Original articleDynamic Gait Stability, Clinical Correlates, and Prognosis of Falls Among Community-Dwelling Older Adults
Section snippets
Participants
This study included 119 ambulatory, community-dwelling older adults (75 women; mean age ± SD, 71±6y; range, 65–90y), who were free of serious musculoskeletal, neurologic, cognitive, or other systemic disorders, as assessed by a health questionnaire. Those classified as osteopenic or osteoporotic through a calcaneal ultrasound scan (Lunar Achilles Insighta) were excluded (T score<–1.516), as were those with a score below 25 on the Folstein Mini Mental Status Exam. Participants' past history of
Results
All 115 older adults with an unambiguous outcome experienced a loss of balance; 59 fell and 56 recovered successfully. There was no effect of age or sex on fall incidence (table 1). TUG was the only functional status measure found to be significantly different between fallers and nonfallers: individuals who fell had higher TUG scores (slower) than those who did not (see table 1). The T score obtained from the ultrasound heel scan was also significantly different between fallers and nonfallers (P
Discussion
The reproduction of actual falls resulting from an unannounced slip has provided a benchmark for comparing the prognostic power of each measure considered. Our results indicated that the time-based TUG test was able to predict immediate fall risk significantly better than the BBS, posturographic balance assessment under varied sensory conditions, or isometric muscle strength testing. The results suggest that dynamic gait stability identified overall slip outcome significantly better than other
Conclusions
These results further verified the power of the TUG as a fall-risk prediction tool. The findings indicate that simultaneous measurement of the COM position and velocity relative to the BOS can also provide important prognostic power, such that the quantitative assessment of regular dynamic gait stability can indeed provide fall-risk assessment in a safe and possibly cost-effective manner among older adults. A simple ultrasound bone scan can be used as a screening tool for fall risk. We conclude
Acknowledgments
The authors thank Ting-yun Wang for assisting in data collection and processing.
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Supported by the National Institutes of Health (grant nos. 2R01-AG16727 and R01-AG029616).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Reprints will not be available from the author.
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Espy is currently located at the School of Health Sciences, Cleveland State University, Cleveland, OH.