KU Faculty Emphasizes Importance of Quality of Life as We Age

The university's School of Health Professions is also researching ways to decrease fall risks in older adults.

In furthering research for preventing fall risks, the University of Kansas School Health of Professions is also addressing the importance of older adults maintaining a good quality of life as they age.

Currently, the KU Cares Research Center is exploring neuro rehabilitation-emphasis in stroke recovery and treatment for Parkinson’s Disease, as well as diet and nutrition best practices that caregivers and nurses can consider for their clients and patients.

HealthLeaders spoke with a group of University of Kansas faculty to learn more about their efforts and how they can be implemented.

The following transcript has been edited for brevity and clarity.

HealthLeaders: When does an individual's range of mobility begin to decline to the point where falling could be a health risk?

Jacob Sosnoff (associate dean, Research, School of Health Professions): The first thing to consider is that falls happen throughout the lifespan. Really, where we're getting concerned about falls for older adults is because the injury risk goes up. It's complicated when that starts to go up, but it's things like the tissue strength decreasing, bone density decreasing, and losing muscle mass, so you're not as reactive as you used to be.

The beautiful thing about humans is we're designed to move, but we're really designed poorly for balance and our neuromuscular system helps us do that. Then with age, it doesn't work as well and that's what ultimately puts us at risk for losing our balance.

If you have a good diet and you're physically active, your fall risk will stay relatively low for most of your life.

HL: How can home health workers nurses and caregivers work with their patients and clients to ensure they stay physically active and maintain a healthy diet?

Dr. Debra Sullivan, RD (department chair, Dietetics and Nutrition): It depends on any preexisting conditions they have, like if they have a medical condition that is going to require them to follow some sort of specialized diet. But you can always be very clear by making sure that person does have an adequate, healthy diet and that they're eating enough. Making sure that they're not losing weight, that they're getting enough protein, that they're getting enough of the vitamins and minerals that they need to support their muscles, brain health, and bones.

Those are probably the key things that you worry about with those individuals. Increasing fruits and vegetables is great. Then you also must know if their teeth are strong enough to chew those foods. Do they need softer foods?

Dr. Hannes Devos, PT, FACRM (associate professor, Physical Therapy, Rehabilitation Science, and Athletic Training): There's two interesting features when we're looking at how to increase mobility in older adults, and that is from the person and the caretaker, the partner, the spouse, but also what environmental improvements can be done. We have seen that many studies focus on exercise or diet. They show how they can reduce the risk of falls.

One of the challenges that we have at this time is how we can implement that into a lifestyle intervention—how we can encourage older adults to continue to be physically active, to continue with the diet that has proven to reduce fall risks. But then one of the interesting improvements that are being made now is looking at houses of the future and how ambient technology can help detect early changes in case patterns that can pick up an increased risk of falling. I think these will be very helpful in early screening, diagnosis, and monitoring of false risk in older adults.

Sosnoff: One thing that we've been doing is trying to look at mobile apps to measure fall risk. Giving the non-clinical care team tools that they can look at to determine if this person has a fall risk or not.

One of the challenges we're going to be facing with the increase in the older adults population is that we're not going to have enough clinicians. Especially if you go out into rural areas, there's just a lack of care, so not everyone can make it to the doctor. How do we triage that? Leveraging tools that are already out there, like smartphones.

Then, we must understand that risk factors vary from person to person. If someone's primarily using a wheelchair, their fall risk factors are much different than somebody who's ambulatory with and without a device. In my experience, a lot of times when we have someone we're working with who has impaired mobility, they start with a wheelchair. People are excited because they think that's going to solve their mobility needs, but it's just a different level of challenge. There's still risk for falls. There's probably greater risk of a catastrophic injury because usually at that point, they're deconditioned.

HL: What are some things that you feel caregivers should be paying attention to, to detect that risk?

Sosnoff: It’s looking at those changes in performance. If someone was able to do an activity and now suddenly, they're not, that's going to give pretty us a critically important understanding of what's normal. Looking at that change can help us understand it.

You start working with somebody, knowing where they are, and look for that change. Something too, that we don't give enough credit to is just social interaction.

Sullivan: Another thing to think about is quality of life. How are those changes impacting their quality of life? How does it impact their social interactions?

Dr. Abiodun Akinwuntan, MPH, MBA, FASAHP, FACRM, FAMedS (dean, KU School of Health Professions): I have read enough articles that have shown that isolation and lack of social contact has been a major cause of declining quality of life. It has led to depression and has led to untimely death in many places. I like the concept of KU Cares, particularly because we are looking at the concept of social integration from multiple angles. Is it from the nutritional angle, from the community ambulation angle, from the driving perspective, or from the inevitable fall?

Our goal is not to be afraid of falling, but to be better prepared for falls and know how to fall safely. All of those things intrinsically coincide to the level of social interactions that people have with one another. And you know, for Drs. Sosnoff and Devos, who are particularly looking at the pathophysiological aspect of all the things we've talked about, and being able to detect the earliest form of decline in any of the areas that will eventually lead to that, the decrease in that social interaction and addressing it before it gets full-blown again is the strength of the KU Cares Center.

HL: How would you like to see the research and efforts of the KU Cares Center implemented?

Akinwuntan: What I hope to see is that our research can create the global awareness of what we each can contribute to increasing the quality of life of our older folks, from how to advise them on the use of commonly used mobile devices to what resources are available to help them continue to have good quality of life. Also, showing that all those interventions have had positive impacts on our increasing longevity with good quality of life.

It seems to me that our holistic approach of looking at social interaction from different angles—nutrition, fall risk enablement, rehabilitation—and even understanding the process of developing different conditions that older people typically have is a unique component of the KU Care Center. And that's what's exciting about what we do.