title: Association between gait abnormality and malnutrition in a community-dwelling elderly population.
abstract: OBJECTIVE
  Malnutrition is common in older adults, and contributes to the risk of falls and functional impairment. Gait performance also contributes to falls and functional impairment; however, the association between malnutrition and gait performance remains unclear. The purpose of the present study was to investigate the association between malnutrition risk and gait performance.
  
  
  METHODS
  The study participants included 204 community-dwelling older adults with a mean age of 73.4 ± 4.3 years. Nutritional status was evaluated using the short version of the Mini-Nutritional Assessment. A score of 11 points was used as the cut-off, and the participants were categorized into two groups: ≤11, malnutrition-risk group; and ≥12, well-nourished group. Gait performance was assessed by gait speed and walking smoothness. Walking smoothness was quantified by harmonic ratios (HR), which were derived from vertical (VT), mediolateral (ML) and anteroposterior trunk accelerations, recorded during over-ground walking. Skeletal muscle mass index, handgrip strength and physical functions were also measured.
  
  
  RESULTS
  HR in the ML direction was significantly lower in the malnutrition-risk group than the well-nourished group (P = 0.002); however, no differences between the two groups were observed in gait speed or HR in the VT and anteroposterior directions. The relationship between malnutrition and HR in the ML direction was independent of skeletal muscle mass index, handgrip strength, physical function, gait speed, and other confounders (P < 0.05).
  
  
  CONCLUSIONS
  In community-dwelling older adults, malnutrition is related to decreased walking smoothness in the ML direction, suggesting that nutritional status affects lateral trunk control during walking. Geriatr Gerontol Int 2017; 17: 1155-1160.
authors.affiliation: Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan.|Kobe City Hospital Organization, Kobe City Medical Center, West Hospital, Kobe, Japan.
authors.forename: Shogo
authors.initials: S
authors.lastname: Misu
authors.affiliation: Department of Physical Therapy, Faculty of Rehabilitation, Kobegakuin University, Kobe, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Asai
authors.affiliation: Department of Preventive Gerontology, Center for Gerontology and Social Science, Aichi, Japan.
authors.forename: Takehiko
authors.initials: T
authors.lastname: Doi
authors.affiliation: Department of Physical Therapy, School of Health Sciences at Narita ,International University of Health and Welfare, Chiba, Japan.
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Sawa
authors.affiliation: Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan.
authors.forename: Yuya
authors.initials: Y
authors.lastname: Ueda
authors.affiliation: Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Saito
authors.affiliation: Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Nakamura
authors.affiliation: Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Murata
authors.affiliation: Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan.|The Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Aichi, Japan.|Medical Genome Center, National Center for Geriatrics and Gerontology, Aichi, Japan.
authors.forename: Taiki
authors.initials: T
authors.lastname: Sugimoto
authors.affiliation: Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Yamada
authors.affiliation: Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan.
authors.forename: Rei
authors.initials: R
authors.lastname: Ono
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D015577:Geriatric Assessment; D006801:Humans; D015994:Incidence; D057187:Independent Living; D008297:Male; D044342:Malnutrition / Q000453:epidemiology*; D051346:Mobility Limitation; D015596:Nutrition Assessment; D012189:Retrospective Studies; D018570:Risk Assessment; D000072797:Walking Speed / Q000502:physiology*
keywords: aged; gait; harmonic ratio; malnutrition