Relationship between subjective fall risk assessment and falls and fall-related fractures in frail elderly people

Abstract

BackgroundObjective measurements can be used to identify people with risks of falls, but many frail elderly adults cannot complete physical performance tests. The study examined the relationship between a subjective risk rating of specific tasks (SRRST) to screen for fall risks and falls and fall-related fractures in frail elderly people.MethodsThe SRRST was investigated in 5,062 individuals aged 65 years or older who were utilized day-care services. The SRRST comprised 7 dichotomous questions to screen for fall risks during movements and behaviours such as walking, transferring, and wandering. The history of falls and fall-related fractures during the previous year was reported by participants or determined from an interview with the participant's family and care staff.ResultsAll SRRST items showed significant differences between the participants with and without falls and fall-related fractures. In multiple logistic regression analysis adjusted for age, sex, diseases, and behavioural variables, the SRRST score was independently associated with history of falls and fractures. Odds ratios for those in the high-risk SRRST group (≥ 5 points) compared with the no risk SRRST group (0 point) were 6.15 (p < 0.01) for a single fall, 15.04 (p < 0.01) for recurrent falls, and 5.05 (p < 0.01) for fall-related fractures. The results remained essentially unchanged in subgroup analysis accounting for locomotion status.ConclusionThese results suggest that subjective ratings by care staff can be utilized to determine the risks of falls and fall-related fractures in the frail elderly, however, these preliminary results require confirmation in further prospective research.

Association Between Short Physical Performance Battery and Falls in Older People: The Progetto Veneto Anziani Study

“…Participants' characteristics according to the SPPB score categories (poor performers scoring 0-6, moderate performers scoring 7-9, and good performers scoring [10][11][12] are shown in Tables 1a and 1b, for women and men, respectively. In both genders, participants in the lowest SPPB score category were significantly older than those in the group with the highest scores ( p for trend < 0.001).…”

“…The study sample consisted of 2710 community-dwelling elderly subjects, comprising 1594 women aged 75.1 years (-7.2; range 65-97 years) with a mean SPPB score of 7.79 -3.22 (range, 1-12) and 1116 men aged 75.8 years (-7.6; range, 65-97) with a mean SPPB score of 9.03 (-3.12; range, [1][2][3][4][5][6][7][8][9][10][11][12]. The proportion of these individuals reporting at least one fall over the previous year was 32.5% among women and 22.2% among men (chi-squared test, p < 0.001).…”

“…5,6 Older people are characterized by a higher incidence of falling compared to adults and a high susceptibility to injury, 7 leading to an increasing need to identify individuals at higher risk of falling repeatedly as soon as possible to take appropriate fall prevention measures and thereby prevent or delay the onset of disability. 7,8 It is well known that balance disorders and weakness in the lower limbs are associated with recurrent falls in old people, 9,10 and several studies have confirmed that poor physical performance increases the risk of falling. People who experience recurrent falls also do not perform well in the tests commonly used to assess motor function.…”

Cluster Analysis of Center-of-Pressure Measures

“…Falls and fall associated fractures are the major cause of disability in seniors (Shimada et al, 2011). Early intervention can help to mitigate the risk of falling, and related health and social issues (Shimada et al, 2011). All this motivates researchers and clinicians to develop new ways to understand and quantify postural stability.…”

“…There are many additional age-associated factors contributing to a decline in stability, such as balance or gait disorders (Lord, Menz, & Tiedemann, 2003), and cognitive impairments, particularly a misperception of orientation (Jensen, Nyberg, Gustafson, & Lundin-Olsson, 2003). Falls and fall associated fractures are the major cause of disability in seniors (Shimada et al, 2011). Early intervention can help to mitigate the risk of falling, and related health and social issues (Shimada et al, 2011).…”