Intraindividual Changes in Ambulation Associated With Falls in a Population of Vulnerable Older Adults in Long-Term Care.

Abstract:

OBJECTIVE:To examine how intraindividual changes in ambulation characteristics may be used to predict falls. DESIGN:Longitudinal study design. SETTING:Assisted living facility. PARTICIPANTS:Ambulatory older adults (N=26; mean age, 79y). INTERVENTIONS:Not applicable. MAIN OUTCOME MEASURES:Continuous measure of average weekly ambulation characteristics (time and distance walked, speed, path measures [eg, path time and distance, number of paths (where a path is at least 60s of uninterrupted walking separated by at least a 30-s stop)]), accounting for weekly changes in these ambulation characteristics on an individual level over time along with falls (yes/no) and cognitive impairment (CI) (measured by the Montreal Cognitive Assessment). RESULTS:In hierarchical linear models accounting for intraindividual changes in ambulation characteristics over the 8-month course of the study and level of CI, path distance (odds ratio, 1.02; P≤.001) was associated with an increased risk of a fall. In the short-term, intraindividual changes in path distance were associated with a fall within the 4-week interval the change was noted. Path distance had fair sensitivity (.74) and specificity (.66) to a fall (area under the curve, .70). CONCLUSIONS:Study findings suggest that falls may have specific predictors, specifically that older adults with CI are more likely to fall when walking continuously with little/no breaks. Interventions focused on reducing path-associated fatigue may effectively reduce fall incidence in this population.

journal_name

Arch Phys Med Rehabil

authors

Bowen ME,Rowe M

doi

10.1016/j.apmr.2016.05.013

subject

Has Abstract

pub_date

2016-11-01 00:00:00

pages

1963-1968

issue

11

eissn

0003-9993

issn

1532-821X

pii

S0003-9993(16)30240-4

journal_volume

97

pub_type

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