Using Consumer-grade Wearable Devices for Fall Risk Evaluation and Alerts

Detect cognitive involvement, Scores greater than 26 indicates normal cognition; scores less than 26 indicate cognitive impairment. Therefore, lower scores are a worse outcome. 18-25: Mild cognitive impairment; 10-17: Moderate cognitive impairment; Less than 10: Severe cognitive impairment.

Assess static and dynamic balance and risk of fall. 14 item scale. Lower scores indicate poorer balance and higher scores indicate better balance. Score of less than 45 out of 56 indicates that the individual may be at a greater risk of fall. Out of 56, 41-56 Independent, 21-40 walking with assistance, 0-20 wheelchair bound.

Assess mobility, balance, walking ability and risk of fall. Less than or equal to 10 seconds: normal; 11-30 seconds: good mobility, can go outside alone, mobile without a gait assistive device; greater than 30 seconds: problems, cannot go outside alone, requires a gait assistive device.

Assess functional lower extremity strength. The time it takes to complete the 5XSTS task is recorded. For community-dwelling older adults, the cut-off score is greater than or equal to 15 seconds which indicates risk of fall. Greater than or equal to 12 seconds identifies the need for further assessment for falls. Therefore, the greater the number of seconds, the greater the risk of fall.

Self-report measure of perceived balance confidence. 16 items are rated on a 0% to 100% whole number rating scale. Scores of zero represent no confidence; scores of 100 indicate complete confidence.

Total the ratings (possible range = 0-1600) and divide by 16 (number of items) to get the patient's ABC score or overall percent of balance confidence. For older adults, scores less than 67% indicate risk for falling and accurately classify people who fall 84% of the time. Greater than 80% indicates a high level of physical functioning, 50-80% indicates moderate level of physical functioning, and less than 50% indicates low level of physical functioning.

Assess distance walked over a duration of 6 minutes, submaximal test for endurance. For community-dwelling older adults: 60-69 years old: 572 (male) and 538 (female) meters; 70-79 years old: 527 (male) and 471 (female) meters, and 80-90 years old: 417 (male) and 392 (female) meters. Therefore, the less distance walked in 6 minutes indicates that the individual has less submaximal aerobic and functional walking capacity.

FES-I is a modified measure that was introduced to improve the generalizability and the construct validity of the original. It is a measure of self efficacy which is commonly used to measure fear of falling. It gauges a person's perception of their ability to complete common activities without losing balance. It includes sixteen activities and the answer's possible lay on a scale of 1 (not at all concerned) to 4 (very concerned). Scores between 16-19 are low concern (i.e. high self efficacy), 20-27 have moderate concern, and 28-64 have high concern about falling.

UP-COF was developed to uncover maladaptive fear of falling. It identifies perceived control over balance threats as the bridging attribute between fear and increased fall risk. Thus it is able to distinguish between protective and maladaptive reactions to threats. It is composed of four statements that participants reply to 0 (strongly disagree) to 5 (strongly agree). Results of 13 or below indicate low perceived control.

The FFQ-R is a multi-item scale developed from the original Fear of Falling Questionnaire (FFQ) capable of uncovering fear of falling in community dwelling adults as well as in cases post hip injury. It assesses concepts related to FoF and has low correlation with depression and negative or positive affect. It is composed of 15 items self-report questionnaire with each item reported on a Likert scale of 1 (strongly disagree) - 4 (strongly agree). Higher scores indicate a higher degree of fear of falling.