Functional ability and health status of community-dwelling late age elderly people with and without a history of falls

Background: Obvious functional deterioration is demonstrated in elderly people aged 75 years and older. However, there is only little objective evidence relating to falls in these individuals. Objective: This cross-sectional study compared functional abilities and health status in the elderly age at least 75 years with no fall, single fall (1 fall), and multiple falls (≥2 falls) during the past 6 months. Furthermore, the study describes fall information of the participants. Methods: Ninety participants (30 individuals/group) were interviewed for their health status and fall history within the past 6 months. Then they were objectively assessed in terms of their functional ability to conduct daily activities independently. Results: The findings indicated that the functional abilities of participants with multiple falls were significantly poorer, with the number of those requiring a walking device significantly greater than that in the other groups. These individuals reported loss of balance as a major factor for falls, whereas individuals with a single fall reported an environmental hazard as a common cause of falls. Conclusion: Although the cross-sectional findings may be unable to clearly confirm the causal relationship of the outcomes, the data support the influence of intrinsic impairments and can be used to promote functional ability and minimise fall risk in these individuals

Walking devices used by community-dwelling elderly: Proportion, types, and associated factors

Background: Advancing age is likely to increase the requirement for walking devices. However, the existing evidence mostly involves all types of external devices used from participants in developed countries with or without medical problems. The findings may be different from the data on the use of walking devices exclusively, particularly for the elderly who live in a rural community of a developing country. Objective: This study explored the proportion, types, and factors associated with the use of walking devices in 343 elderly aged ≥ 65 years who live in a rural area of Thailand. Methods: The participants were interviewed and assessed for their walking device used and functional mobility. Results: The data demonstrated that 74 participants (22%) used a walking device for mobility. Most of them used a modified walking stick (70%), followed by a standard single cane (27%), and a walker (3%). Although most of these participants used a walking device due to their own determination with only a few of them using it according to medical prescription, their functional ability was significantly poorer than those who walked without a walking device (p < 0.05). Being unable to walk faster than 1 m/s and having a caregiver had the strongest relationship with the use of a walking device. The findings may be related to the study's locations. Being in a rural community of a developing country with a low level of education, participants may encounter some difficulty in accessing proper medical services. Therefore they used a device that could possibly help them to execute daily activities independently. Conclusion: Our findings may provide an insight into planning programmes for health monitoring and promotion, and medical services for community-dwelling elderly who live in a similar context

Validity and reliability of a thoracic kyphotic assessment tool measuring distance of the seventh cervical vertebra from the wall

Background: In primary healthcare (PHC) service, community residents, village health volunteers (VHVs), and healthcare professionals need to work in partnership to facilitate universal and equitable healthcare services. However, these partnerships may need an appropriate tool helping them to execute an effective health-related activity. Objectives: To investigate the reliability and validity of a simple kyphosis measure using a perpendicular distance from the seventh cervical vertebra (C7) to the wall (C7WD). Methods: Elderly people with different degrees of kyphosis (n = 179) were cross-sectionally investigated for the intra- and interrater reliability of the measurement by a physical therapist (PT), VHV, and caregiver. The validity was assessed in terms of concurrent validity as compared with the Flexicurve, and discriminative validity for functional deterioration in participants with mild, moderate, and severe kyphosis. Results: The method showed excellent reliability among PT, VHV, and caregivers (ICC > 0.90, p < 0.001), and excellent correlation to the data from the Flexicurve. Results of the assessment were greater than a level of minimal detectable change and could clearly discriminate functional deterioration in participants with different severity of kyphosis (p < 0.001). Conclusion: C7WD is valid and reliable, thus it can be used to promote the standardisation of kyphosis measures among PHC members