Evde ve Bakımevinde Yaşayan ve Düşme Hikayesi Olmayan Yaşlıların Fiziksel Parametre, Fonksiyonel Performans ve Yaşam Kalitelerinin Karşılaştırılması

Amaç: Bu çalışmada evde (EY) ve bakımevinde yaşayan (BY) ve düşme hikayesi olmayan yaşlıların fiziksel parametre, fonksiyonel performans ve yaşam kalitelerini karşılaştırmak ve bu faktörler arasındaki ilişkiyi araştırmak amaçlanmıştır. Gereç ve Yöntemler: Kesitsel tipteki bu çalışmada 44 EY ve 59 BY yaşlı; Berg Denge Ölçeği, Süreli Kalk ve Yürü Testi, Mini Mental Durum Testi, 30 Saniyede Sandalyeden Kalkma Testi ve Nottingham Sağlık Profili ile değerlendirildi. Bulgular: EY ve BY katılımcılar arasında alt ekstremite kas kuvveti, denge, yaşam kalitesi, fonksiyonel performans ve mental durum bakımından istatistiksel olarak anlamlı fark tespit edilmedi (p>0,05). Korelasyon analizinde yalnızca BY grupta fonksiyonel performans ile alt ekstremite kas kuvveti (r=-0,401; p=0,003) ve denge (r=-0,519; p=0,0001) arasında negatif ilişki bulundu. Tartışma ve Sonuç: EY ve BY yaşlıların düşme riski değerlendirmelerinde alt ekstremite kas kuvveti, fonksiyonel performans, mental durum ve yaşam kalitesi gibi çeşitli faktörler göz önünde bulundurulmalıdır. Fiziksel parametre ölçümleri yanı sıra fonksiyonel performans ve yaşam kalitesi verileri de sunan bu çalışma, benzer biçimde bütüncül bir perspektiften gerçekleştirilecek daha ileri çalışmalar için öncü niteliktedir.

A Comparison of Physical Parameters, Functional Performance, and Life Quality in Home-residing and Nursing Home-residing Older Adults with No History of Falls

Aim: In this study, we aimed to compare physical parameters, functional performance, and lifequality scores in home-residing (HR) and nursing home-residing (NHR) older adults with nohistory of falls and evaluate the possible correlations between these factors.Materials and Methods: This cross-sectional study assessed 44 HR and 59 NHR participantsby using the Berg Balance Scale, Timed Up and Go Test, Mini Mental State Examination,30-Second Chair Stand Test, and Nottingham Health Profile (NHP).Results: No statistically significant difference was found between the NHR and HR participantsin terms of lower extremity muscle strength, balance, life quality, functional performance, andmental status (p>0.05). Correlation analysis only showed a significant negative relationshipbetween functional performance and lower extremity muscle strength (r=-0.401, p=0.003)and balance (r=-0.519, p=0.0001) in the NHR group.Discussion and Conclusion: Fall risk assessments for HR and NHR elderly should considervarious factors including lower extremity muscle strength, functional performance, mental status, and life quality. This study presenting functional performance and life quality data as wellas physical parameter measurements is preliminary to further studies from a similarly holisticperspective.

PDF

___

1. Ishigaki EY, Ramos LG, Carvalho ES, Lunardi AC. Effectiveness of muscle strengthening and description of protocols for preventing falls in the elderly: a systematic review. Braz J Phys Ther. 2014;18(2):111–8.
2. Shubert TE. Evidence-based exercise prescription for balance and falls prevention: a current review of the literature. J Geriatr Phys Ther. 2011;34(3):100–8.
3. Bloch ML, Jønsson LR, Kristensen MT. Introducing a third Timed Up & Go Test trial improves performances of hospitalized and community-dwelling older als. J Geriatr Phys Ther. 2017;40(3):121–6.
4. Sherrington C, Whitney JC, Lord SR, Herbert RD, Cumming RG, Close JC. Effective exercise for the prevention of falls: a systematic review and metaanalysis. J Am Geriatr Soc. 2008;56:2234–43.
5. Zhao Y, Chung PK. Differences in functional fitness among older adults with and without risk of falling. Asian Nurs Res (Korean Soc Nurs Sci). 2016;10(1):51–5.
6. Amold CM, Faulkner RA. The history of falls and the association of the timed up and go test to falls and nearfalls in older adults with hip osteoarthritis. BMC Geriatr. 2007;7(17):1–9.
7. Whitney SL, Wrisley DM, Marchetti GF, Gee MA, Redfern MS, Furman JM. Clinical measurement of sit-tostand performance in people with balance disorders: validity of data for the five-times-sit-to-stand test. PTJ. 2005;85(10):1034–45.
8. Bogle Thorbahn LD, Newton RA. Use of Berg Balance Test to predict falls in elderly persons. Phys Ther. 1996;76:576–85.
9. Güngen C, Ertan T, Eker E, Yaşar R, Engin F. Reliability and validity of the standardized Mini Mental State Examination in the diagnosis of mild dementia in Turkish Population. Turk Psikiyatri Derg. 2002;13(4):273–81.
10. Küçükdeveci AA, McKenna Sp, Kutlay S, Gürsel Y, Whalley D, Arasil T. The development and psychometric assessment of the Turkish version of the Nottingham Health Profile. Int J Rehabil Res. 2000;23:31–8.
11. Yümin ET, Şimşek TT, Sertel M, Öztürk A, Yümin M. The effect of functional mobility and balance on healthrelated quality of life (HRQoL) among elderly people living at home and those living in nursing home. Arch Gerontol Geriatr. 2011;52(3):180–4.
12. Karinkanta S, Heinonen A, Sievanen H, Uusi-Rasi K, Kannus P. Factors predicting dynamic balance and quality of life in home-dwelling elderly women. Gerontology. 2005;51:116–21.
13. Downs S, Marquez J, Chiarelli P. Normative scores on the Berg Balance Scale decline after age 70 years in healthy community-dwelling people: a systematic review. J Physiother. 2014;60(2):85–9.
14. Guralnik JM, Ferrucci L, Pieper CF, Leveille SG, Markides KS, Ostir GV, et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci. 2000;55(4):M221–31.
15. Telenius EW, Engedal K, Bergland A. Physical performance and quality of life of nursing-home residents with mild and moderate dementia. Int J Environ Res Public Health. 2013;10(12):6672–86.
16. Kamińska MS, Brodowski J, Karakiewicz B. Fall risk factors in community-dwelling elderly depending on their physical function, cognitive status and symptoms of depression. Int J Environ Res Public Health. 2015;12(4):3406–16.
17. Jamal Alkadri, Jeffrey Jutai Cognitive impairment and assistive devices: outcomes and adverse effects. J Rehabil Assist Technol Eng. 2016;3:1–10.
18. Gell NM, Wallace RB, LaCroix AZ, Mroz TM, Patel KV. Mobility device use in older adults and incidence of falls and worry about falling: findings from the 2011–2012 national health and aging trends study. J Am Geriatr Soc. 2015;63(5):853–9.
19. Rubenstein LZ, Josephson KR, Robbins AS. Falls in the nursing home. Ann Intern Med. 1994;121(6):442–51.
20. Taylor ME, Lord SR, Delbaere K, Mikolaizak AS, Close JC. Physiological fall risk factors in cognitively impaired older people: a one-year prospective study. Dement Geriatr Cogn Disord. 2012;34(3–4):181–9.
21. Musich S, Wang SS, Ruiz J, Hawkins K, Wicker E. The impact of mobility limitations on health outcomes among older adults. Geriatr Nurs. 2018;39(2):162–9.
22. Król-Zielińska M, Kusy K, Zieliński J, Osiński W. Physical activity and functional fitness in institutionalized vs. independently living elderly: a comparison of 70–80-year-old city-dwellers. Arch Gerontol Geriatr. 2011;53(1):10–6.
23. Wu H, Ouyang P. Fall prevalence, time trend and its related risk factors among elderly people in China. BMJ. 2003;326(7389):580.
24. Matchar DB, Duncan PW, Lien CT, Ong MEH, Lee M, Gao F, et al. Randomized controlled trial of screening, risk modification, and physical therapy to prevent falls among the elderly recently discharged from the emergency department to the community: the Steps to Avoid Falls in the Elderly study. Arch Phys Med Rehabil. 2017;98(6):1086–96.
25. Hughes VA, Frontera WR, Roubenoff R, Evans WJ, Singh MA. Longitudinal changes in body composition in older men and women: role of body weight change and physical activity. The Am J Clin Nutr. 2002;76:473–81.