title: Physical factors underlying the association between lower walking performance and falls in older people: a structural equation model.
abstract: The purpose of this study was to determine the interrelationships between lower limb muscle performance, balance, gait and falls in older people using structural equation modeling. Study participants were two hundred and thirteen people aged 65 years and older (mean age, 80.0 ± 7.1 years), who used day-care services in Japan. The outcome measures were the history of falls three months retrospectively and physical risk factors for falling, including performance in the chair stand test (CST), one-leg standing test (OLS), tandem walk test, 6m walking time, and the timed up-and-go (TUG) test. Thirty-nine (18.3%) of the 213 participants had fallen at least one or more times during the preceding 3 months. The fall group had significantly slower 6m walking speed and took significantly longer to undertake the TUG test than the non-fall group. In a structural equation model, performance in the CST contributed significantly to gait function, and low gait function was significantly and directly associated with falls in older people. This suggests that task-specific strength exercise as well as general mobility retraining should be important components of exercise programs designed to reduce falls in older people.
authors.affiliation: Section for Health Promotion, Department of Health and Medical Care, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, 35 Gengo, Morioka-machi, Obu, Aichi 474-8511, Japan. shimada@ncgg.go.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shimada
authors.forename: Anne
authors.initials: A
authors.lastname: Tiedemann
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Lord
authors.forename: Megumi
authors.initials: M
authors.lastname: Suzukawa
authors.forename: Hyuma
authors.initials: H
authors.lastname: Makizako
authors.forename: Kumiko
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Takao
authors.initials: T
authors.lastname: Suzuki
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D007564:Japan; D035002:Lower Extremity / Q000502:physiology*; D008297:Male; D008954:Models, Biological; D004856:Postural Balance / Q000502:physiology*; D012307:Risk Factors; D016138:Walking / Q000502:physiology*