BMC Geriatrics | |
Age-related self-overestimation of step-over ability in healthy older adults and its relationship to fall risk | |
Kuniyasu Imanaka1  Hayato Uchida2  Takahiro Higuchi1  Masami Ishihara1  Yoshinori Fujiwara3  Ryota Sakurai4  | |
[1] Health Promotion Science, Tokyo Metropolitan University, 1-1 Minami-Osawa, Hachioji-shi, Tokyo 192-0397, Japan;School of Human Science & Environment, University of Hyogo, 8-2-1, Gakuennishi-machi, Nishi-ku, Kobe-shi, Hyogo, 651-2197, Japan;Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan;Research Fellow of the Japan Society for the Promotion of Science, Japan Society for the Promotion of Science, 5-3-1 Kojimachi, Chiyoda-ku, Tokyo 102-0083, Japan | |
关键词: Psychomotor performance; Safety; Judgment; Accidental falls; Stepping-over; Self-assessment; Aging; | |
Others : 857707 DOI : 10.1186/1471-2318-13-44 |
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received in 2013-01-12, accepted in 2013-04-30, 发布年份 2013 | |
【 摘 要 】
Background
Older adults could not safely step over an obstacle unless they correctly estimated their physical ability to be capable of a successful step over action. Thus, incorrect estimation (overestimation) of ability to step over an obstacle could result in severe accident such as falls in older adults. We investigated whether older adults tended to overestimate step-over ability compared with young adults and whether such overestimation in stepping over obstacles was associated with falls.
Methods
Three groups of adults, young-old (age, 60–74 years; n, 343), old-old (age, >74 years; n, 151), and young (age, 18–35 years; n, 71), performed our original step-over test (SOT). In the SOT, participants observed a horizontal bar at a 7-m distance and estimated the maximum height (EH) that they could step over. After estimation, they performed real SOT trials to measure the actual maximum height (AH). We also identified participants who had experienced falls in the 1 year period before the study.
Results
Thirty-nine young-old adults (11.4%) and 49 old-old adults (32.5%) failed to step over the bar at EH (overestimation), whereas all young adults succeeded (underestimation). There was a significant negative correlation between actual performance (AH) and self-estimation error (difference between EH and AH) in the older adults, indicating that older adults with lower AH (SOT ability) tended to overestimate actual ability (EH > AH) and vice versa. Furthermore, the percentage of participants who overestimated SOT ability in the fallers (28%) was almost double larger than that in the non-fallers (16%), with the fallers showing significantly lower SOT ability than the non-fallers.
Conclusions
Older adults appear unaware of age-related physical decline and tended to overestimate step-over ability. Both age-related decline in step-over ability, and more importantly, overestimation or decreased underestimation of this ability may raise potential risk of falls.
【 授权许可】
2013 Sakurai et al.; licensee BioMed Central Ltd.
【 预 览 】
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【 参考文献 】
- [1]Campbell AJ, Borrie MJ, Spears GF: Risk factors for falls in a community-based prospective study of people 70 years and older. J Gerontol 1989, 44(4):M112-117.
- [2]Campbell AJ, Borrie MJ, Spears GF, Jackson SL, Brown JS, Fitzgerald JL: Circumstances and consequences of falls experienced by a community population 70 years and over during a prospective study. Age Ageing 1990, 19(2):136-141.
- [3]Tinetti ME, Speechley M, Ginter SF: Risk factors for falls among elderly persons living in the community. N Engl J Med 1988, 319(26):1701-1707.
- [4]Blake AJ, Morgan K, Bendall MJ, Dallosso H, Ebrahim SB, Arie TH, Fentem PH, Bassey EJ: Falls by elderly people at home: prevalence and associated factors. Age Ageing 1988, 17(6):365-372.
- [5]Hill K, Schwarz J, Flicker L, Carroll S: Falls among healthy, community-dwelling, older women: a prospective study of frequency, circumstances, consequences and prediction accuracy. Aust N Z J Public Health 1999, 23(1):41-48.
- [6]Lord SR, Ward JA, Williams P, Anstey KJ: An epidemiological study of falls in older community-dwelling women: the Randwick falls and fractures study. Aust J Public Health 1993, 17(3):240-245.
- [7]Hahn ME, Lee HJ, Chou LS: Increased muscular challenge in older adults during obstructed gait. Gait Posture 2005, 22(4):356-361.
- [8]Moreland JD, Richardson JA, Goldsmith CH, Clase CM: Muscle weakness and falls in older adults: a systematic review and meta-analysis. J Am Geriatr Soc 2004, 52(7):1121-1129.
- [9]Shimada H, Suzukawa M, Tiedemann A, Kobayashi K, Yoshida H, Suzuki T: Which neuromuscular or cognitive test is the optimal screening tool to predict falls in frail community-dwelling older people? Gerontology 2009, 55(5):532-538.
- [10]Sherrington C, Lord SR: Increased prevalence of fall risk factors in older people following hip fracture. Gerontology 1998, 44(6):340-344.
- [11]Alexander NB, Ashton-Miller JA, Giordani B, Guire K, Schultz AB: Age differences in timed accurate stepping with increasing cognitive and visual demand: a walking trail making test. J Gerontol A Biol Sci Med Sci 2005, 60(12):1558-1562.
- [12]Di Fabio RP, Zampieri C, Henke J, Olson K, Rickheim D, Russell M: Influence of elderly executive cognitive function on attention in the lower visual field during step initiation. Gerontology 2005, 51(2):94-107.
- [13]Yamada M, Higuchi T, Tanaka B, Nagai K, Uemura K, Aoyama T, Ichihashi N: Measurements of stepping accuracy in a multitarget stepping task as a potential indicator of fall risk in elderly individuals. J Gerontol A Biol Sci Med Sci 2011, 66(9):994-1000.
- [14]Yamada M, Higuchi T, Mori S, Uemura K, Nagai K, Aoyama T, Ichihashi N: Maladaptive turning and gaze behavior induces impaired stepping on multiple footfall targets during gait in older individuals who are at high risk of falling. Arch Gerontol Geriatr 2012, 54(2):e102-108.
- [15]Lord SR, Fitzpatrick RC: Choice stepping reaction time: a composite measure of falls risk in older people. J Gerontol A Biol Sci Med Sci 2001, 56(10):M627-632.
- [16]Persad CC, Giordani B, Chen HC, Ashton-Miller JA, Alexander NB, Wilson CS, Berent S, Guire K, Schultz AB: Neuropsychological predictors of complex obstacle avoidance in healthy older adults. J Gerontol B Psychol Sci Soc Sci 1995, 50(5):P272-277.
- [17]Buracchio TJ, Mattek NC, Dodge HH, Hayes TL, Pavel M, Howieson DB, Kaye JA: Executive function predicts risk of falls in older adults without balance impairment. BMC Geriatr 2011, 11:74. BioMed Central Full Text
- [18]Robinovitch SN, Cronin T: Perception of postural limits in elderly nursing home and day care participants. J Gerontol A Biol Sci Med Sci 1999, 54(3):B124-130. discussion B131
- [19]Butler AA, Lord SR, Fitzpatrick RC: Reach distance but not judgment error is associated with falls in older people. J Gerontol A Biol Sci Med Sci 2011, 66(8):896-903.
- [20]Duncan PW, Weiner DK, Chandler J, Studenski S: Functional reach: a new clinical measure of balance. J Gerontol 1990, 45(6):M192-197.
- [21]Hofstetter HW: New standards procedures for measuring visual acuity. J Am Optom Assoc 1981, 52(4):321-327.
- [22]Folstein MF, Folstein SE, McHugh PR: Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975, 12(3):189-198.
- [23]Koyano W, Shibata H, Nakazato K, Haga H, Suyama Y: Measurement of competence: reliability and validity of the TMIG Index of Competence. Arch Gerontol Geriatr 1991, 13(2):103-116.
- [24]Gibson MJ, Andres RO, Isaacs B, Radebaugh T, Worm-Petersen J: The prevention of falls in later life. A report of the Kellogg International Work Group on the Prevention of Falls by the Elderly. Dan Med Bull 1987, 34(Suppl 4):1-24.
- [25]Konczak J, Meeuwsen HJ, Cress ME: Changing affordances in stair climbing: the perception of maximum climbability in young and older adults. J Exp Psychol Hum Percept Perform 1992, 18(3):691-697.
- [26]Botwinick J: Cautiousness in advanced age. J Gerontol 1966, 21(3):347-353.
- [27]Cho CY, Gilchrist L, White S: A Comparison between young and old adults in their ability to rapidly sidestep during gait when attention is divided. Gerontology 2008, 54(2):120-127.
- [28]Robinovitch SN: Perception of postural limits during reaching. J Mot Behav 1998, 30(4):352-358.
- [29]Shah RC, Buchman AS, Leurgans S, Boyle PA, Bennett DA: Association of total daily physical activity with disability in community-dwelling older persons: a prospective cohort study. BMC Geriatr 2012, 12:63. BioMed Central Full Text
- [30]Fujita K, Fujiwara Y, Chaves PH, Motohashi Y, Shinkai S: Frequency of going outdoors as a good predictors for incident disability of physical function as well as disability recovery in community-dwelling older adults in rural Japan. J Epidemiol 2006, 16(6):261-270.
- [31]Kono A, Kai I, Sakato C, Rubenstein LZ: Frequency of going outdoors: a predictor of functional and psychosocial change among ambulatory frail elders living at home. J Gerontol A Biol Sci Med Sci 2004, 59(3):275-280.
- [32]Brach JS, VanSwearingen JM, Newman AB, Kriska AM: Identifying early decline of physical function in community-dwelling older women: performance-based and self-report measures. Phys Ther 2002, 82(4):320-328.
- [33]Simonsick EM, Guralnik JM, Fried LP: Who walks? Factors associated with walking behavior in disabled older women with and without self-reported walking difficulty. J Am Geriatr Soc 1999, 47(6):672-680.
- [34]Liu-Ambrose T, Ahamed Y, Graf P, Feldman F, Robinovitch SN: Older fallers with poor working memory overestimate their postural limits. Arch Phys Med Rehabil 2008, 89(7):1335-1340.
- [35]Lord SR, Dayhew J: Visual risk factors for falls in older people. J Am Geriatr Soc 2001, 49(5):508-515.
- [36]Menant JC, St George RJ, Fitzpatrick RC, Lord SR: Impaired depth perception and restricted pitch head movement increase obstacle contacts when dual-tasking in older people. J Gerontol A Biol Sci Med Sci 2010, 65(7):751-757.
- [37]Menant JC, St George RJ, Sandery B, Fitzpatrick RC, Lord SR: Older people contact more obstacles when wearing multifocal glasses and performing a secondary visual task. J Am Geriatr Soc 2009, 57(10):1833-1838.
- [38]Close J, Ellis M, Hooper R, Glucksman E, Jackson S, Swift C: Prevention of falls in the elderly trial (PROFET): a randomised controlled trial. Lancet 1999, 353(9147):93-97.
- [39]Yasumura S, Haga H, Niino N: Circumstances of injurious falls leading to medical care among elderly people living in a rural community. Arch Gerontol Geriatr 1996, 23(2):95-109.
- [40]Chou LS, Draganich LF: Stepping over an obstacle increases the motions and moments of the joints of the trailing limb in young adults. J Biomech 1997, 30(4):331-337.
- [41]Lamoureux EL, Sparrow WA, Murphy A, Newton RU: The relationship between lower body strength and obstructed gait in community-dwelling older adults. J Am Geriatr Soc 2002, 50(3):468-473.
- [42]Arfken CL, Lach HW, Birge SJ, Miller JP: The prevalence and correlates of fear of falling in elderly persons living in the community. Am J Public Health 1994, 84(4):565-570.
- [43]Scheffer AC, Schuurmans MJ, van Dijk N, van der Hooft T, de Rooij SE: Fear of falling: measurement strategy, prevalence, risk factors and consequences among older persons. Age Ageing 2008, 37(1):19-24.