Functional Mobility Limitations and Falls in Assisted Living Residents With Dementia

McGough, Ellen L.; Logsdon, Rebecca G.; Kelly, Valerie E.; Teri, Linda

doi:10.1519/jpt.0b013e318268de7f

Cited by 57 publications

(91 citation statements)

References 32 publications

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“…To our knowledge, there is little in the literature on the association between falls and SPPB scores, but our findings are consistent with another two studies involving smaller groups of old people. 23,24 In our logistic regression analysis, both male and female participants with a SPPB score under 6 were three-fold at greater likelihood of being recurrent fallers, compared to subjects scoring from 10 to 12 with the SPPB tool. Among women, even lower SPPB scores (from 7 to 9) were associated with a higher probability of being a recurrent faller.…”

Section: Discussionmentioning

confidence: 84%

“…20 Although poor scores in the SPPB have been associated with an increased short-and long-term disability risk, 21,22 very few studies have investigated the relationship between SPPB levels and the frequency of falls. 23,24 To our knowledge, moreover, no published studies have analyzed the association between falls and the impact of each separate SPPB test. The aims of the present study were: First, to verify in a large sample of older-aged people the relationship between SPPB and recurrent falling, and, second, to investigate which of the tests included in the SPPB tool is most strongly associated with recurrent falls, after controlling for a wide number of possible confounders.…”

Section: Introductionmentioning

confidence: 99%

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

Veronese

Bolzetta

Toffanello

et al. 2014

Rejuvenation Research

151

113

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It is known that weakness in the lower limbs is associated with recurrent falls in old people. Among the tests routinely used to assess lower extremity strength, the Short Physical Performance Battery (SPPB) is one of those used most often, but its relationship with recurrent falls is poorly investigated. We aimed to determine if SPPB scores are related to recurrent falling in a sample of 2710 older-aged people, and to ascertain which test in the SPPB is most strongly associated with a higher rate of falls. In this cross-sectional study, we demonstrated that participants scoring 0-6 in the SPPB were more likely to be recurrent fallers than those scoring 10-12 (odds ratio [OR] = 3.46, 95% confidence interval [CI] 2.04-5.88 in women; OR = 3.82, 95% CI 1.77-8.52, in men). SPPB scores of 7-9 were only associated with women being more likely to be recurrent fallers (OR = 2.03, 95% CI 1.28-3.22). When the SPPB items were analyzed separately, even a lower score in gait speed for women was significantly associated with the presence of recurrent falls (OR = 2.11; 95% CI 1.04-4.30), whereas in men only a significant increase in the time taken to complete the five timed chair stands test was associated with a higher rate of falls (OR = 2.75; 95% CI 1.21-6.23). In conclusion, our study demonstrated that SPPB scores £ 6 are associated with a higher fall rate in old people of both genders; in females, even an SPPB score between 7 and 9 identifies subjects at a higher likelihood of being recurrent fallers. Among the single items of the SPPB, the most strongly associated with falls were gait speed in women and the five timed chair stands test in men.

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Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

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

Veronese

Bolzetta

Toffanello

et al. 2014

Rejuvenation Research

151

113

View full text Add to dashboard Cite

show abstract

“…[21] Preliminary results also indicate a relationship between mobility disability and the probability of a fall. [22][23][24] This phenomenon is particularly often reported in RCFs. [25] Nursing scientists have analyzed the severity of physical, psychological, and economic consequences of a fall of an older adult.…”

Section: Introductionmentioning

confidence: 89%

Prevalence of mobility disabilities in nursing home residents and the association with age, BMI, fall risk and social participation

Fehling¹,

Dassen²

2017

JNEP

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Background and aim: Physical mobility is often described as a basic prerequisite for independence, self-determination, and social participation. Older people, particularly those in long-term care facilities, are more often affected by the loss of their mobility. However, the prevalence of the mobility disabilities of nursing home residents and their association with demographic and care-specific/medical factors have so far been studied less. This prevalence study should investigate a possible association of mobility disability with age, BMI, multimorbidity, fall risk, and social participation. Methods: The prevalence study covered the data of residents in 30 German residential care facilities (RCFs). Trained staff nurses used a standardised instrument to collect data about the age, obesity, medical diagnoses, the fall risk, the level of mobility disability, and the need for supporting the social participation of the residents. Results: The representative sample included 2,066 nursing home residents, of whom 81.5% required support in their mobility. The level of a mobility disability or the need for a support in matters of mobility by others was not associated either with age, with the BMI, or with the fall risk of the participants. The groups with higher mobility disability included the more multimorbid participants with more difficult medical diagnoses, and these had a higher need for support in their social participation. Conclusions: It may be that professional care must reflect the premature link between older and obese patients with mobility disability. In addition to nursing diagnoses, medical diagnoses should necessarily be integrated into the nursing assessment. The association between the level of mobility disability and the fall risk, which is often mentioned in the literature, should be critically reflected. Nursing home residents should be informed that there is a possible association between their mobility disability and their social participation.

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“…Decreased velocity and stride length [16,17], increased double-support time [18], and increased stride-to-stride variability in swing time [19,20], have been shown to be associated with risk of falls [16 -20].…”

Section: Introductionmentioning

confidence: 99%

The Importance of Safe Patient Handling to Create a Culture of Safety: An Evidential Review

Cammen

Sterke

Halilovic

et al. 2016

Open Ergonomics. J.

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Objective:To investigate the influence of three different types of shoe models frequently worn at home, including an open heel shoe model, on gait parameters that are associated with fall risk in older persons. Methods:Twenty-five community-dwelling independent older persons were asked to walk on an electronic walkway system, the GAITRite ® walkway, while wearing three different shoe models which are frequently worn at home. We measured spatial and temporal gait parameters. Results:Gait velocity and stride length were significantly reduced, and step time, stance, and double support time were significantly increased, when older persons wore an open heel shoe model compared to the high collar shoe models. Conclusion:Wearing an open heel shoe model is associated with gait parameters that are associated with fall risk, compared with a high collar shoe model, in community-dwelling older persons. With regard to falls prevention, further attention for footwear in older persons seems warranted, especially for footwear worn in and around the home.

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Functional Mobility Limitations and Falls in Assisted Living Residents With Dementia

Abstract: The results of this study provide support for the application of brief physical performance assessments by physical therapists to identify functional mobility limitations and fall risk in older adults with advanced dementia.

Cited by 57 publications

References 32 publications

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

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

Prevalence of mobility disabilities in nursing home residents and the association with age, BMI, fall risk and social participation

The Importance of Safe Patient Handling to Create a Culture of Safety: An Evidential Review

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