Yearlong Evaluation of Fall Risk Determinants Among 40 Older Adults in Two Residential Assisted Living Facilities

BACKGROUND Falls among the elderly, the second leading cause of death from unintentional injury globally, represent significant social and economic challenges. We evaluated the relationship between physical activity, physical performance, falls, and cognitive functioning at 1 year in 40 older adults living in 2 residential assisted living facilities in 2 communities in Wisconsin, USA.
MATERIAL AND METHODS Forty participants took part in the study, including 25 women and 15 men, with a mean age of 86.6 (±6.3) years. The Montreal Cognitive Assessment (MoCA) assessed cognitive functions, Hospital Anxiety and Depression Scale assessed depression, and Fall Efficacy Scale (FES) assessed fear of falling. Physical performance tests included the 10-meter walking test, 2-minute step test (2MST), and lower extremity strength and hand grip strength using a dynamometer. Additionally, posturography, using a portable Wii platform, Timed Up and Go test (TUG) test, and Performance Oriented Mobility Assessment (POMA) assessed balance.
RESULTS As many as 40% participants had at least 1 fall in 6 months. Significant deterioration in gait speed (P<0.0001) and mood (P=0.0137) over 1 year was noted. A significant correlation was found between number of falls and the 2MST (rho=-0.48), POMA and gait speed (rho=0.63), and the TUG (rho=-0.62), FES, and 2MST (rho=-0.54). The 2MST was the only significant parameter affecting the risk of falls in the study group (P=0.0118).
CONCLUSIONS Among assisted living facility residents, a higher risk of falling was associated with decreased gait speed, impaired balance, decreased mood, increased fear of falling, and fewer repetitions performed in the 2MST.