Assessing gait and balance impairment in elderly residents of nursing homes

[Purpose] The risk of falls in the elderly is an important public health problem. Suitable tests may help detect those at risk of falling. This study determined which balance test for older adults generates the most reliable results in terms of fall risk assessment, based on the number of falls over the last 12 months. [Subjects and Methods] A total of 153 individuals (31 males, 122 females, aged 76.67 ± 8.3 years; median 76.5, range 65–94) were investigated. The subjects were subdivided between fallers (a fall over the last 12 months) and non-fallers (no falls over the last 12 months). All participants were assessed with the following: Barthel Scale, Mini-Mental State Examination, Timed Up and Go, Tinetti Performance-Oriented Mobility Assessment), Berg Balance Test, and One-Legged Stance Test. [Results] Statistically significant differences were detected between fallers and non-fallers in TUG, POMA, BBS, and OLST scores. The number of falls correlated positively with the results for TUG, POMA, and OLST. [Conclusion] TUG and POMA were the most useful screening tests for balance and gait impairment in elderly nursing home residents. Two or more tests should be performed for more precise assessment of the risk of falling.

[1]  K. Eckert,et al.  Comparison of physical activity questionnaires for the elderly with the International Classification of Functioning, Disability and Health (ICF) – an analysis of content , 2015, BMC Public Health.

[2]  K. Musselman,et al.  Physical Function and Health Status among Seniors with and without a Fear of Falling , 2004, Gerontology.

[3]  S. Straus,et al.  Clinical balance assessment: perceptions of commonly-used standardized measures and current practices among physiotherapists in Ontario, Canada , 2013, Implementation Science.

[4]  E. D. de Bruin,et al.  The effect of interactive cognitive-motor training in reducing fall risk in older people: a systematic review , 2014, BMC Geriatrics.

[5]  B. Karakiewicz,et al.  Fall Risk Factors in Community-Dwelling Elderly Depending on Their Physical Function, Cognitive Status and Symptoms of Depression , 2015, International journal of environmental research and public health.

[6]  M. Tinetti,et al.  A multifactorial intervention to reduce the risk of falling among elderly people living in the community. , 1994, The New England journal of medicine.

[7]  T. Sinkjaer,et al.  Fall risk in an active elderly population – can it be assessed? , 2007, Journal of Negative Results in BioMedicine.

[8]  A. Ataş,et al.  Evaluation of balance in fallers and nonfallers elderly , 2015, Brazilian journal of otorhinolaryngology.

[9]  Diane Podsiadlo,et al.  The Timed “Up & Go”: A Test of Basic Functional Mobility for Frail Elderly Persons , 1991, Journal of the American Geriatrics Society.

[10]  K. Markides,et al.  Falls and cognitive decline in Mexican Americans 75 years and older , 2014, Clinical interventions in aging.

[11]  Laurie A. King,et al.  Do Clinical Scales of Balance Reflect Turning Abnormalities in People With Parkinson's Disease? , 2012, Journal of neurologic physical therapy : JNPT.

[12]  D. Connelly,et al.  Threshold Berg balance scale scores for gait-aid use in elderly subjects: a secondary analysis. , 2010, Physiotherapy Canada. Physiotherapie Canada.

[13]  Magdalena Roszak,et al.  Assessment of the risk of falling with the use of timed up and go test in the elderly with lower extremity osteoarthritis , 2015, Clinical interventions in aging.

[14]  R W Bohannon,et al.  Decrease in timed balance test scores with aging. , 1984, Physical therapy.

[15]  Suzanne G. Leveille,et al.  Sex differences in circumstances and consequences of outdoor and indoor falls in older adults in the MOBILIZE Boston cohort study , 2013, BMC Geriatrics.

[16]  M. Borrie,et al.  Circumstances and consequences of falls experienced by a community population 70 years and over during a prospective study. , 1990, Age and ageing.

[17]  Banu Mujdeci,et al.  Avaliação do equilíbrio em idosos que sofrem queda e aqueles que não sofrem quedas , 2012 .

[18]  Tom Fahey,et al.  Is the Timed Up and Go test a useful predictor of risk of falls in community dwelling older adults: a systematic review and meta- analysis , 2014, BMC Geriatrics.

[19]  A. Mitnitski,et al.  Assessing Balance and Mobility to Track Illness and Recovery in Older Inpatients , 2011, Journal of General Internal Medicine.

[20]  G. Gehlsen,et al.  Falls in the elderly: Part II, Balance, strength, and flexibility. , 1990, Archives of physical medicine and rehabilitation.

[21]  Lisa C. Blum,et al.  Usefulness of the Berg Balance Scale in Stroke Rehabilitation: A Systematic Review , 2008, Physical Therapy.

[22]  P. Shekelle,et al.  Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials , 2004, BMJ : British Medical Journal.

[23]  Victoria A Goodwin,et al.  Multiple component interventions for preventing falls and fall-related injuries among older people: systematic review and meta-analysis , 2014, BMC Geriatrics.

[24]  S. Lo,et al.  A comparison of four functional tests in discriminating fallers from non-fallers in older people , 2003, Disability and rehabilitation.

[25]  C. Carmo,et al.  Physical Performance, Balance, Mobility, and Muscle Strength Decline at Different Rates in Elderly People , 2014, Journal of physical therapy science.

[26]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.