A simple test, using a pedometer, could predict older people at risk of falls
Melbourne researchers have found a simple and accurate marker of those particularly at risk of falls, which could have a significant impact on the large number of older Australians who end up in hospital following a fall each year.
Falls are the leading cause of hospitalised injuries and injury deaths among older Australians, making up 77% of all injury hospitalisations and 71% of injury deaths in this age group and over 30% of the general older population fall at least once every year, resulting in multiple adverse health outcomes, and costing the Australian hospital system over $600 million annually.
Now research from the National Centre for Healthy Ageing (NCHA, a partnership between Monash University and Peninsula Health) has used daily step counts as a predictor of those most at risk of falling, allowing for preventative measures to be put in place before the fall occurs.
The study, led by Associate Professor Michele Callisaya and Professor Velandai Srikanth from Peninsula Health and Monash University and Dr Oshadi Jayakody from Albert Einstein College of Medicine in New York, was published in the Journal of Ageing and Physical Activity.
Falls history was prospectively obtained in 431 community-dwelling people with an average age of 72, over a period of 12 months. Daily step count was measured when people entered the study using a pedometer worn consecutively for 7 days, with a low daily step count defined as less than ~ 5000 steps a day. The study also looked at the way cognitive, medical, and other factors such as poor muscle strength were associated with falls in those with higher versus lower levels of daily step count.
Among people with <5575 steps per day, an increased risk of falls occurred in those with poorer executive cognitive function (the mental processes that enable us to plan, focus attention, juggle multiple tasks, and judge risks), slower gait speed, and lower step count.
In those with >5575 steps per day, only low mood was associated with increased fall risk.
According to Associate Professor Callisaya, identifying those older people at the greatest risk of falling is an important healthcare priority. Knowing how active people are with step counts can help towards this. “Such people would benefit from consideration of additional risk factors such as altered cognitive function in devising strategies for prevention,” she said.
“We also found that in those who are active and taking a higher number of daily steps, the presence of a low mood increased the risk of falling. Although the reason for this is not entirely clear, in active people who fall, it may be important to assess their mood and help them manage their psychological state as best as possible.”
“Assessing daily step count is becoming increasingly feasible via eHealth (e.g., small wearable sensors) and smart watches and phone apps. Daily step count is a low-cost and low-tech measure that can be used to flag people who may require falls-risk assessment and interventions” according to Prof. Srikanth.
The research team used data from the Tasmanian Study of Cognition and Gait (TASCOG), a longitudinal study of cognition, balance, and gait in older people. The participants were randomly selected using the Southern Tasmania electoral roll, which included all residents over the age of 60 years, except those living in residential aged care or with a history of dementia. The participants completed surveys regarding the number of falls they had experienced over a year and participants wore the pedometer and filled out daily monitoring logs with the start and finish wear times, as well as any duration and reason for periods wherein the pedometer, was removed (e.g., sleeping, showering, or any water-based activities).
About the National Centre for Healthy Ageing
The National Centre for Healthy Ageing (NCHA) is a centralised hub for innovation and transformation of care practices, based on the Mornington Peninsula. A partnership between Peninsula Health and Monash University, it aims to create better-integrated care models to promote health and well-being across people's lifespans and drive improvements in the way people seek out and access care, to ensure they reflect and align with their values and needs.
The NCHA is a significant part of the Australian Government’s commitment to driving healthy ageing in Australia and is working to facilitate healthier, more productive and more independent lives as people age.
About Monash University
Monash University is Australia’s largest university with more than 80,000 students. In the 60 years since its foundation, it has developed a reputation for world-leading high-impact research, quality teaching, and inspiring innovation.
With four campuses in Australia and a presence in Malaysia, China, India, Indonesia and Italy, it is one of the most internationalised Australian universities.
As a leading international medical research university with the largest medical faculty in Australia and integration with leading Australian teaching hospitals, we consistently rank in the top 50 universities worldwide for clinical, pre-clinical and health sciences.
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