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Physical Function and Fall Risk among Urban Community Dwelling Elders

Physical Function and Fall Risk among Urban Community Dwelling Elders. Arline Bohannon, MD Pamela Parsons, PhD Department of Internal Medicine Section of Geriatrics. Falls in Elderly. Common feature of frailty Increased morbidity Restricted mobility

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Physical Function and Fall Risk among Urban Community Dwelling Elders

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  1. Physical Function and Fall Risk among Urban Community Dwelling Elders Arline Bohannon, MD Pamela Parsons, PhD Department of Internal Medicine Section of Geriatrics

  2. Falls in Elderly • Common feature of frailty • Increased morbidity • Restricted mobility • Increased risk of nursing home placement

  3. Predictors of Fall Risk • Intrinsic Factors • Advanced age • Sensory deficits • Musculoskeletal Disorders • Neurologic Disorders

  4. Predictors of Fall Risk • Environmental Factors • Use of multiple medications • Cluttered hallways • Slippery floors

  5. Physical Performance Measures • Lower extremity weakness • Gait assessment • Balance

  6. Objectives • To describe physical function and fall risk among community dwelling minority elders • To evaluate the relationships between self-reported physical function and physical performance among minority elders

  7. Study Design • Cross sectional • Study sample – 50 volunteers Exclusion criteria: Unable to understand English Moderate-severe cognitive impairment

  8. Short Portable Mental Status Questionnaire • Cognitive Function • 10 item survey • 5 or more errors = cognitive impairment

  9. Late Life Function and Disability Instrument (LLFDI) • Self report physical function instrument • Administered by trained reviewer • 48 item questionnaire • Disability component (16 items) • Functional component (32 items)

  10. Scoring of LLDFI • Overall functioning • Physical functioning upper extremity basic lower advanced lower • Disability functioning limitation frequency

  11. LLFDI (mean ± SEM)

  12. Modified Timed Get Up and Go • Measures physical mobility • Measured in seconds • Test • Stand from a standard armchair • Walk three meters • Turn 180° • Walk back to chair • Sit down

  13. Modified Timed Get Up and GO

  14. Tinetti Assessment Tool • Measures gait and balance • Balance test • 14 maneuvers • Scored on a three point ordinal scale • Range from 0 to 2 for each task • Maximum score is 16

  15. Tinetti Assessment Tool • Gait test • 10 components • Ranges form 0 to 16 • Maximum score = 12 • Total score • Balance + Gait • Maximum score = 28 • Higher functioning = better mobility

  16. Tinetti Assessment Tool • Low Risk • Total score > 24 • Moderate Risk • Total score 19-24 • High Risk • Total score < 19

  17. Fall Risk Stratification • High risk • Medium • Low risk

  18. Stratification Methods • Tinetti Assessment Tool – Total Score • Modified Timed Get Up and Go • Combination

  19. Analyses – Objective 1 Demographic characteristics Compare risk factors between groups • ANOVA • t tests • Logistic regression

  20. Analyses – Objective 2 • Correlation • LLDFI and Modified Timed Get Up and Go • LLDFI and Tinetti Assessment Tool – Total score • LLDFI – composite or combination score taking into account both measures

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