Development of profiles using venn diagrams to customize fall prevention interventions among older adults

Abstract

Preventing falls among older adults will be a challenge in the upcoming decades, especially in the median and low-income countries in Latin America and Asia. Annually, fall-related direct medical costs are estimated in 30 billion dollars. Furthermore, falls can cause a major long-term biopsychosocial burden for families and societies. Evidence-based research shows that the incidence of falls can be reduced up to 23% using structured physical exercises programs. However, some exercise characteristics have been reported by older adults as barriers for adherence. Some older adults may consider the exercise 'easy' and 'not challenging enough', while others may consider exercise to be 'too challenging'. Individually tailored exercises are recommended, even when delivered in group, in order to guarantee its effectiveness and maximize resources. Although there are algorithms aiming to stratify individuals at high or low risk of falling, none of the existent instruments have been developed to help professionals to identify different profiles of fallers according to their functional level. With this study, we aim to explore different profile of fallers and identify possible overlapping of characteristics for developing an algorithm facilitating evidence implementation in a more assertive way, and improve the process of designing falls prevention exercises. Objectives: To investigate overlapping of the number of falls, number of comorbidities and level of disability and, analyze the different profiles of older adults from these overlaps. Methods: A cross-sectional study using secondary data from the randomized control trial Prevquedas Brasil. Participants are 715 older adults (e 60 years old), men and women, with a fall history in the past twelve months. Participants were recruited from four specialized care centres (IOT - FMUSP, Instituto Paulista de Geriatria e Gerontologia, Hospital do Servidor Público Estadual and CRI - Zona Norte). Participants will be categorized according to its level of disability in performing basic and instrumental activities of daily life (Brazilian OARS - Multidimensional Functional Assessment Questionnaire - BOMFAQ), the number of comorbidities and the number of falls (single or recurrent). Venn diagrams will be created and the overlaps will be further investigated in relation to mobility and balance. Multivariate stepwise regression analyses will be conducted to analyze the profiles. Based on the results of the study we can help professionals to identify subgroups of older adults and to design falls prevention exercise-based interventions, minimizing barriers for participating and contributing for the development of an algorithm.