Eye-head coordination during postural perturbation as a predictor of falls in community-dwelling elderly women.
OBJECTIVE
To assess the functional significance of eye-head coordination during postural perturbations and to determine the contribution of angular vestibulo-ocular reflex (AVOR) suppression to the prediction of 1-year fall history in community-dwelling elderly women.


METHODS
Descriptive analysis of factors correlated with falls.


METHODS
Community-based independent and senior assisted living facilities.


METHODS
Volunteer sample of 38 older women (mean age +/- standard deviation, 81.6+/-3.9y; range, 74-92y).


METHODS
Not applicable.


METHODS
Multiple and logistic regression variables (slope coefficients, partial R2, percent-correct fall history classifications) and fall prediction equations generated by using minimal sets of predictor variables.


RESULTS
Instantaneous AVOR gain and sedative use were predictors of 1-year history of falls in all minimal sets of predictor variables. R2 for the prediction models varied from.47 to.62 and indicated substantial shared variance with the 1-year history of falling. Elderly women who failed to suppress the AVOR gain were 18 times more likely to have experienced a fall in the past year compared with elderly women who showed AVOR suppression (odds ratio=18; 95% confidence interval, 1.63-198.42).


CONCLUSIONS
When controlling for all other variables in the model, instantaneous AVOR gain accounted for nearly 30% of the variance of fall history. The strong association between 1-year fall history, the use of sedatives, and changes in the AVOR gain supports a functional link between AVOR suppression and effective balance in elderly women.
Di Fabio
Richard P
RP
Department of Physical Medicine & Rehabilitation, School of Medicine, University of Minnesota, Minneapolis 55455, USA. difab001@tc.umn.edu
Greany
John F
JF
Emasithi
Alongkot
A
Wyman
Jean F
JF
D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D001259:Ataxia / Q000175:diagnosis* / Q000503:physiopathology; D004585:Electrooculography; D005260:Female; D005403:Fixation, Ocular / Q000502:physiology*; D006801:Humans; D016015:Logistic Models; D011187:Posture / Q000502:physiology*; D011237:Predictive Value of Tests; D011597:Psychomotor Performance / Q000502:physiology*; D012027:Reflex, Vestibulo-Ocular / Q000502:physiology*; D018570:Risk Assessment; D012307:Risk Factors; D012438:Saccades / Q000502:physiology