Citation

Kyrdalen IL, Thingstad P, Sandvik L, Ormstad H. Physiother. Res. Int. 2019; 24(1): e1743.

Affiliation

Faculty of Health and Social Sciences, University College of Southeast, Drammen, Norway.

Copyright

(Copyright © 2019, John Wiley and Sons)

DOI

10.1002/pri.1743

PMID

30198603

Abstract

BACKGROUND AND PURPOSE: Exercise interventions are effective at preventing falls in community-dwelling older adults, especially before disability is present. Gait speed below 1.0 m/s is a strong predictor for falls in the elderly. However, evidence is sparse for gait speed alone being sufficient to identify individuals at a high risk of falling. This study aimed to describe the prevalence of fall risk factors among community-dwelling older adults in their late 70s and to investigate the associations between these risk factors and low gait speed in this population.

METHODS: This cross-sectional cohort study comprised 108 elderly living in a small Norwegian municipality, born between 1936 and 1938. Exclusion criteria were living in residential care, inability to walk 4 m, and severe cognitive impairment. Measurements included gait speed, depressive symptoms, executive functions, fear of falling, vision function, fall history, body mass index, medications, and comorbidity. Gait speed was dichotomized using a cut-off of 1 m/s, and associations between different risk factors and low gait speed was explored using logistic regression analysis.

RESULTS: Mean gait speed was 1.0 ± 0.3 m/s. In 44.4% of the participants, gait speed was below 1.0 m/s, indicating increased fall risk. Low gait speed was significantly associated with a history of multiple falls (odds ratio [OR] = 3.70, 95% CI [1.18, 11.65]), low educational level (OR = 3.58, 95% CI [1.10, 11.66]), higher number of medications (OR = 4.28, 95% CI [1.63, 11.2]), and higher number of depressive symptoms (OR = 1.31, 95% CI [1.09, 1.58]). We found no significant associations between gait speed and comorbidity, sex, vision, executive functions, or fear of falling.

CONCLUSION: Our results indicate that gait speed with cut-off 1.0 m/s could represent a useful tool for identifying individuals who are vulnerable but not yet disabled and could benefit from fall-preventive exercise. However, extended assessment is probably needed to personalize interventions.

Copyright © 2018 John Wiley & Sons, Ltd.

Language: en

Keywords

community dwelling; fall risk; gait speed; older adults