A recent report has alerted Congress to the need for more evidence-based research in preventive care for older adults—including more work focused on physical screenings and falls prevention.
In its third annual Report to Congress on High-Priority Evidence Gaps for Clinical Preventive Services (.pdf), the US Preventive Services Task Force (USPSTF) warns of "significant gaps in key areas of knowledge" around preventive services for older adults, it and urges Congress to take a lead in promoting research that would fill in those gaps. The committee identified "high priority" research needs in 5 key areas: screening for dementia; screening for physical and mental well-being; preventing falls and fractures; screening for vision and hearing problems; and avoiding unintended harms of medical procedures.
In its discussion of falls and fractures among older adults, USPSTF writes that "more research is needed to develop and validate practical tools that can be used … to better identify older adults who are at substantial risk for falls" and that "clinical trials are also needed on the effectiveness of interventions … for the prevention of falls." APTA offers its members evidence-based resources on falls through its PT Now webpage as well as through Open Door, its portal to current research works. In addition, APTA provides physical therapists (PTs) and patients with education on exercise prescriptions for balance and falls prevention, a pocket guide on falls risk reduction (.pdf) and an online community where members can share information about falls prevention.
USPSTF is a volunteer group of experts created in 1984. The Patient Protection and Affordable Care Act charged the task force with making annual reports to Congress on needs in evidence-based research around preventive care. The 2013 report marks the group's third—previous reports focused on the need for research on kidney, cervical cancer, and prostate cancer screenings (2012), and gaps in research on screenings for heart disease, colorectal cancer, hepatitis C, and hip dysplasia in newborns (2011).
Overall arthritis rates rose as expected in the United States between 2010 and 2012, but the incidence of arthritis-attributable activity limitation (AAAL) exceeded projections, with an estimated 22.7 million Americans—nearly half of the estimated 52.5 million with arthritis—suffering with symptoms that limited normal physical activity. The federal Centers for Disease Control and Prevention (CDC) released the numbers this week and called for "greater use of evidence-based interventions" to battle the effects of AAAL.
The CDC report on arthritis and AAAL summarizes the results of the National Health Interview Surveys (NHIS) conducted in 2010, 2011, and 2012, and compares these to its predictions for the disease. In its projections CDC estimated that arthritis would affect 55.7 million Americans by 2015—an estimate that it says is still on target given the new numbers. What surprised the CDC was the rate of increase of AAAL, which has passed the 22 million mark predicted for 2020, and "might exceed the 25 million projection for 2030."
Editorial notes accompanying the report point to the incidence of comorbidities such as heart disease and diabetes as contributing to the higher-than-expected rise in AAAL and recommend greater attention to education and exercise. "An opportunity for collaboration is the dissemination of information regarding evidence-based self-management education and physical activity interventions that have been proven to reduce pain and improve function, mood, confidence to manage health, and quality of life," the report states. "The physical activity interventions recommended are appropriate exercise regimens intended to reduce activity limitations and … assuage concerns over aggravating the condition." The APTA website offers multiple resources on exercise and arthritis, including an online course focused on exercise prescription for older adults with osteoarthritis.
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