Nursing Home Residence, Overweight and Cognitive Status are Related to Falls in Older Adults: A Cross-sectional Study

Page: [125 - 132] Pages: 8

  • * (Excluding Mailing and Handling)

Abstract

Background: Nursing home residents are likely to differ from community older adults when their gait parameters are compared, as nursing home residents present more falls.

Aim: The study aim was to identify the main fall (occurrence predictors) (anthropometrics, functional and gait-related parameters) between older adults living in community and nursing homes during self-selected (SSWS) and fast walking speeds (FWS).

Methods: A hundred and sixty-five older adults were selected from the community (n = 92) and nursing home (n = 73) with and without fall history. They were assessed for fall history, functionality, cognitive status, and several gait parameters in SSWS and FWS conditions.

Results: Fallers differed from non-fallers in the SSWS, while such differences were not evidenced during the FWS. Cadence and stride width did not differ when living backgrounds were compared. Nursing home residents walked slower than their non-institutionalized peers, regardless of fall history or walking speed. Besides, binary logistic regression analysis showed that living in a nursing home, age, body mass index (BMI), mini-mental state examination (MMSE), and step width were related to falls in the SSWS. On the other hand, living in a nursing home, having a larger BMI and having low MMSE scores were fall predictors in the FWS.

Conclusion: Fall occurrence can be identified by factors related to living in nursing homes, cognitive status, BMI, and gait parameters, at the SSWS. Cognitive status and BMI are related to falls in the FWS for those living in nursing homes.

Keywords: dfgdfgddf, dfgd, gdfgdf, dfgdfg, fdgdf, dfgf

Graphical Abstract

[1]
Pirker W, Katzenschlager R. Gait disorders in adults and the elderly. Wien Klin Wochenschr 2017; 129(3-4): 81-95.
[http://dx.doi.org/10.1007/s00508-016-1096-4] [PMID: 27770207]
[2]
Hsieh YJ, Cho CY. Age-related changes of arm movements in dual task condition when walking on different surfaces. Hum Mov Sci 2012; 31(1): 190-201.
[http://dx.doi.org/10.1016/j.humov.2011.01.005] [PMID: 21798609]
[3]
McCrum C, Gerards MHG, Karamanidis K, Zijlstra W, Meijer K. A systematic review of gait perturbation paradigms for improving reactive stepping responses and falls risk among healthy older adults. Eur Rev Aging Phys Act 2017; 14(1): 3.
[http://dx.doi.org/10.1186/s11556-017-0173-7]
[4]
Callisaya ML, Blizzard L, Schmidt MD, McGinley JL, Lord SR, Srikanth VK. A population-based study of sensorimotor factors affecting gait in older people. Age Ageing 2008; 38(3): 290-5.
[http://dx.doi.org/10.1093/ageing/afp017] [PMID: 19264860]
[5]
Verlinden VJA, van der Geest JN, Hoogendam YY, Hofman A, Breteler MMB, Ikram MA. Gait patterns in a community-dwelling population aged 50 years and older. Gait Posture 2013; 37(4): 500-5.
[http://dx.doi.org/10.1016/j.gaitpost.2012.09.005] [PMID: 23018028]
[6]
Chiba H, Ebihara S, Tomita N, Sasaki H, Butler JP. Differential gait kinematics between fallers and non-fallers in community-dwelling elderly people. Geriatr Gerontol Int 2005; 5(2): 127-34.
[http://dx.doi.org/10.1111/j.1447-0594.2005.00281.x]
[7]
Rubenstein LZ. Falls in older people: Epidemiology, risk factors and strategies for prevention. Age Ageing 2006; 35 (Suppl. 2): ii37-41.
[http://dx.doi.org/10.1093/ageing/afl084] [PMID: 16926202]
[8]
Baixinho CL, Dixe MA, Madeira C, Alves C, Henriques MA. Falls in institutionalized elderly with and without cognitive decline. Dement Neuropsychol 2019; 713.
[9]
Middleton A, Fulk GD, Herter TM, Beets MW, Donley J, Fritz SL. Self-selected and maximal walking speeds provide greater insight into fall status than walking speed reserve among community-dwelling older adults. Am J Phys Med Rehabil 2016; 95(7): 475-82.
[http://dx.doi.org/10.1097/PHM.0000000000000488] [PMID: 27003205]
[10]
Bento PCB, Bento PCB, Bento PCB. Age-associated differences in the gait pattern changes of older adults during fast-speed and fatigue conditions: Results from the Baltimore longitudinal study of ageing. Age Ageing 2010; 39(6): 688-94.
[11]
Bento PCB, Pereira G, Ugrinowitsch C, Rodacki ALF. Peak torque and rate of torque development in elderly with and without fall history. Clin Biomech (Bristol, Avon) 2010; 25(5): 450-4.
[http://dx.doi.org/10.1016/j.clinbiomech.2010.02.002] [PMID: 20350773]
[12]
Buchner DM, Cress ME, De Lateur BJ, Esselman PC, Margherita AJ, Price R, et al. Effect of Strength and Endurance Training on Gait, Balance, Fall Risk, and Health Services Use in Community-Living Older Adults 1997; 52: 218-24.
[13]
Vandenbroucke JP, von Elm E, Altman DG, et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration. PLoS Med 2007; 4(10): e297.
[http://dx.doi.org/10.1371/journal.pmed.0040297] [PMID: 17941715]
[14]
Bertolucci PHF, Brucki SMD, Campacci SR, Juliano YO. The Mini-Mental State Examination in a general population: impact of schooling. Arq Neuropsiquiatr 1994; 52: 01-7.
[http://dx.doi.org/10.1590/S0004-282X1994000100001]
[15]
Kikkert LHJ, de Groot MH, van Campen JP, et al. Gait dynamics to optimize fall risk assessment in geriatric patients admitted to an outpatient diagnostic clinic. PLoS One 2017; 12(6): e0178615.
[http://dx.doi.org/10.1371/journal.pone.0178615] [PMID: 28575126]
[16]
Pitta A, Pereira G, Lara JPR, et al. The effects of different exergame intensity training on walking speed in older women. Games Health J 2019; 1-9.
[PMID: 31770007]
[17]
Buatois S, Miljkovic D, Manckoundia P, et al. Five times sit to stand test is a predictor of recurrent falls in healthy community-living subjects aged 65 and older. J Am Geriatr Soc 2008; 56(8): 1575-7.
[http://dx.doi.org/10.1111/j.1532-5415.2008.01777.x] [PMID: 18808608]
[18]
Aparicio VA, Ortega FB, Heredia JM, Carbonell-Baeza A, Sjstrm M, Delgado-Fernandez M. Handgrip strength test as a complementary tool in the assessment of fibromyalgia severity in women. Arch Phys Med Rehabil 2011; 92: 83-8.
[http://dx.doi.org/10.1016/j.apmr.2010.09.010]
[19]
Rodacki A, Boneti Moreira N, Pitta A, et al. Is handgrip strength a useful measure to evaluate lower limb strength and functional performance in older women? Clin Interv Aging 2020; 15: 1045-56.
[http://dx.doi.org/10.2147/CIA.S253262] [PMID: 32636619]
[20]
Whitney SL, Wrisley DM, Marchetti GF, Gee MA, Redfern MS, Furman JM. Clinical measurement of sit-to-stand performance in people with balance disorders: Validity of data for the Five-Times-Sit-to-Stand Test. Phys Ther 2005; 85(10): 1034-45.
[http://dx.doi.org/10.1093/ptj/85.10.1034] [PMID: 16180952]
[21]
Elliott AF, McGwin G Jr, Owsley C. Health-related quality of life and visual and cognitive impairment among nursing-home residents. Br J Ophthalmol 2009; 93(2): 240-3.
[http://dx.doi.org/10.1136/bjo.2008.142356] [PMID: 18971236]
[22]
Regan K, Intzandt B, Swatridge K, Myers A, Roy E, Middleton LE. Changes in physical activity and function with transition to retirement living: A pilot study. Can J Aging 2016; 35(4): 526-32.
[http://dx.doi.org/10.1017/S0714980816000593] [PMID: 27917755]
[23]
Ahmed T, Curcio CL, Auais M, et al. Falls and life-space mobility: Longitudinal analysis from The International Mobility in Aging Study. Aging Clin Exp Res 2021; 33(2): 303-10.
[http://dx.doi.org/10.1007/s40520-020-01540-0] [PMID: 32270408]
[24]
Park S, Kim BR, Kwon E, Kown G. Influence of senior housing types on cognitive decline and nursing home admission among lower-income older adults. Aging Ment Health 2019; 24: 1579-88.
[http://dx.doi.org/10.1080/13607863.2019.1650888]
[25]
Mielke MM, Roberts RO, Savica R, et al. Assessing the temporal relationship between cognition and gait: Slow gait predicts cognitive decline in the Mayo Clinic Study of Aging. J Gerontol A Biol Sci Med Sci 2013; 68(8): 929-37.
[http://dx.doi.org/10.1093/gerona/gls256] [PMID: 23250002]
[26]
Van Patten R, Britton K, Tremont G. Comparing the mini-mental state examination and the modified mini-mental state examination in the detection of mild cognitive impairment in older adults. Int Psychogeriatr 2019; 31(5): 693-701.
[http://dx.doi.org/10.1017/S1041610218001023] [PMID: 30021667]
[27]
Rochette AD, Alexander NB, Cigolle CT, et al. Cognitive status as a robust predictor of repeat falls in older Veterans in post-acute care. Aging Clin Exp Res 2020; 33(6): 1677-82.
[http://dx.doi.org/10.1007/s40520-020-01635-8]
[28]
Datta A, Datta R, Elkins J. What factors predict falls in older adults living in nursing homes: A pilot study. J Funct Morphol Kinesiol 2018; 4(1): 3.
[http://dx.doi.org/10.3390/jfmk4010003] [PMID: 33467318]
[29]
Ojagbemi A, D’Este C, Verdes E, Chatterji S, Gureje O. Gait speed and cognitive decline over 2 years in the Ibadan study of aging. Gait Posture 2015; 41(2): 736-40.
[http://dx.doi.org/10.1016/j.gaitpost.2015.01.011] [PMID: 25698351]
[30]
da Silva LP, Moreira NB, Rodacki ALF. Are the spatiotemporal gait parameters at different walking speeds capable of predicting variations in cognitive status by the mini-mental state examination? J Ment Health 2022; 1-8.
[http://dx.doi.org/10.1080/09638237.2022.2091761] [PMID: 35770881]
[31]
Dumurgier J, Artaud F, Touraine C, et al. Gait speed and decline in gait speed as predictors of incident dementia. Gerontol - Ser A Biol Sci. Med Sci 2017; 72(5): 655-61.
[PMID: 27302701]
[32]
Kyrdalen IL, Thingstad P, Sandvik L, Ormstad H. Associations between gait speed and well-known fall risk factors among community-dwelling older adults. Physiother Res Int 2019; 24(1): e1743.
[http://dx.doi.org/10.1002/pri.1743] [PMID: 30198603]
[33]
Kuys SS, Peel NM, Klein K, Slater A, Hubbard RE. Gait speed in ambulant older people in long term care: A systematic review and meta-analysis. J Am Med Dir Assoc 2014; 15: 194-200.
[http://dx.doi.org/10.1016/j.jamda.2013.10.015]
[34]
Brach JS, Berlin JE, VanSwearingen JM, Newman AB, Studenski SA. Too much or too little step width variability is associated with a fall history in older persons who walk at or near normal gait speed. J Neuroeng Rehabil 2005; 2(1): 21.
[http://dx.doi.org/10.1186/1743-0003-2-21] [PMID: 16042812]
[35]
Nordin E, Moe-Nilssen R, Ramnemark A, Lundin-Olsson L. Changes in step-width during dual-task walking predicts falls. Gait Posture 2010; 32(1): 92-7.
[http://dx.doi.org/10.1016/j.gaitpost.2010.03.012] [PMID: 20399100]
[36]
Abualait T, Ahsan M. Comparison of gender, age, and body mass index for spatiotemporal parameters of bilateral gait pattern. F1000 Res 2021; 10: 266.
[http://dx.doi.org/10.12688/f1000research.51700.1]
[37]
Finkelstein EA, Chen H, Prabhu M, Trogdon JG, Corso PS. The relationship between obesity and injuries among U.S. adults. Am J Health Promot 2007; 21(5): 460-8.
[http://dx.doi.org/10.4278/0890-1171-21.5.460] [PMID: 17515011]
[38]
Gonzalez M, Gates DH, Rosenblatt NJ. The impact of obesity on gait stability in older adults. J Biomech 2020; 100: 109585.
[http://dx.doi.org/10.1016/j.jbiomech.2019.109585]
[39]
Orendurff MS, Segal AD, Klute GK, Berge JS, Rohr ES, Kadel NJ. The effect of walking speed on center of mass displacement. J Rehabil Res Dev 2004; 41(6): 829-34.
[http://dx.doi.org/10.1682/JRRD.2003.10.0150] [PMID: 15685471]
[40]
Frederiksen H, Hjelmborg J, Mortensen J, McGue M, Vaupel J, Christensen K. Age trajectories of grip strength: Cross-sectional and longitudinal data among 8,342 Danes aged 46 to 102. Ann Epidemiol 2006; 16(7): 554-62.
[http://dx.doi.org/10.1016/j.annepidem.2005.10.006] [PMID: 16406245]
[42]
Greene BR, McGrath D, Caulfield B. A comparison of crosssectional and prospective algorithms for falls risk assessment 36th Annu Int Conf IEEE Eng Med Biol Soc EMBC 2014; 4527-30.
[43]
Zaninotto P, Huang YT, Di Gessa G, Abell J, Lassale C, Steptoe A. Polypharmacy is a risk factor for hospital admission due to a fall: Evidence from the english longitudinal study of ageing. BMC Public Health 2020; 20(1): 1804.
[http://dx.doi.org/10.1186/s12889-020-09920-x]
[44]
Li M, Tomlinson G, Naglie G, Cook WL, Jassal SV. Geriatric comorbidities, such as falls, confer an independent mortality risk to elderly dialysis patients. Nephrol Dial Transplant 2007; 23(4): 1396-400.
[http://dx.doi.org/10.1093/ndt/gfm778] [PMID: 18057068]
[45]
Cunningham C, O’ Sullivan R, Caserotti P, Tully MA. Consequences of physical inactivity in older adults: A systematic review of reviews and meta-analyses. Scand J Med Sci Sports 2020; 30(5): 816-27.
[http://dx.doi.org/10.1111/sms.13616] [PMID: 32020713]