Abstract
As the population ages, fall rates are expected to increase, leading to a rise in accidental injury and injury-related deaths, and placing an escalating burden on health care systems. Sixty-nine independent community-dwelling adults (60–85 years, 18 males) had their leg strength, physical activity levels and their annual fall rate assessed at two timepoints over three years, (summer 2010 and summer 2013) monitoring balance. Force platform measures of medio-lateral sway range increased significantly under conditions of eyes open (mean difference MD 2.5 cm; 95% CI 2.2 to 2.8 cm) and eyes closed (MD 3.2 cm; 95% CI 2.8 to 3.6 cm), respectively (all p < 0.001) indicating worsening static balance control. Dynamic balance showed similar changes (p < 0.036). Leg strength was not significantly different between visits (p > 0.26). Physical activity reduced significantly (MD −909 Cal/week; 95% CI −347 to −1,470 Cal/week; p = 0.002) during the course of the study. Participants maintained aerobic activities, however resistance and balance exercise levels decreased non-significantly. The likelihood of falling was higher at the end of the study compared to the first timepoint (odds ratio 1.93, 95% CI 0.94 to 3.94; p = 0.07). Results of this study indicate that despite maintenance of leg strength there was an increase in medio-lateral sway over a relatively short time frame, with higher than expected increases in fall rates.
Highlights
As the population ages, fall rates are expected to increase, leading to a rise in accidental injury and injury-related deaths, affecting our society and placing an escalating burden on health care systems.The personal impact of falls is high, often resulting in loss of confidence and reduced functional activity, deconditioning and an increased risk of falling [1]
Sixty-nine independently mobile community-dwelling adults agreed to be followed up three years after initial summer assessment (ISA) [15] (60 to 85 years, mean 73.5 SD 6.9 years, 18 males and 51 females); all participants were of Western European descent, with stable chronic disease including hypertension, cardio-vascular disease, respiratory conditions and diabetes
They were followed up three years apart monitoring balance, leg strength, physical activity levels, and their annual fall data for the previous 12 months (Table 1)
Summary
Fall rates are expected to increase, leading to a rise in accidental injury and injury-related deaths, affecting our society and placing an escalating burden on health care systems.The personal impact of falls is high, often resulting in loss of confidence and reduced functional activity, deconditioning and an increased risk of falling [1]. Fall rates are expected to increase, leading to a rise in accidental injury and injury-related deaths, affecting our society and placing an escalating burden on health care systems. Of the total health budget, it is expected that by 2051 fall related injuries will triple and will cost the Australian health sector over $ 1,375 million dollars per year [2]. There are many reasons why older people fall: some of these factors are environmental and others pertain to the tasks undertaken or the physical characteristics of the faller. These factors include balance impairment and reduced lower limb strength, both of which increase with natural aging processes. It is suggested that changes to postural sway control in older adults who fall may be due to a decrease in the sensitivity of their postural control system [3]
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