How CHR’s Play A Key Role in Falls / injury Prevention of Elders
August 24, 2017Community Health Representatives
AAA NACOG Conference | Flagstaff
Babak M. Nayeri, NMD, FACFE | Director, Healthy Aging
Setting the scene• Worldwide population is aging
• Impacts healthcare planning and provision
• The most problematic expression of population aging is the clinical condition of FRAILTY
• Around 10% of over 65+ have frailty
• Over 25 of over 85+ have frailty (in some studies >50%)
Formal definitions
“a state of increased vulnerability to stressors due to age‐related declines in physiologic
reserves across neuromuscular, metabolic, and immune systems”
American Geriatric Society
Formal Consensus
“a medical syndrome with multiple causes and contributors
that is characterised by diminished strength, endurance, and reduced
physiological function, that increases an individual’s vulnerability for
developing increased dependency and/or death”
J Am Med Dir Assoc 2013
Where are people likely to fall (65 + years)
Home 60%
Public Places 30%
711
792
788920
1,008
0
200
400
600
800
1000
1200
2012 2013 2014 2015 2016
Number of Deaths due to Falls among 65+ Yrs in Arizona, from 2012-2016
Fall Deaths
974Deaths14,384
Inpatient Hospitalizations
42,808Emergency Department
Visits
Chronic malnutrition
& Sarcopenia
Loss of strength & Slowness
Reduction in physical activity
Decreased energy
expenditure
Anorexia of aging
Frailty Cycle
Frailty• 5 meter gait
speed• ABC Scale• Morse Scale
Comorbidity• Chronic
disease(s)• Vision• Hearing
Disability• ADL• IADL• Nagi’s
FALL
DECREASED FUNCTIONAL
ABILITY
REDUCED ▪ MUSCLE
STRENGTH▪ BALANCE
AND GAIT▪ FLEXIBILITY
DECREASED ACTIVITY
FEAR OF FALLING
History of Falls (Previous falls)
Activities‐specific Balance Confidence (ABC) Scale
• ratings should consist of whole numbers (0‐100) for each item – Range = 0 ‐1600 – divide by 16 to get each subject's ABC score
• 80% = high level of physical functioning • 50‐80% = moderate level of physical functioning • < 50%.= low level of physical functioning Myers AM (1998)
• < 67% = older adults at risk for falling; predictive of future fall Lajoie Y (2004)
Morse Fall Scale
What can be done to reduce the risk of unintentional falls?
• Maintain a regular exercise program to increase strength, balance, and coordination. Tai Chi classes are an evidence‐based method.
• Regularly review meds with a healthcare provider, and dispose unused meds
• Have yearly eye exams. • Modify home environments to reduce hazards such as slippery floors, poor lighting, and uneven surfaces.
Being Fit is Ageless
Arizona Falls Prevention Coalition (AFPC)
Our Calling is to Prevent Falling
AZHealthyAging.com
www.AzStopFalls.org
THANK YOUDr. Babak Michael Nayeri | Director, Healthy Aging
azhealth.gov
@azdhs
facebook.com/azdhs
THANK YOUDr. Babak M. Nayeri | Director, Healthy [email protected] | 602-364-0868
azhealth.gov
@azdhs
facebook.com/azdhs