Geriatrics Commons^™

Difference Between Postural Sway, Functional Fitness, And Behavioral Measures In Older Adult Fallers & Non-Fallers, Olivia Maus, Rebecca Brandhorst, Andrea Geisenhof, Kyle Reason

InnovateHER Meeting 2026

BACKGROUND: Falls are among the leading causes of injury, hospitalization, and loss of independence among older adults. There is not enough research to determine how body composition, fitness, and postural sway affect balance.

METHODS: Participants completed surveys measuring behaviors around fall risk, assessment of body composition, postural sway, and functional fitness.

RESULTS: There was a significant difference between OF and ONF on the FES-I (p=0.05; d=-0.41) and the ABC-6 (p=0.008; d=0.57). There was significance on condition three of the mCTSIB (p=0.007; d=-.58), and composite score (p=0.04; d=-0.43).Significance between groups was approached on condition one of the mCTSIB (p=0.06; d=-0.39).

CONCLUSIONS: …

A Multifactorial Fall Prevention Program, Virale Patel, Zeida Gutierrez

Fall 2024 OTD Capstone Symposium

Falls among older adults are a pressing public health concern, leading to significant physical, psychological, and economic consequences. This capstone project aimed to design and implement a multifactorial fall prevention program to address unmet occupational needs and enhance safety and occupational participation among long-term care residents at a skilled nursing facility. The six-week program included targeted weekly sessions focusing on behavior modification, footwear safety, adaptive equipment training, strength and balance exercises, toileting strategies, and environmental modifications. Pre- and post-program assessments utilized the Fall Efficacy Scale International (FES-I) and participant surveys to evaluate changes in confidence, fear of falling, and satisfaction …

The Role Of Occupational Therapy In The Recognition, Assessment, And Treatment Of Presbyvestibulopathy, Jennifer Hill, Ellen Hudgins, Sharon Leonard

The Open Journal of Occupational Therapy

Sensory functions decline with age, and the likelihood of having multiple sensory impairments increases with age, potentially leading to decreased physical activity and performance, decreased social participation, poorer quality of life, and greater health care spending. Presbyvestibulopathy (PVP), a diagnosis established in 2019, is a vestibular dysfunction or loss related to the aging process characterized by mild bilateral vestibular deficits, chronic dizziness, unsteadiness, gait disturbance, and/or recurrent falls. Given the potential impact of vestibular dysfunction on occupational performance and participation in meaningful activities, occupational therapy’s (OT) role in PVP is evident; however, limited literature exists specific to OT and vestibular …

Effectiveness Of An Emergency Department-Based Machine Learning Clinical Decision Support Tool To Prevent Outpatient Falls Among Older Adults: Protocol For A Quasi-Experimental Study, Daniel J Hekman, Amy L Cochran, Apoorva P Maru, Hanna J Barton, Manish N Shah, Douglas Wiegmann, Maureen A Smith, Frank Liao, Brian W Patterson

Faculty, Staff and Student Publications

Background

Emergency department (ED) providers are important collaborators in preventing falls for older adults because they are often the first health care providers to see a patient after a fall and because at-home falls are often preceded by previous ED visits. Previous work has shown that ED referrals to falls interventions can reduce the risk of an at-home fall by 38%. Screening patients at risk for a fall can be time-consuming and difficult to implement in the ED setting. Machine learning (ML) and clinical decision support (CDS) offer the potential of automating the screening process. However, it remains unclear whether …

Satisfaction Of Older Patients With Emergency Department Care: Psychometric Properties And Construct Validity Of The Consumer Emergency Care Satisfaction Scale, Peter L T Hoonakker, Pascale Carayon, Roger L Brown, Rebecca Schwei, Rebecca K Green, Mackenzie Rabas, Ly Hoang, Kathryn L Wust, Rachel Rutkowski, Megan E Salwei, Hanna J Barton, Manish N Shah, Michael S Pulia, Brian W Patterson, Paula V W Dail, Sheryl Krause, Denise Buckley, Jennifer Hankwitz, Nicole E Werner

Faculty, Staff and Student Publications

BACKGROUND: Patient satisfaction is an important indicator of quality of care, but its measurement remains challenging. The Consumer Emergency Care Satisfaction Scale (CECSS) was developed to measure patient satisfaction in the emergency department (ED). Although this is a valid and reliable tool, several aspects of the CECSS need to be improved, including the definition, dimension, and scoring of scales.

PURPOSE: The purpose of this study was to examine the construct validity of the CECSS and make suggestions on how to improve the tool to measure overall satisfaction with ED care.

METHODS: We administered 2 surveys to older adults who presented …

Top 10 Things To Know About Falls In Older Adults, Alexander W. Zirulnik, Shan Liu

Journal of Geriatric Emergency Medicine

No abstract provided.

Assessing The Contributions Of Modifiable Risk Factors To Serious Falls And Fragility Fractures Among Older Persons Living With Hiv, Julie A Womack, Terrence E Murphy, Linda Leo-Summers, Jonathan Bates, Samah Jarad, Thomas M Gill, Evelyn Hsieh, Maria C Rodriguez-Barradas, Phyllis C Tien, Michael T Yin, Cynthia A Brandt, Amy C Justice

Faculty, Staff and Students Publications

BACKGROUND: Although 50 years represents middle age among uninfected individuals, studies have shown that persons living with HIV (PWH) begin to demonstrate elevated risk for serious falls and fragility fractures in the sixth decade; the proportions of these outcomes attributable to modifiable factors are unknown.

METHODS: We analyzed 21,041 older PWH on antiretroviral therapy (ART) from the Veterans Aging Cohort Study from 01/01/2010 through 09/30/2015. Serious falls were identified by Ecodes and a machine-learning algorithm applied to radiology reports. Fragility fractures (hip, vertebral, and upper arm) were identified using ICD9 codes. Predictors for both models included a serious fall within …

Indication Of Mobility Aids And Training Of Older Patients In A Geriatric Emergency Department: Abiding By International Guidelines, Mario C. De Andrade Junior, Christian V. Morinaga, Christina M M Brito, Igor G. Moraes, Wellington P. Yamaguti, Pedro K. Curiati

Journal of Geriatric Emergency Medicine

Falls are the main cause of injuries, hospitalization, and loss of functionality among adults over 65 years of age. Thus, proper indication of assistive gait devices should be part of multidimensional fall prevention. However, many patients receive little or no professional assistance when selecting a mobility aid, and inadequate selection and use can result in a poor gait pattern.

All patients admitted to our emergency department (ED) undergo a medical evaluation, in which, based on their clinical condition, the protocol for indication and training in the use of walking aids can be triggered. Patients need to be clinically stable and …

Examination Of Geriatric Care Processes Implemented In Level 1 And Level 2 Geriatric Emergency Departments, Ilianna Santangelo, Surriya Ahmad, Shan Liu, Lauren Southerland, Christopher Carpenter, Ula Hwang, Adriane Lesser, Nicole Tidwell, Kevin Biese, Maura Kennedy

Journal of Geriatric Emergency Medicine

Background: Older adults constitute a large and growing proportion of the population and have unique care needs in the emergency department (ED) setting. The geriatric ED accreditation program aims to improve emergency care provided to older adults by standardizing care provided across accredited geriatric EDs (GED) and through implementation of geriatric-specific care processes.

Objective: The purpose of this study was to evaluate select care processes at accredited level 1 and level 2 GEDs.

Methods: This was a cross-sectional analysis of a cohort of level 1 and level 2 GEDs that received accreditation between May 7, 2018 and …

Persistent Polypharmacy And Fall Injury Risk: The Health, Aging And Body Composition Study, Lingshu Xue, Robert M. Boudreau, Julie M. Donohue, Janice C. Zgibor, Zachary A. Marcum, Tina Costacou, Anne B. Newman, Teresa M. Waters, Elsa S. Strotmeyer

Health Management and Policy Faculty Publications

Background

Older adults receive treatment for fall injuries in both inpatient and outpatient settings. The effect of persistent polypharmacy (i.e. using multiple medications over a long period) on fall injuries is understudied, particularly for outpatient injuries. We examined the association between persistent polypharmacy and treated fall injury risk from inpatient and outpatient settings in community-dwelling older adults.

Methods

The Health, Aging and Body Composition Study included 1764 community-dwelling adults (age 73.6 ± 2.9 years; 52% women; 38% black) with Medicare Fee-For-Service (FFS) claims at or within 6 months after 1998/99 clinic visit. Incident fall injuries (N = 545 in …

Community-Dwelling Older Adult Fall Prevention Improvement Project, Evan Edminster Bsn, Rn, Cfrn, Tcrn, Cen, Nhdp-Bc

Master's Projects and Capstones

Abstract

Problem: Ground-level falls among community-dwelling adults 60 years and older are significant and contribute to adverse health outcomes such as fractures, functional decline, disability, and death. Additionally, falls among community-dwelling older adults are the number one mechanism of injury seen at a Northern California Level II trauma center. Falls often lead to post-fall fear, activity restriction, and physical deconditioning, further compounding fall risk.

Context: When trauma centers provide targeted outreach and screening for unmanaged health risks such as falls, they reduce unnecessary disability and premature death in the local population. Reducing total fall victim numbers and fall recidivism also …

Emergency Department - Community Partnership To Coordinate Older Adults Falls Prevention Programs, Suzanne Ryer, Ann Gallo, Adam Perry, Michael Malone

Journal of Geriatric Emergency Medicine

Abstract

Falls and injurious falls are common causes for emergency department visits in older adults. Prior literature describing ED care of older adults has focused on the patients' injuries and their ED care. There is a gap in the literature describing community- based falls prevention strategies and interventions deployed by community organizations, beyond health systems. We identified variation in approaches to older adults among paramedic programs from one community to the next within Milwaukee County, Wisconsin. We also noted no organized falls prevention program spanning all communities, emergency departments and health systems in the county. We describe the implementation of …

Strategies And Challenges Associated With Recruiting Retirement Village Communities And Residents Into A Group Exercise Intervention, Rachel L. Duckham, Jamie L. Tait, Caryl A. Nowson, Kerrie M. Sanders, Dennis R. Taaffe, Keith D. Hill, Robin M. Daly

Research outputs 2014 to 2021

BACKGROUND: Randomized controlled trials (RCTs) provide the highest level of scientific evidence, but successful participant recruitment is critical to ensure the external and internal validity of results. This study describes the strategies associated with recruiting older adults at increased falls risk residing in retirement villages into an 18-month cluster RCT designed to evaluate the effects of a dual-task exercise program on falls and physical and cognitive function.

METHODS: Recruitment of adults aged ≥65 at increased falls risk residing within retirement villages (size 60-350 residents) was initially designed to occur over 12 months using two distinct cohorts (C). Recruitment occurred via …

Exploring The Use Of The Timed Up And Go Test To Identify Patient Fall Risk In An Inpatient Geriatric Psychiatry Unit, Danielle Struble-Fitzsimmons

Seton Hall University Dissertations and Theses (ETDs)

Background: Patient falls during hospitalization influence healthcare costs and quality, and hospitals are mandated to complete fall risk assessments on all patients. Inpatient geriatric psychiatry units have the highest fall rates in the acute care setting, and most falls in this population occur during the mobility tasks of transfers and ambulation. The Timed Up and Go (TUG) test includes these two specific functional tasks, and has been used to predict falls in other geriatric populations, but has never been tested in an inpatient geriatric psychiatry unit. The purpose of this study was to determine if the TUG is a predictive …

Fall Risk Reduction Using Lifestyle-Integrated Functional Exercise (Life), Kayla Comer, Tiffany Huang, Kelly Schmidt, Matthew Tong

Student Research Posters

As the population and longevity of older adults’ increases, the prevalence of falls is becoming an ever-growing issue. One in three adults aged 65 years and older experience a fall each year. Falls in older adults may lead to sedentary behavior, decreased independence, and lower quality of life. Evidence has shown that traditional exercise programs emphasizing strength and balance exercises can decrease the fall risk in older adults, but may be difficult to sustain over time. Emerging evidence suggests that exercises that are integrated into daily life may have a more lasting effect in reducing fall risk in older adults. …

Walking-Induced Fatigue Leads To Increased Risk In Older Adults, S. Morrison, S. R. Colberg, H. K. Parson, S. Neumann, R. Handel, E. J. Vinik, J. Paulson, A. I. Vinik

Rehabilitation Sciences Faculty Publications

Background- For older adults, falls are a serious health problem, with more than 30% of people older than 65 suffering a fall at least once a year. One element often overlooked in the assessment of falls is whether a person's balance, walking ability, and overall falls risk is affected by performing activities of daily living such as walking.

Objective- This study assessed the immediate impact of incline walking at a moderate pace on falls risk, leg strength, reaction time, gait, and balance in 75 healthy adults from 30 to 79 years of age. Subjects were subdivided into 5 equal groups …

Building Interprofessional Teams Through Evidence Based Practice Training In Falls Prevention, Constance L. Coogle, Edward F. Ansello, Patricia Slattum, Pamela L. Parsons

Case Studies from Age in Action

Objectives

1. Analyze an Evidence Based Practice (EBP) program on falls prevention as a vehicle for successful interprofessional team-building.

2. Examine ways that organizational characteristics can affect team functioning.

3. Compare interprofessional teambuilding in two sites.

4. Discuss elements of interprofessional teams that contributed to practice changes.

Identification Of Functional Parameters For The Classification Of Older Female Fallers And Prediction Of ‘First-Time’ Fallers, Niklas König Ignasiak

Physical Therapy Faculty Articles and Research

Falls remain a challenge for ageing societies. Strong evidence indicates that a previous fall is the strongest single screening indicator for a subsequent fall and the need for assessing fall risk without accounting for fall history is therefore imperative. Testing in three functional domains (using a total 92 measures) were completed in 84 older women (60–85 years of age), including muscular control, standing balance, and mean and variability of gait. Participants were retrospectively classified as fallers (n = 38) or non-fallers (n = 42) and additionally in a prospective manner to identify first-time fallers (FTFs) (n = 6) within a …

Modern Technology And An Aging Population: Can The Use Of The Wii Fit Gaming System Improve Functional Balance In Community Dwelling Seniors?, Curtis N. Phillips

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

Seniors are a growing segment of the population of the United States. By 2030 they will make up nearly 20% of the general population. Senior citizens face many health challenges as they age. Injury due to falling is a major concern for many in this age group. Research shows that approximately one third of seniors will fall each year. Injuries that result from falls have been identified as the number one cause of accidental death in this age group each year. While falls have been studied by researchers for a number of years, and some progress has been made in …

Medications As A Risk Factor In Falls By Older Adults With And Without Intellectual Disabilities, Patricia Slattum, Edward F. Ansello

Case Studies from Age in Action

Educational Objectives

1. Review common intrinsic and extrinsic risk factors for falls by older adults.

2. Compare risk factors for older adults with and without intellectual disabilities.

3. Focus on medications as a risk factor among a complexity of risk factors.

4. Suggest steps to improve appropriateness of medication regimens, as a step to help reduce risk for falls.

Falling Down: Assessing The Risk Of Falls In Older Adults, Steven Morrison

Case Studies from Age in Action

Educational Objectives

1. To provide an overview of the problems associated with falling in older adults.

2. To outline the strengths and weaknesses of the various screening tools used for effective evaluation of an individual’s fall risk.

3. To highlight the benefits of assessing physiological function when screening for falls risk.

Hip Power Asymmetry In Older Adult Fallers And Non-Fallers, Lauren Grace Mcdonald

Boise State University Theses and Dissertations

The purpose of this study was to determine if a difference exists in hip power asymmetry between community-dwelling older adult fallers and non-fallers. Hypothesis: fallers would be more asymmetrical than non-fallers. Participants: 21 non-fallers (10 females, 11 males) and 18 fallers (14 females, 4 males) over the age of 65 (76.5 ± 6.9yrs). Method: Isokinetic peak torque during flexion, extension, abduction, and adduction at four velocities was recorded as measures of leg power. Asymmetry equaled the percent of power difference between each leg. Data analysis: Differences in age, physical activity, height, weight, and BMI were assessed …

Our Grandparents, Our Parents, Our Future Selves: Optimizing Function In Old Age., Thomas Michael Gill

Center for Policy Research

Most of my research at Yale University School of Medicine over the past several years has focused on identifying older adults at risk of functional decline and disability, identifying events that may precipitate the transition from functional independence to disability, and developing strategies to postpone or reduce frailty and disability. As a result of the Precipitating Events Project (PEP) and other research conducted by the Yale Center on Aging/Pepper Center, we now realize that age is only a proxy for other factors that lead to disability, and that some of these factors can be modified to reduce the risk of …

Determinants Of Balance Confidence In Community-Dwelling Elderly People, Janine Hatch, Kathleen M. Gill-Body, Leslie G. Portney

All PTHMS Faculty Publications

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 (X̄=81.7, SD=6.7).

Methods. Balance was measured using the Berg Balance Scale. Functional mobility was measured using the Timed Up & …

Fall Risk Assessment : A Prospective Investigation Of Nurses' Clinical Judgement And Risk Assessment Tools In Predicting Patient Falls In An Acute Care Setting, Helen Myers

Theses: Doctorates and Masters

Falls are a significant problem in acute care, hospital settings, and can have serious consequences, especially for older patients. Fall prevention has therefore been recognised as an important area for research and intervention. In order to target interventions and use resources effectively, a major strategy of many fall prevention programmes has been the development and/or use of risk assessment tools to identify patients who are at high risk of falling. Although many tools have been developed, few have been rigorously tested, and there is currently no evidence to support the clinical utility of fall risk assessment tools. There is a …

A Qualitative Study Of The Impact Of Hip Fracture In The Elderly Population, Stephanie Anne Price

Theses: Doctorates and Masters

The social, emotional and economic impact of falling in the elderly population is significant. Falls are the leading cause of injury related deaths and hospitalisation amongst people aged 65 years and older, a major factor in their morbidity and mortality rates. Post fall sequelae can have major ramifications that include reduction or avoidance of activities, attributable to an enduring fear of future falls. Twenty-three older people who had fallen in the community were located via hospital records and invited to participate in the study. Subjective accounts of the impact of falling and sustaining a hip fracture were obtained by means …

Medications And Falls, Patricia W. Slattum

Case Studies from Age in Action

Educational Objectives:

1. To describe potential causes of falls and ways to prevent them.

2. To illustrate how medications can contribute to an increased risk of falls and recommend strategies for reducing this risk.