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: 10264885
• 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 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10264885
• 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; 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; Time; Well in self; Woman; actigraphy; balance testing; base; design; disability; fall risk; falls; fear of falling; functional disability; high body mass index; home test; 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.

项目总结/摘要 在美国，生活在低收入社区的老年人（OAs）不太可能参与体育活动 （PA）. PA缺乏与慢性疾病和生活质量差有关。有限的数据表明， 报告害怕跌倒（FOF）和高估跌倒风险的人不太可能参加PA; FOF和PA强度之间的关联因恐惧严重程度而异。三分之一的OAs存在适应不良的跌倒风险 评估（FRA），其中存在FOF水平和平衡性能之间的差异的条件。 适应不良的FRA可能会阻碍低收入OAs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，OAs中的FRA可能具有挑战性。因此，我们开发了一种跌倒风险 评估矩阵，一个图形网格，将FOF和平衡绩效分为四组 （理性/不一致/非理性/一致）。此外，身体成分（例如，肥胖，低骨骼肌 质量）与FOF和功能障碍有关。然而，研究并没有检查 使用辅助健康技术（AHT）的身体成分、FRA和PA之间的关联， 组织知识、技能、程序和系统的应用，以改善运作。我们 建议使用包括生物电在内的AHT来探索身体组成、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。 这些设备是便携式，非侵入性，安全，有效，可靠，并允许家庭测试。我们雇了一个十字架- 分段研究目标1是审查征聘的可行性（例如，需要筛选多少OA， #21453;样的样本）。技术和程序供低收入国家的 设置.目的2是检查跌倒风险评估、身体成分和身体状况之间的关系。 活动受试者（N = 120）将入组，如果他们：1）≥ 60岁，2）低收入（使用贫困 美国人口普查局的阈值），3）没有明显的认知障碍，4）住在自己的家里， 公寓排除标准：1）排除平衡测试的医学状况（例如，无法站在 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OAs的地点收集， 住所将使用问卷对OA进行FOF、平衡性能和身体成分评估， BBS和BIA。OA将佩戴基于加速度计的身体活动设备（ActiGraph GT9X 链接）7天。准确的FRA对于实施体育活动计划至关重要。本研究将提供 用于开发基于技术的干预措施的数据，以促进从适应不良到适应性的转变 提高对公共行政的参与，从而提高低收入环境中的公共行政机构的健康寿命。