Source
From the *Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts; †Division of Gerontology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; and ‡Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts.
Abstract
OBJECTIVES:
To examine the relationship between gait speed and falls risk.
DESIGN:
Longitudinal analysis of the association between gait speed and subsequent falls and analysis of gait speed decline as a predictor of future falls.
SETTING:
Population-based cohort study.
PARTICIPANTS:
Seven hundred sixty-three community-dwelling older adults underwent baseline assessments and were followed for falls; 600 completed an 18-month follow-up assessment to determine change in gait speed and were followed for subsequent falls.
MEASUREMENTS:
Gait speed was measured during a 4-m walk, falls data were collected from monthly post-card calendars, and covariates were collected from in-home and clinic visits.
RESULTS:
There was a U-shaped relationship between gait speed and falls, with participants with faster (≥1.3 m/s, incident rate ratio (IRR)=2.12, 95% confidence interval (CI)=1.48-3.04) and slower (<0.6 m/s, IRR=1.60, 95% CI=1.06-2.42) gait speeds at higher risk than those with normal gait speeds (1.0-<1.3 m/s). In adjusted analyses, slower gait speeds were associated with greater risk of indoor falls (<0.6 m/s, IRR=2.17, 95% CI=1.33-3.55; 0.6-<1.0 m/s, IRR=1.45, 95% CI=1.08-1.94), and faster gait speed was associated with greater risk of outdoor falls (IRR=2.11, 95% CI=1.40-3.16). A gait speed decline of more than 0.15 m/s per year predicted greater risk of all falls (IRR=1.86, 95% CI=1.15-3.01).
CONCLUSION:
There is a nonlinear relationship between gait speed and falls, with a greater risk of outdoor falls in fast walkers and a greater risk of indoor falls in slow walkers.
© 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.