Associations between gait speed and well-known fall risk factors among community-dwelling older adults.

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Exercise interventions are effective at preventing falls in community-dwelling older adults, especially before disability is present. Gait speed below 1.0m/s is a strong predictor for falls in the elderly. However, evidence is sparse for gait speed alone being sufficient to identify individuals at a high risk of falling. This study aimed to describe the prevalence of fall risk factors among community-dwelling older adults in their late 70s and to investigate the associations between these risk factors and low gait speed in this population. This cross-sectional cohort study comprised 108 elderly living in a small Norwegian municipality, born between 1936 and 1938. Exclusion criteria were living in residential care, inability to walk 4m, and severe cognitive impairment. Measurements included gait speed, depressive symptoms, executive functions, fear of falling, vision function, fall history, body mass index, medications, and comorbidity. Gait speed was dichotomized using a cut-off of 1m/s, and associations between different risk factors and low gait speed was explored using logistic regression analysis. Mean gait speed was 1.0±0.3m/s. In 44.4% of the participants, gait speed was below 1.0m/s, indicating increased fall risk. Low gait speed was significantly associated with a history of multiple falls (odds ratio [OR]=3.70, 95% CI [1.18, 11.65]), low educational level (OR=3.58, 95% CI [1.10, 11.66]), higher number of medications (OR=4.28, 95% CI [1.63, 11.2]), and higher number of depressive symptoms (OR=1.31, 95% CI [1.09, 1.58]). We found no significant associations between gait speed and comorbidity, sex, vision, executive functions, or fear of falling. Our results indicate that gait speed with cut-off 1.0m/s could represent a useful tool for identifying individuals who are vulnerable but not yet disabled and could benefit from fall-preventive exercise. However, extended assessment is probably needed to personalize interventions.