Relationship Between Difficulties in Daily Activities and Falling: Loco-Check as a Self-Assessment of Fall Risk

Abstract

BackgroundPeople aged 65 years or older accounted for 25.1% of the Japanese population in 2013, and this characterizes the country as a “super-aging society.” With increased aging, fall-related injuries are becoming important in Japan, because such injuries underlie the necessity for nursing care services. If people could evaluate their risk of falling using a simple self-check test, they would be able to take preventive measures such as exercise, muscle training, walking with a cane, or renovation of their surroundings to remove impediments. Loco-check is a checklist measure of early locomotive syndrome (circumstances in which elderly people need nursing care service or are at high risk of requiring the service within a short time), prepared by the Japanese Orthopaedic Association (JOA) in 2007, but it is unclear if there is any association between this measure and falls.ObjectiveTo investigate the association between falls during the previous year and the 7 “loco-check” daily activity items and the total number of items endorsed, and sleep duration.MethodsWe conducted an Internet panel survey. Subjects were 624 persons aged between 30 and 90 years. The general health condition of the participants, including their experience of falling, daily activities, and sleep duration, was investigated. A multivariate analysis was carried out using logistic regression to investigate the relationship between falls in the previous year and difficulties with specific daily activities and total number of difficulties (loco-check) endorsed, and sleep duration, adjusting for sex and age.ResultsOne-fourth of participants (157 persons) experienced at least one fall during the previous year. Fall rate of females (94/312: 30.1%) was significantly higher than that of males (63/312: 20.2%). Fall rate of persons aged more than 65 years (80/242: 33.1%) was significantly higher than that of younger persons (77/382: 20.2%). Logistic regression analysis revealed that daily activities such as “impossibility of getting across the road at a crossing before the traffic light changes” are significantly related to falling. Logistic regression analysis also demonstrated a relationship between the number of items endorsed on loco-check and incidence of falling, wherein persons who endorsed 4 or more items appear to be at higher risk for falls. However, logistic regression found no significant relationship between sleep duration and falling.ConclusionsOur study demonstrated a relationship between the number of loco-check items endorsed and the incidence of falling in the previous year. Endorsement of 4 or more items appeared to signal a high risk for falls. The short self-administered checklist can be a valuable tool for assessing the risk of falling and for initiating preventive measures.

Adverse effects of the coexistence of locomotive syndrome and sarcopenia on the walking ability and performance of activities of daily living in Japanese elderly females: a cross-sectional study

“…In activities of daily living, previous studies have reported that locomotive syndrome and sarcopenia are associated with ADL performance 9,10) . For example, one study found that decreased rapid walking speed for females aged ≥65 years was associated with incident ADL disability 21) .…”

“…A previous study reported that participants who have fallen or who have gait or balance problems are at higher risk of future falls 17) . Both locomotive syndrome and sarcopenia are associated with fall risk 9,10) . In the present study, TUG time in the L+S group was significantly longer than those in CON and L groups.…”

“…Yoshimura et al reported that locomotive syndrome predicted fall risk and that locomotive syndrome criteria findings correlate with exponential increases in fall risk 9) . Akahane et al reported that locomotive syndrome was associated with a high risk for falls 10) , and other studies have also established that locomotive syndrome is associated with ADL performance 10,11) .…”

Beneficiaries’ Willingness to Pay for Resuscitation Provided by Ambulance Attendants: A Survey Using the Contingent Valuation Approach

“…This may result in a selection bias of subjects. However, web surveys have recently become a common method of conducting research [22] [23].…”

Quantitative assessment of locomotive syndrome by the loco-check questionnaire in older Japanese females

“…A previous study has shown that a larger number of items with an answer of “yes” on the loco-check was significantly associated with reduced health-related quality of life (HRQoL) assessed by the EuroQoL-5 dimensions (EQ-5D) and EuroQoL-visual analog scale (EQ-VAS) 6 ) . Furthermore, the number of times that “yes” was selected on the loco-check has been found to be significantly correlated with the experience of falling in the previous year 7 ) .…”