Association between Physical Functionality and Falls Risk in Community-Living Older Adults

Abstract

Ageing-related declines in physiological attributes, such as muscle strength, can bring with them an increased risk of falls and subsequently greater risk of losing independence. These declines have substantial impact on an individual's functional ability. However, the precise relationship between falls risk and physical functionality has not been evaluated. The aims of this study were to determine the association between falls risk and physical functionality using objective measures and to create an appropriate model to explain variance in falls risk. Thirty-two independently living adults aged 65–92 years completed the FallScreen, the Continuous-Scale Physical Functional Performance 10 (CS-PFP10) tests, and the 12-Item Short-Form Health Survey (SF-12). The relationships between falls risk, physical functionality, and age were investigated using correlational and multiple hierarchical regression analyses. Overall, total physical functionality accounted for 24% of variance in an individual's falls risk while age explained a further 13%. The oldest-old age group had significantly greater falls risk and significantly lower physical functional performance. Mean scores for all measures showed that there were substantial (but not significant) differences between males and females. While increasing age is the strongest single predictor of increasing falls risk, poorer physical functionality was strongly, independently related to greater falls risk.

Risk factors of indoor fall injuries in community-dwelling older women: A prospective cohort study

“…It is also reported that medical conditions (e.g., cancer, diabetes, heart disease) and their risk factors (e.g., smoking, alcohol drinking) are known to be associated with fall risk (Gunn, Creanor, Haas, Marsden, & Freeman, 2013;Kannus, Sievanen, Palvanen, Jä rvinen, & Parkkari, 2005;Pang & Eng, 2008;Stone, Lawlor, Savva, Bennett, & Kenny, 2012). Additionally, functional impairments (e.g., limitations in activities of daily living [ADL]) and physical limitations (e.g., bending knees) generally increase fall risks because these limitations translate into additional burdens on regular everyday activities (Farrell, Rutt, Lusardi, & Williams, 2011;Kwan, Lin, Chen, Close, & Lord, 2011;Smee, Anson, Waddington, & Berry, 2012;Yamashita, Noe, & Bailer, 2012). Environmental hazards also play an important role in the context of falls because some risk factors such as functional limitations may be influenced by individuals' living environments (Clemson, Mackenzie, Ballinger, Close, & Cumming, 2008;Iwarsson, Horstmann, Carlsson, Oswald, & Wahl, 2009).…”

A Balance-Specific Exercise Intervention Improves Falls Risk but not Total Physical Functionality in Community-Dwelling Older Adults

“…It has previously been demonstrated that falls risk and physical functionality are related but distinct (Smee et al, 2012) and, as such, the tools used to assess these must be appropriate to the testing domain and be able to detect change. Due to the large range of falls risk and physical functionality assessment tools available to the clinician, it is often difficult to identify the most appropriate tool.…”

“…As physical functionality and falls risk have overlapping characteristics such as leg strength, balance, and endurance (Smee et al, 2012) from a research and clinical perspective, it is important that the measurement tools used can discriminate between the two and evaluate any specific changes resulting from an intervention. This study aims to investigate whether a simple balance-specific exercise program can simultaneously improve physical function and reduce falls risk.…”

Assessment of an interactive voice response system for identifying falls in a statewide sample of older adults

“…Instead, we opted for a measure of convergent validity, seeking to determine if reports of falls elicited in the monthly IVR interviews were related to (i) self-reports of balance elicited at baseline, since self-reported balance is a strong predictor of incident falls (Tinetti, Richman, Powell 1990; Rubenstein, Vivrette, Harker, Stevens, Kramer 2013), and (ii) lower extremity strength and balance performance, which are also a strong predictor of falls (Fukagawa, Wolfson, Judge, Whipple, King 1995; Smee, Anson, Waddington, Berry 2012; Karlsson et al, 2012). …”