Walton-Mouw R1, Astarita J1, Sneeringer G1, Lamar A1
1University of North Georgia, Dahlonega, United States
Background: Falls in the older adult are not only the most common cause of nonfatal injury, they are also the leading cause of injury death.1 Approximately 30% of community-dwelling adults over the age of 65 fall annually.1 However, that risk increases after discharge from a hospital stay. (2,3,4,5) Approximately 14% of older adults fall within the first 30 days following discharge from a hospital stay.2 Two-week post-discharge period shows a 4-fold higher rate of falling compared to 3 months after discharge.2 At six months post-discharge, participants had 40% risk of falls with 54.4% in injurious falls.3
Indentifying fall risk in community-dwelling and hospitalized older adults is a priority, the assessment of hospitalized older adults at risk for post-hospitalization falls has been largely overlooked.
Purpose: The aim of our study was to investigate the use of the Short Physical Performance Battery (SPPB), if performed while hospitalized, in predicting post-discharge falls in the older adult6. In addition, we hypothesized the scores of the individual functional tasks in the SPPB would be meaningful in determining post-discharge falls.
Methods: Ten subjects, 7 females and 3 males, over age 65 (mean age of 75.6 + 6.06) admitted to the hospital without neurological or neuromuscular dysfunction; recent fractures, surgery or cardiac events; MD ordered movement restrictions; and cognitive deficits were included in the study. The SPPB was administered and recorded by 3 physical therapists during a physical therapy evaluation or treatment at Grady Memorial Hospital in Atlanta, GA. Fall history was also data collected.
At one month after test administration, subjects were called to determine occurance/severity of falls since discharge.
Results: Of the 10 subjects, 3 reported having a fall at the time of the 1 month post-discharge phone call. Two of the 3 falls were defined as a near fall and the other fall required hospitalization. Three subjects were unable to complete the tandem stance task for longer than 3 seconds, obtaining a score of 0 on this task. These 3 were the only subjects who reported a post-discharge fall. No subject's gait speed time was less than 8 seconds. Four subjects were unable to perform the 5TSTS.
Conclusion(s): Our data support previous research that have shown older adults are at heightened risk of falling after discharge from a hospital. Although we did not find a correlation/link/relationship between the total score of the SPPB and discharge fall occurrence, it is significant that the 3 people who experienced post-discharge falls, were unable the subjects to obtain or hold tandem stance for longer than 3 seconds. This suggests that the tandem stance element is more sensitive/specific in identify those at highest risk of fall after hospital discharge. Although few, previous studies have shown the link between tandem stance/SR and balance deficits or falls.7,8,9,10
Implications: Post-discharge falls occur at a high rate and are potentially devasting. It is imperative that PTs have a meaningful assessment to help identify those at risk. This study gives evidence that the SPPB and specifically tandem stance is may be a valuable tool to predict post-discharge falls.
Keywords: Geriatrics, SPPB, Falls
Funding acknowledgements: No funding has been received or issued in relation to this study.
Indentifying fall risk in community-dwelling and hospitalized older adults is a priority, the assessment of hospitalized older adults at risk for post-hospitalization falls has been largely overlooked.
Purpose: The aim of our study was to investigate the use of the Short Physical Performance Battery (SPPB), if performed while hospitalized, in predicting post-discharge falls in the older adult6. In addition, we hypothesized the scores of the individual functional tasks in the SPPB would be meaningful in determining post-discharge falls.
Methods: Ten subjects, 7 females and 3 males, over age 65 (mean age of 75.6 + 6.06) admitted to the hospital without neurological or neuromuscular dysfunction; recent fractures, surgery or cardiac events; MD ordered movement restrictions; and cognitive deficits were included in the study. The SPPB was administered and recorded by 3 physical therapists during a physical therapy evaluation or treatment at Grady Memorial Hospital in Atlanta, GA. Fall history was also data collected.
At one month after test administration, subjects were called to determine occurance/severity of falls since discharge.
Results: Of the 10 subjects, 3 reported having a fall at the time of the 1 month post-discharge phone call. Two of the 3 falls were defined as a near fall and the other fall required hospitalization. Three subjects were unable to complete the tandem stance task for longer than 3 seconds, obtaining a score of 0 on this task. These 3 were the only subjects who reported a post-discharge fall. No subject's gait speed time was less than 8 seconds. Four subjects were unable to perform the 5TSTS.
Conclusion(s): Our data support previous research that have shown older adults are at heightened risk of falling after discharge from a hospital. Although we did not find a correlation/link/relationship between the total score of the SPPB and discharge fall occurrence, it is significant that the 3 people who experienced post-discharge falls, were unable the subjects to obtain or hold tandem stance for longer than 3 seconds. This suggests that the tandem stance element is more sensitive/specific in identify those at highest risk of fall after hospital discharge. Although few, previous studies have shown the link between tandem stance/SR and balance deficits or falls.7,8,9,10
Implications: Post-discharge falls occur at a high rate and are potentially devasting. It is imperative that PTs have a meaningful assessment to help identify those at risk. This study gives evidence that the SPPB and specifically tandem stance is may be a valuable tool to predict post-discharge falls.
Keywords: Geriatrics, SPPB, Falls
Funding acknowledgements: No funding has been received or issued in relation to this study.
Topic: Older people
Ethics approval required: Yes
Institution: University of North Georgia
Ethics committee: Institutional Review Board
Ethics number: 2017-53-HBL
All authors, affiliations and abstracts have been published as submitted.
