Abstract
Objectives
Fear of falling (FoF) is common in older adults. Physical activity decreases as FoF increases. However, this association between physical activity and FoF may vary depending on ...activity intensity. The current study was performed to explore the associations between FoF and step count, light-intensity physical activity (LPA), and moderate/vigorous-intensity physical activity (MVPA) in community-dwelling older adults.
Methods
This cross-sectional observational study was held at a local community association center, with 242 older adults living independently in the community (mean age: 75.1 ± 5.4 years). FoF was defined using the Falls Efficacy Scale-International and categorized into three levels (low, moderate, and high). Physical activity was measured using a uniaxial accelerometer worn for 7 consecutive days, and by calculating daily step count, LPA, and MVPA, over this period.
Results
Step count and physical activity intensity showed significant linear trends across FoF severity (p < .01, respectively). High FoF decreased step count by approximately 2,000 steps/day. Further, high FoF was significantly associated with short durations of both LPA and MVPA. In addition, moderate FoF was associated with decreased LPA duration, even after adjustment for confounding variables.
Discussion
Physical activity decreased concomitantly with a rise in FoF severity. Moreover, the association between physical activity and FoF differed by physical activity intensity level in community-dwelling older adults. Further studies are needed to investigate the causal relationship between FoF and objective physical activity in this population.
We developed a novel quantitative method to assess varus thrust during walking using acceleration data obtained from an inertial measurement unit (IMU). This study aimed to examine the reliability of ...the developed index and to evaluate its ability to distinguish patients with knee osteoarthritis (OA) with varus thrust from healthy adults. Overall, 16 patients with knee OA and 16 healthy adults walked on a treadmill with IMUs attached to the tibial tuberosity and lateral femoral condyle. As an index of varus thrust, we used the root mean square (RMS) of acceleration in the mediolateral direction. This value was adjusted by dividing it by swing speed while walking (adjusted RMS, A-RMS) because the RMS of the acceleration was strongly coupled with the speed of motion. The intraclass correlation coefficients of A-RMS of the tibia and femur were 0.85 and 0.73, respectively. Significant differences were observed in the A-RMSs of the tibia and femur, with large effect sizes between the patients with knee OA and healthy adults (Cohen’s d: 1.23 and 0.97, respectively). Our results indicate that A-RMS has good test–retest reproducibility and can differentiate patients with varus thrust from healthy adults.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Gait variables derived from trunk accelerometry may predict the risk of falls; however, their associations with falls are not fully understood. The purpose of the study was to determine which gait ...variables derived from upper and lower trunk accelerometry are associated with the incidence of falls, and to compare the discriminative ability of gait variables and physical performance.
This study was a 1-year prospective study. Older people (n = 73) walked normally while wearing accelerometers attached to the upper and lower trunk. Participants were classified as fallers (n = 16) or non-fallers (n = 57) based on the incidence of falls over 1 year. The harmonic ratio (HR) of the upper and lower trunk was measured. Physical performance was measured in five chair stands and in the timed up and go test.
The HR of the upper and lower trunk were consistently lower in fallers than non-fallers (P < 0.05). Upper trunk HR, was independently associated with the incidence of falls (P < 0.05) after adjusting for confounding factors including physical performances. Consequently, upper trunk HR showed high discrimination for the risk of falls (AUC = 0.81).
HR derived from upper trunk accelerometry may predict the risk of falls, independently of physical performance. The discriminative ability of HR for the risk of falls may have some validity, and further studies are needed to confirm the clinical relevance of trunk HR.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
This study aimed to assess the association between the degree of varus thrust (VT) assessed by an inertial measurement unit (IMU) and patient-reported outcome measures (PROMs) in patients with knee ...osteoarthritis. Seventy patients (mean age: 59.8 ± 8.6 years; women: n = 40) were instructed to walk on a treadmill with an IMU attached to the tibial tuberosity. For the index of VT during walking (VT-index), the swing-speed adjusted root mean square of acceleration in the mediolateral direction was calculated. As the PROMs, the Knee Injury and Osteoarthritis Outcome Score were used. Data on age, sex, body mass index, static alignment, central sensitization, and gait speed were collected as potential confounders. After adjusting for potential confounders, multiple linear regression analysis revealed that the VT-index was significantly associated with the pain score (standardized β = -0.295;
= 0.026), symptoms score (standardized β = -0.287;
= 0.026), and activities of the daily living score (standardized β = -0.256;
= 0.028). Our results indicated that larger VT values during gait are associated with worse PROMs, suggesting that an intervention to reduce VT might be an option for clinicians trying to improve PROMs.
Full text
Available for:
IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Both multiple fall experiences and fear of falling (FoF) would make people susceptible to another fall; however, the associations are unknown. This study investigates the association of FoF with fall ...occurrence among older adults according to their fall history.
In this study, we adopted a longitudinal observational design. We visited 20 community centers to recruit 1,025 older adults (aged 65 years or older). At baseline, FoF was assessed using a single-item questionnaire. The number of falls in the past year was obtained via a self-questionnaire and participants were classified into three fall history groups (0: non-faller, 1: single faller, 2 or more: multiple faller). After a year of following-up, the number of falls during the year was considered as the main outcome. Poisson regression models clarified the influence of FoF on fall occurrence during the one-year follow-up, according to the participants' fall history.
The final sample comprised 530 individuals (follow-up rate: 530/801, 66.4%). Fall history, FoF, and interaction between multiple fallers and FoF were significant in the adjusted statistical model (rate ratio 95% confidence interval: single faller = 2.81 1.06, 6.30, multiple faller = 13.60 8.00, 23.04, FoF = 3.70 2.48, 5.67, multiple faller*FoF = 0.37 0.20, 0.68).
We found that FoF was associated with the occurrence of falls in community-dwelling older adults. However, its association was lower in multiple fallers.
Aim
To translate the Simplified Nutritional Appetite Questionnaire (SNAQ) into Japanese, and assess its reliability and validity in Japanese community‐dwelling older adults.
Methods
A total of 84 ...community‐dwelling older adults people aged 65 years or older were included in the present study, and those with a Mini‐Mental State Examination score of <24, had dementia, had digestive disease or who did not complete the examination were excluded. The SNAQ was translated into Japanese according to an internationally accepted methodology. The internal reliability of the SNAQ was evaluated by Cronbach's alpha coefficient. Test–retest reliability was evaluated using the intraclass correlation coefficient. The dimensionality of the SNAQ was evaluated by factor analysis. Concurrent validity was evaluated by measuring the Pearson's correlation coefficient between the SNAQ and Mini‐Nutritional Assessment Short‐Form scores, Geriatric Depression Scale scores, walking speed test, chair‐stand test, hand grip strength test, or the Timed Up and Go test.
Results
The mean score of the Japanese version of the SNAQ was 15.5, with a Cronbach's alpha coefficient of 0.545 and intraclass correlation coefficient of 0.754. Factor analysis showed a single factor with 50.0% explained variance. The SNAQ was significantly associated with the Mini‐Nutritional Assessment Short‐Form, Geriatric Depression Scale, walking speed test, chair‐stand test and the Timed Up and Go test. Handgrip strength test did not show a significant association with the SNAQ.
Conclusion
The Japanese version of the SNAQ had sufficient reliability and validity. Furthermore, SNAQ (Japanese version) is useful for evaluating the appetite of community‐dwelling older adults in Japan. Geriatr Gerontol Int 2015; 15: 1264–1269.
Full text
Available for:
FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Background
Previous studies using relatively large samples and longitudinal observational designs reported dual-tasking had additional value in timed “up and go” test (TUG) for falls assessment among ...well-functioning older adults.
Aim
To elucidate the additional value of dual-tasking in TUG for predicting the occurrence of falls among community-dwelling older adults by age group using a predictive model.
Methods
This longitudinal observation study included 987 community-dwelling older adults at baseline. A TUG without performing another task (single-TUG) and a TUG while counting aloud backward from 100 were conducted at baseline. We computed the dual-task cost (DTC) value, which is used to quantify trends in subjects’ execution of motor tests under dual-task conditions. Data on fall history were obtained using a self-administered questionnaire at the 1-year follow-up. The final analysis included 649 individuals divided into a young-older adult group (aged 60–74 years) and an old-older adult group (aged ≥ 75 years). Associations between the occurrence of falls and TUG-related values were analyzed by age group using multivariate logistic regression models.
Results
For old-older adults, there were significant associations between the occurrence of falls and single-TUG time (odds ratio OR 1.143, 95% confidence interval CI 1.018–1.285) and DTC value (OR 0.981, 95% CI 0.963–0.999). No significant associations were observed for young-older adults.
Conclusions
Slower single-TUG time and lower DTC value are associated with the occurrence of falls among old-older adults but not among young-older adults. Dual tasking may provide an additional value in TUG for predicting falls among old-older adults.
Full text
Available for:
EMUNI, FZAB, GEOZS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
The purpose of this systematic review and meta-analysis was to investigate the effects of low-intensity resistance training on knee extension strength with respect to intensity, frequency, duration ...and training site in community-dwelling older adults.
A literature search was conducted for articles published up to December 2018 on PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Physiotherapy Evidence Database (PEDro), OTseeker and Ichushi-Web. Randomized controlled trials involving resistance training with <60 % one repetition maximum (1RM) in community-dwelling older adults aged 60 years and older were eligible.
In total, 7 studies involving 275 participants were included in the meta-analysis. The results showed significant improvements in knee extension strength with low-intensity resistance training standardized mean difference (SMD) 0.62, 95 % confidence interval (CI) 0.32 to 0.91. In subgroup analyses, significant improvements were observed in the group with intensity at 50–60 % 1RM (0.83, 0.46 to 1.19), but not in the group at 40 % or less 1RM (0.30, 95%CI: −0.08 to 0.68). Concerning frequency, there were significant improvements in knee strength for those receiving training three times (0.90, 0.52 to 1.27) and two times (0.36, 0.03 to 0.69) per week, with a significant difference between the groups (p = 0.04).
Low-intensity resistance training should be considered as an effective intervention to improve knee extension strength in community-dwelling older adults. Older adults may show more improvement in knee extension strength if intensity of the training is set at 50–60 % 1RM and frequency of training is three times per week.
•It is necessary to develop other effective interventions for safe and sustainable muscle strength training for older adults•Systematic review and meta-analysis to examine the effects of low-intensity resistance training on knee extension strength in older adults.•Older adults may benefit from the low-intensity intervention particularly at more than 50%1RM and from sessions three times per week.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Highlights • Dual-task-related trunk movements depend on the nature of the additional task. • Dual-task-related gait changes affect trunk movement while walking. • Fear of falling affects lateral ...trunk movement in cognitive-task gait.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Aim
To investigate the associations between fall history and the Timed Up and Go (TUG) test (single‐TUG test), TUG test while counting aloud backwards from 100 (dual‐TUG test) and the dual‐task cost ...(DTC) among independent community‐dwelling older adults.
Methods
This cross‐sectional study included 537 older adults who lived independently in the community. Data on fall history in the previous year were obtained by self‐administrated questionnaire. The single‐ and dual‐TUG tests were carried out, and the DTC value was computed from these results. Associations between fall history and these TUG‐related values were analyzed using multivariate logistic regression models. The participants were divided into fall risk groups using the cut‐off values of those significantly associated with falling, and the odds ratios (OR) were computed.
Results
Slower single‐TUG test scores and lower DTC values were significantly associated with fall history after adjusting for potential confounders (single‐TUG test score: OR 1.133, 95% CI 1.029–1.249; DTC value: OR 0.984, 95% CI 0.968–0.998). Older adults with slower single‐TUG test scores and lower DTC values reported a fall history more often than those in other categories (OR compared with the lower‐risk single‐TUG and lower‐risk DTC groups: 3.474, 95% CI 1.881–6.570).
Conclusions
Slower single‐TUG test scores and lower DTC values are associated with fall history among independent community‐dwelling older adults. To some extent, dual task performance might provide added value for fall assessment, compared with administering the TUG test alone. Geriatr Gerontol Int 2018; 18: 1189–1193.
Full text
Available for:
FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
PDF
