what percentage of community dwelling adults > 65 fall each year?
30%
what percentage of hip fx are due to falls?
>95%
what is the definition of a fall
- end up on the floor
- due to postural instability
not due to LOC
what does STEADI stand for?
STopping
Elderly
Accidental
Deaths
and
Injuries
what is STEADI?
- a health system wide change to encourage physician screening and referral for falls
- an algorithm for fall risk assessment
3 assessments used in the STEADI?
1. TUG
2. 4 stage balance test
3. 30 sec sit to stand
STEADI - TUG fall risk
- 10 feet
- with or without AD
- score of >12 seconds = fall risk
13.5 listed in other literature
STEADI - 4 stage balance test fall risk
stance time - feet together, partial tandem, tandem, one legged
timed in seconds, holding for 10s
fall risk = <10 s in tandem
STEADI - 30 second chair stand
-fall risk for M/W 65-69y/o
- UE folded across body
- must come to full stand
- count reps
fall risk = age and gender biased
there's a bunch of categories but...65-69 years = <12, <11 for men, women
who is the BERG test good for?
-score for 100% fall
-score for increase fall
-better at predicting fall or nonfaller?
community dwelling adults
- <36/56 = 100% of falling in elderly
<45/56 = inc fall risk
better at predicting non fallers than fallers
functional gait assessment - score for predicting falls?
<22/30 = predicts future falls
what is the 6th vital sign?
walking speed
what is the MDC in walking speed?
>.1 m/s
walking speed to:
- predict fall risk
- early mortality
predict fall risk: <.56 m/s
early mortality: <.6 m/s
modifiable risk factor for elderly
what is LE muscle force strongly correlated too?
scores on BERG
what score in 5 times sit to stand doubles risk for recurrent falls?
-what is MDIC
>15 second with MCID 2.3 sec
what type of effort are older adults giving for chair rises?
almost max
2 interventions to focus on for elderly
balance and strength with sufficient dose and duration
what may be the most important aspect of exercise intervention to reduce fall risk?
-how many hours needed to effectively reduce fall risk?
balance
-minimal 50 hours of exercise
how much can tai chi reduce falls? what is the typical dose?
25-50%
- 1 hour 3x/week
appropriate dose for balance training and strength in older adults to reduce fall risk?
balance:
- 60 min, 3x/week for 3 months
strength:
- 40-80% 1RM, 3x/week for 10 weeks
is just walking good for elderly?
no, walking alone without concurrent balance and strength training may result in increased fall risk