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Participation Restrictions of Community-dwelling Older Adults with High Fall Risk

Armando S. Miciano, Jr., MD FAAPMR (Nevada Rehabilitation Institute, Las Vegas, NV, United States); Chad L. Cross, PhD, PStat(R), C-MDI

Meeting: AAPM&R Annual Assembly 2019

Session Information

Date: Thursday, November 14, 2019

Session Title: General Rehabilitation Research Report & Practice Management and Leadership Case Report

Session Time: 12:30pm-2:00pm

Location: Research Hub - Kiosk 2

Disclosures: Armando S. Miciano, Jr., MD FAAPMR: Nothing to disclose

Objective: Quantify fall risk (FR) and participation restrictions (PR) of community-dwelling older adults; analyze inter-relationship between FR and PR in these individuals; investigate correlations of FR with other WHO-ICF components – body function (BF) and activity limitation (AL) and with clinical-derived performance-based assessments (PBA).

Design: Retrospective cross-sectional study.

Setting: PMR clinic

Participants: 22 adults >/=65 years old (12 men; mean age (SD) male/female 77(6)/70 (11) years) were identified as having high fall risk, defined as STEADI score.

Interventions: n/a

Main Outcome Measures: STEADI stratified individuals into high (HFR) and low fall risks (LFR). PROMIS-57v2.0-satisfaction-with-social-role (SSR) and PROMIS-Pain-Interference sub-quantified PR. BF was measured by PROMIS-57v2.0-fatigue (FA), sleep disturbance (SD), anxiety, depression, and pain intensity sub-scales; and, AL by PROMIS-57v2.0-physical-function (PF). PBA included the: 6-Minute Walk Test (6MWT), Dynamometer test, and Berg Balance Scale (BBS).

Results: After testing for normality using the Shapiro-Wilk statistics and examining measures of skewness and kurtosis, data met normality assumptions; parametric procedures (t-tests, ANOVA, and Pearson correlations) were used. Variables were found to differ significantly by gender: males as being older (P =.029); males with higher dynamometer (P =.015); and females with higher BBS (P = .031) Mean scores (SD) were (male/female): dynamometer 30(9)/22(7) kg; and  BBS 44(8)/50(7). Variables were found to differ significantly by FR group: HFR with higher depression score (P =.004); HFR with higher FA (P =.008); and LFR with higher SSR (P =.042). HFR mean PROMIS T-scores (SD) were: depression 51.3(9); fatigue 58.4(7); and SSR 37.8(8). STEADI scores correlated with: PROMIS-SSR (r=-.467; P =.002), PROMIS-anxiety (r= 354; P =.029), PROMIS-depression (r=.560; P <.01), and PROMIS-fatigue (r=.471; P =.002).

Conclusions: Being a community-dwelling older adult with HFR is associated with PR. HFR tend to have mild depressive symptoms, mild fatigue, and severe PR. HFR tend to have significantly higher depression, higher fatigue, and higher PR when compared to LFR. Future research is needed to determine BF, AL, and PR inter-relationships in other geriatric syndromes like frailty.

Level of Evidence: Level II

To cite this abstract in AMA style:

Miciano AS. Participation Restrictions of Community-dwelling Older Adults with High Fall Risk [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/participation-restrictions-of-community-dwelling-older-adults-with-high-fall-risk/. Accessed May 17, 2025.
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