Gait Disturbances as Specific Predictive Markers of the First Fall Onset in Elderly People: A Two-Year Prospective Observational Study
Falls are common in the elderly, and potentially result in injury and disability. Thus, preventing falls as soon as possible in older adults is a public health priority, yet there is no specific marker that is predictive of the first fall onset. We hypothesized that gait features should be the most...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2014-02-01
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| Series: | Frontiers in Aging Neuroscience |
| Subjects: | |
| Online Access: | http://journal.frontiersin.org/Journal/10.3389/fnagi.2014.00022/full |
| _version_ | 1819295685670862848 |
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| author | Jean-Baptiste eMignardot Thibault eDeschamps Eric eBarrey Eric eBarrey Bernard eAuvinet Gilles eBerrut Christophe eCornu Thierry eConstans Laure eDedecker |
| author_facet | Jean-Baptiste eMignardot Thibault eDeschamps Eric eBarrey Eric eBarrey Bernard eAuvinet Gilles eBerrut Christophe eCornu Thierry eConstans Laure eDedecker |
| author_sort | Jean-Baptiste eMignardot |
| collection | DOAJ |
| description | Falls are common in the elderly, and potentially result in injury and disability. Thus, preventing falls as soon as possible in older adults is a public health priority, yet there is no specific marker that is predictive of the first fall onset. We hypothesized that gait features should be the most relevant variables for predicting the first fall. <br/>Clinical baseline characteristics (e.g., gender, cognitive function) were assessed in 259 home-dwelling people aged 66 to 75 that had never fallen. Likewise, global kinetic behavior of gait was recorded from 22 variables in 1036 walking tests with an accelerometric gait analysis system. Afterward, monthly telephone monitoring reported the date of the first fall over 24 months. A principal components analysis was used to assess the relationship between gait variables and fall status in four groups: non-fallers, fallers from 0 to 6 months, fallers from 6 to 12 months and fallers from 12 to 24 months. The association of significant principal components (PC) with an increased risk of first fall was then evaluated using the area under the Receiver Operator Characteristic Curve (ROC). <br/>No effect of clinical confounding variables was shown as a function of groups. An eigenvalue decomposition of the correlation matrix identified a large statistical PC1 (termed Global kinetics of gait pattern), which accounted for 36.7% of total variance. Principal component loadings also revealed a PC2 (12.6% of total variance), related to the Global gait regularity. Subsequent ANOVAs showed that only PC1 discriminated the fall status during the first 6 months, while PC2 discriminated the first fall onset between 6 and 12 months. After one year, any PC was associated with falls. These results were bolstered by the ROC analyses, showing good predictive models of the first fall during the first six months or from 6 to 12 months.<br/>Overall, these findings suggest that the performance of a standardized walking test at least once a year |
| first_indexed | 2024-12-24T04:46:09Z |
| format | Article |
| id | doaj.art-ccd18930df6a4a8294df4fef5f2a91de |
| institution | Directory Open Access Journal |
| issn | 1663-4365 |
| language | English |
| last_indexed | 2024-12-24T04:46:09Z |
| publishDate | 2014-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Aging Neuroscience |
| spelling | doaj.art-ccd18930df6a4a8294df4fef5f2a91de2022-12-21T17:14:41ZengFrontiers Media S.A.Frontiers in Aging Neuroscience1663-43652014-02-01610.3389/fnagi.2014.0002267102Gait Disturbances as Specific Predictive Markers of the First Fall Onset in Elderly People: A Two-Year Prospective Observational StudyJean-Baptiste eMignardot0Thibault eDeschamps1Eric eBarrey2Eric eBarrey3Bernard eAuvinet4Gilles eBerrut5Christophe eCornu6Thierry eConstans7Laure eDedecker8University of NantesUniversity of NantesGenople, Université d’Evry Val d’Essonne, France.GABI, UMR-1313, INRACentre Hospitalier de Laval,Univesrity Hospital of NantesUniversity of NantesUniversity Hospital of ToursUnivesrity Hospital of NantesFalls are common in the elderly, and potentially result in injury and disability. Thus, preventing falls as soon as possible in older adults is a public health priority, yet there is no specific marker that is predictive of the first fall onset. We hypothesized that gait features should be the most relevant variables for predicting the first fall. <br/>Clinical baseline characteristics (e.g., gender, cognitive function) were assessed in 259 home-dwelling people aged 66 to 75 that had never fallen. Likewise, global kinetic behavior of gait was recorded from 22 variables in 1036 walking tests with an accelerometric gait analysis system. Afterward, monthly telephone monitoring reported the date of the first fall over 24 months. A principal components analysis was used to assess the relationship between gait variables and fall status in four groups: non-fallers, fallers from 0 to 6 months, fallers from 6 to 12 months and fallers from 12 to 24 months. The association of significant principal components (PC) with an increased risk of first fall was then evaluated using the area under the Receiver Operator Characteristic Curve (ROC). <br/>No effect of clinical confounding variables was shown as a function of groups. An eigenvalue decomposition of the correlation matrix identified a large statistical PC1 (termed Global kinetics of gait pattern), which accounted for 36.7% of total variance. Principal component loadings also revealed a PC2 (12.6% of total variance), related to the Global gait regularity. Subsequent ANOVAs showed that only PC1 discriminated the fall status during the first 6 months, while PC2 discriminated the first fall onset between 6 and 12 months. After one year, any PC was associated with falls. These results were bolstered by the ROC analyses, showing good predictive models of the first fall during the first six months or from 6 to 12 months.<br/>Overall, these findings suggest that the performance of a standardized walking test at least once a yearhttp://journal.frontiersin.org/Journal/10.3389/fnagi.2014.00022/fullCentral Nervous Systemmotor controlgait analysisgait speedPrincipal Components Analysisneuromuscular system |
| spellingShingle | Jean-Baptiste eMignardot Thibault eDeschamps Eric eBarrey Eric eBarrey Bernard eAuvinet Gilles eBerrut Christophe eCornu Thierry eConstans Laure eDedecker Gait Disturbances as Specific Predictive Markers of the First Fall Onset in Elderly People: A Two-Year Prospective Observational Study Frontiers in Aging Neuroscience Central Nervous System motor control gait analysis gait speed Principal Components Analysis neuromuscular system |
| title | Gait Disturbances as Specific Predictive Markers of the First Fall Onset in Elderly People: A Two-Year Prospective Observational Study |
| title_full | Gait Disturbances as Specific Predictive Markers of the First Fall Onset in Elderly People: A Two-Year Prospective Observational Study |
| title_fullStr | Gait Disturbances as Specific Predictive Markers of the First Fall Onset in Elderly People: A Two-Year Prospective Observational Study |
| title_full_unstemmed | Gait Disturbances as Specific Predictive Markers of the First Fall Onset in Elderly People: A Two-Year Prospective Observational Study |
| title_short | Gait Disturbances as Specific Predictive Markers of the First Fall Onset in Elderly People: A Two-Year Prospective Observational Study |
| title_sort | gait disturbances as specific predictive markers of the first fall onset in elderly people a two year prospective observational study |
| topic | Central Nervous System motor control gait analysis gait speed Principal Components Analysis neuromuscular system |
| url | http://journal.frontiersin.org/Journal/10.3389/fnagi.2014.00022/full |
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