10 | Chapter 1 falls and fractures because they negatively affect mobility, muscle mass and muscle strength (28). Frailty encompasses a biological syndrome of decreased reserve and resistance to stressors, resulting from cumulative declines across multiple physiologic systems (29). Frailty is associated with a heightened susceptibility to falls and their associated consequences (30, 31). There are several operationalizations of frailty, such as the Groningen Frailty Indicator, the Tilburg Frailty Indicator, and the Frailty Index (32-34). Fried and colleagues operationalize frailty as the presence of weakness, exhaustion, physical inactivity, slowed walking speed, and unintentional weight loss (29). Older adults are classified as non-frail if none of these criteria are met (29). Meeting one or two criteria classifies adults as pre-frail, while meeting three or more of the criteria categorizes them as frail (29-31). Physical activity strengthens functional status by maintaining the capacity for daily, independent activities. This underpins functional abilities and mitigates the progression of frailty, promoting greater overall independence and health (35-37). Conversely, when functional status declines due to inactivity, frailty status tends to increase, consequently increasing one’s fall risk (35, 38). Fall prevention interventions Fall risk is generally classified into low, moderate, or high risk, based on factors such as previous falls, and balance and gait issues according to the world guidelines for fall prevention (39-41). A fall risk analysis can help in identifying appropriate interventions. Since frailty status is strongly associated with fall risk, frailty status can also be used to guide the selection of appropriate interventions (42). While frail older adults may benefit from more structured and supervised interventions to enhance their functional status, non-frail or pre-frail individuals may be offered more independent and flexible programs (43-45). Globally, various fall prevention interventions have been developed to prevent falls and fall-related injuries in older adults (46). Key components of effective fall prevention interventions include balance and strength training, education on fall risk, and home environment modifications (47-49). According to the World Falls Guidelines, these interventions should also incorporate a comprehensive assessment of fall risk factors and personalized intervention strategies (50). These elements together aim to improve functional status, increase self-confidence, and reduce concern about falling, ultimately leading to a lower incidence of falls and fall-related injuries (49, 51). To ensure that individuals are matched with a suitable intervention, effective screening is essential (52). This typically involves a comprehensive assessment that includes 1) physical assessments to evaluate balance, gait and strength performance (functional status), 2) risk questionnaires to gather information on previous falls, concern about falling and daily activity
RkJQdWJsaXNoZXIy MjY0ODMw