Decline in functional ability among the elderly is of clinical relevance as a marker of potentially treatable clinical disease. It is possible to screen older people for mobility issues and apply early interventions to prevent mobility problems and rehabilitate existing mobility impairments. This article discusses the predictors of mobility decline, available screening tools and the prevention and management of mobility impairment in primary care.
Get full access to this article
View all access options for this article.
References
1.
AgrawalY.CareyJ. P.HoffmanH. J.SklareD. A.SchubertM. C. (2011) The modified Romberg Balance Test: Normative data in U.S. adults. Otology and Neurotology32(8): 1309–1311. doi: 10.1097/MAO.0b013e31822e5bee.
2.
Carter, S. E., Campbell, E. M., Sanson-Fisher, R. W., Redman, S., & Gillespie, W. J. (1997). Environmental hazards in the homes of older people. Age and Ageing, 26(3), 195–202. doi: 10.1093/ageing/26.3.195.
3.
CohenH.BlatchlyC. A.GombashL. L. (1993) A study of the clinical test of sensory interaction and balance. Physical Therapy73(6): 346–351. discussion 351–344.
4.
DuncanP. W.WeinerD. K.ChandlerJ.StudenskiS. (1990) Functional reach: A new clinical measure of balance. Journal of Gerontology45(6): M192–197.
5.
HaradaN.ChiuV.Damron-RodriguezJ.FowlerE.SiuA.ReubenD. B. (1995) Screening for balance and mobility impairment in elderly individuals living in residential care facilities. Physical therapy75(6): 462–469.
6.
KennyR. A.RubensteinL. Z.TinettiM. E.BrewerK.CameronK. A.CapezutiL.SutherM. (2011) Summary of the updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons. Journal of the American Geriatrics Society59(1): 148–157.
7.
KoponenM. P.BellJ. S.KarttunenN. M.NykanenI. A.DesplenterF. A.HartikainenS. A. (2013) Analgesic use and frailty among community-dwelling older people: A population-based study. Drugs Aging30(2): 129–136. doi: 10.1007/s40266-012-0046-8.
8.
LihavainenK.SipilaS.RantanenT.SihvonenS.SulkavaR.HartikainenS. (2010) Contribution of musculoskeletal pain to postural balance in community-dwelling people aged 75 years and older. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences65(9): 990–996. doi: 10.1093/gerona/glq052.
OliverD.DalyF.MartinF. C.McMurdoM. E. T. (2004) Risk factors and risk assessment tools for falls in hospital in-patients: A systematic review. Age and ageing33(2): 122–130. doi: 10.1093/ageing/afh017.
11.
PerellK. L.NelsonA.GoldmanR. L.LutherS. L.Prieto-LewisN.RubensteinL. Z. (2001) Fall risk assessment measures an analytic review. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences56(12): M761–M766.
12.
PortegijsE.SipilaS.RantanenT.LambS. E. (2008) Leg extension power deficit and mobility limitation in women recovering from hip fracture. American Journal of Physical and Medical Rehabilitation87(5): 363–370. doi: 10.1097/PHM.0b013e318164a9e2.
Scott, V., Bawa, H., Feldman, F., Gould, S. J., Leung, M., & Tan, N. (2008). Promoting active living (PAL): Best practice guidelines for fall prevention in assisted living. BC Ministry of Health Living and Sport. Retrieved from www.injuryresearch.bc.ca/docs/3_20090127_162808PAL%20BPG%20intro.pdf.
15.
ScottV.VotovaK.ScanlanA.CloseJ. (2007) Multifactorial and functional mobility assessment tools for fall risk among older adults in community, home-support, long-term and acute care settings. Age and ageing36(2): 130–139. doi: 10.1093/ageing/afl165.
16.
SixsmithA.JohnsonN. (2004) A smart sensor to detect the falls of the elderly. IEEE Pervasive computing3(2): 42–47.
17.
StenholmS.SainioP.RantanenT.KoskinenS.JulaA.HeliövaaraM.AromaaA. (2007) High body mass index and physical impairments as predictors of walking limitation 22 years later in adult Finns. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences62(8): 859–865.
18.
Stevens, M., Holman, C. A. J., & Bennett, N. (2001). Preventing falls in older people: Impact of an intervention to reduce environmental hazards in the home. Journal of the American Geriatrics Society, 49(11), 1442–1447. doi: 10.1046/j.1532-5415.2001.4911235.x.
19.
Tinetti, M. E., & Speechley, M. (1989). Prevention of falls among the elderly. New England Journal of Medicine, 320(16), 1055–1059.
20.
WeinerD. K.DuncanP. W.ChandlerJ.StudenskiS. A. (1992) Functional reach: A marker of physical frailty. Journal of American Geriatric Society40(3): 203–207. doi: 10.1111/j.1532-5415.1992.tb02068.x.
21.
World Health Organization. (2001). International classification of Functioning, Diability and Health (ICF) webpage. Retrieved from www.who.int/classifications/icf/en/.