Technology-based Fall Risk Assessments for Older Adults in Low-income Settings

Study Overview
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Brief Summary
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The goal of this observational study is to examine the associations among fall risk appraisal, body composition, and physical activity in older adults in low-income settings. The main questions it aims to answer are: What is the feasibility of recruitment (e.g., how many older adults need to be screened to recruit the sample?), especially during the COVID-19 pandemic, and acceptability of technologies and procedures for use among older adults in low-income settings? What are the the dynamic relationships between fall risk appraisal, body composition, physical activity, and behavioral changes related to fear of falling? Participants will: complete questionnaires about their characteristics, socio-demographic, medical history, cognition, depressive symptoms, anxiety, and fear of falling. participate in static and dynamic balance tests, body composition measurement and handgrip strength test. wear an accelerometer for physical activity assessment for 7 consecutive days.

Detailed Description
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The investigators will use a cross-sectional design to address aims. The investigators will administer the study instruments which consist of objective and subjective measures. Participants will complete questionnaires about their characteristics, socio-demographic, medical history, cognition, depressive symptoms, anxiety, and fear of falling. Balance performance will be assessed by the BTrackS Balance System (BBS). This test consists of four, 20 seconds trials. For each trial, the participants will stand as still as possible on the BBP with hands on their hips, and eye closed. This test consists of four trials. This test will take about 5-10 minutes. Body composition will be assessed using a bioelectrical impedance analysis (BIA): InBody S10. The BIA InBody S10 measures fat mass, muscle mass and body water levels. There are no risks, no dunking, no pinching, no discomfort associated with the use of bioelectrical impedance analysis. Test duration is 1-2 minutes. Physical Activity (PA) will be measured by activity monitoring devices. All participants will wear the ActiGraph GT9X Link wireless activity monitor (ActiGraph LLC.), a tri-axial accelerometer, on the non-dominant wrist for 7 consecutive days.

Official Title
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Technology-based Fall Risk Assessments for Older Adults in Low-income Settings

Conditions
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Fall, Physical Inactivity, Sedentary Behavior

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ≥ 60 years of age no marked cognitive impairment [Memory Impairment Screen (MIS) score ≥5] speak English or Spanish live in Kinneret Sr. Apartments or in Orlando FL. Exclusion Criteria: a medical condition precluding balance test (e.g., unable to stand on the balance plate) and/or PA (e.g., shortness of breath; feeling pressure when performing PA) currently receiving treatment from a rehabilitation facility have a metal implant.

Ages Eligible for Study
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Minimum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Feasibility of recruitment of low-income older adults | The investigators will assess the ability to recruit the participants by tracking the number of days and time spent to recruit the sample. | Through study completion, an average of 2 years | 
| Acceptability of using technologies in low-income older adults | The acceptability of the technologies and procedures will be examined based on an evaluation form (e.g., what the participants thought about the questionnaires and technology) and participants' recommendations. | Through study completion, an average of 2 years | 
| Maladaptive fall risk appraisal | A condition in which there is a discrepancy between perceived fall risk (levels of fear of falling) and physiological fall risk (balance performance). Fear of falling will be assessed using the Short Fall Efficacy Scale International (short FES-I) with 7 items and balance performance will be assessed using the BTrackS Balance test. Maladaptive fall risk will be plotted on a electronic graph as the interaction between balance performance on the X-axis and fear of falling on the Y-axis. | Once at baseline, an average of 5 minutes | 
| Time spent in each physical activity intensity domain | Participants will wear the ActiGraph GT9X Link wireless activity monitor (ActiGraph LLC.), a tri-axial accelerometer, on the non-dominant wrist for 7 consecutive days.This device will assess the time (minutes) spent in light, moderate, and vigorous physical activity domains throughout the 7-day assessment period. | 7 days | 
| Body Composition | Body composition will be assessed using a direct segmental multi-frequency bioelectrical impedance analysis (BIA): InBody s10 device. | Once at baseline, an average of 2 minutes | 
| Balance Performance | Balance performance will be assessed using the BTrackS Balance test. | Once at baseline, an average of 4 minutes | 
| Fear of Falling | Fear of falling will be assessed using the Short Fall Efficacy Scale International (short FES-I) with 7 items.The minimum score possible is 7 and the maximum possible score is 28. Scores of 7-8 indicate low concern, scores of 9-13 indicate moderate concern, and scores of 14-28 indicate high concern. | Once at baseline, an average of 10 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Depression | Depression will be assessed using the Patient Health Questionnaire-9 (PHQ-9). The minimum possible score is 0 and the maximum possible score is 27. Scores of 0-4 indicate minimal depression, scores of 5-9 indicate mild depression, scores of 10-14 indicate moderate depression, scores of 15-19 indicate moderately severe depression, and scores of 20-27 indicate severe depression. | Once at baseline, an average of 10 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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accidental falls, body composition, falls, fear, risk assessment, technology, wearable devices