Lee Youngjae, Alexander Neil B, Pompeii Lisa, Nyquist Linda V, Madigan Michael L
Grado Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, Virginia, USA.
Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
J Am Geriatr Soc. 2025 Jan;73(1):193-198. doi: 10.1111/jgs.19148. Epub 2024 Aug 16.
Most falls among community-dwelling older adults are due to a loss of balance (LOB) after tripping or slipping. Unfortunately, limited insight is available on the detailed circumstances and context of these LOBs. Moreover, commonly used methods to collect this information is susceptible to limitations of memory recall. The goal of this pilot observational study was to explore the circumstances and context of self-reported LOBs captured by wrist-worn voice recorders among community-dwelling older adults.
In this pilot observational cohort study, 30 community-dwelling adults with a mean (SD) age of 71.8 (4.4) years were asked to wear a voice recorder on their wrist daily for 3 weeks. Following any naturally-occurring LOB, participants were asked to record their verbal responses to six questions regarding the circumstances and context of each LOB abbreviated with the mnemonic 4WHO: When, Where, What, Why, How, and Outcome.
Participants wore the voice recorder 10.9 (0.6) hours per day for 20.7 (0.5) days. One hundred seventy-five voice recordings were collected, with 122 meeting our definition of a LOB. Each participant reported 0-23 LOBs over the 3 weeks or 1.4 (2.1) per participant per week. Across all participants, LOBs were most commonly reported 3 p.m. or later (42%), inside the home (39%), while walking (33%), resulting from a trip (54%), and having induced a stepping response to regain balance (48%). No LOBs resulted in a fall.
Among community-dwelling older adults, wrist-worn voice recorders capture the circumstances and context of LOBs thereby facilitating the documentation of detail of LOBs and potentially falls, without reliance on later recall.
社区居住的老年人中，大多数跌倒都是由于绊倒或滑倒后失去平衡（LOB）所致。不幸的是，对于这些失去平衡情况的详细情形和背景，人们了解有限。此外，收集此类信息的常用方法容易受到记忆回想方面的限制。这项初步观察性研究的目的是探讨社区居住老年人中，通过佩戴在手腕上的录音机所记录的自我报告的失去平衡情况的情形和背景。
在这项初步观察性队列研究中，30名社区居住的成年人，平均（标准差）年龄为71.8（4.4）岁，被要求每天在手腕上佩戴录音机，持续3周。在发生任何自然发生的失去平衡情况后，要求参与者记录他们对六个问题的口头回答，这些问题涉及每次失去平衡情况的情形和背景，用助记符4WHO表示：何时、何地、何事、为何、如何以及结果。
参与者每天佩戴录音机10.9（0.6）小时，共佩戴20.7（0.5）天。收集到175份录音，其中122份符合我们对失去平衡情况的定义。每位参与者在3周内报告了0至23次失去平衡情况，即每位参与者每周报告1.4（2.1）次。在所有参与者中，失去平衡情况最常报告发生在下午3点或更晚（42%）、家中（39%）、行走时（33%）、绊倒导致（54%）以及引发了恢复平衡的脚步反应（48%）。没有失去平衡情况导致跌倒。
在社区居住的老年人中，佩戴在手腕上的录音机能够记录失去平衡情况的情形和背景，从而有助于记录失去平衡情况以及潜在跌倒情况的细节，而无需依赖事后回想。
