Technology-based fall risk assessments for older adults in low-income settings

基于技术的低收入老年人跌倒风险评估

• 批准号: 10093556
• 负责人: Ladda Thiamwong
• 金额: $ 7.45万
• 依托单位: UNIVERSITY OF CENTRAL FLORIDA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-30 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10093556
• 关键词: Accelerometer; Age-Years; American; Biolectric Impedance; Body Composition; Body fat; Body mass index; Body measure procedure; Censuses; Chronic; Cognitive deficits; Communities; Cross-Sectional Studies; Data; Development; Devices; Elderly; Enrollment; Equilibrium; Exclusion Criteria; Florida; Fright; Health Technology; Home environment; Impaired cognition; Intervention; Knowledge; Link; Longevity; Low income; Measurement; Measures; Medical; Obesity; Overweight; Pacemakers; Participant; Patient Self-Report; Performance; Physical activity; Physiological; Pilot Projects; Poverty; Procedures; Quality of life; Questionnaires; Rehabilitation therapy; Reporting; Research; Risk Assessment; Safety; Sampling; Severities; Shortness of Breath; Skeletal Muscle; Social isolation; System; Technology; Testing; Time; Well in self; Woman; actigraphy; balance testing; base; design; disability; fall risk; falls; fear of falling; functional disability; improved; improved functioning; medical implant; monitoring device; muscle form; novel; physical inactivity; portability; programs; recruit; residence; skills

PROJECT SUMMARY/ABSTRACT In the US, older adults (OAs) who live in low-income communities are less likely to engage in physical activity (PA). Lack of PA is related to chronic conditions and poor quality of life. Limited data suggest that OAs who report fear of falling (FOF) and overestimate their fall risk are less likely to participate in PA; and the association between FOF and PA intensity differs by fear severity. One-third of OAs have maladaptive fall risk appraisal (FRA), a condition in which there is a discrepancy between levels of FOF) and balance performance. Maladaptive FRA may impede low-income OAs participation in PA and can result in social isolation. Measuring FRA in OAs can be challenging due to self-report bias and cognitive deficit. Thus, we developed a fall risk appraisal matrix, a graphical grid categorizing levels of FOF and balance performance into four groups (rational/ incongruent/ irrational/ congruent). Additionally, body composition (e.g., obesity, low skeletal muscle mass) has been associated with FOF and functional impairment. However, research has not examined the association among body composition, FRA, and PA using Assistive Health Technology (AHT), which is the application of organization knowledge, skills, procedures, and systems in order to improve functioning. We propose to explore the associations among body composition, FRA, and PA using AHT including bioelectric impedance analysis (BIA), BTracK Balance System (BBS), and accelerometer-based physical activity devices. These devices are portable, non-invasive, safe, valid, reliable and allow for home testing. We employ a cross- sectional study. Aim 1 is to examine the feasibility of recruitment (e.g., how many OAs need to be screened to recruit the sample?) and acceptability of technologies and procedures for use among OAs in low-income settings. Aim 2 is to examine the associations among fall risk appraisal, body composition, and physical activity. Participants (N=120) will be enrolled if they are: 1) ≥ 60 years of age, 2) low-income (using poverty thresholds from the US Census Bureau), 3) no marked cognitive impairment, and 4) live in their own homes or apartments. Exclusion criteria: 1) a medical condition precluding balance test (e.g., unable to stand on the balance plate) and/or PA (e.g., shortness of breath when performing PA); or 2) currently receiving treatment from a rehabilitation facility, or 3) medical implants (e.g., pacemakers). Data will be collected at OAs’ place of residence. OAs will be assessed FOF, balance performance, and body composition using a questionnaire, BBS, and BIA, respectively. OAs will wear an accelerometer-based physical activity device (ActiGraph GT9X Link) for 7 days. Accurate FRA is essential in implementing physical activity programs. This study will provide data for the development of a technology-based intervention that facilitates a shift from maladaptive to adaptive FRA, and improving participation in PA, thus enhancing healthy longevity among OAs in low-income settings.

项目概要/摘要 在美国，生活在低收入社区的老年人 (OA) 从事体育活动的可能性较小 （宾夕法尼亚州）。缺乏 PA 与慢性病和生活质量差有关。有限的数据表明，OA 报告对跌倒的恐惧 (FOF) 并高估其跌倒风险的人不太可能参与 PA；和 FOF 和 PA 强度之间的关联因恐惧严重程度而异。三分之一的骨关节炎有适应不良跌倒风险 评估（FRA），一种 FOF 水平与平衡绩效之间存在差异的情况。 适应不良的 FRA 可能会阻碍低收入 OA 参与 PA，并可能导致社会孤立。测量 由于自我报告偏差和认知缺陷，OA 中的 FRA 可能具有挑战性。因此，我们开发了跌倒风险 评估矩阵，一个图形网格，将 FOF 和平衡绩效级别分为四组 （理性/不一致/非理性/一致）。此外，身体成分（例如肥胖、骨骼肌含量低） 质量）与 FOF 和功能障碍有关。然而，研究并未检验 使用辅助健康技术 (AHT) 将身体成分、FRA 和 PA 关联起来，这是 应用组织知识、技能、程序和系统以改善运作。我们 建议使用 AHT（包括生物电）探索身体成分、FRA 和 PA 之间的关联 阻抗分析 (BIA)、BTrack 平衡系统 (BBS) 和基于加速度计的身体活动设备。 这些设备便携式、非侵入性、安全、有效、可靠，并且允许家庭测试。我们采用交叉 截面研究。目标 1 是检查招聘的可行性（例如，需要筛选多少 OA 才能 招募样本？）以及低收入 OA 使用技术和程序的可接受性 设置。目标 2 是检查跌倒风险评估、身体成分和身体素质之间的关联 活动。参与者 (N=120) 如果满足以下条件，将被纳入： 1) ≥ 60 岁，2) 低收入（利用贫困） 美国人口普查局的阈值），3）没有明显的认知障碍，4）住在自己的家中或 公寓。排除标准： 1) 无法进行平衡测试的健康状况（例如，无法站立 平衡板）和/或 PA（例如，进行 PA 时呼吸短促）；或 2) 目前正在接受治疗 来自康复机构，或 3) 医疗植入物（例如起搏器）。数据将在 OA 所在地收集 住宅。 OA 将通过问卷评估 FOF、平衡表现和身体成分， 分别是 BBS 和 BIA。 OA 将佩戴基于加速计的身体活动设备 (ActiGraph GT9X 链接）7 天。准确的 FRA 对于实施身体活动计划至关重要。这项研究将提供 用于开发基于技术的干预措施的数据，以促进从适应不良向适应的转变 FRA，并提高 PA 的参与度，从而提高低收入环境中 OA 的健康寿命。