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

Détails

ID Serval
serval:BIB_245979263088
Type
Actes de conférence (partie): contribution originale à la littérature scientifique, publiée à l'occasion de conférences scientifiques, dans un ouvrage de compte-rendu (proceedings), ou dans l'édition spéciale d'un journal reconnu (conference proceedings).
Sous-type
Abstract (résumé de présentation): article court qui reprend les éléments essentiels présentés à l'occasion d'une conférence scientifique dans un poster ou lors d'une intervention orale.
Collection
Publications
Titre
Does falls efficacy predict gait performance in high-functioning older people?
Titre de la conférence
76e Assemblée annuelle de la Société suisse de médecine interne (SGIM/SSMI)
Auteur(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
Adresse
Lausanne, Suisse, 21-23 mai 2008
ISBN
1424-3784
Statut éditorial
Publié
Date de publication
2008
Volume
8
Série
Swiss Medical Forum = Forum Médical Suisse
Pages
8S
Langue
anglais
Résumé
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.
Mots-clé
Aged, Accidental Falls, Gait, Geriatric Assessment, Geriatric Assessment/methods
Création de la notice
03/03/2009 10:59
Dernière modification de la notice
20/08/2019 13:02
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