Sensorimotor Performance and Reference Values for Fall Risk Assessment in Community-Dwelling Adults: The Yishun Study
Objective: What are the reference values of sensorimotor performance for fall risk in community-dwelling adults? How do our population norms compare to that of other populations? Are younger adults at risk of falls?
Methods: In a cross-sectional study design, sensorimotor functions and fall risk scores of community-dwelling adults were assessed and calculated to derive corresponding fall risk categories. Reference values were determined using the average scores by age-group. A total of 542 community-dwelling adults were recruited (21-90 years old) across 10-year (21-60 years) and 5-year age-groups (>60 years) to obtain a representative sample of community-dwelling adults in Singapore. We assessed five physiological domains: vision, proprioception, muscle strength, reaction time and postural balance, according to the Physiological Profile Assessment (PPA). Fall risk scores and the corresponding fall risk profiles were generated from an online calculator.
Results: Sensorimotor performance and PPA fall risk scores were significantly worse for increasing age categories (p<.01). Females had significantly slower reaction time (p<.001), lower muscle strength (p<.001) and higher fall risk (p=.008). Our representative sample of older adults (≥65 years) performed poorer in postural sway (z=-0.50) and reaction time (z=-0.55), but better in proprioception (z=0.29) and vision (z=0.23) compared to Caucasian norms. Among younger adults (21-59 years), 36.8% appeared to exhibit higher fall risk.
Conclusions: Our study presents important reference data and compared sensorimotor functions and physiological fall risk across the age groups of community-dwelling adults in a South-East Asian population. Poor sensorimotor performance and fall risk appear already pertinent in younger adults. Further studies are warranted to improve our understanding of fall risk among younger adults.
Impact Statement: In physical therapy practice, PPA reference values can aid clinicians in the development of targeted interventions tailored towards an individual’s physiological risk profile, addressing specific physiological systems that require particular attention.