The Relationship between the Activity Balance Confidence and Mobility Tests among Older Adults in Indonesia

Abstract

Introduction. Unsteady gait, instability, and lower extremity muscle weakness are some of the risk factors for falls. Reduced balance is a further precursor of falls, and injuries adversely affect the instability. In doing an activity without losing their balance, confidence among older adults is also crucial because it will influence their mobility. Objectives. The objective of this study is to examine the association between activity balance confidence and functional mobility, including gait, balance, and strength, among older adults. Methods. A cross-sectional study was conducted among older adults living in long-term care facilities and community dwellings. A total of 326 older adults (>60 years old) participated in this study from three provinces in Java Island, Indonesia. The inclusion criteria were older adults living independently and without obstacles in communication, who have no hearing loss, and who agreed to be respondents. The activity-specific balance confidence (ABC) scale determines the level of confidence. The participants were asked about their balance confidence not to lose their balance while doing 16 activities. The dependent variable is the mobility test, including a gait test using TUG (times up and go) to see how the subjects stand, walk, and turn around; a balance test (four stages); and a strength test (30-second chair stand). Results. The results of the ABC scale showed the respondents felt the most confidence not to lose their balance when they walk around the house (82.01%) and the less confidence when they stepped onto or off an escalator while holding onto a railing (37.7%). The gait, balance, and strength test revealed that 51.2% of the respondents showed an unsteady gait, 63.8% showed instability that felt awkward and unusual when standing on one leg, and 60.1% of the participants showed muscle weakness. The bivariate analysis significantly correlated the ABC scale test and all mobility tests. The older adult participants who are not confident will have 12.03 times higher the unstable result of the gait test, 8.4 times higher the unstable result of the balance test, and 7.47 times higher the less strength result of the strength test who are confident. Conclusion. Older adults who lack balance confidence showed significantly poorer results in mobility tests.

Validitas dan Reliabilitas Two-Level Quick-Steadi Algorithm untuk Skrining Risiko Jatuh Lansia di Indonesia: Studi Observasional Analitik

“…Meskipun sebelumnya telah ada upaya skrining menggunakan Kuesioner SIB STEADI, penelitian lain menunjukkan bahwa dari 12 pertanyaan dalam SIB, yang paling efisien adalah 3 pertanyaan kunci yang juga terdapat dalam TLQSA. 6,9 Sementara itu, Morse Fall Scale (MFS) digunakan sebagai alat untuk mengidentifikasi risiko jatuh pada pasien rawat inap. 10 Skrining pada lansia di komunitas umumnya dilakukan dengan menggunakan TUG Test oleh tenaga medis yang telah terlatih.…”

“…Faktor-faktor yang berhubungan dengan kejadian jatuh tersebut meliputi usia yang lebih tua, jenis kelamin perempuan, tinggal di layanan institusi swasta, rendahnya tingkat pendidikan, tinggal di perkotaan, gangguan penglihatan, gangguan memori, dan arthritis. 6 Jatuh pada kelompok usia 65 tahun ke atas menjadi penyebab utama kematian dan kegawatdaruratan, serta memiliki konsekuensi pembiayaan yang tinggi. Setiap tahunnya, terdapat setidaknya 646.000 kematian akibat jatuh, dengan rata-rata 1770 kematian per hari.…”

Assessment of balance and risk of falls in people over 60 years old

“…These factors lead to an increased risk of falls in the elderly, which is the leading cause of injury among seniors. Causing an increase in hospitalizations, complications, and even premature loss of independence [2,3,4,5].…”

“…Superficial and deep sensation and the efficiency of the integration of sensory stimuli also play an important role in maintaining the stability of the body and adequate reactions to factors that throw it out of balance. The weakening of the above-mentioned factors significantly increases the risk of falls and related injuries in people over 60 years of age [2,4,7].…”

Analysis and prevention of falls among community‐dwelling older adults in southern Thailand

“…While fall rates vary globally based on factors such as region, sex and community-dwelling status, it is estimated that 28%-35% of individuals aged 64 and over experience falls annually, a figure that increases to 32%-42% for those over the age of 70 (WHO, 2007). Furthermore, specific studies conducted in Southeast Asia have demonstrated a fall prevalence of 29% among older adults in Indonesia (Susilowati et al, 2020) and approximately 15.3% among community-dwelling older adults in Thailand (Aekplakorn et al, 2021). These findings highlight the need for targeted interventions in the region.…”