Dr. Kim van Schooten has always been intrigued by ageing and by how age-related changes affect daily-life behavior. Her research on why and how older people fall will inspire interventions to help people around the world.
She says, “Everyone occasionally experiences a fall. However, as we age, falls appear to happen more frequently and consequences are more severe. Each year one-third of people aged 65 and over fall at least once. About 10% of these falls result in serious injury, such as hip fractures or traumatic brain injury, making falls the number one cause of accidental death among seniors.”
With a current world population of 600 million people aged 65 and over — and that number is expected to double by 2020 — injurious falls and their prevention are a major societal issue.
She adds, “Even when a fall does not result in injury, fear of falls may render seniors less active, leading to deconditioning and thereby increasing the risk of falls and other adverse health events. My work aims to prevent or intervene in this downward spiral.”
To understand why certain people are at risk, Dr. van Schooten studies the physical, behavioral and environmental factors that contribute to falls and impair the ability to successfully recover balance.
Dr. van Schooten says: “Simply said, whether we experience a fall depends on whether we lose our balance and if we are able to recover it. The group I am currently focusing on, older people residing in long-term care, is of particular interest as they frequently experience imbalance and have limited ability to recover. This leads them to be at constant risk for falls and allows me to gain insight in why some balance recovery attempts are successful and others are not.“
Dr. van Schooten performed her doctoral research at the Vrije Universiteit Amsterdam, The Netherlands, where she studied the application of body-worn sensors in daily life to detect mobility impairments and fall risk. She employed advanced signal processing techniques to quantify daily-life gait stability and demonstrated that accelerometers can be used to reliably assess habitual physical activity. She further showed that daily-life gait stability and physical activity are strong predictors of falls among older people and was able to show that these measures have important added value over commonly used fall-risk profiles.
She says, “My doctoral work suggests that the quality of gait may interact with physical activity, making physical activity a risk factor for falls in those with gait impairments. These results are particularly interesting as physical activity is often incorporated in intervention programs to prevent falls. This suggests that such fall prevention attempts may paradoxically even increase the risk for falls in a frail population.”
During her postdoctoral work at SFU’s Department of Biomedical Physiology and Kinesiology, Dr. van Schooten aims to gain insight in how people respond to imbalance and impending falls. Together with Canada research chair Dr. Steve Robinovitch, professor in Engineering and Kinesiology, she continues to study why and how falls occur.
Using video captures and wearable sensors, they analyze how people try to recovery from imbalance and protect themselves against injury when this fails. They further study the location of falls to identify environmental risk factors and advise facilities on where to focus for injury prevention by for instance installing compliant flooring. They further plan to test an exoskeleton that may support recovery when imbalance occurs.