File
Martins A.1, Baltazar D.1, Silva C.1, Silva J.2, Sousa I.2
1IPC-ESTeSC Coimbra Health School, Physiotherapy, Coimbra, Portugal, 2Fraunhofer Portugal AICOS, Porto, Portugal
Background: According to the recent National Institute for Health and Care Excellence (NICE) quality standards, the assessment of fall risk and preventing falls should be multifactorial and include factors like falls history, self-assessment of functional ability, fear of falling and home hazards, analysis of gait, balance, mobility and muscle strength.
Purpose: Concerning the self-reported data, some studies reported subjectivity and difficulty in extracting reliable information when using such methods. Number of previous falls is often used as a golden standard in fall risk assessment studies; however, this question is a source of misjudgement, in part, due to difficulty for an older person remember exactly how many times he/she has fallen in a past period of time. The study aimed to compare self-reported data and golden standard measures for assessing the risk of fall to verify the confidence of the self-reported data.
Methods: 326 community-dwelling adults aged 50+ years were surveyed regarding demographics, history of fall, fear of falling, sedentary lifestyle, use of upper-extremities to stand up from a chair, by self-reported questionnaire; and analysis of gait, balance, mobility and muscle strength, by golden standard measures for screening risk of fall - 10 meters walking speed test, 30 second sit to stand test, timed up & go test and grip strength (Jamar®). Independent samples t tests were performed to compare groups. Data were analyzed using SPSS.20 for Windows.
Results: The study comprised a sample of 326 community-dwelling adults with mean age 71,24± 11,12 years (68,1% female), 30,7% had at least one fall in the last year (fallers), 50,3% reported fear of fall, 47,9% had sedentary lifestyle, 37,1% used their upper extremities assistance to stand from a chair. Individuals who reported history of fall demonstrated lower grip strength (p=0,002) compared with no-fallers and no significant differences in any other functional measure. However, those who had sedentary lifestyle showed lower scores of gait velocity (p≤0,001), lower extremities strength (p=0,017), balance ((p≤0,001) and grip strength (p=0,017) compared with non-sedentary. Simultaneously, who assumed fear of falling showed lower scores of gait velocity (p≤0,001), lower extremities strength (p=0,018), balance ((p≤0,001) and grip strength (p≤0,001) compared with who had no fear of falling. Finally, those who use the upper-extremities to stand up from a chair showed lower scores of gait velocity (p≤0,001), lower extremities strength (p≤0,001), balance (p≤0,001) and grip strength (p=0,001) compared with those who do not use upper extremities to stand up from a chair.
Conclusion(s): The findings suggest that self-reported data like sedentary lifestyles, fear of falling and use of upper extremities to stand up from a chair, obtained by simple questions, have emerged as reliable information on risk factors for falling, in opposite to the question about number of falls in the previous 12 months.
Implications: Tailored preventive programs might be beneficial in reducing fall risk if they focus on walking speed, balance reeducation, upper and lower extremities strength, complemented with strategies to prevent sedentary lifestyles and strategies to reduce fear of falling.
Funding acknowledgements: Financial support from project FallSensing (POCI-01-0247-FEDER-003464), co-funded by Portugal 2020, framed under the COMPETE 2020
Topic: Health promotion & wellbeing/healthy ageing
Ethics approval: All research procedures were conducted under the Declaration of Helsinki, approved by the Scientific Commission of the IPC-IIA Research Institute.
All authors, affiliations and abstracts have been published as submitted.
