• This record comes from PubMed

Spatio-Temporal Gait Parameters in Association with Medications and Risk of Falls in the Elderly

. 2022 ; 17 () : 873-883. [epub] 20220527

Language English Country New Zealand Media electronic-ecollection

Document type Journal Article

PURPOSE: The aim of this study was to analyze factors affecting spatio-temporal gait parameters in elderly people of both genders and different ages with different risks of fall, fall history, and medications. PATIENTS AND METHODS: A total of 210 community-dwelling older adults (156 females, 54 males; mean age 72.84±6.26 years) participated in this study. To assess the risk of falls, the Downton Fall Risk Index was used. An additional question about medication intake (all prescribed drugs) was asked. To assess the spatio-temporal gait parameters, the Zebris FDM platform was used. Gait parameters and Downton Fall Risk Index, stratified by participants' history of falls, multiple medication use (0/1/2+), gender, age, and medication categories, were statistically analyzed using the Mann-Whitney U-test and Kruskal-Wallis test. RESULTS: When comparing different medication categories, a Downton Fall Risk Index score indicating a high risk of falls was observed in the psychotropic medication category (3.56±1.67). A gait velocity suggesting a higher risk of falls (≤3.60 km/h) was observed in the psychotropic (2.85±1.09 km/h) and diabetes (2.80±0.81 km/h) medication categories, in the age groups 70-79 years (3.30±0.89 km/h) and 80+ years (2.67±0.88 km/h), and in participants using two or more medications (3.04±0.93 km/h). CONCLUSION: The results of this study confirm previous observations and show that higher age and multiple medication negatively affect the gait, and that the higher risk of falls is associated with psychotropic and diabetes medication use. These results provide important information for future fall preventive programs for the elderly that would be especially beneficial for elderly people taking psychotropic and diabetes medication.

See more in PubMed

Tinetti ME, Kumar C. The patient who falls: “It’s always a trade-off.”. JAMA. 2010;303(3):258–266. doi:10.1001/jama.2009.2024 PubMed DOI PMC

Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988;319(26):1701–1707. doi:10.1056/NEJM198812293192604 PubMed DOI

Richardson K, Bennett K, Kenny RAN. Polypharmacy including falls risk-increasing medications and subsequent falls in community-dwelling middle-aged and older adults. Age Ageing. 2015;44(1):90–96. doi:10.1093/ageing/afu141 PubMed DOI

Ziere G, Dieleman JP, van der Cammen TJM, Hofman A, Pols HAP, Stricker BHC. Selective serotonin reuptake inhibiting antidepressants are associated with an increased risk of nonvertebral fractures. J Clin Psychopharmacol. 2008;28(4):411–417. doi:10.1097/JCP.0b013e31817e0ecb PubMed DOI

Huang AR, Mallet L, Rochefort CM, Eguale T, Buckeridge DL, Tamblyn R. Medication-related falls in the elderly. Drugs Aging. 2012;29(5):359–376. doi:10.2165/11599460-000000000-00000 PubMed DOI

Ensrud KE, Blackwell TL, Mangione CM, et al. Central nervous system–active medications and risk for falls in older women. J Am Geriatr Soc. 2002;50(10):1629–1637. doi:10.1046/j.1532-5415.2002.50453.x PubMed DOI

Woolcott JC, Richardson KJ, Wiens MO, et al. Meta-analysis of the impact of 9 medication classes on falls in elderly persons. Arch Intern Med. 2009;23:1952–1960. doi:10.1001/archinternmed.2009.357 PubMed DOI

Berdot S, Bertrand M, Dartigues J-F, et al. Inappropriate medication use and risk of falls – a prospective study in a large community-dwelling elderly cohort. BMC Geriatr. 2009;9(1). doi:10.1186/1471-2318-9-30 PubMed DOI PMC

Quach L, Yang FM, Berry SD, et al. Depression, antidepressants, and falls among community-dwelling elderly people: the Mobilize Boston study. J Gerontol a Biol Sci Med Sci. 2013;68(12A):1575–1581. doi:10.1093/gerona/glt084 PubMed DOI PMC

van Strien AM, Koek HL, van Marum RJ, Emmelot-Vonk MH. Psychotropic medications, including short acting benzodiazepines, strongly increase the frequency of falls in elderly. Maturitas. 2013;74(4):357–362. doi:10.1016/j.maturitas.2013.01.004 PubMed DOI

Brandler TC, Wang C, Oh-Park M, Holtzer R, Verghese J. Depressive symptoms and gait dysfunction in the elderly. Am J Geriatr Psychiatry. 2012;20(5):425–432. doi:10.1097/JGP.0b013e31821181c6 PubMed DOI PMC

Busch TDA, Duarte YA, Pires Nunes D, et al. Factors associated with lower gait speed among the elderly living in a developing country: a cross-sectional population-based study. BMC Geriatr. 2015;15(1). doi:10.1186/s12877-015-0031-2 PubMed DOI PMC

Bano A, Chaker L, Darweesh SKL, et al. Gait patterns associated with thyroid function: the Rotterdam Study. Sci Rep. 2016;6. doi:10.1038/srep38912 PubMed DOI PMC

Allet L. Gait and balance characteristics in patients with diabetes type 2: evaluation and treatment efficacy; 2009. doi:10.26481/dis.20091216la DOI

Kyrdalen IL, Thingstad P, Sandvik L, Ormstad H. Associations between gait speed and well-known fall risk factors among community-dwelling older adults. Physiother Res Int. 2019;24(1):e1743. doi:10.1002/pri.1743 PubMed DOI

Giladi N, Herman T, Reider-Groswasser II, Gurevich T, Hausdorff JM. Clinical characteristics of elderly patients with a cautious gait of unknown origin. J Neurol. 2005;252(3):300–306. doi:10.1007/s00415-005-0641-2 PubMed DOI

Weir E, Culmer L. Fall prevention in the elderly population. CMAJ. 2004;171(7):724. doi:10.1503/cmaj.1041381 PubMed DOI PMC

Thaler-Kall K, Peters A, Thorand B, et al. Description of spatio-temporal gait parameters in elderly people and their association with history of falls: results of the population-based cross-sectional KORA-Age study. BMC Geriatr. 2015;15(1). doi:10.1186/s12877-015-0032-1 PubMed DOI PMC

Society AG, Society G, Of AA, On Falls Prevention OSP. Guideline for the prevention of falls in older persons. J Am Geriatr Soc. 2001;49(5):664–672. doi:10.1046/j.1532-5415.2001.49115.x. PubMed DOI

Rosendahl E, Lundin-Olsson L, Kallin K, Jensen J, Gustafson Y, Nyberg L. Prediction of falls among older people in residential care facilities by the Downton index. Aging Clin Exp Res. 2003;15:142–147. doi:10.1007/BF03324492 PubMed DOI

Štefan L, Kasović M, Zvonar M. Gait speed as a screening tool for foot pain and the risk of falls in community-dwelling older women: a cross-sectional study. Clin Interv Aging. 2020;15:1569–1574. doi:10.2147/CIA.S260931 PubMed DOI PMC

Kasović M, Štefan L, Zvonař M. Domain-specific and total sedentary behavior associated with gait velocity in older adults: the mediating role of physical fitness. Int J Environ Res Public Health. 2020;17(2):593. doi:10.3390/ijerph17020593 PubMed DOI PMC

Alvidrez J, Areán PA. Physician willingness to refer older depressed patients for psychotherapy. Int J Psychiatry Med. 2002;32:21–35. doi:10.2190/J26T-YQMJ-BF83-M05D PubMed DOI

Bloch F, Thibaud M, Dugué B, Brèque C, Rigaud AS, Kemoun G. Psychotropic drugs and falls in the elderly people: updated literature review and meta-analysis. J Aging Health. 2011;23(2):329–346. doi:10.1177/0898264310381277 PubMed DOI

Leipzig RM, Cumming RG, Tinetti ME. Drugs and falls in older people: a systematic review and meta-analysis: i. psychotropic drugs. J Am Geriatr Soc. 1999;47(1):30–39. doi:10.1111/j.1532-5415.1999.tb01898.x PubMed DOI

Seppala LJ, van de Glind EMM, Daams JG, et al. Fall-risk-increasing drugs: a systematic review and meta-analysis: III. others. J Am Med Dir Assoc. 2018;19(4):372.e1–372.e8. doi:10.1016/j.jamda.2017.12.099 PubMed DOI

Landi F, Onder G, Cesari M, Barillaro C, Russo A, Bernabei R Psychotropic medications and risk for falls among community-dwelling frail older people: an observational study. J Gerontol A Biol Sci Med Sci . 2005;60(5):622–626. PubMed

Howland HR. Prescribing psychotropic medications for elderly patients. J Psychosoc Nurs Ment Health Serv. 2022;47(11):17–20. doi:10.3928/02793695-20090930-06 PubMed DOI

Berlie HD, Garwood CL. Diabetes medications related to an increased risk of falls and fall-related morbidity in the elderly. Ann Pharmacother. 2010;44:712–719. doi:10.1345/aph.1 PubMed DOI

Tiedemann A, Sherrington C, Close JCT, Lord SR. Exercise and sports science Australia position statement on exercise and falls prevention in older people. J Sci Med Sport. 2011;14(6):489–495. doi:10.1016/j.jsams.2011.04.001 PubMed DOI

Gillespie LD, Robertson MC, Gillespie WJ, et al. Interventions for preventing falls in older people living in the community. In: editor, Gillespie LD. Cochrane Database of Systematic Reviews. John Wiley & Sons, Ltd; 2009. doi:10.1002/14651858.CD007146.pub2 PubMed DOI

Verghese J, LeValley A, Hall CB, Katz MJ, Ambrose AF, Lipton RB. Epidemiology of gait disorders in community-residing older adults. J Am Geriatr Soc. 2006;54(2):255–261. doi:10.1111/j.1532-5415.2005.00580.x PubMed DOI PMC

Schoon Y, Bongers K, van Kempen J, Melis R, Olde Rikkert M. Gait speed as a test for monitoring frailty in community-dwelling older people has the highest diagnostic value compared to step length and chair rise time. Eur J Phys Rehabil Med. 2014;50(6):693–701. PubMed

Cho SH, Park JM, Kwon OY. Gender differences in three dimensional gait analysis data from 98 healthy Korean adults. Clin Biomech. 2004;19(2):145–152. doi:10.1016/j.clinbiomech.2003.10.003 PubMed DOI

Laufer Y. Age- and gender-related changes in the temporal-spatial characteristics of forwards and backwards gaits. Physiother Res Int. 2003;8(3):131–142. doi:10.1002/pri.281 PubMed DOI

Di Nardo F, Mengarelli A, Maranesi E, Burattini L, Fioretti S. Gender differences in the myoelectric activity of lower limb muscles in young healthy subjects during walking. Biomed Signal Process Control. 2015;19:14–22. doi:10.1016/j.bspc.2015.03.006 DOI

Stolze H, Kuhtz-Buschbeck JP, Mondwurf C, et al. Gait analysis during treadmill and overground locomotion in children and adults. Electroencephalogr Clin Neurophysiol. 1997;105(6):490–497. doi:10.1016/S0924-980X(97)00055-6 PubMed DOI

Schwenk M, Schmidt M, Pfisterer M, Oster P, Hauer K. Rollator use adversely impacts on assessment of gait and mobility during geriatric rehabilitation. J Rehabil Med. 2011;43(5):424–429. doi:10.2340/16501977-0791 PubMed DOI

Downton J. Falls in the Elderly. London: Edward Arnold; 1993:128–130.

Lamb SE, Jørstad-Stein EC, Hauer K, Becker C. Development of a common outcome data set for fall injury prevention trials: the prevention of falls network Europe consensus. J Am Geriatr Soc. 2005;53:1618–1622. doi:10.1111/j.1532-5415.2005.53455.x PubMed DOI

Nyberg L, Gustafson Y. Using the Downton index to predict those prone to falls in stroke rehabilitation. Stroke. 1996;27(10):1821–1824. doi:10.1161/01.STR.27.10.1821 PubMed DOI

Mojtaba M, Alinaghizadeh H, Rydwik E. Downton Fall Risk Index during hospitalization is associated with fall-related injuries after discharge: a longitudinal observational study. J Physiother. 2018;64(3):172–177. doi:10.1016/j.jphys.2018.05.005 PubMed DOI

Colberg SR, Sigal RJ, Yardley JE, et al. Physical activity/exercise and diabetes: a position statement of the American Diabetes Association. Diabetes Care. 2016;39(11):2065–2079. doi:10.2337/dc16-1728 PubMed DOI PMC

Lahti J, Lallukka T, Lahelma E, Rahkonen O. Leisure-time physical activity and psychotropic medication: a prospective cohort study. Prev Med. 2013;57:173–177. doi:10.1016/j.ypmed.2013.05.019 PubMed DOI

Lampinen P, Heikkinen RL, Ruoppila I. Changes in intensity of physical exercise as predictors of depressive symptoms among older adults: an eight-year follow-up. Prev Med. 2000;30(5):371–380. doi:10.1006/pmed.2000.0641 PubMed DOI

Kwon MS, Kwon YR, Park YS, Kim JW. Comparison of gait patterns in elderly fallers and non-fallers. Technol Health Care. 2018;26(S1):427–436. doi:10.3233/THC-174736 PubMed DOI PMC

Herssens N, van Criekinge T, Saeys W, et al. An investigation of the spatio-temporal parameters of gait and margins of stability throughout adulthood. J R Soc Interface. 2020;17(166):20200194. doi:10.1098/rsif.2020.0194 PubMed DOI PMC

Panero E, Digo E, Dimanico U, et al. Effect of deep brain stimulation frequency on gait symmetry, smoothness and variability using IMU. 2021 IEEE International Symposium on Medical Measurements and Applications (Memea); 2021:1–6. doi:10.1109/MeMeA52024.2021.9478602. DOI

Find record

Citation metrics

Loading data ...

Archiving options

Loading data ...