title: Gait impairment and falls in cognitively impaired older adults: an explanatory model of sensorimotor and neuropsychological mediators.
abstract: OBJECTIVE
  to explore the associations between spatiotemporal gait parameters and falls in cognitively impaired older people and to investigate whether sensorimotor and neuropsychological factors mediate the association between gait performance and falls.
  
  
  METHODS
  prospective cohort study with a 1 year follow-up.
  
  
  METHODS
  community-dwelling sample.
  
  
  METHODS
  sixty-four participants (62-96 years of age) with cognitive impairment.
  
  
  METHODS
  gait analysis and sensorimotor and neuropsychological functions were assessed in all participants. Falls were identified prospectively for 1 year.
  
  
  RESULTS
  multiple fallers (≥2 falls) had significantly slower gait velocity, shorter stride length, greater double support time and increased step length variability in univariate analyses. Multivariate logistic regression indicated that the relationship between gait and falls was mediated primarily by sensorimotor function and to a lesser extent by neuropsychological performance.
  
  
  CONCLUSIONS
  the findings indicate that slow and variable gait patterns increase the risk of falls in cognitively impaired older adults. Further, the association between gait and falls seems to be mediated in large by reduced sensorimotor functioning. Further research is needed to investigate whether interventions aimed at improving gait and/or sensorimotor fall risk factors, such as strength and balance, can prevent falls in cognitively impaired older adults.
authors.affiliation: Neuroscience Research Australia, Falls and Balance Research Group, University of New South Wales, Randwick, NSW, Australia. m.taylor@neura.edu.au
authors.forename: Morag E
authors.initials: ME
authors.lastname: Taylor
authors.forename: Marjolein M
authors.initials: MM
authors.lastname: Ketels
authors.forename: Kim
authors.initials: K
authors.lastname: Delbaere
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Lord
authors.forename: A Stefanie
authors.initials: AS
authors.lastname: Mikolaizak
authors.forename: Jacqueline C T
authors.initials: JC
authors.lastname: Close
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000150:complications*; D015331:Cohort Studies; D056228:Feedback, Sensory / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology; D020233:Gait Disorders, Neurologic / Q000150:complications / Q000503:physiopathology* / Q000523:psychology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012111:Residence Characteristics; D012307:Risk Factors