Mismatch of Subjective and Objective Risk of Falling in Patients with Dementia

2020 ◽  
Vol 78 (2) ◽  
pp. 557-572
Author(s):  
Klaus Hauer ◽  
Michael Schwenk ◽  
Stefan Englert ◽  
Rixt Zijlstra ◽  
Sabine Tuerner ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Fall Risk ◽  
Psychological Status ◽  
Risk Of Falling ◽  
Activity Avoidance ◽  
Mobility Assessment ◽  
Moderate Dementia ◽  
Objective Risk ◽  
Support Seeking

Background: Match or mismatch of objective physiological and subjectively perceived fall risk may have serious consequences in patients with dementia (PwD) while research is lacking. Objective: To analyze mismatch of objective and subjective fall risk and associated factors in PwD. Method: Cohort study in a geriatric rehabilitation center. Objective and subjective risk of falling were operationalized by Tinetti’s Performance Oriented Mobility Assessment and the Falls Efficacy Scale-International. Four sub-groups according to objective and subjective fall risk were classified. Subgroups were compared for differences in clinical, cognitive, psychological, and behavioral variables. Results: In geriatric rehab patients with mild to moderate dementia (n = 173), two-thirds showed a mismatch of subjective versus objective risk of falling, independently associated with previous falls. Underestimation of objective fall risk (37.6%) was determined by lower activity avoidance (OR 0.39), less concerns about falling due to previous falls (OR 0.25), and higher quality of life (OR 1.10), while overestimation (28.9%) was determined by higher rate of support seeking strategies (OR 50.3), activity avoidance (OR 15.2), better executive (OR 21.0) and memory functions (OR 21.5), and lower quality of life (OR.75) in multivariate logistic regression. Conclusion: The majority of patients showed a mismatch between objective and subjective falls risk. Underestimation as well as overestimation of fall risk was associated with specific profiles based on cognitive- and psychological status, falls and fall-related behavioral consequences which should be included in the comprehensive assessment of fall risk, and planning of individualized fall prevention programs for this population.

Health-related quality of life in relation to mobility and fall risk in 85-year-old people: a population study in Sweden

2015 ◽  
Vol 36 (9) ◽  
pp. 1982-1997 ◽  
Author(s):  
EVA TÖRNVALL ◽  
JAN MARCUSSON ◽  
EWA WRESSLE
Keyword(s):  
Quality Of Life ◽  
Body Mass Index ◽  
Fall Risk ◽  
Health Related Quality ◽  
Risk Of Falling ◽  
Old People ◽  
Related Quality ◽  
Health Related ◽  
Lower Hrqol

ABSTRACTOptimal mobility is fundamental for healthy ageing and quality of life. This study is part of a cross-sectional population-based study of 85-year-old people residing in Linköping municipality, Sweden. The purpose was to describe 85-year-old peoples' health-related quality of life (HRQoL) in relation to mobility and fall risk while adjusting for gender and body mass index. Data collection included a postal questionnaire, a home visit and a reception visit. HRQoL was assessed with EQ-5D-3L, mobility with the Timed Up and Go test (TUG) and fall risk with the Downton Fall Risk Index (DFRI). All those who completed the DFRI, TUG and EQ-5D-3L were included in the present study (N = 327). Lower HRQoL was associated with longer time taken to complete TUG and higher fall risk in both genders but not with body mass index. Women had higher risk of falling, took a longer time to complete TUG and reported less physical activity compared with men. Health-care professionals should address mobility capacity and fall risk in order to maintain quality of life in elderly people. This is of utmost importance, especially for elderly women because impaired mobility, high risk of falling and occurrence of pain are common among women, and related to lower HRQoL.

scholarly journals Usability of a Fall Risk mHealth App for People With Multiple Sclerosis: Mixed Methods Study

10.2196/25604 ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e25604 ◽  
Author(s):  
Katherine Hsieh ◽  
Jason Fanning ◽  
Mikaela Frechette ◽  
Jacob Sosnoff
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Risk Score ◽  
Fall Risk ◽  
Risk Of Falling ◽  
System Usability Scale ◽  
System Usability ◽  
Mhealth Apps ◽  
User Centered

Background Multiple sclerosis (MS) is a chronic, neurodegenerative disease that causes a range of motor, sensory, and cognitive symptoms. Due to these symptoms, people with MS are at a high risk for falls, fall-related injuries, and reductions in quality of life. There is no cure for MS, and managing symptoms and disease progression is important to maintain a high quality of life. Mobile health (mHealth) apps are commonly used by people with MS to help manage their health. However, there are limited health apps for people with MS designed to evaluate fall risk. A fall risk app can increase access to fall risk assessments and improve self-management. When designing mHealth apps, a user-centered approach is critical for improving use and adoption. Objective The purpose of this study is to undergo a user-centered approach to test and refine the usability of the app through an iterative design process. Methods The fall risk app Steady-MS is an extension of Steady, a fall risk app for older adults. Steady-MS consists of 2 components: a 25-item questionnaire about demographics and MS symptoms and 5 standing balance tasks. Data from the questionnaire and balance tasks were inputted into an algorithm to compute a fall risk score. Two iterations of semistructured interviews (n=5 participants per iteration) were performed to evaluate usability. People with MS used Steady-MS on a smartphone, thinking out loud. Interviews were recorded, transcribed, and developed into codes and themes. People with MS also completed the System Usability Scale. Results A total of 3 themes were identified: intuitive navigation, efficiency of use, and perceived value. Overall, the participants found Steady-MS efficient to use and useful to learn their fall risk score. There were challenges related to cognitive overload during the balance tasks. Modifications were made, and after the second iteration, people with MS reported that the app was intuitive and efficient. Average System Usability Scale scores were 95.5 in both iterations, representing excellent usability. Conclusions Steady-MS is the first mHealth app for people with MS to assess their overall risk of falling and is usable by a subset of people with MS. People with MS found Steady-MS to be usable and useful for understanding their risk of falling. When developing future mHealth apps for people with MS, it is important to prevent cognitive overload through simple and clear instructions and present scores that are understood and interpreted correctly through visuals and text. These findings underscore the importance of user-centered design and provide a foundation for the future development of tools to assess and prevent scalable falls for people with MS. Future steps include understanding the validity of the fall risk algorithm and evaluating the clinical utility of the app.

scholarly journals Contribution of the Built Environment towards Elderlies’ Quality of Life and Risk of Falling

2019 ◽  
Vol 4 (12) ◽  
pp. 101
Author(s):  
Nurul Liyana Hanapi ◽  
Sabarinah Sheikh Ahmad ◽  
Azli Abd Razak ◽  
Norhati Ibrahim
Keyword(s):  
Quality Of Life ◽  
Built Environment ◽  
Fall Risk ◽  
Publishing House ◽  
The Elderly ◽  
Risk Of Falling ◽  
International Publishing ◽  
Current Concerns ◽  
Open Access Article

Recent study trends on elderlies range from improving their quality of life to reducing the risk of falling. This paper investigates current concerns on the risk of any untoward fall or injury of elderly residents in public housing due to the rising number of the elderly population. This study aims to analyze published literature with a focus on finding a non-semantic relation on the built environment with the elderly quality of life and risk of falling. Results show that a pleasant environment could introduce social activities in which significantly improves the quality of life and reduce fall risk among the elderly population.Keywords: elderly; quality of life; fall risk; environment.eISSN: 2398-4287 © 2019. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open-access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.DOI: https://doi.org/10.21834/e-bpj.v4i12.1939

Problems and fall risk determinants of quality of life in older adults with increased risk of falling

2014 ◽  
Vol 15 (5) ◽  
pp. 579-587 ◽  
Author(s):  
Sang-I Lin ◽  
Ku-Chou Chang ◽  
Hsuei-Chen Lee ◽  
Yi-Ching Yang ◽  
Jau-Yih Tsauo
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Fall Risk ◽  
Risk Of Falling ◽  
Increased Risk ◽  
Risk Determinants

scholarly journals Possibility of Estimating the Risk of Falling at the Seat-Off Face While Rising Up from a Chair

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Hideo Hirai
Keyword(s):  
Quality Of Life ◽  
Motor Function ◽  
Fall Risk ◽  
Daily Life ◽  
The Elderly ◽  
Horizontal Distance ◽  
Risk Of Falling ◽  
The Stability ◽  
The Relationship

It is known that falls in the daily life of the elderly occur frequently during walking and rising up and greatly affect their quality of life. In the previous study we obtained the COG-heel horizontal distance and the COG horizontal velocity when the subjects performed rising up under the “fastest” or “slowest” velocity task. These seat-off parameters which were an indicator of the stability in rising from a chair were defined based on the relationship between them. In this experiment with healthy adults as subjects the seat-off parameters were found to become a different distribution because of the rising up strategies of each subject. Moreover, based on the relationship between the seat-off parameters and motor function, they could become an index expressing current fall risk and predicting future fall risk.

scholarly journals Usability of a Fall Risk Mobile Health Application for People with Multiple Sclerosis (Preprint)

2020 ◽  
Author(s):  
Katherine Hsieh ◽  
Jason Fanning ◽  
Mikaela Frechette ◽  
Jacob Sosnoff
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Risk Score ◽  
Mobile Health ◽  
Fall Risk ◽  
Risk Of Falling ◽  
Health Apps ◽  
System Usability Scale ◽  
Cognitive Overload

BACKGROUND Multiple Sclerosis (MS) is a chronic, neurogenerative disease that causes a range of motor, sensory, and cognitive symptoms. Because of these symptoms, people with MS (pwMS) are at a high risk for falls, fall related injuries, and reductions in quality of life. There is no cure for MS, and managing symptoms and disease progression is important to maintain high quality of life. Mobile health applications (apps) are commonly used by people with MS (pwMS) to help manage their health. However, there are limited health apps for pwMS designed to evaluate fall risk. A fall risk app can increase access to fall risk assessment and improve self-management. When designing health apps, a user-centered approach is critical to improve usage and adoption. OBJECTIVE The purpose of this study was to develop a fall risk app for pwMS and to test the usability of the app through an iterative design process. METHODS The fall risk app, Steady-MS, consists of two components: a 25-item questionnaire about demographics and MS symptoms, and 5 standing balance tasks. Data from the questionnaire and balance tasks are inputted into an algorithm to compute a fall risk score. Two iterations of semi-structed interviews (n=5/iteration) were performed to evaluate usability. PwMS used Steady-MS on a smartphone, thinking their thoughts aloud. Interviews were recorded, transcribed, and developed into codes and themes. PwMS also completed the System Usability Scale (SUS). RESULTS Three themes were identified: 1) intuitive navigation; 2) efficiency of use; and 3) perceived value. Overall, participants found Steady-MS efficient to use and found it useful to learn their fall risk score. There were challenges related to cognitive overload during the balance tasks. Modifications were made, and after the second iteration, pwMS reported that the app was intuitive and efficient to use. Average SUS scores were 95.5 in both iterations, representing “excellent” usability. CONCLUSIONS Steady-MS is the first health app for pwMS asses their overall risk of falling and can help pwMS manage their fall risk. PwMS found Steady-MS to be usable and useful to understand their risk of falling. When developing future mobile health apps for pwMS, it is important to: 1) prevent cognitive overload through simple and clear instructions, and 2) present scores that are understood and interpreted correctly through visuals and text. These findings underscore the importance of user-center design and provide a foundation for the future development of scalable falls assessment and prevention tools for pwMS.

Assessment of the Therapeutic Effect of Physiotherapy on Minimizing Imbalances of Geriatric Patients

2020 ◽  
Vol 62 (2) ◽  
pp. 86-91
Author(s):  
Justyna Pawlak ◽  
Małgorzata Dudkiewicz ◽  
Łukasz Kikowski
Keyword(s):  
Quality Of Life ◽  
Therapeutic Effect ◽  
Body Mass ◽  
Geriatric Patients ◽  
The Elderly ◽  
Risk Of Falling ◽  
Increased Risk ◽  
Climbing Stairs ◽  
Tinetti Test

Introduction: The progressing aging process and comorbidities worsen the efficiency of the balance system in the elderly, which leads to a weakening of stability and, as a consequence, to falls and injuries. The first ones lead to: worsening of functioning, reduced mobility, an increased risk of disease and mortality, therefore systematic physical activity and shaping the balance using physiotherapy, which can prevent dangerous falls is very important. Aim: Assessment of the therapeutic effect of physiotherapy on minimizing imbalances in geriatric patients. M aterial and Methods: The study group consisted of 46 people, including 32 women (69.6%) and 14 men (30.4%); average age of respondents – 72.5 years. They were patients of the Department of Rehabilitation of Poddębice Health Center, Ltd. The researchers used a self-made questionnaire, body mass to height index (BMI) and the Tinetti Test. Results: Patients with an elevated BMI (89.1%), as well as those taking more than 4 medication (78.3%), have had more falls over the past year (respectively 91.4% and 81.4%). After the use of comprehensive therapy, none of the patients achieved a worse result than before the physiotherapy while 91.3% of the respondents had an increase in the number of points scored in the Tinetti Test. The percentage of patients at high risk of falling reduced from 67.4% to 37%. There was also a decrease in the fear of walking (in 58.7%), falling (in 57.7%) and climbing stairs (in 47.9%). According to 78.3% of respondents, physiotherapy positively affected their independence and quality of life. Conclusions: The use of comprehensive physiotherapy reduces the fear of walking, climbing stairs and falling, which can be a good predictor of prevention. Both polypragmasia and an elevated body mass index (BMI) increase the risk of falling. Comprehensive physiotherapy of geriatric patients helps to improve balance and gait stereotype. Physiotherapy for the elderly helps improve the quality of life, independence, minimize imbalances, and thus reduce the risk of falls. Balance exercises play an important role in preventing falls.

scholarly journals Fear of Falling, Recurrence of Falls, and Quality of Life in Patients with a Low Energy Fracture—Part II of an Observational Study

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 584
Author(s):  
Puck C. R. van der Vet ◽  
Jip Q. Kusen ◽  
Manuela Rohner-Spengler ◽  
Björn-Christian Link ◽  
Roderick M. Houwert ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Low Energy ◽  
Activity Levels ◽  
Activity Restriction ◽  
One Year ◽  
Falls In Elderly

Background and objective: Falls in elderly cause injury, mortality, and loss of independence, making Fear of Falling (FoF) a common health problem. FoF relates to activity restriction and increased fall risk. A voluntary intervention including fall risk assessment and prevention strategies was implemented to reduce falls in elderly patients with low energy fractures (LEF). The primary purpose of this study was to evaluate FoF and the number of subsequent falls in trauma patients one year after a LEF. The secondary aim was to examine how FoF affects patients’ lives in terms of Quality of Life (QoL), mobility, and activity levels. Finally, participation in the voluntary fall prevention program (FPP) was evaluated. Materials and Methods: Observational cohort study in one Swiss trauma center. LEF patients, treated between 2012 and 2015, were analyzed one year after injury. Primary outcomes were Falls-Efficacy Score-International (FES-I) and number of subsequent falls. Secondary outcomes were EuroQoL-5-Dimensions-3-Levels (EQ5D-3L), mobility, activity levels, and participation in the FPP. Subgroup analysis was performed for different age categories. Results: 411 patients were included for analysis. Mean age was 72 ± 9.3, mean FES-I was 21.1 ± 7.7. Forty percent experienced FoF. A significant negative correlation between FoF and QoL (R = 0.64; p < 0.001) was found. High FoF correlated with lower activity levels (R= −0.288; p < 0.001). Six percent visited the FPP. Conclusions: At follow-up, 40% suffered from FoF which seems to negatively affect patients’ QoL. Nevertheless, participation in the FPP was low. Simply informing patients about their susceptibility to falls and recommending participation in FPPs seems insufficient to motivate and recruit patients into FPPs. We suggest implementing repeated fall risk- and FoF screenings as standard procedures in the follow-up of LEF, especially in patients aged over 75 years.

Sign in / Sign up

Export Citation Format

Share Document