Technology-Based Fall Risk Assessments for Older Adults in Low-Income Settings: Protocol for a Cross-sectional Study.

Ladda Thiamwong,Xin Yan,Joon-Hyuk Park,Jeffrey R Stout

doi:10.2196/27381

Abstract

BackgroundOne-third of older adults have maladaptive fall risk appraisal (FRA), a condition in which there is a discrepancy between the level of fear of falling (FOF) and physiological fall risk (balance performance). Older adults who overestimate their physiological fall risk and report a high FOF are less likely to participate in physical activity. Limited data suggest that the association among FOF, body composition, and physical activity intensity differs by fear severity. ObjectiveThis study aims to examine the associations among FRA, body composition, and physical activity using assistive health technology, including the BTrackS balance system, bioelectrical impedance analysis, and activity monitoring devices. This study also aims to examine the feasibility of recruitment and acceptability of technologies and procedures for use among older adults in low-income settings. MethodsThis cross-sectional study will be conducted in older adults’ homes or apartments in low-income settings in Central Florida, United States. Following consent, participants will be contacted, and our team will visit them twice. The first visit includes questionnaire completion (eg, sociodemographic or FOF) and balance performance test using the BTrackS balance system. The participants will be stratified by the FRA matrix. In addition, they will perform hand grip strength and dynamic balance performance tests. Participants will then be asked to wear the ActiGraph GT9X Link wireless activity monitor on the nondominant wrist for 7 consecutive days. The second visit includes body composition testing and a structured interview about the acceptability of the technologies and procedures. ResultsEthical approval was obtained from the institutional review board of the University of Central Florida (protocol number 2189; September 10, 2020). As of December 2020, participation enrollment is ongoing and the results are expected to be published in Summer 2022. ConclusionsAccurate FRA is essential for implementing physical activity programs, especially in older adults with low income. This study will provide data for developing technology-based fall risk assessments to improve participation in physical activity, thus enhancing healthy longevity among older adults in low-income settings. International Registered Report Identifier (IRRID)PRR1-10.2196/27381

Highlights

BackgroundMore than 15 million (30%) older adults in the United States have income below 200% of the poverty line [1,2]
Limited data suggest that older adults who overestimate their fall risk and report fear of falling (FOF) are less likely to participate in physical activity (PA), and the association between FOF and PA intensity differs by fear severity [9]
This study examines the associations among body composition, fall risk appraisal (FRA), and PA using assistive health technology (AHT), including bioelectrical impedance analysis (BIA) [25], BTrackS balance system BIA (BBS) [26,27], and activity monitoring devices [28]

Summary

Introduction

BackgroundMore than 15 million (30%) older adults in the United States have income below 200% of the poverty line [1,2]. Changes in body composition have a significant effect on physical functions and quality of life [10] These studies did not include older adults from low-income settings, who were more likely to report falls in the previous year [11]. Older adults who overestimate their physiological fall risk and report a high FOF are less likely to participate in physical activity. Objective: This study aims to examine the associations among FRA, body composition, and physical activity using assistive health technology, including the BTrackS balance system, bioelectrical impedance analysis, and activity monitoring devices. This study will provide data for developing technology-based fall risk assessments to improve participation in physical activity, enhancing healthy longevity among older adults in low-income settings.

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Conclusion