scholarly journals A Home Hazard Removal Program to Reduce Falls in Community-Dwelling Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 385-385
Author(s):  
Susy Stark
Keyword(s):  
Older Adults ◽  
Low Income ◽  
Fall Risk ◽  
Low Cost ◽  
Management Program ◽  
Community Dwelling ◽  
Control Group ◽  
Age In Place ◽  
Increased Risk ◽  
Community Dwelling Older Adults

Abstract The majority of falls experienced by older adults occur in the home with home hazards associated with an increased risk of falling. Low-income older adults, who have more disability and live in substandard housing, need feasible interventions to help them safely age in place. The Home Hazard Removal Program (HARP) is a new home hazard removal and fall risk self-management program delivered in the home by occupational therapists to prevent falls. To evaluate the program, a randomized control trial was conducted with 310 community-dwelling older adults receiving aging services in the community. HARP had high acceptability with older adults and was feasible to deliver in the community. Adjusted for fall risk, individuals in the HARP group fell 1.4 times versus 2.2 times in the control group over 12 months. This low-cost home hazard removal program demonstrated acceptability, feasibility, and a significant reduction in falls for at-risk community-dwelling older adults.

scholarly journals The Effectiveness of a Dyadic Pain Management Program for Community-Dwelling Older Adults with Chronic Pain: A Pilot Randomized Controlled Trial

2020 ◽  
Vol 17 (14) ◽  
pp. 4966
Author(s):  
Ziyan Li ◽  
Mimi Tse ◽  
Angel Tang
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Controlled Trial ◽  
The Elderly ◽  
Management Program ◽  
Community Dwelling ◽  
Control Group ◽  
Pain Management Program ◽  
Community Dwelling Older Adults ◽  
Experimental Group

Background: Chronic pain is a major health problem among older adults and their informal caregivers, which has negative effects on their physical and psychological status. The dyadic pain management program (DPMP) is provided to community-dwelling older adults and informal caregivers to help the dyads reduce pain symptoms, improve the quality of life, develop good exercise habits, as well as cope and break the vicious circle of pain. Methods: A pilot randomized controlled trial was designed and all the dyads were randomly divided into two groups: the DPMP group and control group. Dyads in the DPMP group participated in an 8-week DPMP (4-week face-to-face program and 4-week home-based program), whereas dyads in the control group received one page of simple pain-related information. Results: In total, 64 dyads participated in this study. For baseline comparisons, no significant differences were found between the two groups. After the interventions, the pain score was significantly reduced from 4.25 to 2.57 in the experimental group, respectively. In the repeated measures ANOVA, the differences in pain score (F = 107.787, p < 0.001, d = 0.777) was statistically significant for the group-by-time interaction. After the interventions, the experimental group participants demonstrated significantly higher pain self-efficacy compared with the control group (F = 80.535, p < 0.001, d = 0.722). Furthermore, the elderly increased exercise time significantly (F = 111.212, p < 0.001, d = 0.782) and reported developing good exercise habits. Conclusions: These results provide preliminary support for the effectiveness of a DPMP for relieving the symptoms of chronic pain among the elderly.

scholarly journals Dancing Against falls iN Community-dwElling older adults (DANCE): a study protocol of a stratified, block-randomised trial

2021 ◽  
pp. injuryprev-2021-044224
Author(s):  
Mikkel Jacobi Thomsen ◽  
Matthew Liston ◽  
Merete Grothe Christensen ◽  
Peter Vestergaard ◽  
Rogerio Pessoto Hirata
Keyword(s):  
Older Adults ◽  
Randomised Trial ◽  
Community Dwelling ◽  
Control Group ◽  
Mineral Density ◽  
Risk Of Death ◽  
Dance Training ◽  
Increased Risk ◽  
Risk Factors For Falls ◽  
Community Dwelling Older Adults

BackgroundUnintentional falls among older adults are of primary importance due to their impact on quality of life. Falling accounts for 95% of hip fractures, leading to an approximately six times increased risk of death within the first 3 months. Furthermore, physical and cognitive parameters are risk factors for falls. The purpose of this study is to examine the effect of a 6-month salsa dance training intervention, compared with regular fitness circuit training and a control group.MethodsThis study will include 180 older adults: 90 healthy patients and 90 patients with osteoporosis. Participants will be allocated randomly in either of the groups, stratified according to age. Training groups will receive 2 weekly 1-hour training sessions, continuously through 6 months. Participants will be tested at baseline and 6 and 18 months post baseline. Primary outcome will be number of falls and secondary outcomes include bone mineral density, body composition, pain evaluation, weekly physical activity, single-task and dual-task gait patterns, balance, Fullerton Functional Fitness Test and assessment of the mini-BESTest.DiscussionThis study will investigate the effects of a specially designed dance training programme (Dancing Against falls iN Community-dwElling older adults (DANCE)) to reduce the risk of falling among older adults. The study will investigate the effect against an active and passive comparator, resulting in the possibility to state, if DANCE training should be an alternative to traditional training.Trial registration numberNCT03683849.

Cost-effectiveness of a preventive self-care health management program for community-dwelling older adults: a randomised controlled trial

2020 ◽  
Author(s):  
Arkers Kwan Ching Wong ◽  
Frances Kam Yuet Wong ◽  
Ching SO
Keyword(s):  
Older Adults ◽  
Hong Kong ◽  
Cost Effectiveness ◽  
Health Management ◽  
Self Care ◽  
Management Program ◽  
Community Dwelling ◽  
Control Group ◽  
Care Health ◽  
Community Dwelling Older Adults

Abstract Objective To examine the cost-effectiveness of a preventive self-care health management program for community-dwelling older adults as compared to usual care. Design/Intervention A cost-effectiveness analysis was executed alongside a randomised controlled trial. Nurse case managers provided interventions, including holistic assessment, empowerment of self-care, preventive health behaviours and self-efficacy with co-produced care planning, supported by nursing students. The control group received social control calls. Participants/Setting Community-dwelling older adults were randomly assigned to the intervention (n = 271) or control (n = 269) group. The intervention was conducted in collaboration with 11 community centres under four non-government organisations in various districts of Hong Kong. Measurements Cost and quality-adjusted life years (QALYs) were collected pre (baseline, 0 months) and post intervention (3 months) and 3 months after completion of the program (6 months). Incremental cost-effectiveness ratios between the groups were calculated, dividing the difference in cost by the difference in QALYs. Results Analysis showed that the net incremental QALY gain was 0.0014 (3 months) and 0.0033 (6 months) when the intervention group was compared to the control group. The probability of being cost-effective at 6 months was 53.2% and 53.4%, based on the cost-effectiveness thresholds recommended by both the National Institute for Health and Clinical Excellence ($200,000/QALYs) and the World Health Organization (Hong Kong gross domestic product/capita, HK$381,780). Conclusions The results provide some evidence to suggest that the addition of a home-based, preventive self-care health management program may have effects on cost outcomes for community-dwelling older adults in Hong Kong.

scholarly journals Balance Impairment as a Risk Factor for Falls in Community-Dwelling Older Adults Who Are High Functioning: A Prospective Study

2010 ◽  
Vol 90 (3) ◽  
pp. 338-347 ◽  
Author(s):  
Susan W. Muir ◽  
Katherine Berg ◽  
Bert Chesworth ◽  
Neil Klar ◽  
Mark Speechley
Keyword(s):  
Older Adults ◽  
Fall Risk ◽  
Community Dwelling ◽  
Self Report ◽  
Adjusted Relative Risk ◽  
Balance Impairment ◽  
Increased Risk ◽  
Injurious Fall ◽  
Community Dwelling Older Adults ◽  
Balance Problems

BackgroundScreening should have simple and easy-to-administer methods that identify impairments associated with future fall risk, but there is a lack of literature supporting validation for their use.ObjectiveThe aim of this study was to evaluate the independent contribution of balance assessment on future fall risk, using 5 methods to quantify balance impairment, for the outcomes “any fall” and “any injurious fall” in community-dwelling older adults who are higher functioning.DesignThis was a prospective cohort study.MethodsA sample of 210 community-dwelling older adults (70% male, 30% female; mean age=79.9 years, SD=4.7) received a comprehensive geriatric assessment at baseline, which included the Berg Balance Scale to measure balance. Information on daily falls was collected for 12 months by each participant's monthly submission of a falls log calendar.ResultsSeventy-eight people (43%) fell, of whom 54 (30%) sustained an injurious fall and 32 (18%) had recurrent falls (≥2 falls). Different balance measurement methods identified different numbers of people as impaired. Adjusted relative risk (RR) estimates for an increased risk of any fall were 1.58 (95% confidence interval [CI]=1.06, 2.35) for self-report of balance problems, 1.58 (95% CI=1.03, 2.41) for one-leg stance, and 1.46 (95% CI=1.02, 2.09) for limits of stability. An adjusted RR estimate for an increased risk of an injurious fall of 1.95 (95% CI=1.15, 3.31) was found for self-report of balance problems.LimitationsThe study was a secondary analysis of data.ConclusionsNot all methods of evaluating balance impairment are associated with falls. The number of people identified as having balance impairment varies with the measurement tool; therefore, the measurement tools are not interchangeable or equivalent in defining an at-risk population. The thresholds established in this study indicate individuals who should receive further comprehensive fall assessment and treatment to prevent falls.

Community-dwelling older adults who are low-income and disabled weathering financial challenges

2021 ◽  
Vol 42 (4) ◽  
pp. 901-907
Author(s):  
Laura J. Samuel ◽  
Rebecca Wright ◽  
Marianne Granbom ◽  
Janiece L. Taylor ◽  
Ciara Hupp ◽  
...  
Keyword(s):  
Older Adults ◽  
Low Income ◽  
Community Dwelling ◽  
Financial Challenges ◽  
Community Dwelling Older Adults

Effects of Aerobic, Resistance, or Combined Exercise Training Among Older Adults with Subjective Memory Complaints: A Randomized Controlled Trial

2021 ◽  
pp. 1-17
Author(s):  
Taeko Makino ◽  
Hiroyuki Umegaki ◽  
Masahiko Ando ◽  
Xian Wu Cheng ◽  
Koji Ishida ◽  
...  
Keyword(s):  
Older Adults ◽  
Exercise Training ◽  
Controlled Trial ◽  
Community Dwelling ◽  
Control Group ◽  
Subjective Memory ◽  
Logical Memory ◽  
Randomized Controlled ◽  
Community Dwelling Older Adults

Background: Physical exercise is suggested to be effective for preventing cognitive decline in older adults, but the relative efficacy of different types of exercise have yet to be clarified. Objective: This single-blinded randomized controlled trial was designed to investigate the differential effects of aerobic exercise training (AT), resistance exercise training (RT), and combined exercise training (CT) on cognition in older adults with subjective memory complaints (SMC). Methods: Community-dwelling older adults with SMC (n = 415; mean age = 72.3 years old) were randomly assigned to one of the four groups: AT, RT, CT, or control group. The study consisted of two phases: a 26-week intervention and a 26-week follow-up. The participants were evaluated at baseline, 26 weeks (postintervention), and 52 weeks (follow-up). The primary outcome of this study was memory function, which was assessed using the Logical Memory II subtest of the Wechsler Memory Scale-Revised (WMS-R) score. The secondary outcomes included global cognitive function, verbal fluency, working memory, processing speed, and executive functions. Results: Intention-to-treat analysis by a mixed-effect model repeated measure showed that the AT group had significantly improved performance on the WMS-R Logical Memory II test (2.74 [1.82–3.66] points) than the control group (1.36 [0.44–2.28] points) at the postintervention assessment (p = 0.037). The effect was more pronounced in those without amnesia than those with amnesia. No significant improvement was observed in the RT and CT groups. Conclusion: This study suggests that AT intervention can improve delayed memory in community-dwelling older adults, particularly in individuals without objective memory decline.

scholarly journals Physical Activity Level Following Resistance Training in Community-Dwelling Older Adults Receiving Home Care: Results from a Cluster-Randomized Controlled Trial

2021 ◽  
Vol 18 (13) ◽  
pp. 6682
Author(s):  
Hilde Bremseth Bårdstu ◽  
Vidar Andersen ◽  
Marius Steiro Fimland ◽  
Lene Aasdahl ◽  
Hilde Lohne-Seiler ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Resistance Training ◽  
Home Care ◽  
Community Dwelling ◽  
Activity Level ◽  
Group Differences ◽  
Control Group ◽  
Cluster Randomized ◽  
Community Dwelling Older Adults

Older adults’ physical activity (PA) is low. We examined whether eight months of resistance training increased PA level in community-dwelling older adults receiving home care. A two-armed cluster-randomized trial using parallel groups was conducted. The included participants were >70 years and received home care. The resistance training group performed resistance training using body weight, elastic bands, and water canes twice per week for eight months. The control group was informed about the national PA guidelines and received motivational talks. The ActiGraph GT3X+ accelerometer was used to estimate PA. Outcomes included total PA (counts per minute), sedentary behavior (min/day), light PA (min/day), moderate-to-vigorous PA (min/day), and steps (mean/day). Between-group differences were analyzed using multilevel linear mixed models. Twelve clusters were randomized to either resistance training (7 clusters, 60 participants) or the control group (5 clusters, 44 participants). A total of 101 participants (median age 86.0 (interquartile range 80–90) years) had valid accelerometer data and were included in the analysis. There were no statistically significant between-group differences for any of the PA outcomes after four or eight months. This study offers no evidence of increased PA level following resistance training in older adults with home care.

scholarly journals Multisensory integration involved in the body perception of community-dwelling older adults

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
M. Hide ◽  
Y. Ito ◽  
N. Kuroda ◽  
M. Kanda ◽  
W. Teramoto
Keyword(s):  
Older Adults ◽  
Multisensory Integration ◽  
Fall Risk ◽  
Community Dwelling ◽  
The Body ◽  
Risk Of Falling ◽  
Body Perception ◽  
Rubber Hand ◽  
Timed Up And Go ◽  
Community Dwelling Older Adults

AbstractThis study investigates how the multisensory integration in body perception changes with increasing age, and whether it is associated with older adults’ risk of falling. For this, the rubber hand illusion (RHI) and rubber foot illusion (RFI) were used. Twenty-eight community-dwelling older adults and 25 university students were recruited. They viewed a rubber hand or foot that was stimulated in synchrony or asynchrony with their own hidden hand or foot. The illusion was assessed by using a questionnaire, and measuring the proprioceptive drift and latency. The Timed Up and Go Test was used to classify the older adults into lower and higher fall-risk groups. No difference was observed in the RHI between the younger and older adults. However, several differences were observed in the RFI. Specifically, the older adults with a lower fall-risk hardly experienced the illusion, whereas those with a higher fall-risk experienced it with a shorter latency and no weaker than the younger adults. These results suggest that in older adults, the mechanism of multisensory integration for constructing body perception can change depending on the stimulated body parts, and that the risk of falling is associated with multisensory integration.

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