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Suarez JRM, Lafontant K, Blount A, Park JH, Thiamwong L. Recreating Fall Risk Appraisal matrix using R to support fall prevention programs. JAMIA Open 2024; 7:ooae088. [PMID: 39297152 PMCID: PMC11410192 DOI: 10.1093/jamiaopen/ooae088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2024] [Revised: 08/27/2024] [Accepted: 08/30/2024] [Indexed: 09/21/2024] Open
Abstract
Objective This study aimed to optimize Fall Risk Appraisal (FRA) graphing for use in intervention programs tailored toward reducing the fall risk of older adults by using computing graphic functions in the R language. Materials and Methods We utilized RStudio, a free development environment for the R language, as well as the functions within the "ggplot2" and "grid" packages, to develop a code that would recreate the FRA matrix for use in data visualization and analysis, as well as feedback for older adults. Results The developed code successfully recreates the FRA matrix in R and allows researchers and clinicians to graph participant data onto the matrix itself. Discussion The use of an R code allows for a streamlined approach to manipulating the FRA matrix for use in data visualization and feedback for older adults, which improves upon the traditional paper-pencil method that has been previously used. Conclusions The code presented in this study recreates the FRA matrix instrument in the R language and gives researchers the ability to instantaneously add, remove, or change different aspects of the instrument to improve its readability for researchers and older adults.
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Affiliation(s)
- Jethro Raphael M Suarez
- Department of Mechanical and Aerospace Engineering, University of Central Florida, Orlando, FL 32816, United States
- College of Nursing, University of Central Florida, Orlando, FL 32826, United States
| | - Kworweinski Lafontant
- College of Nursing, University of Central Florida, Orlando, FL 32826, United States
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL 32816, United States
| | - Amber Blount
- College of Nursing, University of Central Florida, Orlando, FL 32826, United States
- Department of Counselor Education and School Psychology, University of Central Florida, Orlando, FL 32816, United States
| | - Joon-Hyuk Park
- Department of Mechanical and Aerospace Engineering, University of Central Florida, Orlando, FL 32816, United States
- Disability, Aging, and Technology Cluster, University of Central Florida, Orlando, FL 32816, United States
| | - Ladda Thiamwong
- College of Nursing, University of Central Florida, Orlando, FL 32826, United States
- Disability, Aging, and Technology Cluster, University of Central Florida, Orlando, FL 32816, United States
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Ojo EO, Thiamwong L. Recruitment Strategies for a Technology-Based Fall Risk Assessment Research Study Among Community-Dwelling Older Adults During a Global Pandemic. J Gerontol Nurs 2024; 50:18-23. [PMID: 39194324 PMCID: PMC11382612 DOI: 10.3928/00989134-20240809-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2024]
Abstract
PURPOSE To describe successful strategies for the recruitment of diverse community-dwelling older adults for a technology-based fall risk assessment research study during the global coronavirus disease 2019 pandemic. METHOD In this cross-sectional study, 124 adults aged ≥60 years agreed to participate. We used several recruitment strategies, including social media platforms, local community centers, flyers, contacting key persons, word of mouth, and contacting participants from previous research projects. RESULTS Targeted and personalized strategies for recruitment, including contacting a key community leader (52.4%, n = 65) and communication with friends and family members (46.7%, n = 58), were the most successful. One (0.8%) participant was recruited from a prior research project. In contrast, individuals were not recruited from posted flyers and social media. CONCLUSION Recruitment can be improved with word of mouth and contacting key persons, such as community leaders, which can be achieved by building a trusted relationship between researchers and community leaders. [Journal of Gerontological Nursing, 50(9), 18-23.].
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Lafontant K, Sterner DA, Fukuda DH, Stout JR, Park JH, Thiamwong L. Comparing Device-Generated and Calculated Bioimpedance Variables in Community-Dwelling Older Adults. SENSORS (BASEL, SWITZERLAND) 2024; 24:5626. [PMID: 39275537 PMCID: PMC11397826 DOI: 10.3390/s24175626] [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: 07/27/2024] [Revised: 08/18/2024] [Accepted: 08/29/2024] [Indexed: 09/16/2024]
Abstract
Despite BIA emerging as a clinical tool for assessing older adults, it remains unclear how to calculate whole-body impedance (Z), reactance (Xc), resistance (R), and phase angle (PhA) from segmental values using modern BIA devices that place electrodes on both sides of the body. This investigation aimed to compare both the whole-body and segmental device-generated phase angle (PhADG) with the phase angle calculated using summed Z, Xc, and R from the left, right, and combined sides of the body (PhACalc) and to compare bioelectric variables between sides of the body. A sample of 103 community-dwelling older adults was assessed using a 50 kHz direct segmental multifrequency BIA device. Whole-body PhACalc values were assessed for agreement with PhADG using 2.5th and 97.5th quantile nonparametric limits of agreement and Spearman's rho. Bioelectrical values between sides of the body were compared using Wilcoxon rank and Spearman's rho. A smaller mean difference was observed between PhADG and right PhACalc (-0.004°, p = 0.26) than between PhACalc on the left (0.107°, p = 0.01) and on the combined sides (0.107°, p < 0.001). The sum of Z, R, and PhACalc was significantly different (p < 0.01) between the left (559.66 ± 99.55 Ω, 556.80 ± 99.52 Ω, 5.51 ± 1.5°, respectively) and the right sides (554.60 ± 94.52 Ω, 552.02 ± 94.23 Ω, 5.41 ± 0.8°, respectively). Bilateral BIA values do not appear to be interchangeable when determining whole-body measurements. Present data suggest that using right-sided segmental values would be the most appropriate choice for calculating whole-body bioelectrical variables.
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Affiliation(s)
- Kworweinski Lafontant
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL 32816, USA
- College of Nursing, University of Central Florida, Orlando, FL 32826, USA
| | - Danielle A Sterner
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL 32816, USA
| | - David H Fukuda
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL 32816, USA
| | - Jeffrey R Stout
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL 32816, USA
- Disability Aging & Technology Cluster, University of Central Florida, Orlando, FL 32826, USA
| | - Joon-Hyuk Park
- Disability Aging & Technology Cluster, University of Central Florida, Orlando, FL 32826, USA
- Department of Mechanical and Aerospace Engineering, University of Central Florida, Orlando, FL 32826, USA
| | - Ladda Thiamwong
- College of Nursing, University of Central Florida, Orlando, FL 32826, USA
- Disability Aging & Technology Cluster, University of Central Florida, Orlando, FL 32826, USA
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Nguyen T, Thiamwong L, Lou Q, Xie R. Unveiling Fall Triggers in Older Adults: A Machine Learning Graphical Model Analysis. MATHEMATICS (BASEL, SWITZERLAND) 2024; 12:1271. [PMID: 38784721 PMCID: PMC11113328 DOI: 10.3390/math12091271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
While existing research has identified diverse fall risk factors in adults aged 60 and older across various areas, comprehensively examining the interrelationships between all factors can enhance our knowledge of complex mechanisms and ultimately prevent falls. This study employs a novel approach-a mixed undirected graphical model (MUGM)-to unravel the interplay between sociodemographics, mental well-being, body composition, self-assessed and performance-based fall risk assessments, and physical activity patterns. Using a parameterized joint probability density, MUGMs specify the higher-order dependence structure and reveals the underlying graphical structure of heterogeneous variables. The MUGM consisting of mixed types of variables (continuous and categorical) has versatile applications that provide innovative and practical insights, as it is equipped to transcend the limitations of traditional correlation analysis and uncover sophisticated interactions within a high-dimensional data set. Our study included 120 elders from central Florida whose 37 fall risk factors were analyzed using an MUGM. Among the identified features, 34 exhibited pairwise relationships, while COVID-19-related factors and housing composition remained conditionally independent from all others. The results from our study serve as a foundational exploration, and future research investigating the longitudinal aspects of these features plays a pivotal role in enhancing our knowledge of the dynamics contributing to fall prevention in this population.
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Affiliation(s)
- Tho Nguyen
- Department of Statistics and Data Science, University of Central Florida, Orlando, FL 32816, USA
| | - Ladda Thiamwong
- College of Nursing, University of Central Florida, Orlando, FL 32816, USA
| | - Qian Lou
- Department of Computer Science, University of Central Florida, Orlando, FL 32816, USA
| | - Rui Xie
- Department of Statistics and Data Science, University of Central Florida, Orlando, FL 32816, USA
- College of Nursing, University of Central Florida, Orlando, FL 32816, USA
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Choudhury R, Park JH, Banarjee C, Coca MG, Fukuda DH, Xie R, Stout JR, Thiamwong L. Associations between monitor-independent movement summary (MIMS) and fall risk appraisal combining fear of falling and physiological fall risk in community-dwelling older adults. FRONTIERS IN AGING 2024; 5:1284694. [PMID: 38660534 PMCID: PMC11040232 DOI: 10.3389/fragi.2024.1284694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 03/20/2024] [Indexed: 04/26/2024]
Abstract
Introduction: Fall Risk Appraisal (FRA), a process that integrates perceived and objective fall risk measures, serves as a crucial component for understanding the incongruence between fear of falling (FOF) and physiological fall risk in older adults. Despite its importance, scant research has been undertaken to investigate how habitual physical activity (PA) levels, quantified in Monitor-Independent Movement Summary (MIMS), vary across FRA categories. MIMS is a device-independent acceleration summary metric that helps standardize data analysis across studies by accounting for discrepancies in raw data among research-grade and consumer devices. Objective: This cross-sectional study explores the associations between MIMS (volume and intensity) and FRA in a sample of older adults in the United States. Methods: We assessed FOF (Short Falls Efficacy Scale-International), physiological fall risk (balance: BTrackS Balance, leg strength: 30-s sit-to-stand test) and 7-day free-living PA (ActiGraph GT9X) in 178 community-dwelling older adults. PA volume was summarized as average daily MIMS (MIMS/day). PA intensity was calculated as peak 30-min MIMS (average of highest 30 non-consecutive MIMS minutes/day), representing a PA index of higher-intensity epochs. FRA categorized participants into following four groups: Rational (low FOF-low physiological fall risk), Irrational (high FOF-low physiological fall risk), Incongruent (low FOF-high physiological fall risk) and Congruent (high FOF-high physiological fall risk). Results: Compared to rational group, average MIMS/day and peak 30-min MIMS were, respectively, 15.8% (p = .025) and 14.0% (p = .004) lower in irrational group, and 16.6% (p = .013) and 17.5% (p < .001) lower in congruent group. No significant differences were detected between incongruent and rational groups. Multiple regression analyses showed that, after adjusting for age, gender, and BMI (reference: rational), only irrational FRA was significantly associated with lower PA volume (β = -1,452.8 MIMS/day, p = .034); whereas irrational and congruent FRAs were significantly associated with lower "peak PA intensity" (irrational: β = -5.40 MIMS/day, p = .007; congruent: β = -5.43 MIMS/day, p = .004). Conclusion: These findings highlight that FOF is a significant barrier for older adults to participate in high-intensity PA, regardless of their balance and strength. Therefore, PA programs for older adults should develop tailored intervention strategies (cognitive reframing, balance and strength exercises, or both) based on an individual's FOF and physiological fall risk.
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Affiliation(s)
- Renoa Choudhury
- Department of Mechanical Engineering, University of Central Florida, Orlando, FL, United States
| | - Joon-Hyuk Park
- Department of Mechanical Engineering, University of Central Florida, Orlando, FL, United States
- Disability, Aging and Technology Cluster, University of Central Florida, Orlando, FL, United States
| | - Chitra Banarjee
- College of Medicine, University of Central Florida, Orlando, FL, United States
| | - Miguel Grisales Coca
- Department of Mechanical Engineering, University of Central Florida, Orlando, FL, United States
| | - David H. Fukuda
- School of Kinesiology and Rehabilitation Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, United States
| | - Rui Xie
- Department of Statistics and Data Science, University of Central Florida, Orlando, FL, United States
- College of Nursing, University of Central Florida, Orlando, FL, United States
| | - Jeffrey R. Stout
- Disability, Aging and Technology Cluster, University of Central Florida, Orlando, FL, United States
- School of Kinesiology and Rehabilitation Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, United States
| | - Ladda Thiamwong
- Disability, Aging and Technology Cluster, University of Central Florida, Orlando, FL, United States
- College of Nursing, University of Central Florida, Orlando, FL, United States
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Lafontant K, Blount A, Suarez JRM, Fukuda DH, Stout JR, Trahan EM, Lighthall NR, Park JH, Xie R, Thiamwong L. Comparing Sensitivity, Specificity, and Accuracy of Fall Risk Assessments in Community-Dwelling Older Adults. Clin Interv Aging 2024; 19:581-588. [PMID: 38562971 PMCID: PMC10982579 DOI: 10.2147/cia.s453966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/13/2024] [Indexed: 04/04/2024] Open
Abstract
Purpose The US Centers for Disease Control and Prevention (CDC) has implemented the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) initiative. This initiative provides an algorithm for fall risk screening. However, the algorithm has the potential to overcategorize individuals as high risk for falling upon initial screening, which may burden clinicians with the task of recategorizing individuals after follow-up testing. Therefore, this study aimed to compare the accuracy, sensitivity, and specificity of fall risk appraisal between the STEADI, Short Fall-Efficacy Scale International (FES-I), and portable balance system (BTrackS) assessments in community-dwelling older adults. Patients and Methods This cross-sectional analysis included 122 community-dwelling older adults, comprising 94 women and 28 men. Center-of-pressure postural sway was assessed using the BTrackS, fear of falling was assessed using the Short FES-I questionnaire, and all participants completed the STEADI checklist. Each assessment categorized participants as either high or low fall risk and fall risk appraisal was compared between groups using McNemar tests. Results The STEADI checklist (high risk: n = 62; low risk: n = 60) significantly differed in fall risk appraisal compared to the BTrackS (high risk: n = 44; low risk: n = 78; p = 0.014) and the Short FES-I (high risk: n = 42; low risk: n = 80; p = 0.002). Compared to the BTrackS, the STEADI checklist had a specificity of 62.8%, sensitivity of 70.5%, and accuracy of 65.6%. Compared to the Short FES-I, the STEADI checklist had a specificity of 67.5%, sensitivity of 81.0%, and accuracy of 72.1%. Conclusion The STEADI checklist appears to overcategorize individuals as high fall risk more frequently than direct assessments of postural sway and fear of falling. Further research is needed to examine potential improvements in accuracy when combining the STEADI checklist with direct assessments of postural sway and/or fear of falling.
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Affiliation(s)
- Kworweinski Lafontant
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, USA
- College of Nursing, University of Central Florida, Orlando, FL, USA
| | - Amber Blount
- College of Nursing, University of Central Florida, Orlando, FL, USA
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Jethro Raphael M Suarez
- College of Nursing, University of Central Florida, Orlando, FL, USA
- Mechanical and Aerospace Engineering Department, University of Central Florida, Orlando, FL, USA
| | - David H Fukuda
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, USA
| | - Jeffrey R Stout
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, USA
- Disability, Aging, and Technology Cluster, University of Central Florida, Orlando, FL, USA
| | - Evette M Trahan
- College of Nursing, University of Central Florida, Orlando, FL, USA
| | | | - Joon-Hyuk Park
- Mechanical and Aerospace Engineering Department, University of Central Florida, Orlando, FL, USA
- Disability, Aging, and Technology Cluster, University of Central Florida, Orlando, FL, USA
| | - Rui Xie
- College of Nursing, University of Central Florida, Orlando, FL, USA
- Department of Statistics and Data Science, University of Central Florida, Orlando, FL, USA
| | - Ladda Thiamwong
- College of Nursing, University of Central Florida, Orlando, FL, USA
- Disability, Aging, and Technology Cluster, University of Central Florida, Orlando, FL, USA
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Sterner DA, Stout JR, Lafontant K, Park JH, Fukuda DH, Thiamwong L. Phase Angle and Impedance Ratio as Indicators of Physical Function and Fear of Falling in Older Adult Women: Cross-Sectional Analysis. JMIR Aging 2024; 7:e53975. [PMID: 38488531 PMCID: PMC10986333 DOI: 10.2196/53975] [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: 10/25/2023] [Revised: 12/30/2023] [Accepted: 01/29/2024] [Indexed: 03/19/2024] Open
Abstract
Background Older adults experience a significant decline in muscle integrity and function with aging. Early detection of decreased muscle quality can pave the way for interventions to mitigate the progression of age-related physical declines. Phase angle (PhA) and impedance ratio (IR) are measures of muscle integrity, which can be assessed quickly via bioelectrical impedance analysis (BIA) and may be indicative of physical function. Objective This study aimed to characterize the relationships among handgrip strength (HGS), sit-to-stand (STS), BTrackS balance scores, fear of falling (evaluated using the Short Falls Efficacy Scale-International [Short FES-I]), and IR among community-dwelling older adult women classified as having a low or high PhA. Methods A cross-sectional analysis was conducted with 85 older women (mean age 75.0, SD 7.2 years; mean weight 71.0, SD 15.0 kg; mean height 162.6, SD 6.1 cm). To examine the influence of PhA on performance measures, participants were divided into 2 PhA groups: high (>4.1°; n=56) and low (≤4.1°; n=29). Data were nonnormative; hence, the Mann-Whitney U test was used to evaluate between-group differences, and Kendall τ coefficients were used to determine the partial correlations. Results The low PhA group had a significantly higher IR (mean 0.85, SD 0.03) than the high PhA group (mean 0.81, SD 0.03; r=.92; P<.001). The high PhA group had superior HGS (mean 21.4, SD 6.2 kg; P=.007; r=0.36), BTrackS balance scores (mean 26.6, SD 9.5 cm; P=.03; r=0.30), and STS scores (mean 16.0, SD 5.5; P<.001; r=0.49) than the low PhA group (mean HGS 17.6, SD 4.7 kg; mean BTrackS balance score 37.1, SD 21.1 cm; mean STS score 10.7, SD 6.2). Both PhA and IR were significantly correlated with HGS and BTrackS balance, STS, and Short FES-I scores (P<.05). However, on adjusting for the whole sample's age, only PhA was strongly correlated with HGS (τb=0.75; P=.003) and STS scores (τb=0.76; P=.002). Short FES-I scores were moderately correlated with IR (τb=0.46; P=.07) after controlling for age. No significant between-group differences were observed for height, weight, or BMI. Conclusions PhA and IR are associated with physical function and the fear of falling in older women. However, only PhA was significantly associated with physical function (HGS and STS) independent of age. Conversely, only IR was significantly associated with the fear of falling. Diminished physical function and increased IR appear to be characteristics of older women with a PhA of ≤4.1°. These findings suggest that PhA and IR measured through BIA together may serve as a valuable tool for early identification of older women at the risk of functional decline and a heightened fear of falling.
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Affiliation(s)
- Danielle A Sterner
- Physiology of Work and Exercise Response (POWER) Lab, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Jeffrey R Stout
- Physiology of Work and Exercise Response (POWER) Lab, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
- Disability, Aging, and Technology Cluster, University of Central Florida, Orlando, FL, United States
| | - Kworweinski Lafontant
- Physiology of Work and Exercise Response (POWER) Lab, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
- College of Nursing, University of Central Florida, Orlando, FL, United States
| | - Joon-Hyuk Park
- Disability, Aging, and Technology Cluster, University of Central Florida, Orlando, FL, United States
- Mechanical and Aerospace Engineering Department, University of Central Florida, Orlando, FL, United States
| | - David H Fukuda
- Physiology of Work and Exercise Response (POWER) Lab, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Ladda Thiamwong
- Disability, Aging, and Technology Cluster, University of Central Florida, Orlando, FL, United States
- College of Nursing, University of Central Florida, Orlando, FL, United States
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Thiamwong L, Xie R, Conner NE, Renziehausen JM, Ojo EO, Stout JR. Body composition, fear of falling and balance performance in community-dwelling older adults. TRANSLATIONAL MEDICINE OF AGING 2023; 7:80-86. [PMID: 38516177 PMCID: PMC10957135 DOI: 10.1016/j.tma.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024] Open
Abstract
Objectives We aimed to 1) assess body composition using a portable technology, bioelectrical impedance analysis, (BIA) and 2) examine the associations between body composition and the discrepancy of fear of falling (FOF) and balance performance. Methods A cross-sectional study included 121 older adults 60 years and older, 78% were female, 41% lived alone, and 71% had no history of falls. The discrepancy between fear of falling and balance performance was categorized into four groups. We found 47% rational (low FOF and normal balance), 19% incongruent (low FOF despite poor balance), 18% irrational (high FOF despite normal balance), and 16% congruent (high FOF and poor balance). Results Body Fat Mass (BFM), Percent Body Fat (PBF), and Body Mass Index (BMI) were correlated with fear of falling and balance performance. BMI was significantly different in the rational group (p = 0.004) and incongruent group (p = 0.02) compared to the congruent group. PBF was significantly different between the incongruent (p = 0.002), irrational (p = 0.014), and rational (p < 0.001) groups, compared to the congruent group. Conclusions The study found that body BFM, PBF, and BMI were correlated with fear of falling and balance impairment. High Body Mass Index and Body Fat Mass were associated with a discrepancy between FOF and balance. Body composition analysis devices, such as BIA and other portable technologies, could be taken to underserved communities and may help identify community-dwelling older adults who are frail and may be at high risk of falling.
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Affiliation(s)
- Ladda Thiamwong
- College of Nursing, University of Central Florida, Orlando, FL, USA
- Disability, Aging and Technology Cluster, University of Central Florida, Orlando, FL, USA
| | - Rui Xie
- Department of Statistics and Data Science, College of Science, University of Central Florida, Orlando, FL, USA
| | - Norma E. Conner
- College of Nursing, University of Central Florida, Orlando, FL, USA
- Disability, Aging and Technology Cluster, University of Central Florida, Orlando, FL, USA
| | - Justine M. Renziehausen
- School of Kinesiology and Rehabilitation Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
| | | | - Jeffrey R. Stout
- Disability, Aging and Technology Cluster, University of Central Florida, Orlando, FL, USA
- School of Kinesiology and Rehabilitation Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA
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Thiamwong L, Xie R, Park JH, Choudhury R, Malatyali A, Li W, Eckstrom E, Stout JR. Levels of Accelerometer-Based Physical Activity in Older Adults With a Mismatch Between Physiological Fall Risk and Fear of Falling. J Gerontol Nurs 2023; 49:41-49. [PMID: 37256756 PMCID: PMC10513747 DOI: 10.3928/00989134-20230512-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
We examined the associations between levels of accelerometer-based physical activity and the mismatch of physiological fall risk and fear of falling (FOF) in community-dwelling older adults. We assessed 123 participants who received 7-day wrist-worn accelerometry. Physiological fall risk was assessed using the portable BTrackS™ balance system and FOF was assessed using a short version of the Falls Efficacy Scale-International. Participants were categorized into four groups: rational (low FOF/normal balance), irrational (high FOF/normal balance), incongruent (low FOF/poor balance), and congruent (high FOF/poor balance). One third of older adults had a mismatch between their FOF and actual fall risk. Accelerometer-based moderate to vigorous physical activity (MVPA) was significantly different in the irrational group compared to the rational group (p = 0.023) and the congruent group compared to the rational group (p = 0.032). Encouraging older adults to improve MVPA may prevent them from shifting from rational to irrational or congruent groups, thereby reducing the risk of injurious falls. [Journal of Gerontological Nursing, 49(6), 41-49.].
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Choudhury R, Park JH, Banarjee C, Thiamwong L, Xie R, Stout JR. Associations of Mutually Exclusive Categories of Physical Activity and Sedentary Behavior with Body Composition and Fall Risk in Older Women: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3595. [PMID: 36834290 PMCID: PMC9961100 DOI: 10.3390/ijerph20043595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/08/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
The individual effects of physical activity (PA) and sedentary behavior (SB) on health are well-recognized. However, little is known about the extent to which different combinations of these behaviors are associated with body composition and fall risk in older adults. This cross-sectional study examined the associations of mutually exclusive categories of PA and SB with body composition and fall risk in older women. Accelerometer-measured PA, body composition and fall risk (static and dynamic balance) parameters were assessed among 94 community-dwelling older women. The participants were categorized into four groups: active-low sedentary, active-high sedentary, inactive-low sedentary and inactive-high sedentary (active: ≥150 min/week moderate-to-vigorous PA (MVPA); low sedentary: lowest tertile of SB and light PA ratio). Compared to the inactive-high sedentary group, more favorable body composition and dynamic balance results were found in the active-low sedentary (body fat mass index (BFMI): β = -4.37, p = 0.002; skeletal muscle mass index (SMI): β = 1.23, p = 0.017; appendicular lean mass index (ALMI): β = 1.89, p = 0.003; appendicular fat mass index (AFMI): β = -2.19, p = 0.003; sit-to-stand: β = 4.52, p = 0.014) and inactive-low sedentary (BFMI: β = -3.14, p = 0.007; SMI: β = 1.05, p = 0.014; AFMI: β = -1.74, p = 0.005, sit-to-stand: β = 3.28, p = 0.034) groups. Our results suggest that PA programs focusing on concurrently achieving sufficient MVPA and reduced SB might promote a healthy body composition and reduced fall risk among older adults.
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Affiliation(s)
- Renoa Choudhury
- Department of Mechanical Engineering, University of Central Florida, Orlando, FL 32816, USA
| | - Joon-Hyuk Park
- Department of Mechanical Engineering, University of Central Florida, Orlando, FL 32816, USA
- Disability, Aging and Technology Cluster, University of Central Florida, Orlando, FL 32816, USA
| | - Chitra Banarjee
- College of Medicine, University of Central Florida, Orlando, FL 32816, USA
| | - Ladda Thiamwong
- Disability, Aging and Technology Cluster, University of Central Florida, Orlando, FL 32816, USA
- College of Nursing, University of Central Florida, Orlando, FL 32816, USA
| | - Rui Xie
- Department of Statistics and Data Science, University of Central Florida, Orlando, FL 32816, USA
| | - Jeffrey R. Stout
- Disability, Aging and Technology Cluster, University of Central Florida, Orlando, FL 32816, USA
- School of Kinesiology and Physical Therapy, College of Health Professions and Sciences, University of Central Florida, Orlando, FL 32816, USA
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Choudhury R, Park JH, Thiamwong L, Xie R, Stout JR. Objectively Measured Physical Activity Levels and Associated Factors in Older US Women During the COVID-19 Pandemic: A Cross-sectional Study (Preprint). JMIR Aging 2022; 5:e38172. [PMID: 35994346 PMCID: PMC9400844 DOI: 10.2196/38172] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/27/2022] [Accepted: 07/14/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Renoa Choudhury
- Department of Mechanical and Aerospace Engineering, University of Central Florida, Orlando, FL, United States
| | - Joon-Hyuk Park
- Department of Mechanical and Aerospace Engineering, University of Central Florida, Orlando, FL, United States
- Disability, Aging and Technology Cluster, University of Central Florida, Orlando, FL, United States
| | - Ladda Thiamwong
- College of Nursing, University of Central Florida, Orlando, FL, United States
| | - Rui Xie
- Department of Statistics and Data Science, University of Central Florida, Orlando, FL, United States
| | - Jeffrey R Stout
- School of Kinesiology and Physical Therapy, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, United States
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Thiamwong L. Future Nursing Research of Older Adults: Preserving Independence and Reducing Health Disparities. PACIFIC RIM INTERNATIONAL JOURNAL OF NURSING RESEARCH 2022; 26:1-5. [PMID: 35935604 PMCID: PMC9355488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Nursing professionals are at the forefront of primary care and the largest segment of the health workforce, and nurse researchers can bring vital perspectives to aging research and clinical practice. Although healthcare systems are experiencing more work from the aging of populations, unfortunately there are limited nurse researchers trained in gerontological nursing. Future research in older adults needs to be based on the current needs of and for older adults. In this article, I identify potential future research of aspects for older adults by highlighting opportunities and examples to conduct culturally appropriate interventions that aim to reduce health disparities and preserve independence. Because there is a complexity of health issues in older adults, nurse researchers need to pursue the best ways to address their needs, investigate and disseminate technology-based assessments, provide culturally appropriate interventions to promote independence, prevent chronic conditions, and enhance health equality. Nurses and nurse researchers also need to monitor the changes in functional status and health of older adults, especially as the global burden and costs of diseases and disability of this population grows, and to save unnecessary health care expenditure. To create new knowledge and discover best practices in aging care, nurse researchers lead multidisciplinary teams, develop innovative ideas with the potential for significant clinical impact, and use appropriate research approaches that steer to successful grant applications to national funding agencies. It is essential to establish a program for training or mentoring nurse researchers dedicated to caring for older adults, advocating, and disseminating innovative care to maximize the independence of older adults.
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Affiliation(s)
- Ladda Thiamwong
- College of Nursing, University of Central Florida, Orlando, FL, USA
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