title: Ambulatory fall-risk assessment: amount and quality of daily-life gait predict falls in older adults.
abstract: BACKGROUND
  Ambulatory measurements of trunk accelerations can provide valuable information on the amount and quality of daily-life activities and contribute to the identification of individuals at risk of falls. We compared associations between retrospective and prospective falls with potential risk factors as measured by daily-life accelerometry. In addition, we investigated predictive value of these parameters for 6-month prospective falls.
  
  
  METHODS
  One week of trunk accelerometry (DynaPort MoveMonitor) was obtained in 169 older adults (mean age 75). The amount of daily activity and quality of gait were determined and validated questionnaires on fall-risk factors, grip strength, and trail making test were obtained. Six-month fall incidence was obtained retrospectively by recall and prospectively by fall diaries and monthly telephone contact.
  
  
  RESULTS
  Among all participants, 35.5% had a history of ≥1 falls and 34.9% experienced ≥1 falls during 6-month follow-up. Logistic regressions showed that questionnaires, grip strength, and trail making test, as well as the amount and quality of gait, were significantly associated with falls. Significant associations differed between retrospective and prospective analyses although odds ratios indicated similar patterns. Predictive ability based on questionnaires, grip strength, and trail making test (area under the curve .68) improved substantially by accelerometry-derived parameters of the amount of gait (number of strides), gait quality (complexity, intensity, and smoothness), and their interactions (area under the curve .82).
  
  
  CONCLUSIONS
  Daily-life accelerometry contributes substantially to the identification of individuals at risk of falls, and can predict falls in 6 months with good accuracy.
authors.affiliation: MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University Amsterdam, the Netherlands.
authors.forename: Kimberley S
authors.initials: KS
authors.lastname: van Schooten
authors.affiliation: MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University Amsterdam, the Netherlands.
authors.forename: Mirjam
authors.initials: M
authors.lastname: Pijnappels
authors.affiliation: MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University Amsterdam, the Netherlands.
authors.forename: Sietse M
authors.initials: SM
authors.lastname: Rispens
authors.affiliation: EMGO+ Institute, Department of General Practice and Elderly Care and.
authors.forename: Petra J M
authors.initials: PJ
authors.lastname: Elders
authors.affiliation: MOVE Research Institute Amsterdam, Department of Internal Medicine, Endocrine section, VU University Medical Center, Amsterdam, the Netherlands.
authors.forename: Paul
authors.initials: P
authors.lastname: Lips
authors.affiliation: MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University Amsterdam, the Netherlands. j.van.dieen@vu.nl.
authors.forename: Jaap H
authors.initials: JH
authors.lastname: van Dieën
mesh_terms: D061725:Accelerometry; D000058:Accidental Falls / Q000706:statistics & numerical data*; D000203:Activities of Daily Living; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D005684:Gait / Q000502:physiology*; D015577:Geriatric Assessment; D006801:Humans; D015994:Incidence; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011788:Quality of Life; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: Accelerometry; Accidental falls; Activities of daily living; Activity monitoring; Elderly.