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Volume 6, Issue 3, September 2021

Original Article JFSF, Vol 6, No 3, September 2021, p.92-97
Prevalence and factors associated with recurrent falls among middle-aged community-dwelling women
Nirmala Rathnayake, Sarath Lekamwasam
Keywords: Middle-aged women, Obesity, Recurrent falls, Sarcopenia, Sri Lanka
Objective: This community-based study evaluated the prevalence and associated risk factors of recurrent falls among middle-aged community-dwelling women in Southern-Sri Lanka. Methods: Randomly selected 285 middle-aged women (40-60years, Mean±SD;51.7±6.1years) participated. History of falls within the previous 12-months was inquired and those who reported two or more falls within 6-month period were considered as recurrent fallers. Age, menopausal status, weight (kg), height (m), waist-circumference (WC, cm), appendicular-skeletal-muscle-mass (ASMM, kg by DXA), hand-grip-strength (HGS, kg) and gait-speed (GS, m/s) were evaluated. Body-mass-index (BMI, kg/m2) and relative-ASMM-index (RSMI, kg/m2) were calculated. Results: The prevalence of recurrent falls was 13% (95%CI; 9.4%-17.5%) (n=37). Recurrent falls were higher among postmenopausal women compared to premenopausal women, older middle-aged women (51-60years) compared to young middle-aged women (40-50years), those with low RSMI compared to normal RSMI, low HGS compared to normal HGS and low GS compared to normal GS (p<0.01). BMI and WC did not show significant associations with recurrent falls. Risk factors associated with recurrent falls were age (OR;7.41, 95%CI; 1.23-44.43, p=0.02), RSMI (OR;3.21, 95%CI; 1.00-10.32, p=0.04) and HGS (OR;3.19, 95%CI; 1.26-8.09, p=0.01). Conclusions: The prevalence of falls among middle-aged women was considerably high. Falls were associated with advanced age, low muscle mass and muscle strength.
Original Article JFSF, Vol 6, No 3, September 2021, p.98-110
Using accelerometers in the assessment of sarcopenia in older adults attending a day hospital service in Ireland
Kieron Connolly, Conal Cunningham, Niamh Murphy, Roman Romero-Ortuno, Frances Horgan
Keywords: Accelerometer, Day Hospital, Frailty, Physical Activity, Sarcopenia
Objectives: The aim of this study was to describe the associations between sarcopenia and variables derived from wrist accelerometry in community-dwelling older adults attending a day hospital service in Ireland. Methods: An observational cross-sectional study was carried out using a consecutive series of older adults attending a day hospital service. Sarcopenia was diagnosed using the latest European Working Group of Sarcopenia in Older People guidelines. Accelerometers were worn by each participant for a 7-day period on their non-dominant wrist. Results: Thirty-eight out of forty-one participants (93%) met the accelerometer wear time criterion and were included in statistical analyses. Included participants had a mean age of 81.1 years (standard deviation 6.2). Both sarcopenia (Grip) and sarcopenia (Lower limb) were associated with increased time spent in low physical activity and reduced average of Kcals per hour. Only sarcopenia (Lower limb) was associated with increased time in sedentary behaviour as well as reduced number of steps taken in a week. Conclusions: Accelerometer data can be used in an older day hospital population to track physical activity levels and sedentary behaviours. The assessment tool used to assess muscle strength and the cut-off criteria for physical activity behaviour influences the association with sarcopenia.
Original Article JFSF, Vol 6, No 3, September 2021, p.111-118
Detecting a valid screening method for sarcopenia in acute care setting
Mohamad A. Alsadany, Hoda T. Sanad, Mohamed H. Elbanouby, Safaa Ali
Keywords: Elderly, Hospitalized, Sarcopenia, Screening, Tool
Objectives: Sarcopenia is prevalent among geriatric patients and it has a high rate of negative health related outcomes. Diagnostic and assessment approaches are not always feasible. The aim of the study was to detect a valid screening tool for sarcopenia that could be used easily in acute care setting. Methods: A cross sectional study was conducted in Geriatrics department, Ain Shams University Hospital. 127 inpatient elderly participants were recruited. Sarcopenia was defined according to the European Working Groups on Sarcopenia in Older People (EWGSOP) criteria as low skeletal muscle mass with either low handgrip strength or slow gait speed. Muscle mass was measured by bioelectrical impedance analysis (BIA). Two screening methods for sarcopenia were investigated, namely SARC-F questionnaire and Ishii equation including age, handgrip, and calf circumference (CC). Results: Both SARC-F questionnaire and Ishii equation can detect sarcopenia in both genders and both showed good agreement with the standard diagnostic method. Combining SARC-F to Ishii equation improved the diagnostic accuracy, with a higher sensitivity and specificity. Conclusions: SARC-F and Ishii equation could be used as a valid simple screening tool in acute hospital setting. Combing these two screening tools resulted in better diagnostic accuracy with higher sensitivity and specificity.
Review Article JFSF, Vol 6, No 3, September 2021, p.119-130
Associations between Disability in Activities of Daily Living and Social Capital aspects among older adults: a scoping review
Christiana Zidrou, Christos Kleisiaris, Theodoula Adamakidou
Keywords: Disability in ADL, Healthy aging, Health-related quality of life, Independence, Social capital
Social capital aspects are playing an important role in activities of daily living (ADL) performance, thus on independent living. This paper was aimed to present an overview of the associations and adverse effects between social capital aspects and disability in ADL and health-related quality of life (HRQoL) in an older population aged 65 years old and over. Α scoping review was designed following the guidelines of PRISMA Extension for Scoping Reviews (PRISMA-ScR) and the review was conducted by 3 authors. A total of 185 primary studies were extracted and, finally, 40 studies did meet the inclusion criteria and critically appraised in two main categories; Category 1(29 studies) ‘social capital and disability in ADL’ deducing that as greater a social capital as better ADL performance and Category 2 (11 studies) ‘Social capital and HRQoL’ concluding that people 65 years old and over with lower social capital were presented with a poor HRQoL. Study synthesis highlights the impact of social capital suggesting that nurses caring for older people must focus on their engagement in terms of social diversity and trust in the community.
Review Article JFSF, Vol 6, No 3, September 2021, p.131-138
Falls efficacy: Extending the understanding of self-efficacy in older adults towards managing falls
Shawn Leng-Hsien Soh, Chee-Wee Tan, Janet I. Thomas, Gideon Tan, Tianma Xu, Yoke Leng Ng, Judith Lane
Keywords: Falls efficacy, Older Adults, Person-centred care, Physiotherapy, Rehabilitation
Falls efficacy is a widely studied construct. The understanding of falls efficacy has evolved over time. Falls efficacy was initially perceived to be suitably used as a measure of fear of falling. However, further research suggested that falls efficacy and fear of falling are distinct constructs, and therefore, would be inappropriate to be used as a proxy. Instead, some researchers posited that falls efficacy is synonymous with balance confidence. Falls efficacy has been conventionally understood as the perceived ability of individuals to perform activities without losing balance or falling. A recently conducted systematic review by the authors on existing falls efficacy related measures had revealed a fresh perspective of recognising falls efficacy as a perceived ability to manage a threat of a fall. Falls efficacy, with a broadened interpreted construct, relates to the individual’s perceived self-efficacy of performing necessary actions needed in different scenarios, including pre-fall, near-fall, fall-landing and completed fall. The conventional interpretation of falls efficacy needs a rethinking of perspective. An extended understanding of falls efficacy would provide an integral approach towards improving the agency of individual to deal with falls and would enhance person-centred care.
Original Article JFSF, Vol 6, No 3, September 2021, p.139-146
Physical function measurement in older long-term cancer survivors
Jennifer Blackwood, Kateri Rybicki
Keywords: Long-term Cancer Survivor, Neoplasms, Physical Functional Performance, Reliability, Validity
Objective: To establish reliability, validity, and minimal detectable change in measures of function in older long-term cancer survivors. Methods: Older cancer survivors were recruited to perform functional measures; 5 Times Sit-to-Stand (5xSTS), 30-second Timed Chair Rise (30sTCR), Short Physical Performance Battery (SPPB), Physical Performance Test-7 (PPT-7). Two testing sessions were completed two weeks apart. Test-retest reliability was examined using the intraclass correlation coefficient (ICC2,1), convergent and discriminant validity using Spearman’s rho and Minimal Detectable Change (MDC95) was calculated. Results: Forty-seven older long-term cancer survivors participated. Test-retest reliability was good for 5xSTS (ICC2,1=0.86), 30sTCR (ICC2,1=0.89), and SPPB (ICC2,1=0.85) and poor for PPT-7 (ICC2,1=0.48). Both convergent and discriminant validity was established. Conclusions: SPPB, 5xSTS, and 30sTCR are reliable and valid tools to measure function in older long-term cancer survivors. MDC95 values were larger than those reported in geriatrics and should be interpreted with caution. Residual effects of cancer treatment, comorbidity, and physical inactivity may contribute to decreased physical function in older long-term cancer survivors, therefore valid and reliable measures like SPPB and the timed chair rise tests should be used objectively measure function throughout the survivorship spectrum.
Original Article JFSF, Vol 6, No 3, September 2021, p.147-152
Does the ASA grading influence the outcomes of best practice tariff in fracture neck of femurs
Aysha Rajeev, Mohammed Ali, Liam Mcentee, Kailash Devalia
Keywords: ASA grade, Best Practice Tariff, Failed, Neck of Femurs, Outcomes
Objectives: The aim of this study is to find the significance of different ASA grades in achieving the Best Practice Tariff (BPT) and their outcomes in patients with fracture neck of femur. Methods: A retrospective study over a five years period. Patient demographics, ASA grading, hospital admission timing, time to theatre and discharge date were recorded. The 30 day mortality rate and length of stay were calculated for each ASA grades for patients who met and failed BPT. Results: 1798 patients were included in the study. 54% was ASA grade 3, grade 4 represented 22% and grade 2, 19%. The mean AMT score was 6.4 who met BPT and 4.4 who failed BPT (p<0.001). 319 patients with ASA≤2 met BPT and 53 patients failed to meet BPT. In ASA ≥3, 1200 patients who met BPT and 225 patients failed BPT. The 30-day mortality in patients with ASA≤2 who met BPT was 2.57% and those who failed were 1.92%. In ASA ≥3 the 30-day mortality was 12.63% and who failed BPT was 25% which is statistically significant. Conclusion: In patients with ASA≥3 the 30-day mortality is significantly higher in those who failed BPT compared to ASA≤2 patients whether they achieved BPT or not.
Research Protocol JFSF, Vol 6, No 3, September 2021, p.153-162
Methodology of a home-based motor control exercise and ergonomic intervention programme for community-dwelling older people: The McHeELP study
Maria Tsekoura, Sophia Stasi, John Gliatis, Vasiliki Sakellari
Keywords: Exercise, Falls, Home modification, Lower extremities, Motor control
The aim of this research (Motor control Home ergonomics Elderlies’ Prevention of falls; McHeELP study) was to develop a novel intervention combining motor control home-based exercises and a home ergonomic safety-improvement strategy in order to reduce falls in frail ambulatory older adults. A randomized controlled trial of a novel intervention is proposed including motor control exercises and home ergonomic assessment and modification in older adults who have at least one fall experience. Participants are randomized to control or intervention group in a 1:1 ratio. Participants will be assessed three times: at baseline, at 3rd month (end of intervention period) and again at 6th month (follow-up measurement). The primary outcome is of the effect on functional mobility using the Timed Up and Go test. Secondary outcomes include assessments of functionality, fear of falling and quality of life. This will be the first study to develop an exercise intervention approach that combines home-based motor control exercise intervention with home assessment and modification. This study is expected to explore a low-cost, easy-to-popularize, and effective exercise intervention approach for improving functional mobility and prevent falls among older adults.