title: Gait initiation time is associated with the risk of multiple falls-A population-based study.
abstract: In a population-based study of older people to examine whether 1) overall gait initiation (GI) time or its components are associated with falls and 2) GI under dual-task is a stronger predictor of falls risk than under single-task.
  
  
  
  Participants aged 60-85 years were randomly selected from the electoral roll. GI was obtained with a force platform under both single and dual-task conditions. Falls were ascertained prospectively over a 12-month period. Log multinomial regression was used to examine the association between GI time (total and its components) and risk of single and multiple falls. Age, sex and physiological and cognitive falls risk factors were considered as confounders.
  
  
  
  The mean age of the sample (n=124) was 71.0 (SD 6.8) years and 58.9% (n=73) were male. Over 12 months 21.8% (n=27) of participants reported a single fall and 16.1% (n=20) reported multiple falls. Slower overall GI time under both single (RR all per 100ms 1.28, 95%CI 1.03, 1.58) and dual-task (RR 1.14, 95%CI 1.02, 1.27) was associated with increased risk of multiple, but not single falls (p<0.05). Multiple falls were also associated with slower time to first lateral movement under single-task (RR 1.90 95%CI 0.59, 1.51) and swing time under dual-task condition (RR 1.44 95%CI 1.08, 1.94).
  
  
  
  Slower GI time is associated with the risk of multiple falls independent of other risk factors, suggesting it could be used as part of a comprehensive falls assessment. Time to the first lateral movement under single-task may be the best measures of this risk.
authors.affiliation: Menzies Institute for Medical Research Tasmania, University of Tasmania, Hobart, Tasmania, Australia; Southern Clinical School, Monash Medical Centre, Monash University, Clayton, Victoria, Australia. Electronic address: Michele.callisaya@utas.edu.au.
authors.forename: Michele L
authors.initials: ML
authors.lastname: Callisaya
authors.affiliation: Menzies Institute for Medical Research Tasmania, University of Tasmania, Hobart, Tasmania, Australia. Electronic address: Leigh.Blizzard@utas.edu.au.
authors.forename: Leigh
authors.initials: L
authors.lastname: Blizzard
authors.affiliation: Cancer Council Victoria, Cancer Epidemiology and Intelligence Division, Melbourne, Victoria, Australia. Electronic address: Kara.Martin@cancervic.org.au.
authors.forename: Kara
authors.initials: K
authors.lastname: Martin
authors.affiliation: Southern Clinical School, Monash Medical Centre, Monash University, Clayton, Victoria, Australia; Menzies Institute for Medical Research Tasmania, University of Tasmania, Hobart, Tasmania, Australia. Electronic address: Velandai.Srikanth@monash.edu.
authors.forename: Velandai K
authors.initials: VK
authors.lastname: Srikanth
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000453:epidemiology / Q000503:physiopathology*; D011159:Population Surveillance; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D014739:Victoria / Q000453:epidemiology
keywords: Accidental falls; Gait; Gait initiation; Older people; Physical examination; Population based