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Motor Performance and Physical Activity as Predictors of Prospective Falls in Community-Dwelling Older Adults by Frailty Level: Application of Wearable Technology.
Gerontology. 2016; 62(6):654-664.G

Abstract

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.

Authors+Show Affiliations

Arizona Center on Aging, College of Medicine, University of Arizona, Tucson, Ariz., USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27160666

Citation

Mohler, M Jane, et al. "Motor Performance and Physical Activity as Predictors of Prospective Falls in Community-Dwelling Older Adults By Frailty Level: Application of Wearable Technology." Gerontology, vol. 62, no. 6, 2016, pp. 654-664.
Mohler MJ, Wendel CS, Taylor-Piliae RE, et al. Motor Performance and Physical Activity as Predictors of Prospective Falls in Community-Dwelling Older Adults by Frailty Level: Application of Wearable Technology. Gerontology. 2016;62(6):654-664.
Mohler, M. J., Wendel, C. S., Taylor-Piliae, R. E., Toosizadeh, N., & Najafi, B. (2016). Motor Performance and Physical Activity as Predictors of Prospective Falls in Community-Dwelling Older Adults by Frailty Level: Application of Wearable Technology. Gerontology, 62(6), 654-664.
Mohler MJ, et al. Motor Performance and Physical Activity as Predictors of Prospective Falls in Community-Dwelling Older Adults By Frailty Level: Application of Wearable Technology. Gerontology. 2016;62(6):654-664. PubMed PMID: 27160666.
* Article titles in AMA citation format should be in sentence-case
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 -