scholarly journals Fall Risk Classification in Community-Dwelling Older Adults Using a Smart Wrist-Worn Device and the Resident Assessment Instrument-Home Care: Prospective Observational Study

JMIR Aging ◽  
10.2196/12153 ◽  
2019 ◽  
Vol 2 (1) ◽  
pp. e12153 ◽  
Author(s):  
Yang Yang ◽  
John P Hirdes ◽  
Joel A Dubin ◽  
Joon Lee
Keyword(s):  
Older Adults ◽  
Observational Study ◽  
Home Care ◽  
Fall Risk ◽  
Prospective Observational Study ◽  
Community Dwelling ◽  
Assessment Instrument ◽  
Resident Assessment ◽  
Community Dwelling Older Adults ◽  
Resident Assessment Instrument

scholarly journals Fall Risk Classification in Community-Dwelling Older Adults Using a Smart Wrist-Worn Device and the Resident Assessment Instrument-Home Care: Prospective Observational Study (Preprint)

2018 ◽  
Author(s):  
Yang Yang ◽  
John P Hirdes ◽  
Joel A Dubin ◽  
Joon Lee
Keyword(s):  
Older Adults ◽  
Fall Risk ◽  
Prospective Observational Study ◽  
Risk Classification ◽  
Community Dwelling ◽  
Assessment Instrument ◽  
Classification Models ◽  
Resident Assessment ◽  
Community Dwelling Older Adults ◽  
Resident Assessment Instrument

BACKGROUND  Little is known about whether off-the-shelf wearable sensor data can contribute to fall risk classification or complement clinical assessment tools such as the Resident Assessment Instrument-Home Care (RAI-HC). OBJECTIVE  This study aimed to (1) investigate the similarities and differences in physical activity (PA), heart rate, and night sleep in a sample of community-dwelling older adults with varying fall histories using a smart wrist-worn device and (2) create and evaluate fall risk classification models based on (i) wearable data, (ii) the RAI-HC, and (iii) the combination of wearable and RAI-HC data. METHODS  A prospective, observational study was conducted among 3 faller groups (G0, G1, G2+) based on the number of previous falls (0, 1, ≥2 falls) in a sample of older community-dwelling adults. Each participant was requested to wear a smart wristband for 7 consecutive days while carrying out day-to-day activities in their normal lives. The wearable and RAI-HC assessment data were analyzed and utilized to create fall risk classification models, with 3 supervised machine learning algorithms: logistic regression, decision tree, and random forest (RF). RESULTS  Of 40 participants aged 65 to 93 years, 16 (40%) had no previous falls, whereas 8 (20%) and 16 (40%) had experienced 1 and multiple (≥2) falls, respectively. Level of PA as measured by average daily steps was significantly different between groups (P=.04). In the 3 faller group classification, RF achieved the best accuracy of 83.8% using both wearable and RAI-HC data, which is 13.5% higher than that of using the RAI-HC data only and 18.9% higher than that of using wearable data exclusively. In discriminating between {G0+G1} and G2+, RF achieved the best area under the receiver operating characteristic curve of 0.894 (overall accuracy of 89.2%) based on wearable and RAI-HC data. Discrimination between G0 and {G1+G2+} did not result in better classification performance than that between {G0+G1} and G2+. CONCLUSIONS  Both wearable data and the RAI-HC assessment can contribute to fall risk classification. All the classification models revealed that RAI-HC outperforms wearable data, and the best performance was achieved with the combination of 2 datasets. Future studies in fall risk assessment should consider using wearable technologies to supplement resident assessment instruments.

Profil des personnes âgées souffrant d’insuffisance cardiaque soignées à domicile en Ontario

2011 ◽  
Vol 31 (2) ◽  
pp. 57-66
Author(s):  
AD Foebel ◽  
JP Hirdes ◽  
GA Heckman ◽  
SL Tyas ◽  
EY Tjam
Keyword(s):  
Home Care ◽  
Nous Avons ◽  
Assessment Instrument ◽  
Services De Santé ◽  
Soins Infirmiers ◽  
Soins À Domicile ◽  
Base De Données ◽  
Resident Assessment ◽  
Resident Assessment Instrument ◽  
Vieillissement De La Population

Introduction Le vieillissement de la population canadienne s’accompagne d’un accroissement du fardeau que représente l’insuffisance cardiaque (IC), affection associée à un taux de morbidité et de mortalité important ainsi qu’à un recours fréquent aux services de santé. Méthodologie Nous avons extrait les données de la base de données du Resident Assessment Instrument-Home Care (RAI-HC) de l’Ontario pour tous les clients bénéficiant de soins à domicile de longue durée et âgés de 65 ans et plus, afin 1) de décrire les caractéristiques démographiques et cliniques des clients de soins à domicile souffrant d’insuffisance cardiaque et 2) d’examiner le recours aux services de santé par les clients de soins à domicile souffrant d’insuffisance cardiaque. Résultats Par rapport aux autres clients de soins à domicile, ceux qui souffrent d’insuffisance cardiaque présentent un état de santé plus instable, consomment davantage de médicaments, affichent un taux plus élevé de comorbidité et ont besoin d’un volume significativement plus élevé de soins infirmiers, ainsi que de services ménagers et culinaires. Ils sont hospitalisés plus fréquemment et font un usage significativement plus élevé des services d’urgence et des soins de première urgence. Analyse Les clients souffrant d’insuffisance cardiaque constituent un groupe plus complexe que les clients des soins à domicile en général. La manière dont les patients prennent en main leur santé doit être adaptée à leurs caractéristiques cliniques, à leurs schémas habituels d’utilisation des services et aux obstacles auxquels ils doivent faire face. Ce constat est particulièrement vrai chez les patients plus âgés, frêles et au profil médical complexe qui souffrent d’insuffisance cardiaque, et ils sont nombreux parmi ceux qui requièrent des services à domicile. Cette étude peut servir d’assise à des initiatives de base permettant d’aider ces clients aux besoins particulièrement grands à gérer leur insuffisance cardiaque à domicile grâce à de l’aide et à des services adaptés.

scholarly journals Impact of the Outbreak of the COVID-19 Pandemic on Formal and Informal Care of Community-Dwelling Older Adults: Cross-National Clustering of Empirical Evidence from 23 Countries

2021 ◽  
Vol 13 (13) ◽  
pp. 7277
Author(s):  
Aviad Tur-Sinai ◽  
Netta Bentur ◽  
Paolo Fabbietti ◽  
Giovanni Lamura
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Informal Care ◽  
Home Care Services ◽  
Community Dwelling ◽  
European Countries ◽  
Care Services ◽  
The Impact ◽  
Community Dwelling Older Adults ◽  
Informal Help

The COVID-19 pandemic has been dramatically affecting the life of older adults with care needs and their family caregivers. This study illustrates how the initial outbreak of the pandemic changed the supply of formal and informal care to older adults in European countries and Israel and assesses the resilience of these countries in providing support to their older populations by means of a mix of both types of care. We subjected data from the Survey of Health, Ageing and Retirement in Europe COVID-19 period (SHARE-COVID-19) across 23 European countries (including Israel) to descriptive and cluster analyses. In the first wave of the outbreak, a significant proportion of older adults in European countries received informal help, with an increase in the frequency of informal help received from children, neighbors, friends, or colleagues and a decrease in that received from other relatives. In most countries, difficulties in receiving home care services from professional providers were reported. Seven clusters were identified, reflecting different combinations of changes in the formal/informal care provision. In most countries, informal care is more resilient than home care services that formal providers deliver. Since they are an essential source for sustainable care, their challenges related to care should be addressed. The impact of the pandemic does not follow the traditional characterization of welfare regimes. A clustering effort may yield more understanding of the priorities that future care policies should exhibit at the national level and may identify potential systems for policymakers to enhance sustainability of care for community-dwelling older adults.

Swallowing disorders and 1-year functional decline in community-dwelling older adults receiving home care

2017 ◽  
Vol 44 (12) ◽  
pp. 982-987 ◽  
Author(s):  
K. Takeuchi ◽  
M. Furuta ◽  
Y. Okabe ◽  
S. Suma ◽  
T. Takeshita ◽  
...  
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Functional Decline ◽  
Swallowing Disorders ◽  
Community Dwelling ◽  
Community Dwelling Older Adults

scholarly journals Physical Activity Level Following Resistance Training in Community-Dwelling Older Adults Receiving Home Care: Results from a Cluster-Randomized Controlled Trial

2021 ◽  
Vol 18 (13) ◽  
pp. 6682
Author(s):  
Hilde Bremseth Bårdstu ◽  
Vidar Andersen ◽  
Marius Steiro Fimland ◽  
Lene Aasdahl ◽  
Hilde Lohne-Seiler ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Resistance Training ◽  
Home Care ◽  
Community Dwelling ◽  
Activity Level ◽  
Group Differences ◽  
Control Group ◽  
Cluster Randomized ◽  
Community Dwelling Older Adults

Older adults’ physical activity (PA) is low. We examined whether eight months of resistance training increased PA level in community-dwelling older adults receiving home care. A two-armed cluster-randomized trial using parallel groups was conducted. The included participants were >70 years and received home care. The resistance training group performed resistance training using body weight, elastic bands, and water canes twice per week for eight months. The control group was informed about the national PA guidelines and received motivational talks. The ActiGraph GT3X+ accelerometer was used to estimate PA. Outcomes included total PA (counts per minute), sedentary behavior (min/day), light PA (min/day), moderate-to-vigorous PA (min/day), and steps (mean/day). Between-group differences were analyzed using multilevel linear mixed models. Twelve clusters were randomized to either resistance training (7 clusters, 60 participants) or the control group (5 clusters, 44 participants). A total of 101 participants (median age 86.0 (interquartile range 80–90) years) had valid accelerometer data and were included in the analysis. There were no statistically significant between-group differences for any of the PA outcomes after four or eight months. This study offers no evidence of increased PA level following resistance training in older adults with home care.

scholarly journals Multisensory integration involved in the body perception of community-dwelling older adults

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
M. Hide ◽  
Y. Ito ◽  
N. Kuroda ◽  
M. Kanda ◽  
W. Teramoto
Keyword(s):  
Older Adults ◽  
Multisensory Integration ◽  
Fall Risk ◽  
Community Dwelling ◽  
The Body ◽  
Risk Of Falling ◽  
Body Perception ◽  
Rubber Hand ◽  
Timed Up And Go ◽  
Community Dwelling Older Adults

AbstractThis study investigates how the multisensory integration in body perception changes with increasing age, and whether it is associated with older adults’ risk of falling. For this, the rubber hand illusion (RHI) and rubber foot illusion (RFI) were used. Twenty-eight community-dwelling older adults and 25 university students were recruited. They viewed a rubber hand or foot that was stimulated in synchrony or asynchrony with their own hidden hand or foot. The illusion was assessed by using a questionnaire, and measuring the proprioceptive drift and latency. The Timed Up and Go Test was used to classify the older adults into lower and higher fall-risk groups. No difference was observed in the RHI between the younger and older adults. However, several differences were observed in the RFI. Specifically, the older adults with a lower fall-risk hardly experienced the illusion, whereas those with a higher fall-risk experienced it with a shorter latency and no weaker than the younger adults. These results suggest that in older adults, the mechanism of multisensory integration for constructing body perception can change depending on the stimulated body parts, and that the risk of falling is associated with multisensory integration.

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