Risk-Taking and Risk of Falls in Community-Dwelling Older Adults: A Scoping Review
DOI:
https://doi.org/10.15621/ijphy/2023/v10i2/1325Keywords:
behaviors, fall risk, risk appraisal, risk propensity, risk attitudes.Abstract
Background: Risk-taking behaviors have emerged as a target for fall prevention. However, the risk-taking concepts are complex, and several approaches exist to identify risk-taking behaviors. In addition, studies of fall-related risk-taking behaviors have not yet been systematically evaluated.
Methods: This scoping review was conducted in accordance with Joanna Briggs Institute’s methodology for scoping reviews. Six electronic databases were searched to identify studies published between 2000 and 2020. Studies were included in our review if they were conducted on community-dwelling older adults (≥ 65 years) and discussed fallrelated risk-taking behaviors. Data extraction and analyses were completed using a table developed a priori by the research team.
Results: Self-reported behaviors using qualitative methodology were the most common approach to identifying risktaking behaviors in community-dwelling older adults. Generally, older adults are aware of their fall risk and tend to adopt behaviours to help mitigate it. However, older adults also described moments of deliberate risk-taking driven by the potential benefits of this behavior. Factors associated with risk-taking include an individual’s abilities, personal values, and physical and social environment.
Conclusion: This review demonstrated that fall-related risk-taking behaviors are a highly individualized concept influenced by a number of factors. Therefore, future research should evaluate how risk appraisal, risk attitudes, and risk propensity predict fall-related risk-taking behaviors in community-dwelling older adults.
References
World Health Organization. WHO Global Report on Falls Prevention in Older Age.; 2007.
Feldman F, Chaudhury H. Falls and the physical environment: A review and a new multifactorial falls-risk conceptual framework. Can J Occup Ther. 2008;75(2):82-95.
Adams T. The social construction of risk by community psychiatric nurses and family carers for people with dementia. Heal Risk Soc. 2001;3(3):307-319. doi:10.1080/13698570120079903
Clarke CL. Risk and ageing populations: practice development research through an international research network. Int J Older People Nurs. 2006;1(3):169-176. doi:10.1111/j.1748-3743.2006.00027.x
Public Health Agency of Canada. Seniors’ Falls in Canada: Second Report.; 2014.
Durocher E, Gibson BE, Rappolt S. Mediators of marginalisation in discharge planning with older adults. Ageing Soc. 2017;37(9):1747-1769. doi:10.1017/S0144686X16000593
Rush KL, Murphy MA, Kozak JF. A photovoice study of older adults’ conceptualizations of risk. J Aging Stud. 2012;26(4):448-458. doi:10.1016/j.jaging.2012.06.004
Sitkin SB, Pablo AL. Reconceptualizing the Determinants of Risk Behavior. Acad Manag. 1992;17(1):9-38.
Haines TP, Lee DCA, O’Connell B, Mcdermott F, Hoffmann T. Why do hospitalized older adults take risks that may lead to falls? Heal Expect. 2015;18(2):233-249. doi:10.1111/hex.12026
Boyer TW. The development of risk-taking: A multi-perspective review. Dev Rev. 2006;26(3):291-345. doi:10.1016/j.dr.2006.05.002
Bran A, Vaidis DC. Assessing risk-taking: what to measure and how to measure it. J Risk Res. 2020;23(4):490-503. doi:10.1080/13669877.2019.1591489
Byrnes JP, Miller DC, Schafer WD. Gender differences in risk taking: A meta-analysis. Psychol Bull. 1999;125(3):367-383. doi:10.1037/0033-2909.125.3.367
Finucane ML, Holup JL. Risk as value: Combining affect and analysis in risk judgments. J Risk Res. 2006;9(2):141-164. doi:10.1080/13669870500166930
Arksey H, O’Malley L. Scoping studies: Towards a methodological framework. Int J Soc Res Methodol Theory Pract. 2005;8(1):19-32. doi:10.1080/1364557032000119616
Levac D, Colquhoun H, O’Brien KK. Scoping studies: advancing the methodology. Implement Sci. 2010;5(69):1-9. doi:10.1017/cbo9780511814563.003
Munn Z, Peters MDJ, Stern C, Tufanaru C, McArthur A, Aromataris E. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med Res Methodol. 2018;18(1):1-7. doi:10.1186/s12874-018-0611-x
Peters M, Godfrey C, McInerney P, Munn Z, Tricco A, Khalil H. Chapter 11: Scoping Reviews (2020 version). In: Aromataris E, Munn Z, eds. JBI Reviewer’s Manual. JBI; 2020. doi:https://doi.org/10.46658/JBIRM-20-01
Begin D, Morgan A, Macedo L, Richardson J, Wojkowski S. Risk-taking behaviours and falls in community-dwelling older adults: a scoping review protocol ´. JBI Evid Synth. 2021:1-9. doi:10.11124/JBIES-20-00355
Tricco AC, Lillie E, Zarin W, O'Brien, KK., Colquhoun, H., Levac, D., et al. PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med. 2018;169(7):467-473. doi:10.7326/M18-0850
Azzarello J, Hall B. Describing older adults’ awareness of fall risk using situation awareness research techniques: A pilot study. Res Gerontol Nurs. 2016;9(4):161-166. doi:10.3928/19404921-20160504-01
Bailey C, Foran T, Scanail C, Dromey B. Older adults, falls and technologies for independent living: a life space approach. Ageing Soc. 2011;31(5):829-848.
Clemson L, Manor D, Fitzgerald MH. Behavioral Factors Contributing to Older Adults Falling in Public Places. OTJR Occup Particip Heal. 2003;23(3):107-117. doi:10.1177/153944920302300304
Clemson L, Cumming RG, Heard R. The development of an assessment to evaluate behavioral factors associated with falling. Am J Occup Ther. 2003;57(4):380-388. doi:10.5014/ajot.57.4.380
Crenshaw JR, Bernhardt KA, Achenbach SJ, Atkinson, EJ., Khosla, S., Kaufman, KR., et al. The circumstances, orientations, and impact locations of falls in community-dwelling older women. Arch Gerontol Geriatr. 2017;73(October 2016):240-247. doi:10.1016/j.archger.2017.07.011
Dollard J, Barton C, Newbury J, Turnbull D. Falls in old age: A threat to identity. J Clin Nurs. 2012;21(17-18):2617-2625. doi:10.1111/j.1365-2702.2011.03990.x
Horton K. Gender and the risk of falling: A sociological approach. J Adv Nurs. 2007;57(1):69-76. doi:10.1111/j.1365-2648.2006.04061.x
Kilian C, Salmoni A, Ward-Griffin C, Kloseck M. Perceiving Falls within a Family Context: A Focused Ethnographic Approach. Can J Aging / La Rev Can du Vieil. 2008;27(4):331-345. doi:10.3138/cja.27.4.331
Kim D, Ahrentzen S. Environmental and Behavioral Circumstances and Consequences of Falls in a Senior Living Development. J Hous Elderly. 2017;31(3):286-301. doi:10.1080/02763893.2017.1335667
Kluft N, van Dieën JH, Pijnappels M. The degree of misjudgment between perceived and actual gait ability in older adults. Gait Posture. 2017;51:275-280. doi:10.1016/j.gaitpost.2016.10.019
Lehtola S, Koistinen P, Luukinen H. Falls and injurious falls late in home-dwelling life. Arch Gerontol Geriatr. 2006;42(2):217-224. doi:10.1016/j.archger.2005.07.002
Mackenzie L, Byles J, Higginbotham N. A prospective community-based study of falls among older people in Australia: Frequency, circumstances, and consequences. OTJR Occup Particip Heal. 2002;22(4):143-152. doi:10.1177/153944920202200403
Berlin Hallrup L, Albertsson D, Bengtsson Tops A, Dahlberg K, Grahn B. Elderly women’s experiences of living with fall risk in a fragile body: A reflective lifeworld approach. Heal Soc Care Community. 2009;17(4):379-387. doi:10.1111/j.1365-2524.2008.00836.x
Nachreiner NM, Findorff MJ, Wyman JF, McCarthy TC. Circumstances and consequences of falls in community-dwelling older women. J Women’s Heal. 2007;16(10):1437-1446. doi:10.1089/jwh.2006.0245
Nyman SR, Ballinger C, Phillips JE, Newton R. Characteristics of outdoor falls among older people: a qualitative study. BMC Geriatr. 2013;13:125. http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emed12&NEWS=N&AN=24245830.
Pohl P, Sandlund M, Ahlgren C, Bergvall-Kåreborn B, Lundin-Olsson L, Wikman AM. Fall risk awareness and safety precautions taken by older community-dwelling women and men-a qualitative study using focus group discussions. PLoS One. 2015;10(3):1-15. doi:10.1371/journal.pone.0119630
Robson K, Coyle J, Pope R. Exploration of older people ’ s perceptions of behavioural factors associated with falls. Age Ageing. 2018;47:734-740. doi:10.1093/ageing/afy051
Roe B, Howell F, Riniotis K, Beech R, Crome P, Ong BN. Older people’s experience of falls: Understanding, interpretation and autonomy. J Adv Nurs. 2008;63(6):586-596. doi:10.1111/j.1365-2648.2008.04735.x
Sattar S, Spoelstra SL, Alibhai SMH, Puts MTE. Circumstances of falls and fear of falling in community-dwelling older adults with cancer: Results from a mixed-methods study. J Geriatr Oncol. 2019;10(1):105-111. doi:10.1016/j.jgo.2018.08.005
Stevens JA, Mahoney JE, Ehrenreich H. Circumstances and outcomes of falls among high risk community-dwelling older adults. Inj Epidemiol. 2014;1(1):1-9. doi:10.1186/2197-1714-1-5
Tomczak U, Sattar S, Schoenbeck KL, Cordner T, Wildes TM. Circumstances around falls in older adults with Cancer. J Geriatr Oncol. 2021;12(1):91-95. doi:10.1016/j.jgo.2020.06.001
Weijer RHA, Hoozemans MJM, van Dieën JH, Pijnappels M. Consistency and test–retest reliability of stepping tests designed to measure self-perceived and actual physical stepping ability in older adults. Aging Clin Exp Res. 2019;31(12):1765-1773. doi:10.1007/s40520-018-01112-3
Zecevic AA, Salmoni AW, Lewko JH, Vandervoort AA, Speechley M. Utilization of the seniors falls investigation methodology to identify system-wide causes of falls in community-dwelling seniors. Gerontologist. 2009;49(5):685-696. doi:10.1093/geront/gnp059
Blalock SJ, Gildner PL, Jones JL, Bowling JM, Casteel CH. Relationship Between Perceived Risk of Falling and Adoption of Precautions to Reduce Fall Risk. J Am Geriatr Soc. 2016;64(6):1313-1317. doi:10.1111/jgs.14136
Bleijlevens MHC, Diederiks JPM, Hendriks MRC, Van Haastregt JCM, Crebolder HFJM, Van Eijk JT. Relationship between location and activity in injurious falls: An exploratory study. BMC Geriatr. 2010;10. doi:10.1186/1471-2318-10-40
Brundle C, Waterman HA, Ballinger C, Olleveant, N., Skelton, DA., Stanfor, P., et al. The causes of falls: Views of older people with visual impairment. Heal Expect. 2015;18(6):2021-2031. doi:10.1111/hex.12355
Butler AA, Lord SR, Taylor JL, Fitzpatrick RC. Ability Versus Hazard: Risk-Taking and Falls in Older People. Journals Gerontol - Ser A Biol Sci Med Sci. 2015;70(5):628-634. doi:10.1093/gerona/glu201
Butler AA, Lord SR, Fitzpatrick RC. Reach distance but not judgment error is associated with falls in older people. Journals Gerontol - Ser A Biol Sci Med Sci. 2011;66 A(8):896-903. doi:10.1093/gerona/glr071
Cayado V, Chahbi R. La perception du risque d’accident et de chute par des personnes âgées vivant à domicile: Un arbitrage complexe ? NPG Neurol - Psychiatr - Geriatr. 2015;15(88):194-199. doi:10.1016/j.npg.2015.02.003
Chaumon MEB, Cuvillier B, Body S, Cros F. Detecting falls at home: User-centered design of a pervasive technology. Hum Technol. 2016;12(2):165-192. doi:10.17011/ht/urn.201611174654
Sandlund M, Pohl P, Ahlgren C, et al. Gender perspective on older people’s exercise preferences and motivators in the context of falls prevention: A qualitative study. Biomed Res Int. 2018;2018. doi:10.1155/2018/6865156
Fox CR, Tannenbaum D. The elusive search for stable risk preferences. Front Psychol. 2011;2(NOV):1-4. doi:10.3389/fpsyg.2011.00298
Blais A, Weber EU. A Domain-Specific Risk-Taking (DOSPERT) scale for adult populations. A Domain-Specific Risk-Taking scale adult Popul. 2006;1(1):33-47.
Farnham A, Ziegler S, Blanke U, Stone E, Hatz C, Puhan MA. Does the DOSPERT scale predict risk-taking behaviour during travel? A study using smartphones. J Travel Med. 2018;25(1):1-7. doi:10.1093/jtm/tay064
Gullone E, Moore S. Adolescent risk-taking and the five-factor model of personality. J Adolesc. 2000;23(4):393-407. doi:10.1006/jado.2000.0327
Lejuez CW, Aklin WM, Zvolensky MJ, Pedulla CM. Evaluation of the Balloon Analogue Risk Task (BART) as a predictor of adolescent real-world risk-taking behaviours. J Adolesc. 2003;26(4):475-479. doi:10.1016/S0140-1971(03)00036-8
Jones G, Milligan J, Llewellyn D, Gledhill A, Johnson MI. Motivational orientation and risk taking in elite winter climbers: A qualitative study. Int J Sport Exerc Psychol. 2017;15(1):25-40. doi:10.1080/1612197X.2015.1069876
Coudin G, Alexopoulos T. “Help me! I’m old!” How negative aging stereotypes create dependency among older adults. Aging Ment Heal. 2010;14(5):516-523. doi:10.1080/13607861003713182
Hanson HM, Salmoni AW, Doyle PC. Broadening our understanding: Approaching falls as a stigmatizing topic for older adults. Disabil Health J. 2009;2(1):36-44. doi:10.1016/j.dhjo.2008.11.001
Kornadt AE, Kessler EM, Wurm S, Bowen CE, Gabrian M, Klusmann V. Views on ageing: a lifespan perspective. Eur J Ageing. 2020;17(4):387-401. doi:10.1007/s10433-019-00535-9
Egan MY, Laliberte Rudman D, Ceci C, Kessler, D, McGrath, C, Gardner, P, et al. Seniors, risk and rehabilitation: broadening our thinking. Disabil Rehabil. 2017;39(13):1348-1355. doi:10.1080/09638288.2016.1192227
Miller KE. Wired: Energy drinks, jock identity, masculine norms, and risk taking. J Am Coll Heal. 2008;56(5):481-490. doi:10.3200/JACH.56.5.481-490
Zinn JO. The meaning of risk-taking–key concepts and dimensions. J Risk Res. 2019;22(1):1-15. doi:10.1080/13669877.2017.1351465
Han K, Jung J, Mittal V, Zyung JD, Adam H. Political Identity and Financial Risk Taking: Insights from Social Dominance Orientation. J Mark Res. 2019;56(4):581-601. doi:10.1177/0022243718813331
World Health Organization. Ageing and health. https://www.who.int/news-room/fact-sheets/detail/ageing-and-health. Published 2018. Accessed May 13, 2021.
Mckendry J, Breen L, Shad BJ, Greig CA. Muscle morphology and performance in master athletes: A systematic review and meta-analyses. Ageing Res Rev. 2018;45(January):62-82. doi:10.1016/j.arr.2018.04.007
Bauman A, Merom D, Bull FC, Buchner DM, Fiatarone Singh MA. Updating the Evidence for Physical Activity: Summative Reviews of the Epidemiological Evidence, Prevalence, and Interventions to Promote “active Aging.” Gerontologist. 2016;56:S268-S280. doi:10.1093/geront/gnw031
Dunlop DD, Semanik P, Song J, Manheim LM, Shih V, Chang RW. Risk factors for functional decline in older adults with arthritis. Arthritis Rheum. 2005;52(4):1274-1282. doi:10.1002/art.20968
Merom D, Pye V, Macniven R, et al. Prevalence and correlates of participation in fall prevention exercise/physical activity by older adults. Prev Med (Baltim). 2012;55(6):613-617. doi:10.1016/j.ypmed.2012.10.001
Unger JB, Johnson CA, Marks G. Functional decline in the elderly: Evidence for direct and stress- buffering protective effects of social interactions and physical activity. Ann Behav Med. 1997;19(2):152-160. doi:10.1007/BF02883332
Campbell AJ, Robertson MC. Otago exercise programme to prevent falls in older adults: a home-based, individually tailored strength and balance retraining programme. 2003:2-71.
Edwards T, Pilutti LA. The effect of exercise training in adults with multiple sclerosis with severe mobility disability: A systematic review and future research directions. Mult Scler Relat Disord. 2017;16(June):31-39. doi:10.1016/j.msard.2017.06.003
Lam FM, Huang MZ, Liao LR, Chung RC, Kwok TC, Pang MY. Physical exercise improves strength, balance, mobility, and endurance in people with cognitive impairment and dementia: a systematic review. J Physiother. 2018;64(1):4-15. doi:10.1016/j.jphys.2017.12.001
Neri SGR, Cardoso JR, Cruz L, Lima, RM, de Oliveira, RJ, Iversen, MD, et al. Do virtual reality games improve mobility skills and balance measurements in community-dwelling older adults? Systematic review and meta-analysis. Clin Rehabil. 2017;31(10):1292-1304. doi:10.1177/0269215517694677
Papa E V, Dong X, Hassan M. Resistance training for activity limitations in older adults with skeletal muscle function deficits: a systematic review. Clin Interv Aging. 2017;12:955-961. doi:10.2147/CIA.S104674
Varahra A, Rodrigues IB, MacDermid JC, Bryant D, Birmingham T. Exercise to improve functional outcomes in persons with osteoporosis: a systematic review and meta-analysis. Osteoporos Int. 2018;29(2):265-286. doi:10.1007/s00198-017-4339-y
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