Falls and Physical Performance among Frail Sexagenarians and Septuagenarians

Ganesan Kathiresan, Sandra Devie, Sunnelly Velintina, Stellah Lenson, Nur Idawanny, Nur Asyikin, Nurul Hijah

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DOI: 10.4236/ijcm.2010.11004                

Abstract

Background: In Malaysia, there are few populationbased studies on the factors associated with falls, and there is a lack of prevention of falls among older adults in primary and secondary health care, particularly in terms of physical activity that could improve the physical performance of individuals at risk of falling. Therefore, the objective of the present study was to determine the relationship between physical performance, the number of falls and the sociodemographic, physical, clinical and functional characteristics of older adult fallers. Methods: Crosssectional study carried out among 72 older adults with a history of falls in the past year, 65.3% of which were women. The participants received care at the geriatric outpatient clinic and divided into the following groups: worst physical performance (WPP) and best physical performance (BPP), onetime fallers (1F) and frequent fallers (2F). Sociodemographic, clinical, physical and functional characteristics were considered as independent variables. Comparison analysis between the groups was conducted. Results: The WPP group was older and had a higher number of illnesses and less independence in most motor dimension tasks compared to the BPP group. The 2F group had a higher number of illnesses, less handgrip strength and less independence in the bowel management task in the motor dimension of the Functional Independence Measure (FIM) compared to the 1F group. Conclusions: Among older adults fallers, poor physical performance is associated with more advanced age, more illnesses and less functional independence. Moreover, recurrent falls are associated with more illnesses, less muscle strength and less functional independence in the bowel management task.

Keywords

Aging, Exercise, Fall, Gait

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	M. R. Perracini and L. R. Ramos, “Factors Associated with Falls in a Cohort of Elderly Community Residents,” Annual Review of Public Health, Vol. 36, No. 6, 2002, pp. 709716.
[2]	M. L. Lebrao, R. Laurenti, “Health, Wellness and Aging: The SABE Study in the City of Sao Paulo,” Revista Brasileira de Epidemiologia, Vol. 8, No. 2, 2005, pp. 127141.
[3]	K. A. Faulkner, M. S. Redfern, J. A. Cauley, et al., “Multitasking: Association between Poorer Performance and a History of Recurrent Falls,” Journal of the American Geriatrics Society, Vol. 55, No. 44, 2007, pp. 570576.
[4]	F. V. Siqueira, L. A. Facchini, R. X. Piccini, et al., “Prevalence of Falls in the Elderly and Related Factors,” Revista de Saúde Pública, Vol. 41, No. 5, 2007, pp. 749 756. E. S. Nahit, A. J. Silman and G. J. Macfarlane, “The Occurrence of Falls among Patients with a New Episode of Hip Pain,” Annals of the Rheumatic Diseases, Vol. 57, No. 3, 1998, pp. 166168.
[5]	T. LiuAmbrose, K. M. Khan, J. J. Eng, P. A. Janssen, et al., “Resistance and Agility Training Reduce Fall Risk in Women Aged 75 to 85 with Low Bone Mass: A 6Month Randomized, Controlled Trial,” Journal of the American Geriatrics Society, Vol. 52, No. 5, 2004, pp. 657665.
[6]	N. van der Velde, B. H. Stricker, H. A. Pols, et al., “Risk of Falls after Withdrawal of FallRiskIncreasing Drugs: A Prospective Cohort Study,” British Journal of Clinical Pharmacology, Vol. 63, No. 2, 2007, pp. 232237.
[7]	J. R. Rebelatto, A. P. Castro and A. Chan, “Falls in Institutionalized Elderly: General Characteristics, Determinant Factors and Relationship with Handgrip Strength,” Acta Ortopédica Brasileira, Vol. 15, No. 3, 2007, pp. 151154.
[8]	Y. Rolland, V. Lauwerscances, M. Cesari, et al., “Physical Performance Measure the Predictors of Mortality in a Cohort of CommunityDwelling Older French Women,” European Journal of Epidemiology, 2006, Vol. 21, No. 2, pp. 113122.
[9]	J. M. Gazzola, M. R. Perracini, M. M. Ganan?a, et al., “Functional Balance Associated Factors in Elderly with Chronic Vestibular,” Revista Brasileira de Otorrinolaringologia, Vol. 72, No. 5, 2006, pp. 683690.
[10]	H. Shimada, S. Obuchi, T. Furuna, et al., “New Intervention Program for Preventing Falls among Frail Elderly People,” American Journal of Physical Medicine & Rehabilitation, 2004, Vol. 83, No. 7, pp. 493499.
[11]	R. Garcia, M. D. Leme and L. E. GarcezLeme, “Evolution of Brazilian Elderly with Hip Fracture Secondary to a Fall,” Clinics (S?o Paulo), Vol. 61, No. 6, 2006, pp. 539 544.
[12]	Clinical Practice Guidelines on Management of Osteopo rosis, Malaysian Osteoporosis Society, 2006.
[13]	A. Braekhus, K. Laake and K. Engedal, “The MiniMental State Examination: Identifying the most Efficient Variables for Detecting Cognitive Impairment in the Elderly,” Journal of the American Geriatrics Society, Vol. 40, No. 11, 1992, pp. 11391145.
[14]	“The Prevention of Falls in Later Life, a Report of the Kellog International Work Group on the Prevention of Falls by the Elderly,” Danish Medical Bulletin, Vol. 34, No. (Suppl. 4), 1987, pp. S124.
[15]	J. M. Guralnik, E. M. Simonsick, L. Ferrucci, et al., “A Short Physical Performance Battery Assessing Lower Extremity Function: Association with SelfReported Disability and Prediction of Mortality and Nursing Home Admission,” Journals of Gerontology Medical Science, Vol. 49, No. 2, 1994, pp. M85M94.
[16]	B. B. Hamilton, C. V. Granger, F. S. Sherwin, et al., “A Uniform National Data System for Medical Rehabilitation,” In: M. J. Fuhrer, Ed., Rehabilitation Outcomes: Analysis and Measurement, Brookes, Baltimore, 1987, pp. 137147.
[17]	M. G. Stineman, A. Jette, R. Fiedler, et al., “ImpairmentSpecific Dimensions within the Functional Independence Measure,” Archives of Physical Medicine and Rehabilitation, Vol. 78, No. 6, 1997, pp. 636643.
[18]	S. C. C. Fabricio, R. A. P. Rodrigues, M. L. Costa Junior, “Causes and Consequences of Falls among Older Adults Seen in Public Hospital,” Annual Review of Public Health, Vol. 38, No. 1, 2004, pp. 9399.
[19]	G. A. M. E. Estefani, “Profile of Elderly People Seen at a Geriatric Clinic According to the Occurrence of Falls,” Dissertation, Universidade Estadual de Campinas, 2007.
[20]	G. P. M. Machado, S. M. Barreto, V. M. A. Passos, et al., “Project Bamboo: Prevalence of Chronic Joint Symptoms in the Elderly,” Revesta da Associa??o Médica Brasileira, Vol. 50, No. 4, 2004, pp. 367372.
[21]	A. Ozcan, H. Donat, N. Gelecek, et al., “The Relationship between Risk Factors for Falling and the Quality of Life in Older Adults,” BMC Public Health, Vol. 5, 2005, p. 90.
[22]	J. M. N. Guimaraes and P. T. V. Farinatti, “Descriptive Analysis of Variables Theoretically Associated with the Risk of Falls in Older Women,” Revesta da Brasileira de Medicina do Esporte, Vol. 11, No. 5, 2005, pp. 299305.
[23]	T. Rantanen, S. Volpato, L. Ferrucci, et al., “Handgrip Strength and CauseSpecific and Total Mortality in Older Disabled Women: Exploring the Mechanism,” Journal of the American Geriatrics Society, Vol. 51, No. 5, 2003, pp. 636641.
[24]	L. P. Fried, C. M. Tangen, J. Walston, et al., “Frailty in Older Adults: Evidence for a Phenotype,” Journals of Gerontology Series A: Biological Sciences and Medical Sciences, Vol. 56, No. 3, 2001, pp. 146156.
[25]	S. C. M. Oliveira, A. M. PintoNeto, D. M. Conde, J. R. N. Goes, D. SantosSa and L. CostaPaiva, “Fecal Incontinence in Postmenopausal Women: Prevalence, Severity and Associated Factors,” Arquivos de Gastroenterologia, Vol. 43, No. 2, 2006, pp. 102106.
[26]	M. I. Parahyba, C. C. S. Simoes, “The Prevalence of Disability among the Elderly in Brazil,” Ciênc Saúde Coletiva, Vol. 11, No. 4, 2006, pp. 967974.
[27]	S. R. Lord, “Visual Risk Factors for Falls in Older People,” Age Ageing, Vol. 35, No. (Suppl. 2), 2006, pp. 4245.
[28]	M. Pahor, S. N. Blair, M. Espeland, et al., “Effects of a Physical Activity Intervention on Measures of Physical Performance: Results of the Lifestyle Interventions and Independence for Elders Pilots (LIFEP),” Journals of Gerontology Series A: Biological Sciences and Medical Sciences, Vol. 61, No. 11, 2006, pp. 11571165.
[29]	G. Z. Mazo, D. B. Liposcki and C. Ananda, “It Provides Health Conditions, Incidence of Falls and Physical Activity Level of Older People,” Revesta da Brasileira de Physiology, 2007, Vol. 11, No. 6, pp. 437442.
[30]	J. Sirola, T. Rikkonen, M. Tuppurainen, et al. “Association of Grip Strength Change with Menopausal Bone Loss and Related Fractures: A PopulationBased Followup Study,” Calcified Tissue International, Vol. 78, No. 4, 2006, pp. 218226.