The Association between Gait Speed and Falls in Community Dwelling Older Adults with and without Mild Cognitive Impairment

Abstract

(1) Background: Falls are common in older adults and result in injuries, loss of independence, and death. Slow gait is associated with falls in older adults, but few studies have assessed the association between gait speed and falls among those with mild cognitive impairment (MCI). (2) Methods: The association between gait speed and falls was assessed in 2705 older adults with and without MCI participating in the Ginkgo Evaluation of Memory Study. Gait speed was measured via a 15-foot walk test and fall history through self-report. We used data collected at the 12-month (2001–2003) and 18-month visits (2002–2004). (3) Results: Participant average age was 78.5 years (sd = 3.2); 45% were female, and 14% had MCI at baseline. The average gait speed was 0.93 m/s (sd = 0.20). Sixteen percent (n = 433) and 18% (n = 498) reported at least one fall at the 12-month and 18-month visits, respectively. Faster gait speed was associated with decreased risk of falling (RR: 0.95, 95% CI: 0.91, 0.99) for every 10 cm/s increase in gait speed adjusted for age, gender, study arm, site, and MCI status. (4) Conclusions: The relationship between gait speed and risk of falling did not vary by MCI status (interaction p-value = 0.78).

Quantitative gait analysis in mild cognitive impairment, dementia, and cognitively intact individuals: a cross-sectional case–control study

“…An attempt to investigate the relationship between gait and cognition not only provides a better understanding of function but also provides an assessment of safety during movement. Decreased ability to walk during a single-or cognitive dual-task has been reported to be a contributing factor to falls in older adults and individuals with cognitive decline [33,34]. Dual-task gait assessment, where individuals have to perform a secondary attentional challenging task while walking, was shown to be more challenging as the tasks interfere with each other and divide the cortical control resources of the brain [35].…”

Motion tracking virtual reality technology in improving gait in the elderly: A randomized controlled trial

“…A systematic review by Bohannon and Glenney 32 summarized information on the minimal clinically important difference for changes in comfortable gait speed among patients with various pathologies, suggesting that alterations of 0.10–0.20 m/s might serve as minimal clinically important difference across multiple patient groups. Furthermore, Adam et al 33 concluded that a gait speed change of 0.10 m/s is generally accepted in clinical practice as an indicator of elevated fall risk among older adults, with a mean age of 78.5 years, regardless of their cognitive status. Based on the minimal clinically important difference values available from prior studies on different gait variables, our study's results indicate the presence of minimal clinically important differences in stance time between both groups at post-1 and post-2, in favor of the experimental group.…”

Social frailty is independently associated with geriatric depression among older adults living in northern Japan: A cross‐sectional study of ORANGE registry

“…In particular, reports related to association between gait speed and cognitive subdomains are available on older adults with mild cognitive impairment (MCI) 26 or with high risk of falling. 27,28 Moreover, physical frailty subdomains can predict the development of social frailty, including gait performance and muscle strength. 29 Considering the above backgrounds, independent risk factors towards social frailty among older adults need to be investigated in the future, as well as monitoring physical and cognitive functions.…”