TY - JOUR T1 - Motor Performance and Physical Activity as Predictors of Prospective Falls in Community-Dwelling Older Adults by Frailty Level: Application of Wearable Technology. AU - Mohler,M Jane, AU - Wendel,Christopher S, AU - Taylor-Piliae,Ruth E, AU - Toosizadeh,Nima, AU - Najafi,Bijan, Y1 - 2016/04/30/ PY - 2015/11/11/received PY - 2016/04/04/accepted PY - 2016/10/21/pubmed PY - 2017/5/4/medline PY - 2016/5/11/entrez SP - 654 EP - 664 JF - Gerontology JO - Gerontology VL - 62 IS - 6 N2 - BACKGROUND: Few studies of the association between prospective falls and sensor-based measures of motor performance and physical activity (PA) have evaluated subgroups of frailty status separately. OBJECTIVE: To evaluate wearable sensor-based measures of gait, balance, and PA that are predictive of future falls in community-dwelling older adults. METHODS: The Arizona Frailty Cohort Study in Tucson, Arizona, followed community-dwelling adults aged 65 years and over (without baseline cognitive deficit, severe movement disorders, or recent stroke) for falls over 6 months. Baseline measures included Fried frailty criteria: in-home and sensor-based gait (normal and fast walk), balance (bipedal eyes open and eyes closed), and spontaneous daily PA over 48 h, measured using validated wearable technologies. RESULTS: Of the 119 participants (36% non-frail, 48% pre-frail, and 16% frail), 48 reported one or more fall (47% of non-frail, 33% of pre-frail, and 47% of frail). Although balance deficit and PA were independent fall predictors in pre-frail and frail groups, they were not sensitive to predict prospective falls in the non-frail group. Even though gait performance deteriorated as frailty increased, gait was not a predictor of prospective falls when participants were stratified based on frailty status. In pre-frail and frail participants combined, center of mass sway [odds ratio (OR) = 5.9, 95% confidence interval (CI) 2.6-13.7], PA mean walking bout duration (OR = 1.1, 95% CI 1.0-1.2), PA mean standing bout duration (OR = 0.94, 95% CI 0.91-0.99), and a fall in previous 6 months (OR = 7.3, 95% CI 1.5-36.4) were independent predictors of prospective falls (area under the curve: 0.882). CONCLUSION: This study suggests that independent predictors of falls are dependent on frailty status. Among sensor-derived parameters, balance deficit, longer typical walking episodes, and shorter typical standing episodes were the most sensitive predictors of prospective falls in the combined pre-frail and frail sample. Gait deficit was not a sensitive fall predictor in the context of frailty status. SN - 1423-0003 UR - https://www.unboundmedicine.com/medline/citation/27160666/Motor_Performance_and_Physical_Activity_as_Predictors_of_Prospective_Falls_in_Community_Dwelling_Older_Adults_by_Frailty_Level:_Application_of_Wearable_Technology_ L2 - https://www.karger.com?DOI=10.1159/000445889 DB - PRIME DP - Unbound Medicine ER -