Physical performance and falls risk in a rural community of older adults in Ghana.

Jannique van Uffelen, Alfred Yawson, Jos Tournoy, Bertha Oppong-Yeboah
Purpose:

The aim of this study was to determine the level of physical performance, past-year fall prevalence and fall risk in a cohort of older adults in a rural district in Ghana. A second objective was to determine the association between the performance tests and history and high risk of falls. 

Methods:

This preliminary cross-sectional study recruited older people aged ≥60 years from 3 villages in the Okere district. Four functional tests i.e., Short Physical Performance Battery (SPPB), 8-ft up-and-go (8FUG), 4m walk speed and Hand Grip Strength (HGS) were performed. The Fall-Risk Questionnaire (FRQ) was used to assess their fall risk and fall prevalence. The Pearson correlation test was used to examine the relationship between the scores of the tests and FRQ scores. The Chi square test and logistic regression were used to examine their associations when categorised using reference values. 

Results:

Forty-three participants with ages ranging from 60-94 years were recruited. The mean age was 72.1 ± 9.2 years and 62.7% were female. The past-year fall prevalence was 32.5% and 48.8% of participants had a high risk of falling. The median scores (Q1,Q3) for the tests were SPPB = 10 (8, 11); 8FUG = 9.88 (8.53, 11.81); Walk speed = 0.87 (0.7, 1.04); and HGS = 19.67 (17.6, 24.67). When scores are categorized using available reference values specific to a sub-Saharan population no (0%) participant had a low walk speed and two (4.6%) participants had a weak HGS. The 8FUG was compared to global reference values and only one participant (2.3%) scored an adequate time. The SPPB scores was categorised based on the 1st quartile of the sample and 16.2% had low functional mobility. 

Conclusion(s):

There was a high falls prevalence and falls risk. The four tests appear to correlate with the risk of fall scores when they are used as continuous data. However, they show no association when they are categorised using reference values. Even so, there is still a need for population-specific reference values for the 8FUG that will enable comparison of patients with others; and this could be the direction of future studies. 

Implications:

The use of these performance tests to assess risk of falls in older adult may not be indicated, nonetheless they remain valuable as outcome measures to monitor progress during rehabilitation. 

Funding acknowledgements:
No funding to acknowledge.
Keywords:
Older people
Falls assessment
Performance tests
Primary topic:
Older people
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
Ethical & Protocol Review Committee, College of Health Sciences, University of Ghana
Provide the ethics approval number:
CHS/Et/M.3 – P 4.1/2023-2-24
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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