Physical functioning measures and risk of falling in older people living in residential aged care facilities

Frail older individuals living in residential aged care facilities (RACFs) have impaired physical function compared with to older people living in the community. In residents of RACFs, we aimed to produce sex-specific means and empirical norms of objective physical function measures to ascertain whether these measures are predictors of falls.

Data were extracted from a large cohort study investigating fall and fracture rates in RACFs in the Northern Sydney Health Area, Australia.

Study participants (n = 602, 70.9% female) were recruited from 51 RACFs. Cohort means (±standard deviation) for females were for grip strength (GS) 16.8±5.3 kg, simple reaction time (RT) 384±154 ms, walking speed (WS) 0.56 ±0.20 ms(-1), balance category (B) 3.8±1.1 and sit to stand category (STS) 3.6±0.5. For males, means were for GS 28.8±7.8 kg, RT 335±150 ms, WS 0.62±0.22 ms(-1), B 4.1±1.1 and STS 3.7±0.5. Means of B and STS decreased significantly over the 1-year study period for males and females (p < 0.001). Individual multivariate negative binomial regression models for each functional outcome showed having a WS <0.6 ms(-1) (IRR = 1.37, 95% Cl = 1.03-1.84), a STS score of 3 (IRR = 1.39, 95% Cl = 1.09-1.79) and B category of 3 or 5 (IRR = 1.69, 95% CI = 1.29-2.22) were significantly associated with an increased fall rate.

This study establishes normative values for physical function tests in mobile residents of RACFs and demonstrates that walking speed, balance and sit to stand impairments are associated with falls in this group.