Does falls efficacy predict gait performance in high-functioning older people?

Details

Serval ID
serval:BIB_245979263088
Type
Inproceedings: an article in a conference proceedings.
Publication sub-type
Abstract (Abstract): shot summary in a article that contain essentials elements presented during a scientific conference, lecture or from a poster.
Collection
Publications
Title
Does falls efficacy predict gait performance in high-functioning older people?
Title of the conference
76e Assemblée annuelle de la Société suisse de médecine interne (SGIM/SSMI)
Author(s)
Rochat Stéphane, Martin Estelle, Aminian Kamiar, Ganea R., Hoskovec C., Ionescu A., Seematter-Bagnoud Laurence, Najafi Bijan, Piot-Ziegler Chantal, Santos-Eggimann Brigitte, Büla Christophe
Address
Lausanne, Suisse, 21-23 mai 2008
ISBN
1424-3784
Publication state
Published
Issued date
2008
Volume
8
Series
Swiss Medical Forum = Forum Médical Suisse
Pages
8S
Language
english
Abstract
Introduction: Falls efficacy, defined as confidence in performing activities without falling, is a measure of fear of falling associated with gait impairment, falls and functional decline in frail older people. This relationship has not been well studied in high-functioning older people.
Objective: To evaluate the relationship between falls efficacy and gait performance in a cohort of high-functioning older people.
Methods: Subjects (N = 864) were a subsample of communitydwelling older people aged 65 to 70 years, enrolled in the "Lc65+" cohort, who completed gait assessment at baseline. Data were collected on demographics, functional, cognitive, affective, and health status. Falls efficacy was assessed using the Falls Efficacy Scale- International (FES-I) that measures confidence in performing 16 activities of daily life (ADL) without falling (score from 16 to 64, higher score indicates lower confidence). Gait parameters were measured over a 20 m walk at preferred gait speed using Physilog, an ambulatory gait monitoring system.
Results: Participants (mean age 68.0 ± 1.4 years, 55.0% women) had excellent physical (92.2% independent in basic ADL, mean gait speed 1.13 ± 0.16 m/sec) and cognitive (98.0% with MMSE 024) performance. Nevertheless, 22.1% reported depressive symptoms and 16.1% one or more fall in the previous year. Mean FES-I score was 18.8 ± 4.1. Falls efficacy was associated with gait speed (Spearman rho -0.23, P <.001) and gait variability (Spearman rho 0.10, P = .006), measured by the coefficient of variation of stride velocity. These associations remained in multivariate analysis for both gait speed (adj [beta] coeff: -0.008, 95%CI -0.005 to -0.010, P <.001) and gait variability (adj [beta] coeff 0.024, 95%CI 0.003 to 0.045, P = .023) independent of gender, falls, functional, affective, cognitive, and frailty (Fried's criteria) status. On average, compared to subjects with poor confidence in performing one ADL without falling, those with full confidence had a 0.02 m/sec (2%) faster gait speed and a 2% decrease in gait variability.
Conclusion: Even in high-functioning older people, poor falls efficacy is associated with reduced gait speed and stability, independent of health, functional, and frailty status. The direction of this relationship needs to be investigated prospectively to determine causality and design interventions to improve gait performance, reduce fall risk, and prevent functional decline.
Keywords
Aged, Accidental Falls, Gait, Geriatric Assessment, Geriatric Assessment/methods
Create date
03/03/2009 11:59
Last modification date
20/08/2019 14:02
Usage data