Technology and Dementia Preconference | JoVE Visualize

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.