The Relationship between Older Adults’ Risk for a Future Fall and Difficulty Performing Activities of Daily Living

Abstract

Functional status is often defined by cumulative scores across indices of independence in performing basic and instrumental activities of daily living (ADL/IADL), but little is known about the unique relationship of each daily activity item with the fall outcome. The purpose of this retrospective study was to examine the level of relative risk for a future fall associated with difficulty with performing various tasks of normal daily functioning among older adults who had fallen at least once in the past 12 months. The sample was comprised of community-dwelling individuals 70 years and older from the 1984–1990 Longitudinal Study of Aging by Kovar, Fitti, and Chyba (1992). Risk analysis was performed on individual items quantifying 6 ADLs and 7 IADLs, as well as 10 items related to mobility limitations. Within a subsample of 1,675 older adults with a history of at least one fall within the past year, the responses of individuals who reported multiple falls were compared to the responses of participants who had a single fall and reported 1) difficulty with walking and/or balance (FRAIL group, n = 413) vs. 2) no difficulty with walking or dizziness (NDW+ND group, n = 415). The items that had the strongest relationships and highest risk ratios for the FRAIL group (which had the highest probabilities for a future fall) included difficulty with: eating (73%); managing money (70%); biting or chewing food (66%); walking a quarter of a mile (65%); using fingers to grasp (65%); and dressing without help (65%). For the NDW+ND group, the most noteworthy items included difficulty with: bathing or showering (79%); managing money (77%); shopping for personal items (75%); walking up 10 steps without rest (72%); difficulty with walking a quarter of a mile (72%); and stooping/crouching/kneeling (70%). These findings suggest that individual items quantifying specific ADLs and IADLs have substantive relationships with the fall outcome among older adults who have difficulty with walking and balance, as well as among older individuals without dizziness or difficulty with walking. Furthermore, the examination of the relationships between items that are related to more challenging activities and the fall outcome revealed that higher functioning older adults who reported difficulty with the 6 items that yielded the highest risk ratios may also be at elevated risk for a fall.

Falls and Social Isolation of Older Adults in the National Health and Aging Trends Study

“…The Activities of daily living (ADL) variable was not predictive of falls in model four. However, ADLs have been found to have a substantive relationship with falls among older adults, and the ability to perform the activities has been associated with physical frailty (Mamikonian-Zarpas & Lagana, 2015).…”

Effects of Aging in Multisensory Integration: A Systematic Review

“…Basic ADL refers to people’s daily self-care activities, such as getting ready in the morning, get from place to place during the day, and going to bed in the evening (Wiener et al, 1990), for example, bathing, dressing, toileting, transferring, continence and feeding (Katz et al, 1963). IADL refers to activities that need more cognition and are essential to live independently within the community, such as the ability to use a phone or to do shopping (Lawton and Brody, 1969; Wiener et al, 1990; Mamikonian-Zarpas and Laganá, 2015). In this systematic review, we will focus on changes that have an impact on the motor performance of all three aspects of ADLs: mobility, basic ADLs and IADLs.…”

Risk of falls in 4 years of follow-up among Chinese adults with diabetes: findings from the China Health and Retirement Longitudinal Study

“…3 Other risk factors include depressive symptoms, 9 reduced physical performance (eg, walking speed, 10 repeated chair stands 11 and grip strength), 12 being overweight/obese 10 and problems with instrumental activities of daily living (IADLs). 13 Hypoglycaemia 14 and vision impairment 15 that are associated with the disease also contribute diabetic fall risk. However, these studies were mainly cross-sectional or had limited follow-up time.…”