Coordination Impairments Are Associated With Falling Among Older Adults
Coordination Impairments Are Associated With Falling Among Older Adults
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DOI：
10.1080/0361073x.2017.1369634
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发表时间：
2017-01-01
影响因子：
1.8
通讯作者：
Bean, Jonathan F.
中科院分区：
文献类型：
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作者：
James, Eric G.;Leveille, Suzanne G.;Bean, Jonathan F.
背景/研究背景：大约三分之一的65岁以上的老年人和超过40%的80岁以上的老年人每年都会跌倒，导致骨折、发病和死亡。在美国，每年因福尔斯下降而造成的直接医疗费用约为192亿美元。识别新的可治疗的危险因素福尔斯有可能推进其预防和rehabilitation.Methods：127个社区居住的成年人年龄在67-99岁的横断面研究进行。电子步态走道用于评估步态协调，测量为正常速度行走期间的相位协调指数。运动捕捉系统被用来评估有节奏的肢体间反相踝关节协调，测量踝关节相对相位的标准差。回顾性地自我报告了前一年的跌倒情况。跌倒的优势比作为协调四分位数的函数，使用多变量逻辑回归确定。调整年龄、性别、体重指数、慢性疾病数量、简易精神状态检查评分、步态速度以及步长、时间和宽度的变异性，在第四位的基础上，步态或踝关节协调的（最差）四分位数为5.5（95%置信区间[CI]：1.2-24.7）和8.2（95% CI：2.2-31.3），和3.7（95% CI：1.0-13.8）的步态协调的第三四分位数相比，最佳（第一）协调四分位数。相似的结果被发现在回归没有调整步态characteristics.Conclusion：结果支持这一假设，即受损的步态和有节奏的肢体间踝关节协调与历史的福尔斯在过去的一年。需要前瞻性的纵向研究来确定福尔斯跌倒和协调能力受损之间可能的因果关系。
Background/Study Context: Approximately one third of older adults over the age of 65, and over 40% of those over 80years, fall each year, leading to fractures, morbidity, and mortality. Annual direct medical costs due to falls in the United States are approximately $19.2 billion. The identification of new treatable risk factors for falls has the potential to advance their prevention and rehabilitation.Methods: A cross-sectional study of 127 community-dwelling adults aged 67-99 years was conducted. An electronic gait walkway was used to assess gait coordination, measured as the Phase Coordination Index during normal speed walking. A motion capture system was used to assess rhythmic interlimb antiphase ankle coordination, measured as the standard deviation of ankle relative phase. Having fallen in the previous year was self-reported retrospectively. Odds ratios for falling as a function of coordination quartiles were determined using multivariable logistic regression.Results: Adjusting for age, sex, body mass index, number of chronic conditions, Mini-Mental State Examination score, gait speed, and the variability of step length, time, and width, the odds ratios for falling based upon being in the 4th (the poorest) quartiles of gait or ankle coordination were 5.5 (95% confidence interval [CI]: 1.2-24.7) and 8.2 (95% CI: 2.2-31.3), respectively, and 3.7 (95% CI: 1.0-13.8) for the 3rd quartile of gait coordination, compared with the best (the 1st) coordination quartiles. Similar results were found in regression without adjustment for gait characteristics.Conclusion: The results support the hypothesis that impaired gait and rhythmic interlimb ankle coordination are associated with a history of falls in the past year. Prospective longitudinal research is needed to determine the possible direction of causality between falls and impaired coordination.