Change in Balance Confidence and Its Associations With Increasing Disability in Older Community-Dwelling Women at Risk for Falling

Talley, Kristine Mc; Wyman, Jean F.; Gross, Cynthia R.; Lindquist, Ruth; Gaugler, Joseph E.

doi:10.1177/0898264314526619

Cited by 19 publications

(20 citation statements)

References 44 publications

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“…This analysis was chosen to illustrate the statistical use of the FWF in SPRE for fall prevention in older adults because little statistical analytical work has been published which looks at prevalence and incidence of adults with fof together with those who have fallen. Even if, as Talley, et al (2014) suggested, fear of falling and having a fall are separate constructs, they can both be considered at the same time like fruit in a bowl by using FWF. This concept was first presented at the Joint Statistical Meeting by Weissman-Miller & Graham (2014).…”

Section: Pilot Studiesmentioning

confidence: 99%

“…Though prevalence of fof varied greatly due to measure variablity, a systemic review identified major fof risk factors as having a fall, being female, and aging adults (Scheffer, Schuurmans, van Dijk, van der Hooft, & de Rooij, 2008). Consequences of fof have been identified as falls, decreased fall-related self efficacy, and activity restriction/decreased quality of life (Jørstad et al, 2005;Scheffer et al, 2008;Talley, Wyman, Gross, Lindquist, & Gaugler, 2014;Tinetti et al, 1994;Tinetti, Richman, & Powell, 1990). As a result of its negative influence and impact on falls and function in older adults, those with fof should be addressed within fall prevention programming.…”

Section: Introduce the Problemmentioning

confidence: 99%

“…Why is this problem important? Falls, fear of falling and fall related self-efficacy should be considered as related yet separate behavioral constructs which can negatively impact older adults (Jørstad et al, 2005;Talley et al, 2014). As a result, many fall prevention programs address fallers, those at risk for falls and those with a fear of falling using the same content; however, related constructs are typically measured separately.…”

Section: Introduce the Problemmentioning

confidence: 99%

“…A recent study of fof over a two year period identified that new onset fof and fof changes over time may have different risk factors (Talley et al, 2014). The participants' baseline fof as measured by balance confidence using the Activities-specific Balance Confidence Scale (ABC) was independently associated with lower scores on the SF36 physical function and mental function scales while decreasing balance confidence over time (5% average decrease) was associated with worsening strength, balance, activity, and social network levels (Talley et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

“…The participants' baseline fof as measured by balance confidence using the Activities-specific Balance Confidence Scale (ABC) was independently associated with lower scores on the SF36 physical function and mental function scales while decreasing balance confidence over time (5% average decrease) was associated with worsening strength, balance, activity, and social network levels (Talley et al, 2014). These authors cautioned that "researchers including fear of falling as a secondary outcome in fall prevention trials need to make careful decisions about who to include in the study and how to measure fear of falling" (p. 630) due to conflicting construct definitions and variability in fof measures.…”

Section: Introductionmentioning

confidence: 99%

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Novel Scale Development for Fear of Falling and Falls: Analysed Using a Semiparametric Ratio Estimator (SPRE)

Weissman-Miller¹,

Graham²

2015

IJSP

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Fear of falling (fof) and falls are increasingly severe worldwide public health problems. The Falls Weight Function (FWF) uses a new scale to incorporate fear of falling (fof) into analyses with participants who have already experienced a fall. FWF is a weight function in the semiparametric ratio estimator (SPRE) to predict a change point and point estimations. FWF data is a discrete set of numbers that is finite or countable. In a study using Stepping On R ⃝ fall prevention program, initial data from fof responses were counted, summed as increments of .10 values (ranging from .1 to 1.0), and then multiplied by 1 fall. The un-weighted value of 1 fall was multiplied by the weight function for fof. Then, the scale of falls and fof is the same, and represented on a continuum from fear of falling to having a fall, so that all participants can be treated and analyzed together.

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Section: Pilot Studiesmentioning

confidence: 99%

Section: Introduce the Problemmentioning

confidence: 99%

Section: Introduce the Problemmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Novel Scale Development for Fear of Falling and Falls: Analysed Using a Semiparametric Ratio Estimator (SPRE)

Weissman-Miller¹,

Graham²

2015

IJSP

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The effects of a strong desire to void on gait for incontinent and continent older community‐dwelling women at risk of falls

Paquin

Duclos

Lapierre

et al. 2019

Neurourology and Urodynamics

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Aims: The fall rate in urgency urinary incontinence (UUI) and mixed UI (MUI) older women is higher when compared with that of continent women. One hypothesis is that a strong desire to void (SDV) could alter gait parameters and therefore increase the risk of falls. The aim of this study was to investigate and compare the effect of SDV on gait parameters in UUI/MUI and continent older women who experienced falls. The secondary aim was to determine the relationship between UI severity and gait parameters in incontinent women. Methods: A quasi-experimental pilot study was conducted with two groups of healthy community-dwelling women who experienced at least one fall in the last year: continent (n = 17; age: 74.1 ± 4.3) and UUI/MUI (n = 15; age: 73.5 ± 5.9). We recorded, analyzed, and compared spatiotemporal gait parameters for participants in each group with both SDV and no desire to void condition.Results: A pattern of reduced velocity (P = 0.05) and stride width (P = 0.02) was observed in both groups with SDV. Incontinence severity was correlated with reduced velocity (r s = −0.63, P = 0.01), increased stance time (r s = 0.65, P = .01) and stance time variability (r s = 0.65, P = .01) in no desire to void condition and with reduced velocity (r s = −0.56, P = .03) and increased stride length variability (r s = 0.54, P = .04) in SDV condition. Conclusions: SDV reduced gait velocity and stride width regardless of continence status in older women at risk of falls. Further, UI severity in the UUI/MUI women was correlated to reduced gait velocity and increased variability. Our findings could explain the higher fall rate in this population. K E Y W O R D Sbladder sensation, community-dwelling, elderly women, falls, spatiotemporal gait parameters, urgency, urinary incontinence

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Validity of the Falls Risk for Older People in the Community (FROP-Com) tool to predict falls and fall injuries for older people presenting to the emergency department after falling

2019

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The aims of this study were to (1) externally validate the accuracy of the Falls Risk for Older People-Community (FROP-Com) falls risk assessment tool in predicting falls, and (2) undertake initial validation of the accuracy of the FROP-Com to predict injurious falls (requiring medical attention) in people aged ≥60 years presenting to Emergency Departments (EDs) after falling. Two hundred and thirteen participants (mean age=72.4 years; 59.2% women) were recruited (control group of a randomised controlled trial). A FROP-Com assessment was completed at a home visit within two weeks of ED discharge. Data on falls and injurious falls requiring medical attention were collected via monthly falls calendars for the next 12-months. Predictive accuracy was evaluated using sensitivity and specificity of a high risk FROP-Com classification (score≥19) in predicting a fall, and injurious falls requiring medical attention. Fifty percent of participants fell, with 60.4% of falls requiring medical attention. Thirty-two percent were classified as high, 49% as moderate and 19% low falls risk. Low sensitivity was achieved for the FROP-Com high risk classification for predicting falls (43.4%) and injurious falls (34.4%), although specificity was high (79.4% and 78.6% respectively). Despite the FROP-Com's low predictive accuracy, the high fall rate and high falls risk of the sample suggest that older people who fall, present to ED and are discharged home are at high risk of future falls. In high falls risk populations such as in this study, the FROP-Com is not a valid tool for classifying risk of falls or injurious falls. Its potential value may instead be in identifying risk factors for falling to direct tailoring of falls prevention interventions to reduce future falls.

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Change in Balance Confidence and Its Associations With Increasing Disability in Older Community-Dwelling Women at Risk for Falling

Cited by 19 publications

References 44 publications

Novel Scale Development for Fear of Falling and Falls: Analysed Using a Semiparametric Ratio Estimator (SPRE)

Novel Scale Development for Fear of Falling and Falls: Analysed Using a Semiparametric Ratio Estimator (SPRE)

The effects of a strong desire to void on gait for incontinent and continent older community‐dwelling women at risk of falls

Validity of the Falls Risk for Older People in the Community (FROP-Com) tool to predict falls and fall injuries for older people presenting to the emergency department after falling

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