Mobility has a non-linear association with falls risk among people in residential aged care: an observational study.

Abstract

QUESTIONS
What is the association between mobility and falls risk for people living in residential aged care? Can the Physical Mobility Scale discriminate between residents at risk of falling and those not at risk?
DESIGN
Prospective longitudinal observational study.
SETTING
Six residential aged care facilities in Australia.
PARTICIPANTS
Eighty-seven high- and low-level care permanent residents.
OUTCOME MEASURES
The primary outcome measure was the number of falls in the six months after the initial mobility assessment. Mobility of all participants was assessed using the Physical Mobility Scale, which includes nine mobility items assessed on a 0-5 scale yielding a total score out of 45.
RESULTS
During the six-month study period, 131 falls were reported. Residents with mild mobility impairment (Physical Mobility Scale total score 28-36) had the highest fall risk (hazard ratio = 1.98, 95% CI 1.30 to 3.03). Residents with fully dependent mobility (Physical Mobility Scale total score 0-9) had the lowest risk for falls (HR=0.05, 95% CI 0.01 to 0.32).
CONCLUSION
Aged care residents with mild mobility impairment are at increased risk of falls and are an appropriate target for falls prevention strategies. Although improving the mobility of residents with moderate to severe mobility impairment may enhance their independence and reduce their burden on staff, paradoxically this may also increase their risk of falls. When these residents improve enough to progress into a higher category of mobility, physiotherapists should be aware that this may increase the risk of falls and should consider instituting appropriate falls prevention strategies.

Links

Publisher Full Text

Authors

Barker AL, Nitz JC, Low Choy NL, Haines TP

Institution

School of Public Health and Preventive Medicine, Monash University, Australia. Anna.Barker@monash.edu

Source

Journal of physiotherapy 58:2 2012 pg 117-25

MeSH

Accidental Falls
Aged
Aged, 80 and over
Cohort Studies
Confidence Intervals
Exercise
Female
Frail Elderly
Gait
Geriatric Assessment
Homes for the Aged
Humans
Male
Mobility Limitation
Odds Ratio
Prospective Studies
Walking

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22613242