The predictive value of gait speed and maximum step length for falling in community-dwelling older persons

Bongers, Kim T J; Schoon, Yvonne; Graauwmans, Maartje J.; Schers, Henk; Melis, René J. F.; Rikkert, Marcel G M Olde

doi:10.1093/ageing/afu151

Cited by 31 publications

(17 citation statements)

References 25 publications

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“…Our study used the standard AUC >0.70, which is used in clinical practice. 26 , 27 Therefore, TUGT can be an effective, simple, and practical tool to predict future recurrent falls in elderly people. This study also did confirm the earlier findings that TUGT is better in predicting recurrent falls, and adding age and gender to the model increases the predictive ability of TUGT.…”

Section: Discussionmentioning

confidence: 99%

Timed Up and Go Test can predict recurrent falls: a longitudinal study of the community-dwelling elderly in China

Li¹,

Han²,

Wang³

et al. 2017

CIA

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PurposeFalling is a major health problem in community-dwelling elderly individuals. The aim of the present study was to conduct a prospective investigation to evaluate the accuracy of the Timed Up and Go Test (TUGT), 4-meter walking test, and grip strength test to screen for the risk of falls and to determine a cutoff point to be used clinically.Patients and methodsThis was a prospective study that included 541 participants. The fall data were obtained via face-to-face interview, and the date, site, and circumstances of any falls were recorded. TUGTs were recorded as part of a comprehensive geriatric assessment. We collected the same data at baseline and after follow-up via comprehensive geriatric assessment.ResultsThe incidence of falls of our study subjects was 20.8%. The recurrent-fall group had a fall rate of 6.8% during the follow-up year. The standard area under the curve (AUC) of our screening tool was >0.70, and hence our tool can be used for clinical purposes. After adjusting for age and gender, the AUC of TUGT became 0.642, so it cannot be used as a predictive tool for measuring any types of falls. However, when recurrent falls were adjusted for age and gender, the TUGT’s AUC improved to 0.733 and a score of 15.96 seconds is used as a cut-point to screen recurrent falls in community-dwelling elderly Chinese individuals.ConclusionFuture falls were best predicted by TUGT in recurrent fallers at baseline. A score of 15.96 seconds is used as a cut-point to screen recurrent falls in community-dwelling elderly Chinese individuals.

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Section: Discussionmentioning

confidence: 99%

Timed Up and Go Test can predict recurrent falls: a longitudinal study of the community-dwelling elderly in China

Li¹,

Han²,

Wang³

et al. 2017

CIA

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“…7–10 Predictive studies linking MSL to fall risk are still limited 911 GS proved to be a feasible and valid measure to predict future adverse events, such as disability and falls, in community-dwelling older persons 11–19. An important limitation of most of these studies was that only a single-baseline MSL or GS measurement was assessed by a professional in a clinical setting.…”

Section: Introductionmentioning

confidence: 99%

“…9 11 GS proved to be a feasible and valid measure to predict future adverse events, such as disability and falls, in community-dwelling older persons. [11][12][13][14][15][16][17][18][19] An important limitation of most of these studies was that only a single-baseline MSL or GS measurement was assessed by a professional in a clinical setting. It can be reasoned that mobility assessment at only one time point may preclude identification of a large proportion of the persons at risk as they may experience a rapid or gradual decline in mobility and balance over time, and may or may not pass in due time a population-based cut-off point.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of repeated self-measurements of maximum step length and gait speed by community-dwelling older persons

Bongers¹,

Schoon²,

Rikkert³

2016

BMJ Open

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ObjectivesSelf-management of mobility and fall risk can be important in fall prevention; however, it remains unstudied. Therefore, the current study assessed whether community-dwelling older persons were able to repeatedly self-assess maximum step length (MSL) and gait speed (GS) in their own home for a 6-month period, how these tests changed during this period and if these changes were related to falling.DesignThis is a prospective study.SettingThis study was conducted at home.ParticipantsA total of 56 community-dwelling older adults (24 women (43%), mean age 76.2 (SD 3.9) years) entered the study; of which, 45 completed the study.MethodsParticipants performed MSL and GS once a week in their own home during a 6-month period.Primary and secondary outcomesRepeated MSL and GS measurements were the primary outcomes. Falls, self-management and mobility were the secondary outcomes.ResultsSelf-assessment of MSL and GS by older persons is feasible. Compliance of repeatedly self-measuring MSL and GS was good; the median number of weekly measurements was 23.0 (88%) and 21.0 (81%) for MSL and GS, respectively. Drop-outs showed less self-management abilities compared to the participants who completed the study (p=0.049). Linear mixed models showed a small significant improvement in MSL and GS over time (p<0.001), without an influence on falling.ConclusionsMost community-dwelling older persons are able and willing to repeatedly assess their MSL and GS. Self-managing mobility and fall risk did not increase fall occurrence. The fact that older persons can be actively involved in their own healthcare is clinically relevant. Further studies are needed to examine the (cost-)effectiveness of self-management in fall prevention interventions.

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“…Although previous studies have proved these three tests may be correlated with fall risk, it hard to identify a single test that can predict the multiple factors involved in falls, and there are also studies that suggest a single tool does not have sufficient power to predict falls in independently living senior adults 8 16 . Specific diseases and impairments may also affect specific aspects of function, which may then determine the characteristics of an individual’s likelihood of falling.…”

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confidence: 99%

Mobility and Muscle Strength Together are More Strongly Correlated with Falls in Suburb-Dwelling Older Chinese

Wang

et al. 2016

Sci Rep

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Falls are common in older adults and result in adverse outcomes. Impaired mobility and poor muscle strength have been consistently identified as the main contributors to falls. We choose three easy-to-perform tests (i.e. Timed Up and Go test (TUGT), walking speed (WS) and grip strength (GS)) in order to assess mobility and muscle strength to further define their relationship with falls. This study is cross-sectional, consisting of 1092 residents over 60-year-old; 589 were female. 204 (18.68%) participants reported falling at least once in the past year. It was found that, of the three tests evaluated independently, a TUGT < 9.1750 s had the strongest association with fewer falls. When evaluating these tests as pairs, the combination of a TUGT < 9.1750 s and a WS < 0.9963 m/s was the best protective indicator of falls after adjusting for age, sex and other variables. When evaluating all three tests in conjunction with each other, the combination of a TUGT < 9.1750 s, a WS < 0.9963 m/s, and a GS > 0.3816 was most correlated with less possibility of falls. The combination of a better TUGT performance, a stronger GS, and a slower WS is the most strongly correlated with less possibility of falls.

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The predictive value of gait speed and maximum step length for falling in community-dwelling older persons

Abstract: Maximum step length and gait speed as single-item tools do not have sufficient power to predict future falls in community-dwelling older persons.

Cited by 31 publications

References 25 publications

Timed Up and Go Test can predict recurrent falls: a longitudinal study of the community-dwelling elderly in China

Timed Up and Go Test can predict recurrent falls: a longitudinal study of the community-dwelling elderly in China

Feasibility of repeated self-measurements of maximum step length and gait speed by community-dwelling older persons

Mobility and Muscle Strength Together are More Strongly Correlated with Falls in Suburb-Dwelling Older Chinese

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