Independent Domains of Gait in Older Adults and Associated Motor and Nonmotor Attributes: Validation of a Factor Analysis Approach
Independent Domains of Gait in Older Adults and Associated Motor and Nonmotor Attributes: Validation of a Factor Analysis Approach
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DOI：
10.1093/gerona/gls255
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发表时间：
2013-07-01
影响因子：
5.1
通讯作者：
Rochester, Lynn
中科院分区：
文献类型：
--
作者：
Lord, Sue;Galna, Brook;Rochester, Lynn
背景步态是老年人生存的重要预测因素。步态特征有助于识别早期病理学的标志物，告知诊断算法和疾病进展，并测量干预措施的有效性。然而，没有明确的框架来指导步态特征的选择。本研究开发和验证了一个模型的步态在老年人的基础上一个强大的理论范式。189名平均（SD）年龄为69.5（7.6）岁的老年人在步行2分钟时使用7米仪器化走道（GAITRite）评估了16个时空步态变量。主成分分析和因子分析“方差最大”程序被用来推导出一个模型，使用多方法的方法进行验证：复制以前的工作;关联的步态域与运动，认知和行为属性;和歧视性的步态域使用年龄作为标准。从主成分分析中出现了五个因素：步伐（22.5%），节奏（19.3%），变异性（15.1%），不对称性（14.5%），姿势控制（8.0%），解释了79.5%的步态变异。年龄、执行功能、注意力、平衡自我效能和身体疲劳与4个步态领域独立和选择性相关，解释总方差的40.1%。中位年龄歧视的步伐，变异性和姿势控制域。这项研究支持了一个5因素模型的步态在老年人的领域，优先选择运动，认知和行为属性。需要进一步的研究来验证模型。如果成功，它将促进假设驱动的研究，以解释潜在的步态机制，确定步态障碍的贡献特征，并检查干预的效果。
Background. Gait is an important predictor of survival in older adults. Gait characteristics help to identify markers of incipient pathology, inform diagnostic algorithms and disease progression, and measure efficacy of interventions. However, there is no clear framework to guide selection of gait characteristics. This study developed and validated a model of gait in older adults based on a strong theoretical paradigm.Methods. One hundred and eighty-nine older adults with a mean (SD) age of 69.5 (7.6) years were assessed for 16 spatiotemporal gait variables using a 7-m instrumented walkway (GAITRite) while walking for 2 minutes. Principal components analysis and factor analysis "varimax" procedure were used to derive a model that was validated using a multimethod approach: replication of previous work; association of gait domains with motor, cognitive, and behavioral attributes; and discriminatory properties of gait domains using age as a criterion.Results. Five factors emerged from the principal components analysis: pace (22.5%), rhythm (19.3%), variability (15.1%), asymmetry (14.5%), and postural control (8.0%), explaining 79.5% of gait variance in total. Age, executive function, power of attention, balance self-efficacy, and physical fatigue were independently and selectively associated with 4 gait domains, explaining up to 40.1% of total variance. Median age discriminated pace, variability, and postural control domains.Conclusions. This study supports a 5-factor model of gait in older adults with domains that preferentially select for motor, cognitive, and behavioral attributes. Future research is required to validate the model. If successful, it will facilitate hypothesis-driven research to explain underlying gait mechanisms, identify contributory features to gait disturbance, and examine the effect of intervention.