Investigating Risk-Prediction Screening Tool for Falls and Effective Intervention to Prevent Falls in Community-Dwelling Older Population

Falls are major public health concern for older adults. Approximately one-thirds of people aged of 65 and over fall each year, leading to three-fourths of deaths. Thus, identifying risk-prediction screening tool for falls is essential to fall prevention in the elderly. Consequently, risk factor identification might be a promising first step in developing effective fall-prevention programs for high-risk patients. The decrease in muscle strength is a major intrinsic factor contributing to falls in older people. Treadmill walking may act as an external sensory cue to stimulate the spinal central pattern generator that may contribute to both forward walking and backward walking gait performances and can strengthen the lower extremity muscles. Little is known on the association between sarcopenia and osteoporosis. Nor are there studies on divided attention and gait parameters measured with an electronic walkway system in predicting falls in community-dwelling older population. The proposed research will first evaluate the relationship of bone mineral density (BMD) and muscle volume by dual-energy X-ray absorptiometry (DXA) scan and walking gaits by electronic walkway parameters to falls. We also will follow up effective interventions to prevent falls with treadmill exercise training program and monitor changes in BMD, muscle volume and walking gaits with these tools in community-dwelling older people. In the 1st In the 2 year proposal (baseline assessment), 80 subjects with a history of falls on standing height (fallers) and 80 age- and gender-matched subjects without a history of falls (non-fallers) will be enrolled. The personal and health related information will be collected. Baseline measures will include physical examination, balance and gait assessment (Berg Balance Scale, Instrumented Timed UP and Go test, and spatiotemporal gait parameters), as well as their divided attention and fear of falling, and BMD and muscle volume measurements of the upper and lower extremities (DXA, Prodigy, General Electric Healthcare Systems, USA). nd and 3rd We believe that this project will establish a new risk-prediction tool for falls in community-dwelling older people and develop a walking exercise program effectively improve body muscle strength and volume, BMD, divided attention, and walking gait performance in order to reduce the prevalence of recurrent falls in community-dwelling older people. year proposal (intervention assessment), we will randomize those fallers to performing intervention (treadmill exercise training) and non-fallers to act as control group. An investigator not involved in recruitment or assessments will perform randomization centrally. After 12 weeks of treadmill exercise training, all patients will be followed up by physical examination as well as balance and gait assessment (Berg Balance Scale, Instrumented Timed UP and Go test, and spatiotemporal gait parameters), attention and fear of falling as well as BMD and muscle volume measurements at 1 week, 4 weeks, and 12 and 24 weeks after intervention. Our researchers will make telephone calls to all participants (fallers and non-fallers) asking for any incident of falls (falls calendars) for both groups every month.