Impact of participation in a wellness program on functional status and falls among aging adults in an assisted living setting.

PROBLEM: Aging adults residing in assisted living facilities are vulnerable to the effects of cumulative chronic illness and increasingly sedentary lifestyle, both contributing to risk of functional decline over time. Participation in regular exercise appears to preserve functional status and may minimize the rate of functional decline. PURPOSE: This quasi-experimental study evaluated the longitudinal impact of regular participation in a wellness exercise program on functional status of residents in assisted living. METHODS: Thirty-six aging adults participating in a multimodal wellness program were evaluated on enrollment and after 12 months of participation. Cognitive status (Mini-Mental State Examination score), postural control/fall risk (Berg Balance Scale score), and cardiovascular endurance/mobility (6-Minute Walk Test distance) were examined on enrollment and at annual reassessment. Falls over 12 months were determined by tracking annual reported incidence of falls. Subjects were classified as "regular" or "nonregular" exercisers on the basis of participation frequency and adherence. Chi-square analysis and analysis of variance were used to screen for initial differences between groups. Repeated-measures analysis of variance evaluated differences in cognitive status, falls, and functional measures between groups at annual reassessment. RESULTS: Mean age (SD) of participants was 85.5 (6.3) years (range = 72-96 years). There were no differences between groups at the time of enrollment. At annual reassessment, regular exercisers demonstrated better preservation of functional status and a lower rate of falling than nonregular exercisers. CONCLUSION: Regular participation in an individualized wellness program as little as twice weekly for 9 of 12 months provides protection against functional decline and risk of falls in older adults in assisted living settings.

The effect of rolling walker use on interpretation of Timed Up and Go test scores: a preliminary study.

Studies have shown that the type of assistive device used during the Timed Up and Go test impacts the time it takes to complete the test. This study examines the impact of the use of a rolling walker within individuals on Timed Up and Go scores and assessment of fall risk. The Berg Balance Scale, Timed Up and Go, and linear gait speed were used to measure balance and fall risk on 13 older adults as part of their usual reassessment in preparation for discharge. Timed Up and Go and gait speed scores were compared assistive device conditions. The Berg Balance Scale was used as a benchmark fall risk assessment. Linear gait speed was similar in both conditions. Timed Up and Go times were slower for all patients using a rolling walker versus a cane or no assistive device. Consideration for the effect of assistive device use on Timed Up and Go scores has important implications as it may influence interpretation of fall risk.

Determinants of balance confidence in community-dwelling elderly people.

BACKGROUND AND PURPOSE: The fear of falling can have detrimental effects on physical function in the elderly population, but the relationship between a persons' confidence in the ability to maintain balance and actual balance ability and functional mobility is not known. The extent to which balance confidence can be explained by balance performance, functional mobility, and sociodemographic, psychosocial, and health-related factors was the focus of this study. SUBJECTS: The subjects were 50 community-dwelling elderly people, aged 65 to 95 years (mean=81.7, SD=6.7). METHODS: Balance was measured using the Berg Balance Scale. Functional mobility was measured using the Timed Up Go Test. The Activities-specific Balance Scale was used to assess balance confidence. Data were analyzed using Pearson correlation, multiple regression analysis, and t tests. RESULTS: Fifty-seven percent of the variance in balance confidence could be explained by balance performance. Functional mobility and subject characteristics examined in this study did not contribute to balance confidence. DISCUSSION AND CONCLUSION: Balance performance alone is a strong determinant of balance confidence in community-dwelling elderly people.