Relationship Between Functional Independence and Fall Risk in Indonesian Community-Dwelling Elderly
https://doi.org/10.33860/jik.v20i1.4293
Keywords:
Elderly, Barthel Index, Fall Risk, Timed Up and Go Test, IndependenceAbstract
Background: Falls among older adults remain a leading cause of injury and loss of independence worldwide. Early detection of functional decline is essential to prevent fall-related complications. This study aimed to examine the correlation between functional independence and fall risk among older adults by employing the Barthel Index and the Timed Up and Go Test (TUGT). Given projections that the global elderly population will surpass 2 billion by 2050, these findings emphasize the importance of integrating functional independence screening into community-based fall prevention programs.
Methods: This observational analytical study with a cross-sectional design was conducted in Saronda Village, North Sulawesi, Indonesia, involving 32 community-dwelling elderly aged 60 years and above. Functional independence was assessed using the Barthel Index, while fall risk was evaluated with the TUGT. Data were analyzed using the Spearman rank correlation test. Ethical approval was obtained from the Health Research Ethics Committee of STIKES Kamus Arunika, and all participants provided informed consent.
Results: The majority of participants (56.25%) demonstrated functional independence; however, 59.38% were identified as having a high fall risk. Statistical analysis revealed a significant negative correlation between Barthel Index scores and TUGT completion time (r = –0.904; p < 0.001), indicating that higher functional independence was associated with lower fall risk.
Conclusion: Greater functional independence is significantly associated with a reduced risk of falls among elderly. These findings highlight the importance of regular functional assessments using the Barthel Index and TUGT as practical tools for early identification of fall risk and for guiding gerontological nursing interventions in community settings.
References
Adam, C. E., Fitzpatrick, A. L., Leary, C. S., Ilango, S. D., Phelan, E. A., & Semmens, E. O. (2024). The Impact of Falls on Activities of Daily Living in Older Adults: A Retrospective Cohort Analysis. PLoS ONE, 19(1 January), 1–16. https://doi.org/10.1371/journal.pone.0294017
Carroll M.D, D. G. (1965). Fungsional Evaluation: The Barthel Index. https://www.massgeneral.org/assets/MGH/pdf/neurology/stop-stroke/barthel_reprint.pdf
Colón-Emeric, C. S., McDermott, C. L., Lee, D. S., & Berry, S. D. (2024). Risk Assessment and Prevention of Falls in Older Community-Dwelling Adults. JAMA, 331(16), 1397. https://doi.org/10.1001/jama.2024.1416
Creswell, J. W. (2015). Research Design Pendekatan Kualitatif, Kuantitatif dan Mixed, (Tiga). Pustaka Pelajar.
Denise F. Polit, & Cheryl Tatano Beck. (2017). Nursing Research: Generating and Assessing Evidence For Nursing Practice (Christina Burns, Katherine Burland, & Cassie Berube, Eds.; 10th ed.). Wolters Kluwer. http://repository.unimus.ac.id/7921/1/2.%20Beck%2C%20Cheryl%20Tatano_%20Polit%2C%20Denise%20F.%20-%20Nursing%20research_%20generating%20and%20assessing%20evidence%20for%20nursing%20practice-Wolters%20Kluwer%20Health%20%282017%29%20%281%29.pdf
Etikan, I. (2016). Comparison of Convenience Sampling and Purposive Sampling. American Journal of Theoretical and Applied Statistics, 5(1), 1. https://doi.org/10.11648/j.ajtas.20160501.11
Indonesia, P., & Sensus, H. (2024). Estimasi dan Komunikasi Data Penduduk Umur Sekolah Berdasarkan Proyeksi Estimasi dan Komunikasi Data Penduduk Umur Sekolah Berdasarkan Proyeksi Penduduk Indonesia 2020-2050 Hasil Sensus Penduduk 2020. November. https://doi.org/10.34123/semnasoffstat.v2024i1.2021
L. Girsang, A. P., Sulistyowati, R., Sulistyowati, N. P., Dewi, F. W. R., Nugroho, S. W., Ramadani, K. D., & Wilson, H. (2022). Statistik Penduduk Lanjut Usia 2022 (A. S. Mustari, R. Sinang, I. Meylasari, & B. Santoso, Eds.). Badan Pusat Statistik (BPS). https://www.bps.go.id/id/publication/2022/12/27/3752f1d1d9b41aa69be4c65c/statistik-penduduk-lanjut-usia-2022.html
Lin, W.-S., Hsu, N.-W., Lee, M.-J., Lin, Y.-Y., Tsai, C.-C., & Pan, P.-J. (2022). Correlation Analysis of Physical Fitness and Its Impact on Falls in 2130 Community- Dwelling Older Adults: A Retrospective Cross-Sectional Study. BMC Geriatrics, 22(1), 447. https://doi.org/10.1186/s12877-022-03138-9
Ma, J. (2022). Comparison on Gait Characteristics between Controlled and Free-Living Conditions in Old Adults. http://arxiv.org/abs/2202.07921
Maneeprom, N., Taneepanichskul, S., Panza, A., & Suputtitada, A. (2019). Effectiveness of Robotics Fall Prevention Program Among Elderly in Senior Housings, Bangkok, Thailand: A Quasi-Experimental Study. In Clinical Interventions in Aging (Vol. 14, pp. 335–346). Dove Medical Press Ltd. https://doi.org/10.2147/CIA.S182336
Martínez-Velilla, N., Casas-Herrero, A., Zambom-Ferraresi, F., de Asteasu, M. L. S., Lucia, A., Galbete, A., García-Baztán, A., Alonso-Renedo, J., González-Glaría, B., & Gonzalo-Lázaro, M. (2019). Effect of Exercise Intervention on Functional Decline in Very Elderly Patients During Acute Hospitalization: A Randomized Clinical Trial. JAMA Internal Medicine, 179(1), 28–36. https://pubmed.ncbi.nlm.nih.gov/30419096/
Nolan, S. A., & Heinzen, T. E. (2011). Statistics for the Behavioral Sciences. Macmillan. https://www.researchgate.net/publication/261991946_Statistics_for_the_Behavioral_Sciences
Padmini, N. L. G., Saraswati, P. A. S., Wibawa, A., & Sugiritama, I. W. (2025). Prevalence of Fall Risk Levels Among the Elderly Using M-IFRAT in Bualu Village: A Cross-Sectional Study. Majalah Ilmiah Fisioterapi Indonesia, 13(2), 209–218. https://doi.org/10.24843/mifi.000000408
Podsiadlo, D., & Richardson, S. (1991). The Timed “Up & Go”: A Test of Basic Functional Mobility for Frail Elderly Persons. Journal of the American Geriatrics Society, 39(2), 142–148. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
Rudnicka, E., Napierała, P., Podfigurna, A., Męczekalski, B., Smolarczyk, R., & Grymowicz, M. (2020a). The World Health Organization (WHO) Approach to Healthy Ageing. Maturitas, 139(February), 6–11. https://doi.org/10.1016/j.maturitas.2020.05.018
Ryrsø, C. K., Hegelund, M. H., Dungu, A. M., Faurholt-Jepsen, D., Pedersen, B. K., Ritz, C., Krogh-Madsen, R., & Lindegaard, B. (2022). Association between Barthel Index, Grip Strength, and Physical Activity Level at Admission and Prognosis in Community-Acquired Pneumonia: A Prospective Cohort Study. Journal of Clinical Medicine, 11(21), 6326. https://doi.org/10.3390/jcm11216326
Ryszewska-Łabędzka, D., Tobis, S., Kropińska, S., Wieczorowska-Tobis, K., & Talarska, D. (2022). The Association of Self-Esteem with the Level of Independent Functioning and the Primary Demographic Factors in Persons over 60 Years of Age. In International Journal of Environmental Research and Public Health (Vol. 19, Issue 4). https://doi.org/10.3390/ijerph19041996
S Notoatmodjo. (2018). Metodologi penelitian kesehatan. Rineka Cipta.
Schober, P., Boer, C., & Schwarte, L. A. (2018). Correlation Coefficients: Appropriate Use and Interpretation. Anesthesia & Analgesia, 126(5), 1763–1768. https://doi.org/10.1213/ANE.0000000000002864
Tinetti, M. E., & Kumar, C. (2010). The Patient Who Falls. Jama, 303(3), 258. https://doi.org/10.1001/jama.2009.2024
Tinetti, M. E., & Williams, C. S. (1998). The Effect of Falls and Fall Injuries on Functioning in Community-Dwelling Older Persons. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 53(2), M112-9. https://doi.org/10.1093/gerona/53a.2.m112
Unnanuntana, A., Jarusriwanna, A., & Nepal, S. (2018). Validity and Responsiveness of Barthel Index for Measuring Functional Recovery after Hemiarthroplasty for Femoral Neck Fracture. Archives of Orthopaedic and Trauma Surgery, 138(12), 1671–1677. https://doi.org/10.1007/s00402-018-3020-z
WHO. (2022). The Healthy Ageing Collaborative: Working Together to Give Everyone the Opportunity to Add Life to Years, Wherever They Live. Https://Www.Decadeofhealthyageing.Org/about/Join-Us/Collaborative.
World Medical Association Declaration of Helsinki. (2013). JAMA, 310(20), 2191. https://doi.org/10.1001/jama.2013.281053
Zhong, Y. J., Meng, Q., & Su, C. H. (2024). Mechanism-Driven Strategies for Reducing Fall Risk in the Elderly: A Multidisciplinary Review of Exercise Interventions. In Healthcare (Switzerland) (Vol. 12, Issue 23). Multidisciplinary Digital Publishing Institute (MDPI). https://doi.org/10.3390/healthcare12232394
Zhou, J., Liu, B., Qin, M. Z., & Liu, J. P. (2021a). A Prospective Cohort Study of The Risk Factors for New Falls and Fragility Fractures in Self-Caring Elderly Patients Aged 80 Years and Over. BMC Geriatrics, 21(1), 1–9. https://doi.org/10.1186/s12877-021-02043-x
Published
How to Cite
Issue
Section
License
Authors who publish with Poltekita : Jurnal Ilmu Kesehatan agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC BY-SA 4.0) that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
This work is licensed under a Creative Commons Attribution-ShareAlike 2.0 Generic License.
Poltekita : Jurnal Ilmu Kesehatan is licensed under a Creative Commons Attribution-Share Alike 4.0 International License
You are free to:
- Share, copy and redistribute the material in any medium or format
- Adapt, remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
