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      Description of spatio-temporal gait parameters in elderly people and their association with history of falls: results of the population-based cross-sectional KORA-Age study

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          Abstract

          Background

          In this epidemiological study we described the characteristics of spatio-temporal gait parameters among a representative, population-based sample of 890 community-dwelling people aged 65 to 90 years. In addition, we investigated the associations between certain gait parameters and a history of falls in study participants.

          Methods

          In descriptive analyses spatio-temporal gait parameters were assessed according to history of falls, frailty, multimorbidity, gender, multiple medication use, disability status, and age group. Logistic regression models were calculated to examine the association between gait velocity and stride length with a history of falls (at least one fall in the last 12 month). Data on gait were collected on an electronic walkway on which participants walked at their usual pace.

          Results

          We found significant differences within gait parameters when stratifying by frailty, multimorbidity, disability and multiple medication use as well as age (cut point 75 years) and sex, with p < 0.05 for all gait parameters (velocity, cadence, time, stride duration, stride length, step width). After stratification by history of falls, only stride length showed a significant difference (p < 0.05) between the groups of fallers and non-fallers. Logistic regression models showed that a decreased stride length was independently associated with falls in men aged older than 74 years (OR 1.34 (CI: 1.05-1.70 per 10 cm decrease)), while this was neither the case for women of similar age nor for men or women aged 65 to 74 years. A decreased walking speed was not associated with falls.

          Conclusion

          Age, frailty, multimorbidity, disability, history of falls, sex, and multiple medication use show an association with different gait parameters measured during gait assessment on an electronic walkway in elderly people. Furthermore, stride length is a good indicator to differentiate fallers from non-fallers in older men from the general population.

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          Most cited references40

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          Risk factors for falls among elderly persons living in the community.

          To study risk factors for falling, we conducted a one-year prospective investigation, using a sample of 336 persons at least 75 years of age who were living in the community. All subjects underwent detailed clinical evaluation, including standardized measures of mental status, strength, reflexes, balance, and gait; in addition, we inspected their homes for environmental hazards. Falls and their circumstances were identified during bimonthly telephone calls. During one year of follow-up, 108 subjects (32 percent) fell at least once; 24 percent of those who fell had serious injuries and 6 percent had fractures. Predisposing factors for falls were identified in linear-logistic models. The adjusted odds ratio for sedative use was 28.3; for cognitive impairment, 5.0; for disability of the lower extremities, 3.8; for palmomental reflex, 3.0; for abnormalities of balance and gait, 1.9; and for foot problems, 1.8; the lower bounds of the 95 percent confidence intervals were 1 or more for all variables. The risk of falling increased linearly with the number of risk factors, from 8 percent with none to 78 percent with four or more risk factors (P less than 0.0001). About 10 percent of the falls occurred during acute illness, 5 percent during hazardous activity, and 44 percent in the presence of environmental hazards. We conclude that falls among older persons living in the community are common and that a simple clinical assessment can identify the elderly persons who are at the greatest risk of falling.
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            Summary of the Updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons.

            (2011)
            The following article is a summary of the American Geriatrics Society/British Geriatrics Society Clinical Practice Guideline for Prevention of Falls in Older Persons (2010). This article provides additional discussion of the guideline process and the differences between the current guideline and the 2001 version and includes the guidelines' recommendations, algorithm, and acknowledgments. The complete guideline is published on the American Geriatrics Society's Web site (http://www.americangeriatrics.org/health_care_professionals/clinical_practice/clinical_guidelines_recommendations/2010/). © 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.
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              Frailty in older adults: evidence for a phenotype

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                Author and article information

                Contributors
                kathrin.thaler@tum.de
                peters@helmholtz-muenchen.de
                thorand@helmholtz-muenchen.de
                Eva.Grill@med.uni-muenchen.de
                autenriethc@unaids.org
                alexander.horsch@imse.med.tu-muenchen.de
                christa.meisinger@helmholtz-muenchen.de
                Journal
                BMC Geriatr
                BMC Geriatr
                BMC Geriatrics
                BioMed Central (London )
                1471-2318
                25 March 2015
                25 March 2015
                2015
                : 15
                : 32
                Affiliations
                [ ]Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstraße 1, Neuherberg, 85764 Germany
                [ ]Institute for Medical Statistics and Epidemiology (IMSE), Technical University Munich (TUM), Ismaninger Str. 22, Munich, 81675 Germany
                [ ]Institute of Medical Information Processing, Biometry and Epidemiology, and German Center for Vertigo and Balance Disorders, Ludwig-Maximilians Universität (LMU), Marchioninistr. 15, Munich, 81377 Germany
                [ ]Department of Computer Science, MI&T Group, University of Tromsø, Tromsø, 9037 Norway
                [ ]Department of Clinical Medicine, Telemedicine and eHealth Group, University of Tromsø, Tromsø, 9037 Norway
                [ ]Central Hospital of Augsburg, MONICA/KORA Myocardial Infarction Registry, Klinikum Augsburg, Stenglinstr. 2, Augsburg, 86156 Germany
                Article
                32
                10.1186/s12877-015-0032-1
                4374293
                25559550
                ce72fada-83fe-4082-a0ce-13eff07fde94
                © Thaler-Kall et al.; licensee BioMed Central. 2015

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 27 October 2014
                : 18 March 2015
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2015

                Geriatric medicine
                gait parameters,falls,electronic walkway,velocity,fall risk
                Geriatric medicine
                gait parameters, falls, electronic walkway, velocity, fall risk

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