Date of Award
Fall 10-20-2025
Document Type
Dissertation
Degree Name
Doctor of Kinesiology (PhD)
Department
Kinesiology
Abstract
Background: Orthostatic hypotension (OH) is an underrecognized contributor to falls among older adults, particularly in skilled nursing facilities (SNFs) where frailty, multimorbidity, and polypharmacy is common. Methods: Thirty-three SNF residents aged ≥65 years completed orthostatic testing after five minutes supine and at one and three minutes of standing. Fall and injury histories were extracted from records and resident reports. Analyses included nonparametric tests, logistic regression, receiver operating characteristic (ROC) analysis, and exploratory qualitative coding of injury descriptions. Results: Systolic and diastolic blood pressures decreased significantly from supine to standing (both p < .001). OH was more prevalent among fallers than non-fallers (96% vs 40%; χ2(1) = 12.68, p = .007). In logistic regression with OH as the outcome, fall history was strongly associated with OH (OR = 27.0, 95% CI [3.67–198.69], p = .001); ROC analysis showed excellent discrimination (AUC = 0.84, p = .029). The most frequently coded injuries were hip and femur fractures, followed by skin tears, head injuries, and humeral fractures (exploratory). Conclusions: OH is strongly linked to falls among SNF residents. Serial measurements at 1 and 3 minutes improved detection, supporting routine OH screening in fall risk assessment and proactive interventions (e.g., medication review, activity scheduling, and environmental safety).