Abstract
Gait quality characteristics obtained from accelerometry during daily life are predictive of falls in older people but it is unclear how they relate to fall risk. Our aim was to test whether these gait quality characteristics are associated with the severity of fall risk. We collected one week of trunk accelerometry data from 279 older people (aged 65–95 years; 69.5% female). We used linear regression to investigate the association between six daily-life gait quality characteristics and categorized physiological fall risk (QuickScreen). Logarithmic rate of divergence in the vertical (VT) and anteroposterior (AP) direction were significantly associated with the level of fall risk after correction for walking speed (both p < 0.01). Sample entropy in VT and the mediolateral direction and the gait quality composite were not significantly associated with the level of fall risk. We found significant differences between the high fall risk group and the very low- and low-risk groups, the moderate- and very low-risk and the moderate and low-risk groups for logarithmic rate of divergence in VT and AP (all p ≤ 0.01). We conclude that logarithmic rate of divergence in VT and AP are associated with fall risk, making them feasible to assess the physiological fall risk in older people.
Highlights
Falls are a major problem in older people
To investigate whether daily life gait quality characteristics are associated with physiological fall risk, trunk accelerometry data from 279 people aged 65 years or older (69.5% female) who participated in the Veilig in Beweging Blijven (VIBE) study at the Vrije Universiteit Amsterdam, were analyzed
In line with the previous validation on falls [5], our results indicated that logarithmic rate of divergence per stride in VT and AP were associated with physiological fall risk while sample entropy and a gait quality composite score were, against our expectations, not associated with physiological fall risk after adjusting for walking speed
Summary
Falls are a major problem in older people. Approximately one in three people aged 65 year or over falls [1,2]. Previous studies demonstrated that gait quality characteristics obtained from daily life trunk accelerometry discriminate between non-fallers and fallers, both retrospectively and prospectively [3,4,5,6,7,8]. Sample entropy in vertical and mediolateral direction (gait regularity), the gait quality composite and logarithmic rate of divergence per stride (gait stability, referred to as the Lyapunov exponent) showed the strongest associations with past and future falls [3,4,5,6,7]. Some but not all of these associations may be a reflection of walking speed, showing better gait quality at higher speeds [9].
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