scholarly journals Sensitivity to Change and Responsiveness of Four Balance Measures for Community-Dwelling Older Adults

2012 ◽  
Vol 92 (3) ◽  
pp. 388-397 ◽  
Author(s):  
Poonam K. Pardasaney ◽  
Nancy K. Latham ◽  
Alan M. Jette ◽  
Robert C. Wagenaar ◽  
Pengsheng Ni ◽  
...  
Keyword(s):  
Older Adults ◽  
Elderly People ◽  
Functional Limitations ◽  
Total Sample ◽  
Functional Independence ◽  
Community Dwelling ◽  
Sensitivity To Change ◽  
Ceiling Effects ◽  
Low Sensitivity ◽  
Community Dwelling Older Adults

BackgroundImpaired balance has a significant negative impact on mobility, functional independence, and fall risk in older adults. Although several, well-respected balance measures are currently in use, there is limited evidence regarding the most appropriate measure to assess change in community-dwelling older adults.ObjectiveThe aim of this study was to compare floor and ceiling effects, sensitivity to change, and responsiveness across the following balance measures in community-dwelling elderly people with functional limitations: Berg Balance Scale (BBS), Performance-Oriented Mobility Assessment total scale (POMA-T), POMA balance subscale (POMA-B), and Dynamic Gait Index (DGI).DesignRetrospective data from a 16-week exercise trial were used. Secondary analyses were conducted on the total sample and by subgroups of baseline functional limitation or baseline balance scores.MethodsParticipants were 111 community-dwelling older adults 65 years of age or older, with functional limitations. Sensitivity to change was assessed using effect size, standardized response mean, and paired t tests. Responsiveness was assessed using minimally important difference (MID) estimates.ResultsNo floor effects were noted. Ceiling effects were observed on all measures, including in people with moderate to severe functional limitations. The POMA-T, POMA-B, and DGI showed significantly larger ceiling effects compared with the BBS. All measures had low sensitivity to change in total sample analyses. Subgroup analyses revealed significantly better sensitivity to change in people with lower compared with higher baseline balance scores. Although both the total sample and lower baseline balance subgroups showed statistically significant improvement from baseline to 16 weeks on all measures, only the lower balance subgroup showed change scores that consistently exceeded corresponding MID estimates.LimitationsThis study was limited to comparing 4 measures of balance, and anchor-based methods for assessing MID could not be reported.ConclusionsImportant limitations, including ceiling effects and relatively low sensitivity to change and responsiveness, were noted across all balance measures, highlighting their limited utility across the full spectrum of the community-dwelling elderly population. New, more challenging measures are needed for better discrimination of balance ability in community-dwelling elderly people at higher functional levels.

scholarly journals Validation of the German Life-Space Assessment (LSA-D): cross-sectional validation study in urban and rural community-dwelling older adults

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e049926
Author(s):  
Sandra Angelika Mümken ◽  
Paul Gellert ◽  
Malte Stollwerck ◽  
Julie Lorraine O'Sullivan ◽  
Joern Kiselev
Keyword(s):  
Older Adults ◽  
Construct Validity ◽  
Outcome Measures ◽  
Total Sample ◽  
Community Dwelling ◽  
Secondary Outcome ◽  
Life Space ◽  
Cross Sectional ◽  
The Past ◽  
Community Dwelling Older Adults

ObjectivesTo develop a German version of the original University of Alabama at Birmingham Study of Aging Life-Space Assessment (LSA-D) for measurement of community mobility in older adults within the past 4 weeks and to evaluate its construct validity for urban and rural populations of older adults.DesignCross-sectional validation study.SettingTwo study centres in urban and rural German outpatient hospital settings.ParticipantsIn total, N=83 community-dwelling older adults were recruited (n=40 from urban and n=43 from rural areas; mean age was 78.5 years (SD=5.4); 49.4% men).Primary and secondary outcome measuresThe final version of the translated LSA-D was related to limitations in activities and instrumental activities of daily living (ADL/iADL) as primary outcome measure (primary hypothesis); and with sociodemographic factors, functional mobility, self-rated health, balance confidence and history of falls as secondary outcome measures to obtain construct validity. Further descriptive measurements of health included hand grip strength, screening of cognitive function, comorbidities and use of transportation. To assess construct validity, correlations between LSA-D and the primary and secondary outcome measures were examined for the total sample, and urban and rural subsamples using bivariate regression and multiple adjusted regression models. Descriptive analyses of LSA-D included different scoring methods for each region. All parameters were estimated using non-parametric bootstrapping procedure.ResultsIn the multiple adjusted model for the total sample, number of ADL/iADL limitations (β=−0.26; 95% CI=−0.42 to −0.08), Timed Up and Go Test (β=−0.37; 95% CI=−0.68 to −0.14), shared living arrangements (β=0.22; 95% CI=0.01 to 0.44) and history of falls in the past 6 months (β=−0.22; 95% CI=−0.41 to −0.05) showed significant associations with the LSA-D composite score, while living in urban area (β=−0.19; 95% CI=−0.42 to 0.03) and male gender (β=0.15; 95% CI=−0.04 to 0.35) were not significant.ConclusionThe LSA-D is a valid tool for measuring life-space mobility in German community-dwelling older adults within the past 4 weeks in ambulant urban and rural settings.Trial registration numberDRKS00019023.

scholarly journals Digital Health Interventions for Healthy Aging: A Qualitative User Evaluation and Ethical Assessment

2020 ◽  
Author(s):  
Marcello Ienca ◽  
Christophe Schneble ◽  
Reto Kressig ◽  
Tenzin Wangmo
Keyword(s):  
Older Adults ◽  
Older People ◽  
Healthy Aging ◽  
Ethical Issues ◽  
Digital Health ◽  
Functional Independence ◽  
Community Dwelling ◽  
Healthy Ageing ◽  
Health Technologies ◽  
Community Dwelling Older Adults

Abstract BackgroundDigital health technologies are being increasingly developed with the aim of allowing older adults to maintain functional independence throughout the old age, a process known as healthy ageing. Such digital health technologies for healthy ageing are expected to mitigate the socio-economic effects of population ageing and improve the quality of life of older people. However, little is known regarding the views and needs of older people regarding these technologies. AimThe aim of this study is to explore the views, needs and perceptions of community-dwelling older adults regarding the use of digital health technologies for healthy ageing. MethodFace-to-face, in-depth qualitative interviews were conducted with community-dwelling older adults (median age 79.6 years). The interview process involved both abstract reflections and practical demonstrations. The interviews were transcribed verbatim and analyzed according to inductive content analysis. ResultsThree main themes and twelve sub-themes emerged. The three main themes revolved around the following thematic areas: favorable views and perceptions on technology-assisted living, usability evaluations and ethical considerations. ConclusionsOur study reveals a generally positive attitude towards digital health technologies as participants believed digital tools could positively contribute to improving their overall wellbeing, especially if designed in a patient-centered manner. Safety concerns and ethical issues related to privacy, empowerment and lack of human contact also emerged as key considerations.

scholarly journals Older Adults—Potential Users of Technologies

Medicina ◽  
2019 ◽  
Vol 55 (6) ◽  
pp. 253 ◽  
Author(s):  
Vita Lesauskaitė ◽  
Gytė Damulevičienė ◽  
Jurgita Knašienė ◽  
Egidijus Kazanavičius ◽  
Agnius Liutkevičius ◽  
...  
Keyword(s):  
Older Adults ◽  
Technology Use ◽  
Positive Attitude ◽  
New Technologies ◽  
Functional Independence ◽  
Community Dwelling ◽  
University Education ◽  
The Internet ◽  
Ageing In Place ◽  
Community Dwelling Older Adults

Background and objective: The successful adoption of technology is becoming increasingly important to functional independence and successful ageing in place. A better understanding of technology usage amongst older people may help to direct future interventions aimed at improving their healthcare. We aimed to obtain the first data regarding technology use, including gerontechnologies, represented by fall detectors, from older adults in Lithuania. Material and methods: The research was carried out in the framework of the project Smart Gerontechnology for Healthy Ageing, which involved assessing the use of technologies and the readiness to use gerontechnologies, as represented by fall detectors. A total of 375 individuals that were more than 60 years of age were enrolled in the study. The self-reporting questionnaires were completed by geriatric in-patients, hospitalized in the geriatric department, and also by community-dwelling older adults. Results: Geriatric in-patients’ use of computers and the internet was associated with age (every year of age decreased the probability of computer and internet use by 0.9-times) and a positive attitude towards new technologies—this predictor increased the use of a computer by six-times in comparison with people who did not have such an attitude. Sex and education had no influence on computer use for geriatric in-patients. For community-dwelling older adults, the use of computers and internet was associated with age, education (a university education increased the use of computers and the internet by four times), and a positive attitude towards technologies. Conclusions: Lithuanian older women in the study used computers, the internet, and cell phones equally with men. Increasing age was a strong negative predictor of technology use. A positive attitude to new technologies was a strong positive predictor of technology use. Most geriatric patients and community-dwelling older adults were ready to use technologies that permit ageing in place.

P3-102: ApoE-e4 allele status is associated with functional limitations in community-dwelling older adults

2015 ◽  
Vol 11 (7S_Part_14) ◽  
pp. P659-P659 ◽  
Author(s):  
Cutter A. Lindbergh ◽  
Antonio N. Puente ◽  
James MacKillop ◽  
Carlos Faraco ◽  
Courtney Brown ◽  
...  
Keyword(s):  
Older Adults ◽  
Functional Limitations ◽  
Community Dwelling ◽  
Allele Status ◽  
E4 Allele ◽  
Community Dwelling Older Adults

scholarly journals Relationship Between Dynamic Balance Measures and Functional Performance in Community-Dwelling Elderly People

2010 ◽  
Vol 90 (5) ◽  
pp. 748-760 ◽  
Author(s):  
Ankur Desai ◽  
Valerie Goodman ◽  
Naaz Kapadia ◽  
Barbara L. Shay ◽  
Tony Szturm
Keyword(s):  
Older Adults ◽  
Elderly People ◽  
Dynamic Balance ◽  
Community Dwelling ◽  
Standing Balance ◽  
Self Report ◽  
Clinical Test ◽  
Balance Assessment ◽  
Test Protocol ◽  
Community Dwelling Older Adults

BackgroundPoor balance control, mobility restrictions, and fall injuries are serious problems for many older adults.ObjectiveThe purpose of this study was to evaluate a new dynamic standing balance assessment test for identifying individuals at risk for falling in a group of community-dwelling older adults.DesignThis was a cross-sectional observational study of 72 community-dwelling older adults who were receiving rehabilitation in a geriatric day hospital.MethodA Dynamic Balance Assessment (DBA) test protocol was developed based on the concept of the Sensory Organization Test and the Clinical Test of Sensory Interaction and Balance. The DBA consists of 6 tasks performed on a normal floor surface and repeated on a sponge surface. A flexible pressure mat was used to record the foot's center of pressure (COP) on both surfaces, and loss of balance was recorded. Balance performance also was evaluated using the Berg Balance Scale, the Timed “Up & Go” Test, gait speed, and the Six-Minute Walk Test. Participants were classified as “fallers” or “nonfallers” based on a self-report.ResultsNo significant differences were noted between the faller group (n=47) and the nonfaller group (n=25) for demographic variables or medications. The DBA composite scores, which were derived from analysis of COP excursions of the 6 tasks performed on the sponge surface, were able to distinguish between fallers and nonfallers. Of the clinical tests, only the Timed “Up & Go” Test was able to differentiate between the faller and nonfaller groups.LimitationsA prospective study is needed to confirm the current findings and to expand testing to a larger and more diverse sample.ConclusionsThe findings indicate that analysis of the extent and amount of COP displacements during selected tasks and under different surface conditions is an appropriate method to assess dynamic standing balance controls and can discriminate between fallers and nonfallers among community-dwelling elderly people.

scholarly journals Effects of Community-Based Physical-Cognitive Training, Health Education, and Reablement among Rural Community-Dwelling Older Adults with Mobility Deficits

2021 ◽  
Vol 18 (17) ◽  
pp. 9374
Author(s):  
Chen-Yi Song ◽  
Pay-Shin Lin ◽  
Pei-Lun Hung ◽  
Keyword(s):  
Older Adults ◽  
Health Education ◽  
Cognitive Training ◽  
Rural Community ◽  
Functional Independence ◽  
Performance Measure ◽  
Community Dwelling ◽  
Control Group ◽  
Community Based ◽  
Community Dwelling Older Adults

Reablement services are approaches for maintaining and improving the functional independence of older adults. Previous reablement studies were conducted in a home environment. Due to the limited evidence on the effects of multicomponent interventions and reablement in a community-based context, this study aimed to develop and evaluate the effect of community-based physical–cognitive training, health education, and reablement (PCHER) among rural community-dwelling older adults with mobility deficits. The trial was conducted in rural areas of New Taipei City, Taiwan. Older adults with mild to moderate mobility deficits were recruited from six adult daycare centers, and a cluster assignment was applied in a counterbalanced order. The experimental group (n = 16) received a PCHER intervention, comprising 1.5 h of group courses and 1 h of individualized reablement training, while the control group (n = 12) underwent PCHE intervention, comprising 1.5 h of group courses and 1 h of placebo treatment. A 2.5-h training session was completed weekly for 10 weeks. The outcome measures contained the de Morton Mobility Index (DEMMI), the Saint Louis University Mental Status (SLUMS) Examination, the Barthel Index (BI), the Short Physical Performance Battery (SPPB), and the Canadian Occupational Performance Measure (COPM). The PCHER significantly improved the DEMMI, SLUMS, BI, SPPB, and COPM (all p < 0.05), with medium-to-large effect sizes. PCHER also showed an advantage over PCHE in terms of the SPPB (p = 0.02). This study verified that combining individualized reablement with group-based multicomponent training was superior to group courses alone in enhancing the functional abilities of community-dwelling older adults with mobility deficits.

scholarly journals Incidence of and Risk Factors for Falls Following Hip Fracture in Community-dwelling Older Adults

2005 ◽  
Vol 85 (7) ◽  
pp. 648-655 ◽  
Author(s):  
Anne Shumway-Cook ◽  
Marcia A Ciol ◽  
William Gruber ◽  
Cynthia Robinson
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Hip Fracture ◽  
Functional Status ◽  
Functional Independence ◽  
Medical Problem ◽  
Community Dwelling ◽  
Self Report ◽  
Risk Factors For Falls ◽  
Community Dwelling Older Adults

Abstract Background and Purpose. Hip fracture is a major medical problem among older adults, leading to impaired balance and gait and loss of functional independence. The purpose of this study was to determine the incidence of and risk factors for falls 6 months following hospital discharge for a fall-related hip fracture in older adults. Subjects. Ninety of 100 community-dwelling older adults (≥65 years of age) hospitalized for a fall-related hip fracture provided data for this study. Methods. An observational cohort study used interviews and medical records to obtain information on demographics, prefracture health, falls, and functional status. Self-report of falls and performance-based measures of balance and mobility were completed 6 months after discharge. Results. A total of 53.3% of patients (48/90) reported 1 or more falls in the 6 months after hospitalization. Older adults who fell following discharge had greater declines in independence in activities of daily living and lower performance on balance and mobility measures. Prefracture fall history and use of a gait device predicted postdischarge falls. Discussion and Conclusion. Falls following hip fracture can be predicted by premorbid functional status.

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