title: Continuous Monitoring of Turning Mobility and Its Association to Falls and Cognitive Function: A Pilot Study.
abstract: Difficulty turning is a major contributor to mobility disability, falls, and reduced quality of life in older people because it requires dynamic balance control that worsens with age. However, no study has quantified the quality and quantity of turning during normal daily activities in older people. The objective of this pilot study was to determine if quality of turning during daily activities is associated with falls and/or cognitive function.
  
  
  
  Thirty-five elderly participants (85 ± 8 years) wore three Opal inertial sensors. Turning and activity rate were measured. Based on retrospective falls, participants were grouped into nonfallers (N = 16), single fallers (N = 12), and recurrent fallers (N = 7). We also determined which turning characteristic predicted falls in the 6 months following the week of monitoring.
  
  
  
  Quality of turning was significantly compromised in recurrent fallers compared with nonfallers (p < .05). In contrast, activity rate and mean number of turns per hour were similar across the three groups. Also, quality of turning during a prescribed test was similar across the three groups. Visuospatial and memory functions and the Tinetti Balance Scores were associated with quality of turning. Future falls were related to an increased variability of number of steps to turn.
  
  
  
  Continuous monitoring of turning characteristics, while walking during daily activities, is feasible in older people. Turning characteristics during daily life appear to be more sensitive to fall risk than prescribed turning tasks. These findings suggest a slower, less variable, cautious turning strategy in elderly volunteers with a history of falls.
authors.affiliation: Department of Neurology, School of Medicine, Oregon Health & Science University, Portland. VA Portland Health Care System (VAPORHCS), Portland, Oregon. mancinim@ohsu.edu.
authors.forename: Martina
authors.initials: M
authors.lastname: Mancini
authors.affiliation: Department of Neurology, School of Medicine, Oregon Health & Science University, Portland.
authors.forename: Heather
authors.initials: H
authors.lastname: Schlueter
authors.affiliation: APDM, Portland, Oregon.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: El-Gohary
authors.affiliation: Oregon Center for Aging and Technology, Oregon Health & Science University, Portland.
authors.forename: Nora
authors.initials: N
authors.lastname: Mattek
authors.affiliation: Oregon Center for Aging and Technology, Oregon Health & Science University, Portland.
authors.forename: Colette
authors.initials: C
authors.lastname: Duncan
authors.affiliation: Department of Neurology, School of Medicine, Oregon Health & Science University, Portland. VA Portland Health Care System (VAPORHCS), Portland, Oregon. Oregon Center for Aging and Technology, Oregon Health & Science University, Portland.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Kaye
authors.affiliation: Department of Neurology, School of Medicine, Oregon Health & Science University, Portland. VA Portland Health Care System (VAPORHCS), Portland, Oregon. APDM, Portland, Oregon.
authors.forename: Fay B
authors.initials: FB
authors.lastname: Horak
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D015374:Biosensing Techniques; D015992:Body Mass Index; D001835:Body Weight; D003071:Cognition; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D018670:Monitoring, Ambulatory / Q000379:methods; D010865:Pilot Projects; D004856:Postural Balance; D011788:Quality of Life; D012189:Retrospective Studies; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D016138:Walking
keywords: Cognition; Continuous monitoring; Fall