Description of spatio-temporal gait parameters in elderly people and their association with history of falls: results of the population-based cross-sectional KORA-Age study.

Kathrin Thaler-Kall,Christa Meisinger,Christine S Autenrieth,Annette Peters,Barbara Thorand,Alexander Horsch,Eva Grill

doi:10.1186/s12877-015-0032-1

Abstract

BackgroundIn this epidemiological study we described the characteristics of spatio-temporal gait parameters among a representative, population-based sample of 890 community-dwelling people aged 65 to 90 years. In addition, we investigated the associations between certain gait parameters and a history of falls in study participants.MethodsIn descriptive analyses spatio-temporal gait parameters were assessed according to history of falls, frailty, multimorbidity, gender, multiple medication use, disability status, and age group. Logistic regression models were calculated to examine the association between gait velocity and stride length with a history of falls (at least one fall in the last 12 month). Data on gait were collected on an electronic walkway on which participants walked at their usual pace.ResultsWe found significant differences within gait parameters when stratifying by frailty, multimorbidity, disability and multiple medication use as well as age (cut point 75 years) and sex, with p < 0.05 for all gait parameters (velocity, cadence, time, stride duration, stride length, step width). After stratification by history of falls, only stride length showed a significant difference (p < 0.05) between the groups of fallers and non-fallers. Logistic regression models showed that a decreased stride length was independently associated with falls in men aged older than 74 years (OR 1.34 (CI: 1.05-1.70 per 10 cm decrease)), while this was neither the case for women of similar age nor for men or women aged 65 to 74 years. A decreased walking speed was not associated with falls.ConclusionAge, frailty, multimorbidity, disability, history of falls, sex, and multiple medication use show an association with different gait parameters measured during gait assessment on an electronic walkway in elderly people. Furthermore, stride length is a good indicator to differentiate fallers from non-fallers in older men from the general population.

Highlights

In this epidemiological study we described the characteristics of spatio-temporal gait parameters among a representative, population-based sample of 890 community-dwelling people aged 65 to 90 years
The mean age of the study participants was 75.4 years (SD ± 6.3 years).Women fell more often than men (16.6% vs. 10.4% falls in the last year, c2(1) = 7.23, p = 0.0072) and reported almost twice as many recurrent falls than men (c2(2) = 7.92, p = 0.0191)
We found that a decreased stride length is significantly associated with falls in men aged older than 74 years and that a decreased walking speed was not related to the history of falls in both elderly men and women from the general population

Summary

Introduction

In this epidemiological study we described the characteristics of spatio-temporal gait parameters among a representative, population-based sample of 890 community-dwelling people aged 65 to 90 years. Several studies have shown that changes in certain spatial and temporal gait parameters such as velocity or step length increase fall risk [2,6,7,8]. Such changes in gait parameters are often very small and could not be identified without a device; in the last few years instrumented gait analysis has become an important method used for fall risk detection, among others, electronic walkway mats are used [1]. These devices overcome problems of other gait assessment instruments which are often subjective and examiner-dependent [9]

Methods

Results

Discussion

Conclusion