Confidence May Affect Mobility in Seniors

Hip fractures can be seriously debilitating. However, a recent study suggests that damaged confidence – not just physical injury – can sometimes be partly responsible for a reduction in mobility.

The Dangers of Falling

A vast majority of hip fractures occur as a result of a fall, with approximately 90 percent of the fractures occurring in seniors, according to Johns Hopkins University. Following surgery and a week's worth of hospitalization, the CDC says adults recovering from a hip fracture can expect long-term rehabilitation and even temporary admission to a nursing home.

The likelihood of enduring a hip fracture, along with the negative side effects, increases roughly tenfold every decade after age 50. Women are particularly vulnerable due to a higher occurrence of osteoporosis, incurring approximately four out of five hip fractures. Rarely does mobility return to pre-fracture levels.

A 2012 university study found that loss of mobility might be due, in part, to “balance confidence”, an issue closely related to a fear of falling.The study concluded that among people who have had a fall-related hip fracture, an independent relationship exists between balance confidence and mobility and balance performance – as well as perceived mobility function.

The study tracked 130 adults over the age of 60 who had suffered hip fractures between six weeks and 7.4 years prior to observation. To test balance confidence, researchers used a simple but comprehensive measure called the Activities-specific Balance Confidence Scale (ABC Scale). The ABC scale can be self-administered, and is comprised of a series of questions that gauge an adult's confidence in various walking scenarios, such as walking up stairs or on an icy path. Adults who rated a higher balance confidence tended to do better in balance and mobility tests.

More frequent homecomings

One in three people who lived independently prior to a hip fracture spent at least some time in a nursing home after their injury and related hospitalization. Mobility, after all, is key to independent living. Yet, the delay in returning home may be avoidable, the study suggests. Identification of people with lack of balance confidence enables the planning of more intensive rehabilitation strategies that facilitate the recovery of mobility function," said Erja Portegijs, a postdoctoral researcher involved in the study.

For those providing senior care, the ability to administer the ABC Scale and aid in the recovery of balance confidence may reduce the number of patients currently living in nursing homes or receiving long-term care. That means not only a reduction in long-term health care costs, but also a restoration of confidence.

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