Wearable Technology in Mobility and Falls Health Care: Finding Consensus on Their Clinical Utility and Identifying a Roadmap to Actual Use.

Background: Despite the promise wearable technology offers through detailed insight into mobility and fall risk, timely identification of high risk, assessment of risk severity, evaluation of clinical interventions, and potential to redefine the assessment of behaviours which influence health, they are not routinely used in clinical practice.

Objective: Establish consensus on how wearable technology can be applied to support clinical care for people aged 50 and over experiencing changes to mobility and/or who are at increased risk of falling.

Methods: A Delphi study was conducted among 17 hospital-based health professionals.

Exploring how falls prevention practitioners assess and manage concerns about falling.

Background: Concerns about falling (CaF) are common in older adults. They can lead to various negative outcomes, including an increased risk for future falls. The Worlds Falls Guidelines recently published recommendations for assessing and treating CaF.

The effect of pain on gait in older people: A systematic review and meta-analysis.

Multi-site pain is common in people aged 60 years and over and is associated with a high risk of falls. To prevent and treat pain-related disabilities, it is crucial to identify the mechanisms underlying these associations. There is some evidence that pain leads to changes in walking, such as slower gait speed and shorter walking distance, which impair mobility and may increase the risk of falls.

Two simple modifications to the World Falls Guidelines algorithm improves its ability to stratify older people into low, intermediate and high fall risk groups.

Background: We conducted a secondary analysis of a cohort study to examine the World Falls Guidelines algorithm's ability to stratify older people into sizable fall risk groups or whether minor modifications were necessary to achieve this.

Methods: Six hundred and ninety-three community-living people aged 70-90 years (52.4% women) were stratified into low, intermediate and high fall risk groups using the original algorithm and a modified algorithm applying broader Timed Up and Go test screening with a >10-s cut point (originally >15 s).

The relationship between pain, quality of life and physical activity in older community living Australians.

The objective of this analysis was to investigate the relationship between pain and quality of life and physical activity as a mediator in the relationship between pain and quality of life. This study utilised a combination of questionnaire data from 503 community-living people aged 70-years and over concerning quality of life, pain, and physical activity. Participants with higher levels of pain intensity experienced lower quality of life and engaged in lessphysical activity (P < 0.

The impact of cognitive-motor interference on balance and gait in hearing-impaired older adults: a systematic review.

Background: Hearing impairments are a rising burden in our aging society. Hearing loss is associated with reduced cognitive performance as well as decrements in balance and gait. Therefore, impaired hearing affects also dual tasking (DT).

Strength together: examining risk and protective factors associated with dementia and cognitive impairment in Aboriginal and Torres Strait Islander peoples through harmonisation of landmark studies.

Background: Rates of dementia for Aboriginal and Torres Strait Islander peoples are three to five times greater compared to non-Indigenous Australians, with earlier age of onset. However, the risk and protective factors that drive these higher rates vary across existing cohort studies, with minimal findings on the role of vascular risk factors beyond stroke. Harmonisation of data across studies may offer greater insights through enhanced diversity and strengthened statistical capabilities.

Brain and brawn in balance: Central processing speed and muscle torque development speed are independently associated with the ability to recover balance with feet-in-place.

Background: Stepping thresholds, i.e. the maximum perturbation one can withstand without taking a step, predict falls in older people.

Physiotherapy-led telehealth and exercise intervention to improve mobility in older people receiving aged care services (TOP UP): protocol for a randomised controlled type 1 hybrid effectiveness-implementation trial.

Introduction: Deteriorating mobility and falls reduce independence and quality of life for older people receiving aged care services. This trial aims to establish effectiveness on the mobility of older people, and explore cost-effectiveness and implementation of a telehealth physiotherapy programme.

Method And Analysis: This type 1 hybrid effectiveness-implementation randomised controlled trial will involve 240 people aged 65+ years receiving aged care services in community or residential settings.

A systems approach to assist policy action to prevent falls among community-dwelling older people in Australia.

Objectives: While systems thinking has gained recognition as an important approach in health policy and prevention research, its application in the context of fall prevention among community-dwelling older adults has been underutilised. Here, we build on the guiding principles of the systemic lens component of the Prevention System Change Framework to assess and identify potential changes that are required to facilitate policy action in the field of falls prevention.

Methods: We conducted a desktop search to identify policy documents encompassing falls prevention among community-dwelling older adults in Australia.

How Perceptions of Aging Influence Physical Activity and Exercise in Older Age: Exploring the Behavior of People Aged 70+ Years Engaged in Fall Prevention Activities.

For older people, physical inactivity increases fall risk as well as other preventable health conditions. Despite the well-documented benefits of physical activity, uptake and adherence continue to challenge efforts aimed at increasing physical activity and reducing falls. Nested within a randomized controlled trial, this study reports on the factors influencing the physical activity behavior of people, aged between 70 and 90 years, engaged in , a home-based balance exercise program proven to reduce falls in the community.

The Relationship Between Rehabilitation and Frailty in Advanced Heart or Lung Disease.

Background: Frailty increases morbidity and mortality in patients with advanced heart and lung disease. Emerging evidence shows that postoperative cardiac or pulmonary rehabilitation can improve the frailty status of these patients. The aim of this hypothesis-generating study was to test the relationship between prehabilitation and frailty in patients with advanced heart or lung disease referred for heart and lung transplantation.

A 10-week intergenerational program bringing together community-living older adults and preschool children (INTERACTION): a pilot feasibility non-randomised clinical trial.

Background: Social isolation and low levels of physical activity are strong drivers for frailty, which is linked to poor health outcomes and transition to long-term care. Frailty is multifactorial, and thus an integrated approach is needed to maintain older adults' health and well-being. Intergenerational programs represent a novel multifactorial approach to target frailty, social isolation and physical decline but these have not yet been rigorously tested in Australia.

Effect of cognitive training on cognitive function in community-dwelling older people with mild-to-moderate dementia: A single-blind randomised controlled trial.

Objectives: The purpose of this assessor-blinded, randomised controlled trial was to determine the effect of computerised cognitive training (CT) on executive function, processing speed and working memory in 61 people with mild-to-moderate dementia.

Methods: The primary outcomes were forward Digit Span and Trail Making Tests (TMT) at the completion of the 6-month intervention. Secondary outcomes included cognitive and physical performance, rate of falls, participant and caregiver's quality of life and usability and adherence to the CT program.

Exergame and cognitive training for preventing falls in community-dwelling older people: a randomized controlled trial.

Exergame training, in which video games are used to promote exercise, can be tailored to address cognitive and physical risk factors for falls and is a promising method for fall prevention in older people. Here, we performed a randomized clinical trial using the smart±step gaming system to examine the effectiveness of two home-based computer game interventions, seated cognitive training and step exergame training, for fall prevention in community-dwelling older people, as compared with a minimal-intervention control group. Participants aged 65 years or older (n = 769, 71% female) living independently in the community were randomized to one of three arms: (1) cognitive training using a computerized touchpad while seated, (2) exergame step training on a computerized mat or (3) control (provided with an education booklet on healthy ageing and fall prevention).

Poor mobility and lower limb weakness are associated with three distinct depressive symptom trajectories over 6 years in older people.

Objectives: Physical decline can be associated with the onset of depressive symptoms in later life. This study aimed to identify physical and lifestyle risk factors for depressive symptom trajectories in community-dwelling older adults.

Methods: Participants were 553 people aged 70-90 years who underwent baseline physical, psychological and lifestyle assessments.

Association of Prospective Falls in Older People With Ubiquitous Step-Based Fall Risk Parameters Calculated From Ambulatory Inertial Signals: Secondary Data Analysis.

Background: In recent years, researchers have been advocating for the integration of ambulatory gait monitoring as a complementary approach to traditional fall risk assessments. However, current research relies on dedicated inertial sensors that are fixed on a specific body part. This limitation impacts the acceptance and adoption of such devices.

Gut microbiota response to in vitro transit time variation is mediated by microbial growth rates, nutrient use efficiency and adaptation to in vivo transit time.

Background: Transit time is an important modulator of the human gut microbiome. The inability to modify transit time as the sole variable hampers mechanistic in vivo microbiome research. We singled out gut transit time in an unprecedented in vitro approach by subjecting faecal microbial communities from six individuals with either short, medium or long in vivo transit times, to three different colonic transit times of 21, 32 and 63 h in the validated human gut in vitro model, SHIME.

MyCOACH (COnnected Advice for Cognitive Health): a digitally delivered multidomain intervention for cognitive decline and risk of dementia in adults with mild cognitive impairment or subjective cognitive decline-study protocol for a randomised controlled trial.

Introduction: Digital health interventions are cost-effective and easily accessible, but there is currently a lack of effective online options for dementia prevention especially for people at risk due to mild cognitive impairment (MCI) or subjective cognitive decline (SCD).

Methods And Analysis: MyCOACH (COnnected Advice for Cognitive Health) is a tailored online dementia risk reduction programme for adults aged ≥65 living with MCI or SCD. The MyCOACH trial aims to evaluate the programme's effectiveness in reducing dementia risk compared with an active control over a 64-week period (N=326).

Theoretical framework of concerns about falling in older people: the role of health literacy.

Adherence and participation can be improved in health programs for older people with concerns about falling. While health literacy empowers older people to have greater control over their health, little is known about the extent to which health literacy influences health behaviours associated with concerns about falling in older people. This study aimed to synthesise current findings on health literacy, concerns about falling and falls to propose a multicomponent theoretical model on health literacy and concerns about falling.