This is a useful property of the Physical Mobility Scale because many falls risk assessment tools used in the residential aged care setting have limited ability to identify residents most at risk of falling (Barker et al 2009). Our study shows that residents categorised as having mild mobility impairment (Physical Mobility Scale total score 28–36) had the highest risk of falling. This means that residents requiring mainly supervision or prompting on most mobility tasks were at higher
risk of falling compared to residents requiring hands-on assistance. Residents requiring minimal assistance are likely to have cognitive impairment (needing supervision or prompting) or have poorer dynamic balance (requiring stand-by assistance or hand holds). If residents with mild mobility impairment are mobilising or transferring alone, any inability to recognise, judge, and avoid hazardous AZD0530 concentration situations encountered in their environment might contribute to their increased falls risk. This suggests that attention to improving mobility (to a Physical Mobility Scale total score > 36), reducing environmental hazards and increasing resident monitoring systems could be required to reduce the incidence of falls in these residents. AT13387 research buy The non-linear association between mobility and falls
risk is intuitive. Residents who are bed or chair bound are unlikely to fall because they do not have the capacity to perform activities where they can potentially fall. Residents who can get out of bed or stand from a chair without assistance but require supervision or hand-hold support
from a rail or chair arms are more at risk of falling than residents who can perform these tasks independently. This non-linear association has important implications for future falls epidemiological research and it is possible that a non-linear association also exists for other fall risk factors. Caution should therefore be exercised when interpreting prior study findings that have assumed the association between mobility or other risk factors and fall risk is linear. This current study helps to secondly explain inconsistencies in much of the existing information relating mobility and falls. Past studies assessing linear associations have produced conflicting data, showing both positive and inverse associations with mobility (Avidan et al 2005, Becker et al 2005, Delbaere et al 2008, French et al 2007, Kallin et al 2002, Kerse et al 2004, Kiely et al 1998, Kron et al 2003, Nordin et al 2008, van Doorn et al 2003). Only one other previous Australian study of 1000 residents examined nonlinear associations and found comparable results (Lord et al 2003). The non-linear association creates a paradox for those seeking to enhance the mobility of aged care residents. Enhancing mobility can be beneficial for improving the independence of residents and minimising the burden they place on care staff.