Self-perceived gait stability modulates the effect of daily life gait quality on prospective falls in older adults

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Abstract

BACKGROUND: Quality of gait during daily life activities and perceived gait stability are both independent risk factors for future falls in older adults.

RESEARCH QUESTION: We investigated whether perceived gait stability modulates the association between gait quality and falling in older adults.

METHODS: In this prospective cohort study, we used one-week daily-life trunk acceleration data of 272 adults over 65 years of age. Sample entropy (SE) of the 3D acceleration signals was calculated to quantify daily life gait quality. To quantify perceived gait stability, the level of concern about falling was assessed using the Falls Efficacy Scale international (FES-I) questionnaire and step length, estimated from the accelerometer data. A fall calendar was used to record fall incidence during a six-month follow up period. Logistic regression analyses were performed to study the association between falling and SE, step length or FES-I score, and their interactions.

RESULTS: High (i.e., poor) SE in vertical direction was significantly associated with falling. FES-I scores significantly modulated this association, whereas step length did not. Subgroup analyses based on FES-I scores showed that high SE in the vertical direction was a risk factor for falls only in older adults who had a high (i.e. poor) FES-I score. In conclusion, perceived gait stability modulates the association between gait quality and falls in older adults such that an association between gait quality and falling is only present when perceived gait stability is poor.

SIGNIFICANCE: The results of the present study indicate that the effectiveness of interventions for fall prevention, aimed at improving gait quality, may be affected by a modulating effect of perceived gait stability. Results indicate that interventions to reduce falls in older adults might sort most effectiveness in populations with both a poor physiological and psychological status.

LanguageEnglish
Pages475-479
Number of pages5
JournalGait and Posture
Volume62
Early online date4 Apr 2018
DOIs
Publication statusPublished - 1 May 2018

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Gait
Quality of Life
Entropy
Cohort Studies
Logistic Models
Regression Analysis
Prospective Studies
Psychology

Keywords

  • Accelerometry
  • Accidental falls
  • Elderly
  • Entropy
  • Self efficacy

Cite this

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title = "Self-perceived gait stability modulates the effect of daily life gait quality on prospective falls in older adults",
abstract = "BACKGROUND: Quality of gait during daily life activities and perceived gait stability are both independent risk factors for future falls in older adults.RESEARCH QUESTION: We investigated whether perceived gait stability modulates the association between gait quality and falling in older adults.METHODS: In this prospective cohort study, we used one-week daily-life trunk acceleration data of 272 adults over 65 years of age. Sample entropy (SE) of the 3D acceleration signals was calculated to quantify daily life gait quality. To quantify perceived gait stability, the level of concern about falling was assessed using the Falls Efficacy Scale international (FES-I) questionnaire and step length, estimated from the accelerometer data. A fall calendar was used to record fall incidence during a six-month follow up period. Logistic regression analyses were performed to study the association between falling and SE, step length or FES-I score, and their interactions.RESULTS: High (i.e., poor) SE in vertical direction was significantly associated with falling. FES-I scores significantly modulated this association, whereas step length did not. Subgroup analyses based on FES-I scores showed that high SE in the vertical direction was a risk factor for falls only in older adults who had a high (i.e. poor) FES-I score. In conclusion, perceived gait stability modulates the association between gait quality and falls in older adults such that an association between gait quality and falling is only present when perceived gait stability is poor.SIGNIFICANCE: The results of the present study indicate that the effectiveness of interventions for fall prevention, aimed at improving gait quality, may be affected by a modulating effect of perceived gait stability. Results indicate that interventions to reduce falls in older adults might sort most effectiveness in populations with both a poor physiological and psychological status.",
keywords = "Accelerometry, Accidental falls, Elderly, Entropy, Self efficacy",
author = "Weijer, {R H A} and Hoozemans, {M J M} and {van Die{\"e}n}, {J H} and M Pijnappels",
note = "Copyright {\circledC} 2018 Elsevier B.V. All rights reserved.",
year = "2018",
month = "5",
day = "1",
doi = "10.1016/j.gaitpost.2018.04.002",
language = "English",
volume = "62",
pages = "475--479",
journal = "Gait and Posture",
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T1 - Self-perceived gait stability modulates the effect of daily life gait quality on prospective falls in older adults

AU - Weijer, R H A

AU - Hoozemans, M J M

AU - van Dieën, J H

AU - Pijnappels, M

N1 - Copyright © 2018 Elsevier B.V. All rights reserved.

PY - 2018/5/1

Y1 - 2018/5/1

N2 - BACKGROUND: Quality of gait during daily life activities and perceived gait stability are both independent risk factors for future falls in older adults.RESEARCH QUESTION: We investigated whether perceived gait stability modulates the association between gait quality and falling in older adults.METHODS: In this prospective cohort study, we used one-week daily-life trunk acceleration data of 272 adults over 65 years of age. Sample entropy (SE) of the 3D acceleration signals was calculated to quantify daily life gait quality. To quantify perceived gait stability, the level of concern about falling was assessed using the Falls Efficacy Scale international (FES-I) questionnaire and step length, estimated from the accelerometer data. A fall calendar was used to record fall incidence during a six-month follow up period. Logistic regression analyses were performed to study the association between falling and SE, step length or FES-I score, and their interactions.RESULTS: High (i.e., poor) SE in vertical direction was significantly associated with falling. FES-I scores significantly modulated this association, whereas step length did not. Subgroup analyses based on FES-I scores showed that high SE in the vertical direction was a risk factor for falls only in older adults who had a high (i.e. poor) FES-I score. In conclusion, perceived gait stability modulates the association between gait quality and falls in older adults such that an association between gait quality and falling is only present when perceived gait stability is poor.SIGNIFICANCE: The results of the present study indicate that the effectiveness of interventions for fall prevention, aimed at improving gait quality, may be affected by a modulating effect of perceived gait stability. Results indicate that interventions to reduce falls in older adults might sort most effectiveness in populations with both a poor physiological and psychological status.

AB - BACKGROUND: Quality of gait during daily life activities and perceived gait stability are both independent risk factors for future falls in older adults.RESEARCH QUESTION: We investigated whether perceived gait stability modulates the association between gait quality and falling in older adults.METHODS: In this prospective cohort study, we used one-week daily-life trunk acceleration data of 272 adults over 65 years of age. Sample entropy (SE) of the 3D acceleration signals was calculated to quantify daily life gait quality. To quantify perceived gait stability, the level of concern about falling was assessed using the Falls Efficacy Scale international (FES-I) questionnaire and step length, estimated from the accelerometer data. A fall calendar was used to record fall incidence during a six-month follow up period. Logistic regression analyses were performed to study the association between falling and SE, step length or FES-I score, and their interactions.RESULTS: High (i.e., poor) SE in vertical direction was significantly associated with falling. FES-I scores significantly modulated this association, whereas step length did not. Subgroup analyses based on FES-I scores showed that high SE in the vertical direction was a risk factor for falls only in older adults who had a high (i.e. poor) FES-I score. In conclusion, perceived gait stability modulates the association between gait quality and falls in older adults such that an association between gait quality and falling is only present when perceived gait stability is poor.SIGNIFICANCE: The results of the present study indicate that the effectiveness of interventions for fall prevention, aimed at improving gait quality, may be affected by a modulating effect of perceived gait stability. Results indicate that interventions to reduce falls in older adults might sort most effectiveness in populations with both a poor physiological and psychological status.

KW - Accelerometry

KW - Accidental falls

KW - Elderly

KW - Entropy

KW - Self efficacy

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U2 - 10.1016/j.gaitpost.2018.04.002

DO - 10.1016/j.gaitpost.2018.04.002

M3 - Article

VL - 62

SP - 475

EP - 479

JO - Gait and Posture

T2 - Gait and Posture

JF - Gait and Posture

SN - 0966-6362

ER -