Activities-specific balance confidence scale in elderly in community nursing home

Background: To investigate the incidence of falls in elderly in nursing homes and to determine the differences in confidence indexes of daily living in the Activities-Specific Balance Confidence Scale (ABC) in elderly fallers or nonfallers. Methods: We conducted a perspective study with elderly (ages >75 years old) from January 1, 2018, to December 31, 2020, living in community nursing homes in Tongzhou district, Beijing. All the participants were able to walk independently, had not experienced any fall episodes, were capable of following commands, and they sufficiently cooperated with the process of the examination. A face-to-face visit or telephone interview was conducted with participants on a regular basis for 12 months. The falling incidence and the differences of ABC scale confidence indexes between fallers and nonfallers were investigated. Results: This study included 87 older adults (67 nonfall participants and 20 fall participants). Falls occurred at a rate of 23 per 100 people per year. The ABC scale index of the faller group was 37%, which indicated very low balance confidence and a high risk of falling. The ABC scale index of the nonfaller group was 80%, which indicated normal balance confidence and no risk of falling. There were significant differences in ABC scale indexes between the faller and nonfaller groups (37% vs. 80%, P = 0.005). There were significant differences in activities such as walking around the house, climbing up and down stairs, picking up slippers from floor, reaching on tiptoes, standing on a chair to reach, walking outside to a nearby car, getting in/out of a car, walking across a parking lot, walking up and down a ramp, walking in a crowded mall between two groups of people, walking in a crowd (risk of bumping into other people), going up an escalator without rail assistance, and walking on an icy sidewalk between the two groups (P < 0.05). Conclusion: Nursing homes have a high rate of falls among older adults. The ABC scale can assess balance confidence and the risk of falling in older adults. To reduce or prevent falls, health-care professionals should screen those who are at high risk of falling and enroll them in a fall prevention program.