 36 were classified with chronic low-back pain (CLBP), and 93 without chronic low-back pain (NCLBP). Physical and psychosocial constructs were analyzed as predictors for postural control measures. Additionally, gender and classification of low-back pain were examined as moderators for all physical and psychosocial measures. Results demonstrated that physical and psychosocial measures were able to significantly predict composite, visual, and vestibular balance measures, but not somatosensory or preference balance measures. The chair-stand test, modified sit-and-reach test, sleep disturbance, and balance efficacy were all identified as individually significant predictors. Gender and CLBP did not moderate the utility of any predictor variables. Results of the current study re-confirm the importance of utilizing the biopsychosocial approach for future research examining postural control in older adults.

Rapid stepping test towards virtual visual objects: Feasibility and convergent validity in older adults

BACKGROUND

Rapid voluntary stepping has been recognized as an important measure of balance control.

OBJECTIVE

The purpose of this study was to assess the feasibility and convergent validity of a Rapid Stepping Test protocol utilizing a virtual reality SeeMeTM system (VR-RST) in elderly ambulatory and independent individuals living in a community residential home.

METHODS

Associations between step execution times determined by the system and the Activities-specific Balance Confidence (ABC) Questionnaire, and clinical measures of balance performance in the MiniBESTest and Timed Up and Go (TUG) test, were established in 60 participants (mean age 88.2 ± 5.0 years). All participants completed the study.

RESULTS

The correlations of the ABC questionnaire and the clinical tests with VR-RST forward and backward stepping were moderate (ρ rage 0.42-0.52), and weak to moderate with sideward stepping (ρ rage 0.32-0.52). Moderate to strong correlations were found across stepping directions (ρ rage 0.45-0.87).

CONCLUSION

Findings support the test's feasibility and validity and confirm the utility of the VR-RST as an assessment tool in an elderly population.

Prevalence of fear of falling, in a sample of elderly adults in the community

Abstract Objectives: To investigate the prevalence of fear of falling among a sample of elderly persons in the community, and to analyze its correlation with age, self-perceived health, difficulty walking, use of an assistive device for walking, history of falls, and functional capacity. Method: A cross-sectional study of 314 non-institutionalized elderly individuals, living in the city of Juiz de Fora in the state of Minas Gerais) in 2015, was carried out. A household survey was conducted and fear of falling was assessed using the Falls Efficacy Scale - International - Brazil (FES-I-BRASIL). The Spearman correlation was used to verify the correlation of the independent variables with the fear of falling. The significance level for the study was 5%. Results: The prevalence of fear of falling among the elderly was 95.2% (95% CI= 92.3; 97.3). Fear of falling was significantly correlated with all the variables analyzed: age (r= 0.199), self-perceived health (r=0.299), difficulty walking (r= -0.480), use of an assistive device for walking (r=0.337), history of falls (r= -0.177), and functional capacity (r = -0.476) . Conclusions: A high prevalence of fear of falling was observed, with a significant correlation between the outcome and the variables studied. These findings point to the need for rehabilitation, prevention, and health promotion strategies that enable healthy aging.

A theoretical and empirical review of psychological factors associated with falls-related psychological concerns in community-dwelling older people

BACKGROUND

Four constructs are encompassed by the term "falls-related psychological concerns" (FrPC); "fear of falling" (FOF), "falls-related self-efficacy" (FSe), "balance confidence" (BC) and "outcome expectancy" (OE). FrPC are associated with negative consequences including physical, psychological, and social. Identifying factors associated with FrPC could inform interventions to reduce these concerns.

METHODS

Sixty-two empirical papers relating to psychological factors associated with FrPC in community-dwelling older people (CDOP) were reviewed. Four levels of evidence were used when evaluating the literature: good, moderate, tentative, and none.

RESULTS

Evidence that anxiety predicted FOF, BC, and OE was tentative. Moderate evidence was found for anxiety predicting FSe. Good evidence was found for depression predicting FSe. Moderate evidence was found for depression predicting both FOF and BC. No evidence was found for depression predicting OE. Tentative evidence was found for FSe predicting depression. Good and moderate evidence was found for quality of life (QoL) being predicted by FOF and BC respectively. Tentative evidence was found for FSe predicting QoL. Moderate evidence was found for QoL predicting both FSe and BC. No evidence was found for QoL predicting FOF. Good and moderate evidence was found for activity avoidance/restriction (AA/AR) being predicted by FOF and FSe respectively. Tentative evidence was found for BC and OE predicting AA/AR, as well as for AA/AR predicting FOF. Moderate evidence for activity level (AL) predicting FOF was identified, however the evidence of this predicting FSe and BC was tentative. Evidence for FOF, FSe, and BC predicting AL was tentative as was evidence to suggest FOF predicted coping.

CONCLUSIONS

Mixed evidence has been found for the association of psychological factors in association with FrPCs. Future research should employ theoretically grounded concepts, use multivariate analysis and longitudinal designs.

Factors associated with fear of falling and associated activity restriction in community-dwelling older adults: a systematic review

OBJECTIVE

Fear of falling (FOF) is an important threat to autonomy. Current interventions to reduce FOF have yielded conflicting results. A possible reason for this discrepancy could be its multicausality. Some risk factors may not have been identified and addressed in recent studies. The last systematic review included studies until 2006.

METHODS

To identify additional risk factors for FOF and to test those mentioned previously, we conducted a systematic literature review. Studies examining FOF in community-dwelling older adults between 2006 and October 2013 were screened.

RESULTS

Outcomes are summarized with respect to different constructs such as FOF, fall-related self-efficacy/balance confidence, and FOF-related activity restriction. Odds ratios and p values are reported. There is no clear pattern with regard to the different FOF-related constructs studied. The only parameters robustly associated across all constructs were female gender, performance-based and questionnaire-based physical function, the use of a walking aid, and, less robust, a history of falls and poor self-rated health. Conflicting results were identified for depression and anxiety, multiple drugs, and psychotropic drugs. Other potentially modifiable risk factors were only mentioned in one or two studies and warrant further investigation. Parameters with mainly negative results are also presented.

CONCLUSION

Only few risk factors identified were robustly associated across all FOF-related constructs and should be included in future studies on FOF. Some newer factors have to be tested again in different cohorts. The comprehensive overview might assist in the conceptualization of future studies.