Exploring Physical Resilience and Mobility Limitations in Patients of a Secondary Falls Prevention Clinic

Introduction: Physical resilience represents a person’s ability to maintain mobility or physical function despite aging, illness, or an acute adverse event such as a fall.  Notably, falls are often a sentinel event and a significant cause of rapid functional decline, or loss of independence. Thus, we aimed to identify characteristics of physical resilience among older adults who have experienced a recent fall, which may help identify those at greater risk of decline and other adverse outcomes.

Methods: Participants were patients of a geriatrician-led falls prevention clinic who were recruited to a prospective cohort study; all participants completed assessments at the clinic at baseline (i.e., initial clinic visit) and approximately 6 months later. Individuals who had a Short Physical Performance Battery (SPPB) score of ³9/12 at 6 months were labelled as “resilient” and those who scored <9/12 as “not resilient”. Baseline characteristics related to sociodemographic, health, mobility, physical, cognitive and psychological function were compared between “resilient” vs. “not resilient” using, t-test, Wilcoxon Rank Sum, and Chi-square/Fisher. Multiple comparison adjustments were made using the Benjamini-Hochberg procedure. 

Results: Two-hundred and fifty-three participants were included, their mean age was 79(6), 71% were female, and the median fall count was two in the previous 12 months. At baseline 53% of participants scored  ³9/12 on the SPPB. At 6 months, 156(62%) older adults were labelled as “resilient” and 97(38%) were “not resilient”. The resilient group was more active, had greater grip strength, and were less likely to report difficulty walking and climbing stairs. Additionally, the resilient group had better cognitive function, falls efficacy, fewer depressive symptoms and fewer limitations in instrumental and activities of daily living.

Conclusions: Characteristics associated with physical resilience extend beyond physical function and mobility outcomes; importantly, cognitive and psychological function also emerged as significant among older adults who recently experienced a fall.