Background
Fear of falling (FoF) is a common psychological problem in community-dwelling older adults. However, which mobility function relate to newly developed FoF and persistent FoF are unknown.
...Aims
We aimed to clarify which baseline mobility function is an independent predictor of one-year change in FoF.
Methods
The study design was a one-year longitudinal predictive validity study. Participants were 581 independently community-dwelling older adults without neurological disorders. We measured FoF, history of falls, inactive lifestyle, and sociodemographic data were obtained via a self-administered questionnaire. Mobility functions were measured by community-based Short Physical Performance Battery (SPPB-com).
Results
Newly developed FoF group accounted for 20% among the non-FoF older adults at baseline. Persistent FoF group accounted for 57% among the older adults with FoF at baseline. Risk of newly developed FoF was significantly related to the SPPB-com total score, among the mobility functions, the low gait test score (OR 95% CI = 2.34 1.12–5.12) and the low tandem balance test score (OR 95% CI = 3.62 1.46–8.90) were significantly related. Risk of persistent FoF was also related to SPPB-com total score, among the mobility functions, the five chair stand test score (OR 95% CI = 1.96 1.19–3.24) was significantly related.
Discussion and conclusion
The risk of newly developed FoF related to lower ability of standing-balance and gait, the risk of persistent FoF related to lower sit-to-stand ability. Appropriate exercise interventions according to FoF subtype may effectively prevent the risk of developing FoF or experiencing persistent FoF.
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EMUNI, FZAB, GEOZS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
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.
Purpose In this study, we verified the validity of the step time and walking speed obtained from the smartphone gait analysis application CareCoaching. Participants and Methods The participants were ...66 independent, community-dwelling adults aged 65 years or older who performed a 10-m walking test twice each under preferred- and slow-speed conditions. We concurrently measured gait motions using CareCoaching and the OptoGait system for reference data. Both systems compute walking speed and step time as gait parameters. We examined the concurrent validity of these parameters by using intra-class correlation coefficients (ICCs) and limits of agreement (LOAs) with Bland−Altman analyses. Results In the preferred walking speed condition, the ICCs of walking speed and step times between the CareCoaching and the OptoGait system were 0.67 and 0.93, respectively. In the slow walking speed condition, the ICCs for walking speed and step time were 0.78 and 0.97, respectively. In addition, the LOAs for step time were −0.0941 to 0.1160 for preferred walking speed and −0.0596 to 0.0883 for slow walking speed. The LOAs for walking speed were −0.4158 to 0.0568 for preferred walking speed and −0.3348 to 0.0523 for slow walking speed. Conclusion CareCoaching showed excellent agreement for step time and moderate-to-good agreement for walking speed in independent, community-dwelling older adults.
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.
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EMUNI, FZAB, GEOZS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Abstract
Background
The sit-to-stand test (STS) is a representative motor test. In most of STS, the time taken to complete the test was used as its score, and its quality of motion has not been ...focused. In the present study, we measured the lower trunk angular velocity using gyro sensor during STS and computed the angular velocity-based indices (AV-index). We investigated its test-retest reliability and concurrent validity.
Method
Seventy-eight older people in community-dwelling were participated. Basic-health-related-information and the previous one-year fall-history were obtained by a questionnaire. As motor-function tests, One Leg Standing test (OLS), 3 minutes walking test (3MWT), Timed Up and Go test (TUG) were performed. Additionally, Modify Five-Times-STS was performed twice, the lower trunk angular velocity during the tests were measured using gyro sensor. From the obtained-signal waveforms in the sagittal plane (SP), root mean square (RMS) and coefficient of auto correlation (AC), the mean impact at sitting timing (STS impact) in Modify Five-Times-STS were computed. The intra-class correlation coefficient (ICC) was calculated for the test-retest reliability of the AV-indices. The coefficients of Pearson’s correlation were computed between AV-indices and the Five-Times-STS score, and scores of motor-function tests.
Result
The ICC of STS impact and RMS in SP were 0.85. The ICC of the other AV-index were lower than 0.5. The RMS in SP was significantly associated with OLS (r = 0.24), and 3MWT (r = 0.36), TUG (r = −0.32). Additionally, the STS impact was significantly associated with 3MWT (r = 0.54).
Conclusions
The test-retest reliability of two AV-index (STS impact and RMS in SP) is good. The concurrent validity of AV-index is partly confirmed.
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.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Introduction
The inability to read quickly can be a disadvantage throughout life. This study focused on the associations of braille reading fluency and individual factors, such as the age at onset of ...blindness and number of years reading braille, and the tactile sensitivity of people with early and late blindness. The relationship between reading speed and these other factors was examined to identify factors that influence reading speed.
Methods
Nine people with early blindness and 10 people with late blindness participated in this study, which included the measurement of accuracy of word recognition, braille reading speed, and tactile sensitivity.
Results
We found a significant partial correlation between reading speed and the age at onset of blindness, controlling for number of years reading braille (r = −0.68, p < .005), and no significant partial correlation between tactile sensitivity and reading speed after controlling for the age at onset of blindness (r = −0.08, ns).
Discussion
A direct relationship between reading speed and tactile sensitivity was not confirmed, and the age at onset of blindness appears not only to mediate the relationship between reading speed and tactile sensitivity but also may be a crucial factor influencing braille reading fluency.
Implications for practitioners
Our results suggested that a crucial factor that influences braille reading fluency was the age at onset of blindness, and that individuals should begin learning braille as early as possible.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK, VSZLJ
Abstract
Introduction
Older people who receive nursing-care-service have multiple fall-risk than well-functioning older people. To our knowledge, there is no appropriate fall-risk assessment for ...them. Most of the fall-risk assessments in previous researches were subjective. Thus, we aimed to develop a new fall-risk score included major fall-related factors such as objective motor-functions for older who receive nursing-care-service, and to verify the validity of the score.
Method
We recruited 264 older people who receive nursing-care-service. They were randomly allocated to the fall-risk score development group (Development group) and the score validity group (Validity group). All assessment items were major fall-risk related factors. As motor-function tests, Short-Physical-Performance-Battery (SPPB) including single-task-walking (STW), and dual-task-walking (DTW) were performed. Dual-task-cost (DTC) was computed. The DTC score was made with 0 = lower than 20%, 1 = more than 20%, 2 = incomplete DTW. As a cognitive-function test, Mini-Mental-State-Examinations was examined. Basic-health-related-information and past one-year fall-history were obtained via patient care records. Information of fear of falling was obtained via interview. In the Development group, the association between fall-history and the major fall-related factors were analyzed using multiple-logistic-regression analysis. Based on these results, we developed the 4-point fall-risk score consisted of DTC score and SPPB score (0=more than 10-point, 1=7 to 9 point, 2=less than 6-point). Finally, in the Validity group, the association between fall-history and the fall-risk score was investigated using logistic-regression analysis, and we computed area-under-the-curve (AUC).
Results
In the Development group, the fall-history was associated with SPPB (Odds ratio95%CI = 0.730.61-0.87), and DTC score (Odds ratio95%CI = 2.501.14-5.79). In the Validity group, our fall-risk score was significantly associated with fall-history AUC=73%, sensitivity=67%, specificity=71% .
Conclusion
In the fall-risk assessment for older people who receive nursing-care-service, our fall-risk score included SPPB and DTC are useful. The validity of our fall-risk score was confirmed.
Abstract
Aim
To elucidate the association between the occurrence of falls and timed “up and go” (TUG) test score in a dual-task condition among community-dwelling older adults by age group.
Methods
...This longitudinal observation study included 987 community-dwelling older adults at baseline. A TUG test (single-TUG) and a TUG test while counting aloud backward from 100 (dual-TUG) were conducted at baseline. The dual-task cost (DTC) value was computed from these results. Data on fall history were obtained using a self-administered questionnaire at the 1-year follow-up. At follow-up, 322 participants had dropped out and six participants had missing data for falls. The final analysis included 658 individuals (follow-up rate: 658/987, 67%) divided into a young-older adult group (aged 60–74 years) and an old-older adult group (aged 75 years or older). 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 DTC value (odds ratio OR 0.981, 95% confidence interval CI: 0.963–0.999, p = 0.040) and single-TUG score (OR 1.129, 95% CI: 1.006–1.268, p = 0.039). However, no significant associations were observed for young-older adults.
Conclusions
Slower single-TUG test score and lower DTC value are associated with the occurrence of falls among old-older adults but not among young-older adults. Dual task assessment is useful for predicting falls in TUG fall assessment for old-older adults.
Lower extremity force steadiness has been shown to decrease with aging and neuromotor dysfunction and to be associated with physical function and fall. Although patients with Parkinson’s disease (PD) ...experience decreased force steadiness, whether the extent of force steadiness differs according to target force or whether this steadiness is associated with postural control remain unclear. Therefore, this study aimed to compare the force steadiness while steadily exerting low and moderate levels of knee extensor force between individuals with and without PD and to examine the association between force steadiness and postural instability against mechanical perturbation in PD.
A total of 33 patients with PD (mean age, 71.7 years) and 33 healthy controls (72.2 years) participated in this study. Participants with PD were classified into postural stability or instability groups based on the Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale motor exam item 12. Participants performed steady task of the knee isometric extension at two levels (10% and 50% of maximal voluntary contraction MVC).
Force steadiness at 10% MVC was lower in postural instability group than that in the control and postural stability groups (P < 0.05) after adjusting for age, sex, and body mass index, whereas it was not significantly different at 50% MVC among the three groups.
These results suggest that the knee extensor force steadiness is affected in patients with PD having postural instability against mechanical perturbation during low intensity force exertion and is not affected regardless of the presence of postural instability during moderate intensity force exertion.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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