Falls often have severe financial and environmental consequences, not only for those who fall, but also for their families and society at large. Identifying fall risk in older adults can be of great use in preventing or reducing falls and fall risk, and preventative measures that are then introduced can help reduce the incidence and severity of falls in older adults. The overall aim of our
(Edited publisher abstract)
Falls often have severe financial and environmental consequences, not only for those who fall, but also for their families and society at large. Identifying fall risk in older adults can be of great use in preventing or reducing falls and fall risk, and preventative measures that are then introduced can help reduce the incidence and severity of falls in older adults. The overall aim of our systematic review was to provide an analysis of existing mechanisms and measures for evaluating fall risk in older adults. The 43 included FRATs produced a total of 493 FRAT items which, when linked to the ICF, resulted in a total of 952 ICF codes. The ICF domain with the most used codes was body function, with 381 of the 952 codes used (40%), followed by activities and participation with 273 codes (28%), body structure with 238 codes (25%) and, lastly, environmental and personal factors with only 60 codes (7%). This review highlights the fact that current FRATs focus on the body, neglecting environmental and personal factors and, to a lesser extent, activities and participation. This over-reliance on the body as the point of failure in fall risk assessment clearly highlights the need for gathering qualitative data, such as from focus group discussions with older adults, to capture the perspectives and views of the older adults themselves about the factors that increase their risk of falling and comparing these perspectives to the data gathered from published FRATs as described in this review.
(Edited publisher abstract)
Subject terms:
adults, falls, risk assessment, ageing, older people;
Objective: The aim of the study was to explore the association between fear of falling (FOF), dual-task ability during a mobility task, and the activities of daily living (ADL) in a sample of older adults. Methods: Seventy-six older adults (mean age M = 70.87 ± 5.16 years) participated in the study. Data on FOF (using the Falls Self-Efficacy Scale-International), walking ability during both
(Edited publisher abstract)
Objective: The aim of the study was to explore the association between fear of falling (FOF), dual-task ability during a mobility task, and the activities of daily living (ADL) in a sample of older adults. Methods: Seventy-six older adults (mean age M = 70.87 ± 5.16 years) participated in the study. Data on FOF (using the Falls Self-Efficacy Scale-International), walking ability during both single- and dual-task performances and ADL were collected. Results: Mediation analysis demonstrated the mediation effect of dual-task ability between FOF and ADL level. Moreover, significantly lower performances were observed during dual-task condition, and lower ADL levels were also found in older adults with. Conclusion: The study underlines the relationship between FOF, dual-task ability and ADL level. These results could be used to develop specific intervention programmes for successful ageing.
(Edited publisher abstract)
Subject terms:
older people, ageing, falls, activities of daily living, anxiety;
International Journal of Geriatric Psychiatry, 35(9), 2020, pp.1028-1035.
Publisher:
Wiley
The purpose of this study was to identify whether the onset and the end of fear of falling (FOF) are associated with psychosocial consequences (in terms of depressive symptoms, loneliness, social isolation, autonomy, and subjective well‐being). Methods/Design: Longitudinal data for this study were taken from the nationally representative German Ageing Survey which included community‐dwelling individuals ≥40 years (wave 5 and wave 6). Psychosocial outcome measures were assessed using widely established and well‐validated scales. The presence of FOF was used as the main explanatory variable. It was adjusted for age, family status, labor force participation, self‐rated health, physical functioning, as well as the number of chronic conditions. Results: Linear fixed effects regressions revealed that FOF was associated with adverse psychosocial outcomes (increased depressive symptoms, lower life satisfaction, lower positive affect, higher negative affect, and lower perceived autonomy). Asymmetric fixed effects regressions analysis showed that the onset of FOF was associated with reduced life satisfaction as well as reduced autonomy, whereas the end of FOF was associated with reduced depressive symptoms, decreased loneliness scores, as well as decreased negative affect. Conclusions: The study findings suggest that future studies should analyze the consequences of FOF differently (onset and end of FOF) which has practical important implications. More specifically, while strategies to avoid the onset of FOF may help to maintain satisfaction with life and autonomy, strategies to end FOF may contribute to avoid increased loneliness, feelings of negative affect, as well as increased depressive symptoms.
(Publisher abstract)
The purpose of this study was to identify whether the onset and the end of fear of falling (FOF) are associated with psychosocial consequences (in terms of depressive symptoms, loneliness, social isolation, autonomy, and subjective well‐being). Methods/Design: Longitudinal data for this study were taken from the nationally representative German Ageing Survey which included community‐dwelling individuals ≥40 years (wave 5 and wave 6). Psychosocial outcome measures were assessed using widely established and well‐validated scales. The presence of FOF was used as the main explanatory variable. It was adjusted for age, family status, labor force participation, self‐rated health, physical functioning, as well as the number of chronic conditions. Results: Linear fixed effects regressions revealed that FOF was associated with adverse psychosocial outcomes (increased depressive symptoms, lower life satisfaction, lower positive affect, higher negative affect, and lower perceived autonomy). Asymmetric fixed effects regressions analysis showed that the onset of FOF was associated with reduced life satisfaction as well as reduced autonomy, whereas the end of FOF was associated with reduced depressive symptoms, decreased loneliness scores, as well as decreased negative affect. Conclusions: The study findings suggest that future studies should analyze the consequences of FOF differently (onset and end of FOF) which has practical important implications. More specifically, while strategies to avoid the onset of FOF may help to maintain satisfaction with life and autonomy, strategies to end FOF may contribute to avoid increased loneliness, feelings of negative affect, as well as increased depressive symptoms.
(Publisher abstract)
Subject terms:
falls, older people, anxiety, ageing, psychosocial approach, loneliness;
NIHR CLAHRC. East Midlands, NATIONAL INSTITUTE FOR HEALTH RESEARCH
Publisher:
NIHR Applied Research Collaboration East Midlands
Publication year:
2020
Pagination:
56
Place of publication:
Leicester
This toolkit provides a suite of resources that commissioners can use to plan, implement and monitor the Falls Management Exercise (FaME) programme. FaME is an evidence-based tailored strength and balance exercise programme that has been shown to reduce the rate of falls, increase physical activity levels and improve wellbeing. The toolkit is an output of the PhISICAL study (Physical activity
(Edited publisher abstract)
This toolkit provides a suite of resources that commissioners can use to plan, implement and monitor the Falls Management Exercise (FaME) programme. FaME is an evidence-based tailored strength and balance exercise programme that has been shown to reduce the rate of falls, increase physical activity levels and improve wellbeing. The toolkit is an output of the PhISICAL study (Physical activity Implementation Study In Community-dwelling AduLts). Sections of the toolkit cover: Building the case for implementing FaME which includes evidence summaries for commissioners, a costing tool, a business case and real life case studies from FaME class participants; Planning the implementation of FaME, which includes an implementation Gantt chart, a service specification, example delivery models, videos, logic model and key learning from the PhISICAL study; Implementing the programme, which includes sample promotional materials and templates; and Monitoring, evaluation and quality improvement, which provides quality assurance guidance and suggested monitoring tools and schedule.
(Edited publisher abstract)
Subject terms:
falls, prevention, physical exercise, older people, intervention, ageing;
Falls pose a major threat to the well-being and quality of life of older people. Falls can result in fractures and other injuries, disability and fear and can trigger a decline in physical function and loss of autonomy. This article synthesises recent published findings on fall risk and mobility assessments and fall prevention interventions and considers how this field of research may evolve in the future. Fall risk topics include the utility of remote monitoring using wearable sensors and recent work investigating brain activation and gait adaptability. New approaches for exercise for fall prevention including dual-task training, cognitive-motor training with exergames and reactive step training are discussed. Additional fall prevention strategies considered include the prevention of falls
(Edited publisher abstract)
Falls pose a major threat to the well-being and quality of life of older people. Falls can result in fractures and other injuries, disability and fear and can trigger a decline in physical function and loss of autonomy. This article synthesises recent published findings on fall risk and mobility assessments and fall prevention interventions and considers how this field of research may evolve in the future. Fall risk topics include the utility of remote monitoring using wearable sensors and recent work investigating brain activation and gait adaptability. New approaches for exercise for fall prevention including dual-task training, cognitive-motor training with exergames and reactive step training are discussed. Additional fall prevention strategies considered include the prevention of falls in older people with dementia and Parkinson’s disease, drugs for fall prevention and safe flooring for preventing fall-related injuries. The review discusses how these new initiatives and technologies have potential for effective fall prevention and improved quality of life. It concludes by emphasising the need for a continued focus on translation of evidence into practice including robust effectiveness evaluations of so that resources can be appropriately targeted into the future.
(Edited publisher abstract)
Subject terms:
prevention, falls, ageing, physical exercise, assistive technology, accidents, older people;
SHAW James A., CONNELLY Denise M., MCWILLIAM Carol L.
Journal article citation:
Ageing and Society, 35(9), 2015, pp.2011-2025.
Publisher:
Cambridge University Press
Falling in later life continues to be a critical issue in gerontology research, health professional practice and ageing health policy. However, much research in the area of fall risk and fall prevention neglects the meaning of the experiences of older people themselves. This humanistic interpretive phenomenological study explored the meaning of the experience of anticipating falling from the perspective of older people in order to foster a more person-focused approach to fall risk assessment and fall prevention. Individual semi-structured interviews were conducted with nine participants over the age of 65 living independently in the community. Follow-up interviews with two key informants were completed to inform the emerging interpretations. For older participants residing in the community, the experience of anticipating falling meant confronting their embodied lived-identity in the context of ageing. Experiential learning shaped how participants understood the meaning of falling, which constituted tacit, pathic knowledge of vulnerability and anxiety with respect to falling. Findings emphasise the importance of critically reflecting on the social experience of anticipating falling to develop effective and relevant fall prevention interventions, programmes and policies. A lifeworld-led approach to fall risk assessment and fall prevention resonates with these findings, and may encourage health-care providers to adopt a sustained focus on embodied lived-identity and quality of life when engaging older people in fall prevention activities.
(Publisher abstract)
Falling in later life continues to be a critical issue in gerontology research, health professional practice and ageing health policy. However, much research in the area of fall risk and fall prevention neglects the meaning of the experiences of older people themselves. This humanistic interpretive phenomenological study explored the meaning of the experience of anticipating falling from the perspective of older people in order to foster a more person-focused approach to fall risk assessment and fall prevention. Individual semi-structured interviews were conducted with nine participants over the age of 65 living independently in the community. Follow-up interviews with two key informants were completed to inform the emerging interpretations. For older participants residing in the community, the experience of anticipating falling meant confronting their embodied lived-identity in the context of ageing. Experiential learning shaped how participants understood the meaning of falling, which constituted tacit, pathic knowledge of vulnerability and anxiety with respect to falling. Findings emphasise the importance of critically reflecting on the social experience of anticipating falling to develop effective and relevant fall prevention interventions, programmes and policies. A lifeworld-led approach to fall risk assessment and fall prevention resonates with these findings, and may encourage health-care providers to adopt a sustained focus on embodied lived-identity and quality of life when engaging older people in fall prevention activities.
(Publisher abstract)
Subject terms:
older people, falls, prevention, risk, risk assessment, ageing, attitudes;
This review of the literature provides a context for the AKTIVE project, which was established to explore how older people, particularly those susceptible to falls or who have cognitive impairments, may benefit from having access in and around their homes to various types of telecare technology. The review considers the social, economic and financial costs of falls and dementia, providing
(Edited publisher abstract)
This review of the literature provides a context for the AKTIVE project, which was established to explore how older people, particularly those susceptible to falls or who have cognitive impairments, may benefit from having access in and around their homes to various types of telecare technology. The review considers the social, economic and financial costs of falls and dementia, providing an overview of the demographic changes in the UK. It offers insights into telecare both from the sociology of technology and ageing and from a design-focused perspective. It also explores the policy context around telecare and some of the evidence base used in commissioning telecare, giving examples from local authorities and discussing the role of ‘personalisation’ as an additional driver behind the telecare agenda. In addition, the review considers the limits and barriers to the take-up and adoption of telecare, focusing on psycho-social barriers, impairment diversity, limited funding and poor design.
(Edited publisher abstract)
Subject terms:
telecare, assistive technology, older people, falls, dementia, ageing;
... to determine whether reported falls are associated with an older adult’s decision to make a residential adjustment and the type of adjustment made in the subsequent 2 years. Data was taken from the Health and Retirement Study, a longitudinal nationally representative survey of community-living older adults, 65 years of age and older. At baseline, the history of number of falls, whether they had resulted in an injury and other factors potentially associated with residential adjustment were used to predict the initiation of a residential adjustment during the subsequent 2 years. The results showed that, compared with those with no history of falls, individuals with a history of falls had higher odds of making a residential adjustment. Among those making an residential adjustment, individuals with an injurious
Faced with declining function, aging Americans may make a residential adjustment in order to maximise independence and remain in the community. Residential adjustments can take several forms including moving to an alternative residence, making a home wheelchair accessible, increasing personal care assistance, increased use of family support, or increasing the use of equipment. This study aimed to determine whether reported falls are associated with an older adult’s decision to make a residential adjustment and the type of adjustment made in the subsequent 2 years. Data was taken from the Health and Retirement Study, a longitudinal nationally representative survey of community-living older adults, 65 years of age and older. At baseline, the history of number of falls, whether they had resulted in an injury and other factors potentially associated with residential adjustment were used to predict the initiation of a residential adjustment during the subsequent 2 years. The results showed that, compared with those with no history of falls, individuals with a history of falls had higher odds of making a residential adjustment. Among those making an residential adjustment, individuals with an injurious fall were more likely than those with no history of a fall to start using adaptive equipment or increase their use of personal care assistance.
Subject terms:
home care, housing, longitudinal studies, older people, ageing, assistive technology, falls;
... and the involvement of practitioners in the process. The model was then applied to the specific issue of falls prevention among community-dwelling older adults. The dialogue and interaction among researchers and practitioners provided new insights beyond a traditional research review. Practitioners offered astute guidance for future research based on their day-to-day field experience. The recommendations
On the basis of the experience of an extensive community-based research partnership in New York City, the authors developed an innovative process for bridging the gap between aging-related research and practice, using a consensus-workshop model. The authors adapted the traditional scientific consensus-workshop model to include translation of the research into nontechnical language and the involvement of practitioners in the process. The model was then applied to the specific issue of falls prevention among community-dwelling older adults. The dialogue and interaction among researchers and practitioners provided new insights beyond a traditional research review. Practitioners offered astute guidance for future research based on their day-to-day field experience. The recommendations that emerged from the workshop demonstrated the value of close interaction between the aging-related research and practice communities. The consensus-conference model has significant potential to establish a bridge between the worlds of research and practice in a variety of settings.
Subject terms:
models, older people, prevention, research implementation, ageing, falls, evidence-based practice;
Journal of Gerontological Social Work, 43(3/4), 2004, pp.151-162.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA
The argument in this article is that the basic conceptual model used in construction of services to older people served well in years past but is now inadequate, descriptively or analytically. An alternative approach to the construction of community-based services is proposed and then examples from the practice of the author and from other communities are described. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580)
The argument in this article is that the basic conceptual model used in construction of services to older people served well in years past but is now inadequate, descriptively or analytically. An alternative approach to the construction of community-based services is proposed and then examples from the practice of the author and from other communities are described. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580)
Subject terms:
older people, social work, social care provision, ageing, community care, falls, health needs;