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  1. Article: Frailty, falls and poor functional mobility predict new onset of activity restriction due to concerns about falling in older adults: a prospective 12-month cohort study.

    Ellmers, Toby J / Delbaere, Kim / Kal, Elmar C

    European geriatric medicine

    2023  Volume 14, Issue 2, Page(s) 345–351

    Abstract: Purpose: Concerns about falling are common in older adults and often cause activity restriction. This can lead to physical deconditioning, falls and social isolation. However, not every concerned older adult will restrict their activities. This 12-month ...

    Abstract Purpose: Concerns about falling are common in older adults and often cause activity restriction. This can lead to physical deconditioning, falls and social isolation. However, not every concerned older adult will restrict their activities. This 12-month longitudinal study investigated the physical and psychosocial factors that predict the new onset of activity restriction due to concerns about falling in older people.
    Methods: Participants were 543 older adults (M
    Results: 10.1% of the sample started to restrict activity due to concerns about falling at Timepoint 2. Three key predictors significantly predicted activity restriction group status at 12-month follow-up: greater frailty at Timepoint-1 (Fried Frailty Index; OR = 1.58, 95% CI 1.09-2.30), experiencing a fall between Timepoint-1 and 2 (OR = 2.22, 95% CI 1.13-4.38) and poorer functional mobility at Timepoint-1 (Timed up and Go; OR = 1.08, 95% CI 1.01-1.15).
    Conclusions: Frailty, experiencing a fall and poorer functional mobility all predicted the onset of activity restriction due to concerns about falling. Clinicians working in balance and falls-prevention services should regularly screen for frailty, and patients referred to frailty services should likewise receive tailored treatment to help prevent the development of activity restriction due to concerns about falling.
    MeSH term(s) Humans ; Aged ; Aged, 80 and over ; Cohort Studies ; Frailty/epidemiology ; Prospective Studies ; Longitudinal Studies
    Language English
    Publishing date 2023-02-05
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2556794-9
    ISSN 1878-7657 ; 1878-7649
    ISSN (online) 1878-7657
    ISSN 1878-7649
    DOI 10.1007/s41999-023-00749-2
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  2. Article ; Online: A systems approach to assist policy action to prevent falls among community-dwelling older people in Australia.

    Costa, Nathalia / Ambrens, Meghan / Delbaere, Kim / Wilson, Louise / Li, Ang / Sherrington, Catherine

    Public health research & practice

    2024  Volume 34, Issue 1

    Abstract: Objectives: While systems thinking has gained recognition as an important approach in health policy and prevention research, its application in the context of fall prevention among community-dwelling older adults has been underutilised. Here, we build ... ...

    Abstract Objectives: While systems thinking has gained recognition as an important approach in health policy and prevention research, its application in the context of fall prevention among community-dwelling older adults has been underutilised. Here, we build on the guiding principles of the systemic lens component of the Prevention System Change Framework to assess and identify potential changes that are required to facilitate policy action in the field of falls prevention.
    Methods: We conducted a desktop search to identify policy documents encompassing falls prevention among community-dwelling older adults in Australia. Documents were considered eligible if they were published in the last 10 years and were authored or endorsed by federal or state government bodies. We collaboratively examined eligible documents to gain insights into the current policy landscape in falls prevention and to illustrate opportunities for action and the potential for strengthening partnerships.
    Results: There is no current national policy on preventing falls in older adults in Australia. While we identified eight policy documents, none focused exclusively on falls prevention, indicating that falls are currently not perceived as a public health issue that warrants a dedicated policy framework. We identified a need for a comprehensive national policy that draws upon insights from various disciplines, suggests intersectoral collaboration, addresses health inequities and involves meaningful engagement with key stakeholders. Future falls prevention policies may benefit from clear governance structures and specific targets, along with mechanisms for monitoring and evaluating outcomes.
    Conclusion: Falls prevention is a pressing public health concern that requires dedicated policy resources. Adopting a systems-oriented approach can help reduce falls and their associated burdens on individuals and the healthcare system. Acknowledging the urgency and complexity of this challenge is a first, essential step toward crafting a comprehensive national falls prevention policy.
    MeSH term(s) Humans ; Aged ; Independent Living ; Australia ; Health Policy ; Public Health ; Systems Analysis
    Language English
    Publishing date 2024-04-04
    Publishing country Australia
    Document type Journal Article
    ISSN 2204-2091
    ISSN (online) 2204-2091
    DOI 10.17061/phrp3412405
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  3. Article ; Online: Brain and brawn in balance: Central processing speed and muscle torque development speed are independently associated with the ability to recover balance with feet-in-place.

    van Schooten, Kimberley S / Sturnieks, Daina L / Menant, Jasmine / Lord, Stephen R / Delbaere, Kim

    Gait & posture

    2024  Volume 111, Page(s) 132–135

    Abstract: Background: Stepping thresholds, i.e. the maximum perturbation one can withstand without taking a step, predict falls in older people. This ability requires fast central processing of sensory information followed by rapid execution of adequate motor ... ...

    Abstract Background: Stepping thresholds, i.e. the maximum perturbation one can withstand without taking a step, predict falls in older people. This ability requires fast central processing of sensory information followed by rapid execution of adequate motor responses, both of which are affected by age. However, there is limited evidence on their combined effect on stepping thresholds.
    Research question: Are cognitive and motor speeds important for stepping thresholds and do they interact, allowing for compensation?
    Methods: Two-hundred forty-two people (mean age: 80 years, standard deviation 4; 110 women) underwent a series of waist-pulls of increasing magnitude to assess stepping thresholds in anterior, posterior and mediolateral directions. Cognitive function was assessed as simple hand reaction time and trail making test performance, and muscle function was assessed as isometric peak and rate of torque development of dominant leg muscles. Principal component analysis reduced these variables to four factors: peak muscle strength, muscle torque development speed (motor speed), executive function and central processing speed (cognitive speed). These factors were used in univariable and multivariable regression models to determine their association with stepping thresholds.
    Results: Faster central processing speed (beta:2.69; 95 %CI:1.49-3.88) and faster muscle torque development speed (beta:2.60, 95 %CI:0.63-4.57) were associated with higher stepping thresholds. These associations remained in a multivariable model. No interaction was found between cognitive and motor speed on stepping thresholds (p = 0.602).
    Significance: Central processing speed and muscle torque development speed affect stepping thresholds independently from each other and may both be important age-related motor impairment targets for preventing falls in older people.
    Language English
    Publishing date 2024-04-10
    Publishing country England
    Document type Journal Article
    ZDB-ID 1162323-8
    ISSN 1879-2219 ; 0966-6362
    ISSN (online) 1879-2219
    ISSN 0966-6362
    DOI 10.1016/j.gaitpost.2024.04.010
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  4. Article ; Online: Risk Factors for Falls and Fall-Related Fractures in Community-Living Older People with Pain: A Prospective Cohort Study.

    Hirase, Tatsuya / Okubo, Yoshiro / Delbaere, Kim / Menant, Jasmine C / Lord, Stephen R / Sturnieks, Daina L

    International journal of environmental research and public health

    2023  Volume 20, Issue 11

    Abstract: 1) Background: This prospective study aimed to identify predictors of falls and fall-related fractures in community-dwelling older people with pain; (2) Methods: Participants comprised 389 community-dwelling older people aged 70+ years who had ... ...

    Abstract (1) Background: This prospective study aimed to identify predictors of falls and fall-related fractures in community-dwelling older people with pain; (2) Methods: Participants comprised 389 community-dwelling older people aged 70+ years who had musculoskeletal pain in the neck, back, hip, leg/knee and/or feet. Demographic, anthropometric, balance, mobility, cognitive function, psychological status and physical activity level measures were obtained at baseline. Falls were monitored with monthly falls calendars for 12 months. Logistic regression analyses were performed to identify predictors of falls and fall-related fractures during a 12-month follow-up; (3) Results: Of the 389 participants, 175 (45.0%) and 20 (5.1%) reported falls and fall-related fractures during the 12-month follow-up, respectively. Greater postural sway on foam, more depressive symptoms and lower physical activity levels at baseline were associated with falls during the 12-month follow-up. Slower walking speed at baseline was associated with fall-related fractures during the 12-month follow-up. These associations remained significant after adjusting for age, sex, body mass index, comorbidities and medication use; (4) Conclusions: This study suggests poor balance, low mood and a less active lifestyle are predictors of falls, and slower walking speed predicts fall-related fractures among community-dwelling older people with pain.
    MeSH term(s) Humans ; Aged ; Prospective Studies ; Fractures, Bone/epidemiology ; Fractures, Bone/etiology ; Risk Factors ; Musculoskeletal Pain ; Independent Living ; Postural Balance
    Language English
    Publishing date 2023-06-02
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2175195-X
    ISSN 1660-4601 ; 1661-7827
    ISSN (online) 1660-4601
    ISSN 1661-7827
    DOI 10.3390/ijerph20116040
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  5. Article ; Online: Longitudinal Impact of Vision Impairment on Concern About Falling in People With Age-Related Macular Degeneration.

    White, Ursula E / Black, Alex A / Delbaere, Kim / Wood, Joanne M

    Translational vision science & technology

    2022  Volume 11, Issue 1, Page(s) 34

    Abstract: Purpose: To explore the longitudinal impact of central vision loss on concern about falling (CF), over a 12-month period, in people with age-related macular degeneration (AMD).: Methods: Participants included 60 community-dwelling older people (age, ... ...

    Abstract Purpose: To explore the longitudinal impact of central vision loss on concern about falling (CF), over a 12-month period, in people with age-related macular degeneration (AMD).
    Methods: Participants included 60 community-dwelling older people (age, 79.7 ± 6.4 years) with central vision impairment due to AMD. Binocular high-contrast visual acuity, contrast sensitivity, and visual fields were assessed at baseline and at 12 months. CF was assessed at both time points using the Falls Efficacy Scale-International (FES-I). Sensorimotor function (sit to stand, knee extension, postural sway, and walking speed) and neuropsychological function (reaction time, symptoms of anxiety and depression) were also assessed at both time points using validated instruments. Falls data were collected using monthly diaries during the 12 months.
    Results: CF increased by a small but significant amount over the 12-month follow-up (2.1 units; P = 0.01), with increasing prevalence of high levels of CF (FES-I score ≥ 23), from 48% at baseline to 65% at 12 months. Linear mixed models showed that reduced contrast sensitivity was significantly associated with increased concern about falling (P = 0.004), whereas declines in both visual acuity and contrast sensitivity during the follow-up period were associated with increases in CF over the 12-month follow-up (P = 0.041 and P = 0.054, respectively), independent of age, gender, falls history, or number of comorbidities.
    Conclusions: Higher levels of CF are common in older people with AMD, and levels increase over time; this increase is associated with declines in both visual acuity and contrast sensitivity. These findings highlight the need for regular assessment of both visual acuity and contrast sensitivity to identify those at greatest risk of developing higher CF.
    Translational relevance: Routine assessment of visual acuity and contrast sensitivity in older people with AMD will assist in identifying those at risk of developing high CF.
    MeSH term(s) Accidental Falls ; Aged ; Aged, 80 and over ; Contrast Sensitivity ; Humans ; Macular Degeneration/complications ; Macular Degeneration/diagnosis ; Macular Degeneration/epidemiology ; Scotoma/complications ; Visual Acuity ; Visual Fields
    Language English
    Publishing date 2022-01-25
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2674602-5
    ISSN 2164-2591 ; 2164-2591
    ISSN (online) 2164-2591
    ISSN 2164-2591
    DOI 10.1167/tvst.11.1.34
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  6. Article ; Online: Association of Prospective Falls in Older People With Ubiquitous Step-Based Fall Risk Parameters Calculated From Ambulatory Inertial Signals: Secondary Data Analysis.

    Al Abiad, Nahime / van Schooten, Kimberley S / Renaudin, Valerie / Delbaere, Kim / Robert, Thomas

    JMIR aging

    2023  Volume 6, Page(s) e49587

    Abstract: Background: In recent years, researchers have been advocating for the integration of ambulatory gait monitoring as a complementary approach to traditional fall risk assessments. However, current research relies on dedicated inertial sensors that are ... ...

    Abstract Background: In recent years, researchers have been advocating for the integration of ambulatory gait monitoring as a complementary approach to traditional fall risk assessments. However, current research relies on dedicated inertial sensors that are fixed on a specific body part. This limitation impacts the acceptance and adoption of such devices.
    Objective: Our study objective is twofold: (1) to propose a set of step-based fall risk parameters that can be obtained independently of the sensor placement by using a ubiquitous step detection method and (2) to evaluate their association with prospective falls.
    Methods: A reanalysis was conducted on the 1-week ambulatory inertial data from the StandingTall study, which was originally described by Delbaere et al. The data were from 301 community-dwelling older people and contained fall occurrences over a 12-month follow-up period. Using the ubiquitous and robust step detection method Smartstep, which is agnostic to sensor placement, a range of step-based fall risk parameters can be calculated based on walking bouts of 200 steps. These parameters are known to describe different dimensions of gait (ie, variability, complexity, intensity, and quantity). First, the correlation between parameters was studied. Then, the number of parameters was reduced through stepwise backward elimination. Finally, the association of parameters with prospective falls was assessed through a negative binomial regression model using the area under the curve metric.
    Results: The built model had an area under the curve of 0.69, which is comparable to models exclusively built on fixed sensor placement. A higher fall risk was noted with higher gait variability (coefficient of variance of stride time), intensity (cadence), and quantity (number of steps) and lower gait complexity (sample entropy and fractal exponent).
    Conclusions: These findings highlight the potential of our method for comprehensive and accurate fall risk assessments, independent of sensor placement. This approach has promising implications for ambulatory gait monitoring and fall risk monitoring using consumer-grade devices.
    Language English
    Publishing date 2023-11-24
    Publishing country Canada
    Document type Journal Article
    ISSN 2561-7605
    ISSN (online) 2561-7605
    DOI 10.2196/49587
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  7. Article ; Online: Clinicians' views on cognitive assessment with Aboriginal Australians.

    Hindman, Emily / Hassmén, Peter / Orchard, Abbey / Radford, Kylie / Delbaere, Kim / Garvey, Gail

    The Australian and New Zealand journal of psychiatry

    2023  Volume 58, Issue 2, Page(s) 134–141

    Abstract: Background: A shortage of standardised cognitive assessment tools for use with Aboriginal Australians is evident. Clinicians also miss the range of guidelines necessary to inform test selection and interpretation for all Aboriginal clients. This mixed ... ...

    Abstract Background: A shortage of standardised cognitive assessment tools for use with Aboriginal Australians is evident. Clinicians also miss the range of guidelines necessary to inform test selection and interpretation for all Aboriginal clients. This mixed methods study examines clinicians' confidence, views and current practices when conducting cognitive assessments with Aboriginal Australian clients.
    Methods: Clinicians were asked about factors that influence their likelihood of using standardised testing in Aboriginal vs non-Indigenous Australian people. Twenty-one health professionals with experience conducting cognitive assessments with Aboriginal and non-Aboriginal Australians participated. Clinicians were presented with a series of different scenarios per the client's level of education and language of origin via an online survey. Clinicians rated their likelihood and confidence using standardised cognitive assessment for each scenario. Open-ended questions captured clinicians' views and information about their current clinical practices.
    Results: Clients' age, education and language of origin influence the likelihood of clinicians' use of standardised cognitive assessment measures with Aboriginal people. Overall, clinicians reported feeling only slightly more confident working with non-Indigenous clients than Aboriginal clients. Qualitative data indicate a lack of consistency regarding test selection.
    Conclusion: Clinicians expressed concerns about the validity of available cognitive assessment tools for use with Aboriginal Australians and the absence of evidence to assist decision-making. Cited barriers included language, educational attainment and cultural factors.
    MeSH term(s) Humans ; Australia ; Australian Aboriginal and Torres Strait Islander Peoples ; Cognition ; Health Services, Indigenous ; Surveys and Questionnaires ; Mental Status and Dementia Tests
    Language English
    Publishing date 2023-06-23
    Publishing country England
    Document type Journal Article
    ZDB-ID 221140-3
    ISSN 1440-1614 ; 0004-8674
    ISSN (online) 1440-1614
    ISSN 0004-8674
    DOI 10.1177/00048674231183354
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  8. Article ; Online: How Perceptions of Aging Influence Physical Activity and Exercise in Older Age: Exploring the Behavior of People Aged 70+ Years Engaged in Fall Prevention Activities.

    Ambrens, Meghan / Macniven, Rona / Perram, Amy / Andrews, Sophie / Hawley-Hague, Helen / Razee, Husna / Todd, Chris / Valenzuela, Trinidad / Delbaere, Kim

    Journal of applied gerontology : the official journal of the Southern Gerontological Society

    2024  , Page(s) 7334648241238315

    Abstract: For older people, physical inactivity increases fall risk as well as other preventable health conditions. Despite the well-documented benefits of physical activity, uptake and adherence continue to challenge efforts aimed at increasing physical activity ... ...

    Abstract For older people, physical inactivity increases fall risk as well as other preventable health conditions. Despite the well-documented benefits of physical activity, uptake and adherence continue to challenge efforts aimed at increasing physical activity and reducing falls. Nested within a randomized controlled trial, this study reports on the factors influencing the physical activity behavior of people, aged between 70 and 90 years, engaged in
    Language English
    Publishing date 2024-03-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 155897-3
    ISSN 1552-4523 ; 0733-4648
    ISSN (online) 1552-4523
    ISSN 0733-4648
    DOI 10.1177/07334648241238315
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  9. Article ; Online: Commentary on: "Mobility Function and Recovery After Stroke: Preliminary Insights From Sympathetic Nervous System Activity".

    Delbaere, Kim / Hadjistavropoulos, Thomas

    Journal of neurologic physical therapy : JNPT

    2018  Volume 42, Issue 4, Page(s) 233–234

    MeSH term(s) Humans ; Range of Motion, Articular ; Stroke ; Sympathetic Nervous System
    Language English
    Publishing date 2018-08-20
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 2276921-3
    ISSN 1557-0584 ; 1557-0576 ; 1085-049X
    ISSN (online) 1557-0584
    ISSN 1557-0576 ; 1085-049X
    DOI 10.1097/NPT.0000000000000241
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  10. Article ; Online: The Relationship Between Concerns About Falling and Daily Life Activity in Older Men and Women.

    Yu Shiu, Zoe / Delbaere, Kim / van Schooten, Kimberley S

    Journal of aging and physical activity

    2021  Volume 30, Issue 2, Page(s) 217–224

    Abstract: Concerns about falling (CAF) affect daily life activities in older people; however, it is unclear whether gender moderates this relationship. The authors investigated the cross-sectional relationship between CAF and objectively measured physical activity ...

    Abstract Concerns about falling (CAF) affect daily life activities in older people; however, it is unclear whether gender moderates this relationship. The authors investigated the cross-sectional relationship between CAF and objectively measured physical activity (PA) and gait quality in 503 community-dwelling older men and women. About 448 people (age = 76.2 [SD 7.9] years, 296 females) contributed sufficient data on movement intensity, activity duration (bouts of walking, sitting, and standing), number of transitions between activities (sit-to-stand and sit-to-walk), number of steps and gait quality, quantified as walking speed, and sample entropy. Associations with the Iconographical Falls Efficacy Scale were tested. The authors found no significant moderation by gender. However, women participated in less PA than men and showed a more irregular walking pattern. Higher levels of CAF led to lower PA and poorer gait quality. Our findings suggest that prevention of CAF-related PA avoidance may be particularly important for women, who are less active and at higher risk of falls.
    MeSH term(s) Accidental Falls/prevention & control ; Aged ; Exercise ; Female ; Gait ; Humans ; Independent Living ; Male ; Walking
    Language English
    Publishing date 2021-08-18
    Publishing country United States
    Document type Journal Article
    ISSN 1543-267X
    ISSN (online) 1543-267X
    DOI 10.1123/japa.2020-0516
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