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.

项目摘要/摘要 在美国，居住在低收入社区的老年人（OAS）从事体育锻炼的可能性较小 （PA）。 PA的缺乏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（FOF）的恐惧，高估其跌倒风险不太可能参加PA；和 FOF与PA强度之间的关联因恐惧严重程度而存在。三分之一的OA患有适应不良的跌倒风险 评估（FRA），在FOF级别之间存在差异）和平衡性能之间存在差异。 适应不良的FRA可能会阻碍低收入OA参与PA，并可能导致社会隔离。测量 由于自我报告的偏见和认知防御，可以挑战OA中的FRA。那，我们发展了跌倒的风险 评估矩阵，将FOF的水平分类的图形网格和四组平衡性能 （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。但是，研究尚未检查 使用辅助卫生技术（AHT）的身体组成，FRA和PA之间的关联，这是 组织知识，技能，程序和系统的应用，以改善功能。我们 提议使用包括生物电的AHT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）和基于加速度计的体育活动设备。 这些设备是便携式，无创，安全，有效，可靠的，并且可以进行家庭测试。我们采用跨 部分研究。目标1是检查招聘的可行性（例如，需要筛选多少个OA 招募样本？）以及在低收入中OA中使用的技术和程序的可接受性 设置。目标2是检查秋季风险评估，身体成分和身体的关联 活动。如果参与者为：1）≥60岁，2）低收入（使用贫困 来自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）医疗状况排除平衡测试（例如，无法站在 平衡板）和/或PA（例如，执行PA时的呼吸急促）；或2）当前接受治疗 来自康复设施，或3）医疗（例如起搏器）。数据将在OAS的位置收集 住宅。将使用问卷调查评估OA，平衡性能和身体组成， BBS和BIA。 OAS将佩戴基于加速度计的体育活动设备（Actigraph GT9X 链接）持续7天。准确的FRA对于实施体育活动计划至关重要。这项研究将提供 开发基于技术的干预措施的数据，该干预措施有助于从适应不良转变为适应性 FRA，并改善了对PA的参与，从而提高了低收入环境中OA的健康寿命。