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.
Keywords
List of abbreviations:
CI (cognitive impairment), IRB (Institutional Review Board), LTC (long-term care), MoCA (Montreal Cognitive Assessment), OR (odds ratio), RTLS (real-time location system)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 10, 2016
Footnotes
Supported by a Rehabilitation Research and Development Career Development Award (II) from the Department of Veterans Affairs (CDA E7503W). The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs.
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
