title: Changes in gait performance over several years are associated with recurrent falls status in community-dwelling older women at high risk of fracture.
abstract: BACKGROUND
  Gait analysis is a recommended geriatric assessment for falls risk and sarcopenia; however, previous research utilises measurements at a single time point only. It is presently unclear how changes in gait over several years influence risk of recurrent falls in older adults.
  
  
  METHODS
  We investigated 135 female volunteers (mean age±SD: 76.7±5.0 years; range: 70-92 years) at high risk of fracture. Gait parameters (speed, cadence, step length, step width, swing time and double support phase) were assessed using the GAITRite Electronic Walkway System at four annual clinics over ∼3.7±0.5 years. Participants reported incident falls monthly for 3.7±1.2 years.
  
  
  RESULTS
  Increasing gait speed (odds ratio: 0.96; 95% confidence interval 0.93, 0.99) and step length (0.87; 0.77, 0.98) from baseline to final follow-up was associated with reduced likelihood of being a recurrent faller over the study period. No significant associations were observed for baseline gait parameters (all P≥0.05). At the second follow-up (2.8±0.6 years), an increase in swing time (0.65; 0.43, 0.98) was associated with reduced likelihood, while an increase in double support phase (1.31; 1.04, 1.66) was associated with increased likelihood, for being a recurrent faller in the subsequent 1.3 years following this time point.
  
  
  CONCLUSIONS
  Changes in gait parameters over several years are significantly associated with the likelihood of being a recurrent faller among community-dwelling older women at high risk of fracture. Further research is required to develop gait monitoring guidelines and gait parameter decline cut points that may be utilised by clinicians to identify older adults at risk of incident falls and sarcopenia.
authors.affiliation: NorthWest Academic Centre, The University of Melbourne and Western Health, St Albans, Victoria, Australia Australian Institute for Musculoskeletal Science, St Albans, Victoria, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Scott
authors.affiliation: Australian Institute for Musculoskeletal Science, St Albans, Victoria, Australia College of Health and Biomedicine, Victoria University, Melbourne, Australia Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, Australia.
authors.forename: Patrick
authors.initials: P
authors.lastname: McLaughlin
authors.affiliation: Rural Clinical School, The University of Queensland, Toowoomba, Queensland, Australia.
authors.forename: Geoff C
authors.initials: GC
authors.lastname: Nicholson
authors.affiliation: Australian Institute for Musculoskeletal Science, St Albans, Victoria, Australia School of Clinical Sciences, Monash Medical Centre, Monash University, Clayton, Victoria, Australia.
authors.forename: Peter R
authors.initials: PR
authors.lastname: Ebeling
authors.affiliation: IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia.
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Stuart
authors.affiliation: Barwon Health, Geelong, Victoria, Australia.
authors.forename: Deborah
authors.initials: D
authors.lastname: Kay
authors.affiliation: NorthWest Academic Centre, The University of Melbourne and Western Health, St Albans, Victoria, Australia Australian Institute for Musculoskeletal Science, St Albans, Victoria, Australia.
authors.forename: Kerrie M
authors.initials: KM
authors.lastname: Sanders
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D005684:Gait; D015577:Geriatric Assessment; D006620:Hip Fractures / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D057187:Independent Living; D016013:Likelihood Functions; D016015:Logistic Models; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014739:Victoria
keywords: falls; gait; older people; older women; sarcopenia