Fear of Falling and Cognitive Impairments in Elderly People with Hip Fractures

Kasai, Mari; Meguro, Kenichi; Ozawa, Hiroshi; Kumai, Keiichi; Imaizumi, Hideki; Minegishi, H; Oi, Hideki; Oizumi, Akira; Yamashiro, Masahiro; Matsuda, Michimasa; Tanaka, Masahiko; Itoi, Eiji

doi:10.1159/000480497

Cited by 16 publications

(12 citation statements)

References 22 publications

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“…The primary reasons for attrition in this study were: declining physical and mental health, prolonged hospitalization and unexpected death. These reasons for attrition have been documented within the published literature (Kasai et al, 2017; Van der Kooi et al, 2017) and this study reaffirms these important considerations.…”

Section: Discussionsupporting

confidence: 87%

Evaluating the Effectiveness of the Translated “A Matter of Balance” Fall Prevention Program Materials for Non-English-Speaking Participants

Wolfe

Arabian

Breeze³

et al. 2018

Journal of Trauma Nursing

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A Matter of Balance (MOB) is an evidence-based fall prevention program shown to reduce fear of falling (FOF) in English speaking participants. The effectiveness of translated (Chinese and Spanish) MOB materials in reducing FOF is unknown. The objective of this study was to evaluate whether MOB was associated with reduced FOF in Chinese- and Spanish-speaking participants, and included an English-speaking comparison group. Participants were recruited from MOB classes in Massachusetts and Illinois. Investigators used the Falls Efficacy Scale-International (FES-I) and a demographic questionnaire to survey the participants at the first class (baseline), last class, and 6 months after the MOB course. Of the 90 participants who enrolled, 77 (85.6%) completed the course (Chinese [n=37]; Spanish [n=19], English [n=21]), and 54 (60%) completed the 6-month survey (Chinese [n=33], English [n=21]). Chinese FES-I scores significantly increased (FOF worsened) at the end of the course (+7.1, p=0.009) and 6 month survey scores were also significantly above baseline (+6.7, p=0.0088). FES-I scores decreased (FOF declined) in both the Spanish (−6.6, p=0.016) and English groups (−2.7, p=0.14) at last class, and English 6 month FES-I scores were slightly lower than baseline (−0.4, p=0.8). Participation in the MOB program did not reduce FOF in the Chinese population but MOB did show promise in reducing FOF in both the Spanish and English groups. Future studies are warranted to explore the cultural, social, and education-related factors that may influence effectiveness of the MOB program.

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Section: Discussionsupporting

confidence: 87%

Evaluating the Effectiveness of the Translated “A Matter of Balance” Fall Prevention Program Materials for Non-English-Speaking Participants

Wolfe

Arabian

Breeze³

et al. 2018

Journal of Trauma Nursing

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“…These individuals had shown confusion between objective cognitive impairments and subjective physical health. In our previous study of patients with hip fractures and dementia, the fear of falling—one of the psychological risk factors for falling—reflected not only physical functions but also cognitive impairments ( Kasai et al, 2017 ). It suggested that the fear and concern of falling may reflect not only physical impairments but also cognitive impairments in patients with dementia ( Kasai et al, 2017 ).…”

Section: Discussionmentioning

confidence: 99%

Patients With Very Mild Dementia May Confuse Objective Cognitive Impairments With Subjective Physical Health of Quality of Life: The Tome City Project in Japan

Kasai

Meguro

2018

Front. Psychol.

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Many elderly people with cognitive dysfunction may observe a decrease in their health levels and quality of life (QOL). The basic concept of QOL consists of several categories including physical functions and mental health. The QOL domain that is most important for elderly people is physical health and, to a lesser extent, psychological health, social relationships, and/ or the environment. Our aim was to explore the relationships between the subjective measure of QOL, an abbreviated version of the World Health Organization Quality of Life (WHOQOL-BREF) scale, and the objective measure of impairment, Clinical Dementia Rating (CDR), among elderly people in a community. Totally, 178 community dwellers aged 75 years and above agreed to participate and completed the WHOQOL-BREF; 66 (32 males, 34 females) scored a CDR of 0 (healthy), 86 (33, 53) scored a CDR of 0.5 (questionable dementia or very mild dementia), and 26 (12, 14) scored a CDR of 1 and above (dementia). According to Pearson’s correlation coefficient analysis (significance level, p < 0.05), the physical domain of the WHOQOL-BREF had significant statistical negative correlations with all CDR subscales. The CDR subscale of memory impairment had a significant statistical negative correlation with the WHOQOL-BREF subscales of the physical (r = -0.151, p = 0.044) and psychological (r = -0.232, p < 0.002) domains. The CDR subscale of home and hobbies impairment had significant statistical negative correlations with all WHOQOL-BREF subscales including the physical (r = -0.226, p = 0.002), psychological (r = -0.226, p = 0.002), social (r = -0.167, p = 0.026), and environmental (r = -0.204, p = 0.006) domains. Patients with very mild dementia may confuse cognitive impairment and physical disabilities. In the future, we need to systematically combine memory clinics and all departments related to the elderly for the successful early detection and rehabilitation of, and long-term care for, dementia.

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“…Lack of movement confidence is associated with an increased risk of falling among older adults, in general [ 17 ]. Among people with dementia or MCI, lack of movement confidence is prevalent [ 18 , 19 ], although no studies have examined the direct link between lack of movement confidence and risk of falling. Given the above, there is a need for practical interventions that mitigate impairments in movement confidence among people with dementia or MCI.…”

Section: Introductionmentioning

confidence: 99%

Impacts of Motion-Based Technology on Balance, Movement Confidence, and Cognitive Function Among People With Dementia or Mild Cognitive Impairment: Protocol for a Quasi-Experimental Pre- and Posttest Study

Dove¹,

Wang²,

Zabjek³

et al. 2020

JMIR Res Protoc

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Background While exercise can benefit the health and well-being of people with dementia or mild cognitive impairment, many exercise programs offered to this population are passive, unengaging, and inaccessible, resulting in poor adherence. Motion-based technologies are increasingly being explored to encourage exercise participation among people with dementia or mild cognitive impairment. However, the impacts of using motion-based technologies with people with dementia or mild cognitive impairment on variables including balance, movement confidence, and cognitive function have yet to be determined. Objective The purpose of this study is to examine the impacts of a group motion-based technology intervention on balance, movement confidence, and cognitive function among people with dementia or mild cognitive impairment. Methods In this quasi-experimental pre- and posttest design, we will recruit 24 people with dementia or mild cognitive impairment from 4 adult day programs and invite them to play Xbox Kinect bowling in a group setting, twice weekly for 10 weeks. We will require participants to speak and understand English, be without visual impairment, and be able to stand and walk. At pretest, participants will complete the Mini-Balance Evaluation Systems Test (Mini-BESTest) and the Montreal Cognitive Assessment (MoCA). We will video record participants during weeks 1, 5, and 10 of the intervention to capture behavioral indicators of movement confidence (eg, fluency of motion) through coding. At posttest, the Mini-BESTest and MoCA will be repeated. We will analyze quantitative data collected through the Mini-BESTest and the MoCA using an intent-to-treat analysis, with study site and number of intervention sessions attended as covariates. To analyze the videos, we will extract count and percentage data from the coded recordings. Results This study will address the question of whether a group motion-based technology intervention, delivered in an adult day program context, has the potential to impact balance, movement confidence, and cognitive function among people with dementia or mild cognitive impairment. The project was funded in 2019 and enrollment was completed on February 28, 2020. Data analysis is underway and the first results are expected to be submitted for publication in 2021. Conclusions This study will assess the feasibility and potential benefits of using motion-based technology to deliver exercise interventions to people with dementia or mild cognitive impairment. This work can also be used as the basis for developing specific software and future exercise programs using motion-based technology for people with dementia or mild cognitive impairment, as well as understanding some of the conditions in which these programs can be delivered. International Registered Report Identifier (IRRID) DERR1-10.2196/18209

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Fear of Falling and Cognitive Impairments in Elderly People with Hip Fractures

Cited by 16 publications

References 22 publications

Evaluating the Effectiveness of the Translated “A Matter of Balance” Fall Prevention Program Materials for Non-English-Speaking Participants

Evaluating the Effectiveness of the Translated “A Matter of Balance” Fall Prevention Program Materials for Non-English-Speaking Participants

Patients With Very Mild Dementia May Confuse Objective Cognitive Impairments With Subjective Physical Health of Quality of Life: The Tome City Project in Japan

Impacts of Motion-Based Technology on Balance, Movement Confidence, and Cognitive Function Among People With Dementia or Mild Cognitive Impairment: Protocol for a Quasi-Experimental Pre- and Posttest Study

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