Technology and Dementia Preconference

Area of Science:

• Gerontology
• Geriatric Medicine
• Public Health

Background:

• Aged residential care (ARC) residents exhibit significantly higher fall risks compared to community-dwelling older adults.
• Dementia and physical impairments in ARC residents exacerbate fall risk, leading to severe consequences like injury and mortality.
• Current falls prevention strategies in ARC often involve restricting resident mobility, despite unclear evidence on the relationship between ambulatory activity and falls.

Purpose of the Study:

• To investigate the association between ambulatory activity (step count) and falls rate in aged residential care residents.
• To explore the influence of physical capacity and cognitive impairment on the relationship between activity and falls.
• To inform falls prevention strategies by examining the risk-reward balance of ambulatory activity in ARC.

Main Methods:

• Utilized data from 281 ARC residents in the Staying Upright randomized controlled trial.
• Assessed daily step count using accelerometers and monitored falls over an extended study duration.
• Classified physical capacity as Moderate or Low using the Short Performance Physical Battery and analyzed associations using quasi-Poisson generalized linear models.

Main Results:

• Residents with Low physical capacity had higher falls rates than those with Moderate capacity (p=0.001).
• Increased daily step count was associated with a higher falls rate (p=0.046), with a significant interaction effect based on physical capacity.
• Moderate-capacity residents showed a positive association between steps and falls, while low-capacity residents did not; cognitive impairment was not associated with falls.

Conclusions:

• Higher physical capacity residents can achieve more falls-free steps, with a modest increase in fall risk that does not elevate injury risk.
• Low-capacity residents have a higher baseline fall risk and injurious fall incidence, with activity levels having minimal impact on their risk.
• Findings challenge the restriction of ambulatory activity in aged care and emphasize the need for individualized interventions, as cognitive impairment did not correlate with fall risk in this cohort.