Community dwelling older adults will fall at least once a year which can lead to adverse outcomes. However, the long term effect of structured community based fitness programs is unclear in age and sex matched individuals.
PURPOSE: To compare predictors of fall risk in older adults who regularly exercised between 2-3x/wk in a community based fitness program for a minimum of a year (CDAE) to an age and sex matched group who had not (CDA).
METHODS: 19 CDAE were matched and compared to 19 CDA [N=38, 30 females and 8 males, 63-84 yrs (M=74.2±6 yrs)]. All subjects were asked to report the number of falls in the last year. The Balance Efficacy Scale (BES) was administered to establish the level of confidence in the participants ability to perform activities of daily living (ADL). Fall risk was assessed by the Fullerton Advanced Balance (FAB) Scale. The APDM (Ambulatory Parkinsons’ Disease Monitoring) Movement Monitoring Mobility Lab™ was employed to assess components of the Instrumented 25 ft Timed Up and Go (ITUG) which included number of steps to complete the turn around the cone (NS), turn time around the cone (TT), time to complete a full sit to stand (SS), sit to stand velocity of the trunk (SSV) and gait cadence (GC). Differences in age and sex matched groups were evaluated using paired t-tests.
RESULTS: 5 CDAE (26.3%) experienced one fall within the previous year compared to 12 CDA (63.2%) who fell which was significant (p=0.004). Of the 12 CDA who fell, 2 had 3, 4 had 2 and 6 had 1 for a total of 20 falls. In the BES, group responses were significantly different (p=0.012); both CDAE and CDA self-reported confidence in not falling during ADL (M=90.2%±7.6 SD and 80.3%±14.2 SD; ≤50% predicts fall risk). However, the FAB predicted falls (score ≤25) in 2 (11%) CDAE and 7 (37%) CDA; paired group scores were significantly different (M=31.2±4.3 SD and 27.6±7.0 SD, p=0.039). In the ITUG the only significant difference between groups was TT (p=0.015). NS (p=0.243), SS (p=0.464), SSV (p=0.106) and GC (p=0.511) were not significantly different between groups.
CONCLUSION: Self-assessment (BES) does not predict fall risk as effectively as actual measurements (FAB and ITUG TT) in older adults whether they regularly exercise or not. However, participation in community based fitness programs can significantly reduce both the number and risk of falls in older adults.