Assessment of mobility, body balance and risk of fractures in the elderly

Authors

DOI:

https://doi.org/10.15584/medrev.2016.2.1

Keywords:

the elderly, balance disorder, risk of falling

Abstract

Introduction. In recent years, we have seen significant changes in the highly dynamic process of ageing amongst the population of Europe, leading to increasing life expectancy. Prolonging the life of the elderly, in which full independence and functional performance are maintained, is a challenge facing modern medicine. It is necessary to take actions to improve health and quality of life during old age.

Purpose. The aim of this research is to assess the differences in mobility level and static/dynamic balance, as well as the risk of bone fractures between people aged 50 and 65 years and the elderly aged between 66 and 80 years. An analysis of the suitability of selected clinical tests is conducted to assess the above mentioned parameters.

Material and methods. The study included a group of 200 randomly selected people living in Rzeszów, a city in southeastern Poland, who were aged between 50 and 80 years. All the results of the research, which ultimately involved 138 people – 103 women and 35 men – have been analysed. To assess the mobility and static/dynamic balance, the following clinical tests were used: Timed Up and Go, Functional Reach, Tandem Stance, Tandem Walk and Tandem 180° Pivot. For the assessment of fracture risk, the Fracture Risk Assessment Tool (FRAX) calculator was used, while the data were collected on the basis of direct interviews.

Results. It was found that, with age, the frequency of dynamic balance, mobility disorders and the risk of bone fractures significantly increase. In a group of people aged 66 to 80 years, a decrease in the efficiency level of mobility and balance was observed in 30% of respondents on average, depending on the kind of functional test used (20-60%), in relation to people whose age did not exceed 65 years.

Conclusion. It is necessary to take preventive actions, especially amongst a group of people aged over 65 years, in order to improve functional efficiency and balance, thereby reducing the risk of fractures.

Downloads

Download data is not yet available.

References

United Nations. World Population Prospects: The 2004 Revision. New York:UN;2005.

Europejski Raport Zdrowia 2012: Droga do osiągnięcia dobrostanu. Europejskie Biuro Regionalne WHO, WHO 2013;1-18.

Brach JS, FitzGerald S, Newman AB, et. al. Physical activity and functional status in community-dwelling older women: a 14-year prospective study. Arch Intern Med 2003; 163:2565–2571.

Główny Urząd Statystyczny. Sytuacja demograficzna osób starszych i konsekwencje starzenia się ludności Polski w świetle prognozy na lata 2014 – 2050. Available from: http://stat.gov.pl/publikacje/szukaj.html?letter=s. Warszawa 2014;33-39.

Rubenstein LZ, Josephson KR. The epidemiolgy of falls and syncope. Clin Geriatr Med 2002;18(Suppl 2):141-158.

Czerwiński E, Białoszewski D, Borowy P, Kumorek A, Białoszewski A. Epidemiologia, znaczenie kliniczne oraz koszty i profilaktyka upadków u osób starszych. Ortop Traumatol Rehab 2008;5(Suppl 6):419-428.

Goldacre M.J, Roberts S, Yeate D. Mortality after admission to hospital with fractured neck of femur: database study. BMJ 2002:325(7369):868–869.

Thompson H, McCormick W, Kagan S. Traumatic Brain Injury in Older Adults: Epidemiology, Outcomes, and Future Implications. J Am Geriatr Soc 2006;54(Suppl 10):1590–1595.

US Centers for Disease Control and Prevention. Falls among older adults: an overview. http://www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html.

March L.M, Chamberlain A, Cameron I, Cumming R, Brnabic A, Finnegan T. How best to fix a broken hip. Fractured Neck of Femur Health Outcomes Project Team. Med J Aust 1999;170(Suppl 10):489–494.

Adelhafiz A, Austin C. Visual factors should be assessed in older people presenting with falls or hip fracture. Age Ageing 2003;32:26–30.

Zijlstra G, van Haastregt J, van Eijk J. Prevalence and correlates of fear of falling, and associated avoidance of activity in the general population of community-living older people. Age Ageing 2007;36:304–309.

Tinetti M.E. Preventing falls in elderly persons. New Engl J Med 2003;348(Supll 1):42–49.

Summary of the updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons. J Am Geriatr Soc 2011;59(Suppl 1):148–157.

World Health Organization: Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Technical Report Series 843,Geneva 1994.

Herman T, Mirelman A, Giladi N, Schweiger A, Hausdorff JM. Executive control deficits as a prodrome to falls in healthy older adults: a prospective study linking thinking, walking, and falling. J Gerontol A Biol Sci Med Sci 2010;65:1086–1092.

Vannorsdall TD, Waldstein SR, Kraut M, Pearlson GD, Schretlen DJ.White matter abnormalities and cognition in a community sample. Arch Clin Neuropsychol 2009;24: 209–217.

Podsiadlo D, Richardson S. The timed “Up & Go: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991;39(Suppl 2):142-148.

Venkatraman VK, Aizenstein H, Guralnik J, Newman AB, Glynn NW. Executive control function, brain activation and white matter hyperintensities in older adults. Neuroimage 2010;49:3436–3442.

Cohen H, Mulavara A, Peters BT, et.al. Sharpening the tandem walking test for screening peripheral neuropathy. South Med J 2013;106:565-569.

Duncan DW, Weiner D, Chandler J, Studenski S. Functional Reach: A New Clinical Measure of Balance. J Gerontol 1990;6:192-197.

Mallinson AI, Longridge NS. Increasing the usefulness of tandem walking evaluation. J Otolaryngol Head Neck Surg 2008;37:860-864.

Guralnik JM, Simonsick EM, Ferrucci L, et. al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 1994;49:85-94.

Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing 2006;35:37-41.

Fraga MF, Esteller M. Epigenetics and aging: the targets and the marks. Trends Genet. 2007;23:413–418.

Adams JM, White M. Biological ageing: a fundamental, biological link between socio-economic status and health? Eur J Public Health 2004;14:331–334.

Granacher U, Gollhofer A, Hortobágyi T, Kressig RW, MuehlbauerT. The importance of trunk muscle strength for balance, functional performance, and fall prevention in seniors: a systematic review. Sports Med 2013;43(Suppl 7):627-41.

Moreland J, Richardson J, Chan DH et.al. Evidence-based guidelines for the secondary prevention of falls in older adults. Gerontology 2003;49(Suppl 2):93-116.

Thomas J, Lane J. A Pilot Study to Explore the Predictive Validity of 4 Measures of Falls Risk in Frail Elderly Patients. Arch Phys Med Rehabil 2005;8:1636–1640.

Be-long C, Scarpace D, Neil BA. Tests of Stepping as Indicators of Mobility, Balance, and Fall Risk in Balance-Impaired Older Adults. J Am Geriatr Soc 2004;52(Suppl 77): 1168–1173.

Nakano M, Otonari TS, Takara K, Carmo CM, Takana C. Physical Performance, Balance, Mobility and Muscule Strenght Decline AT Diffrent Rates in Elderly People. J Phys Ther Sci 2014;26:583-586.

Siqueira FV, Facchini LA, Silveira DS, et.al. Prevalence of falls in elderly in Brazil: a countrywide analysis 2011;27(9):1819-1826.

Beauchet O, Fantino B, Allali G, Muir SW, Montero-Odasso M, Annweiler C. Timed Up and Go test and risk of falls in older adults: a systematic review. J Nutr Health Aging 2011;15(10):933-938.

Vereeck L, Wuyts F, Truijen S, Van de Heyning P. Clinical assessment of balance: normative data, and gender and age effects. Int J Audiol 2008;47(2):67-75.

Salzman B, Jefferson T. Gait and Balance Disorders in Older Adults. Am Fam Physician 2010;82(1):61-68.

American Geriatrics Society British Geriatrics Society American Academy of Orthopedic Surgeons Panel on Falls Prevention. Guideline for the prevention of falls in older persons. J Am Geriatr Soc 2001;49:664–672.

Chantanachai T, Pichaiyongwongdee S, Jalayondeja C. Fall prediction in thai elderly with timed up and go and tandem walk test: a cross-sectional study. J Med Assoc Thai 2014; 9(7):21-25.

Schoene D, Wu SM-S, Mikolaizak AS, et. al. Discriminative ability and predictive validity of the timed up and go test in identifying older people who fall: systematic review and meta-analysis. J Am Geriatr Soc 2013;61:202–208.

Beauchet O, Fantino B, Allali G, Muir SW, Montero-Odasso M, Annweiler C. Timed up and go test and risk of falls in older adults: A systematic review. J Nutr Health Aging 2011;15:933–938.

Barry E, Galvin R, Keogh C, Horgan F, Fahey T. Is the Timed Up and Go test a useful predictor of risk of falls in community dwelling older adults: a systematic review and metaanalysis. BMC Geriatr 2014;14:14-20.

Lönnroos E, Kautiainen H, Karppi P, et.al. Increased incidence of hip fractures. A population based-study in Finland. Bone 2006;39:623- 627.

Finsterwald M, Sidelnikov E, Orav E, et. al. Bischoff-Ferrari. Gender-specific hip fracture risk in community dwelling and institutionalized seniors age 65 years and older. Osteoporosis Int 2014; 25:167-176.

National Center for Chronic Disease Prevention and Health Promotion. At a glance-Healthy aging: Preventing disease and improving quality of life among older Americans, 2004. Centers for Disease Control and Prevention, Atlanta, GA. Available from: http://www.cdc.gov/nccdphp/aag/aag_

aging.htm.

Larson E, Wang L, Bowen JD, et.al. Exercise is associated with reduced risk for incident dementi among persons 65 years of age and older. Ann Intern Med 2006;144:73-81.

Villareal DT, Binder EF, Yarasheski KE, et.al. Effects of exercise training added to ongoning hormone replacement therapy on bone mineral density In frail elderly women. J Am Geriatr Soc 2003;51: 985-990.

Heath JM, Stuart MR. Prescribing exercise for frail elders. J Am. Board Fam. Pract 2002; 15:218–228.

Kozdroń E. Program Rekreacji Ruchowej Osób Starszych. Warszawa:AWF Warszawa; 2008.

Główny Urząd Statystyczny: Mały Rocznik Statystyczny RP. Warszawa 2006.

Published

2016-06-30

How to Cite

Ćwirlej-Sozańska, A., Wilmowska-Pietruszyńska, A., Wiśniowska, A., Guzik, A., Drużbicki, M., & Sozański, B. (2016). Assessment of mobility, body balance and risk of fractures in the elderly. European Journal of Clinical and Experimental Medicine, 14(2), 134–147. https://doi.org/10.15584/medrev.2016.2.1

Issue

Section

ORIGINAL PAPERS

Most read articles by the same author(s)

1 2 > >>