TY - JOUR
T1 - Motor Performance and Physical Activity as Predictors of Prospective Falls in Community-Dwelling Older Adults by Frailty Level
T2 - Application of Wearable Technology
AU - Mohler, M. Jane
AU - Wendel, Christopher S.
AU - Taylor-Piliae, Ruth E.
AU - Toosizadeh, Nima
AU - Najafi, Bijan
N1 - Publisher Copyright: © 2016 S. Karger AG, Basel.
PY - 2016/10/1
Y1 - 2016/10/1
N2 - Background: Few studies of the association between prospective falls and sensor-based measures of motor performance and physical activity (PA) have evaluated subgroups of frailty status separately. Objective: To evaluate wearable sensor-based measures of gait, balance, and PA that are predictive of future falls in community-dwelling older adults. Methods: The Arizona Frailty Cohort Study in Tucson, Arizona, followed community-dwelling adults aged 65 years and over (without baseline cognitive deficit, severe movement disorders, or recent stroke) for falls over 6 months. Baseline measures included Fried frailty criteria: in-home and sensor-based gait (normal and fast walk), balance (bipedal eyes open and eyes closed), and spontaneous daily PA over 48 h, measured using validated wearable technologies. Results: Of the 119 participants (36% non-frail, 48% pre-frail, and 16% frail), 48 reported one or more fall (47% of non-frail, 33% of pre-frail, and 47% of frail). Although balance deficit and PA were independent fall predictors in pre-frail and frail groups, they were not sensitive to predict prospective falls in the non-frail group. Even though gait performance deteriorated as frailty increased, gait was not a predictor of prospective falls when participants were stratified based on frailty status. In pre-frail and frail participants combined, center of mass sway [odds ratio (OR) = 5.9, 95% confidence interval (CI) 2.6-13.7], PA mean walking bout duration (OR = 1.1, 95% CI 1.0-1.2), PA mean standing bout duration (OR = 0.94, 95% CI 0.91-0.99), and a fall in previous 6 months (OR = 7.3, 95% CI 1.5-36.4) were independent predictors of prospective falls (area under the curve: 0.882). Conclusion: This study suggests that independent predictors of falls are dependent on frailty status. Among sensor-derived parameters, balance deficit, longer typical walking episodes, and shorter typical standing episodes were the most sensitive predictors of prospective falls in the combined pre-frail and frail sample. Gait deficit was not a sensitive fall predictor in the context of frailty status.
AB - Background: Few studies of the association between prospective falls and sensor-based measures of motor performance and physical activity (PA) have evaluated subgroups of frailty status separately. Objective: To evaluate wearable sensor-based measures of gait, balance, and PA that are predictive of future falls in community-dwelling older adults. Methods: The Arizona Frailty Cohort Study in Tucson, Arizona, followed community-dwelling adults aged 65 years and over (without baseline cognitive deficit, severe movement disorders, or recent stroke) for falls over 6 months. Baseline measures included Fried frailty criteria: in-home and sensor-based gait (normal and fast walk), balance (bipedal eyes open and eyes closed), and spontaneous daily PA over 48 h, measured using validated wearable technologies. Results: Of the 119 participants (36% non-frail, 48% pre-frail, and 16% frail), 48 reported one or more fall (47% of non-frail, 33% of pre-frail, and 47% of frail). Although balance deficit and PA were independent fall predictors in pre-frail and frail groups, they were not sensitive to predict prospective falls in the non-frail group. Even though gait performance deteriorated as frailty increased, gait was not a predictor of prospective falls when participants were stratified based on frailty status. In pre-frail and frail participants combined, center of mass sway [odds ratio (OR) = 5.9, 95% confidence interval (CI) 2.6-13.7], PA mean walking bout duration (OR = 1.1, 95% CI 1.0-1.2), PA mean standing bout duration (OR = 0.94, 95% CI 0.91-0.99), and a fall in previous 6 months (OR = 7.3, 95% CI 1.5-36.4) were independent predictors of prospective falls (area under the curve: 0.882). Conclusion: This study suggests that independent predictors of falls are dependent on frailty status. Among sensor-derived parameters, balance deficit, longer typical walking episodes, and shorter typical standing episodes were the most sensitive predictors of prospective falls in the combined pre-frail and frail sample. Gait deficit was not a sensitive fall predictor in the context of frailty status.
KW - Balance
KW - Falls
KW - Frailty
KW - Gait
KW - Monitoring
KW - Physical activity
KW - Physical function
KW - Wearable sensors
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U2 - 10.1159/000445889
DO - 10.1159/000445889
M3 - Article
C2 - 27160666
SN - 0304-324X
VL - 62
SP - 654
EP - 664
JO - Gerontology
JF - Gerontology
IS - 6
ER -