@article{ref1,
title="Intra-individual changes in ambulation associated with falls in a population of vulnerable older adults in long-term care",
journal="Archives of physical medicine and rehabilitation",
year="2016",
author="Bowen, Mary Elizabeth and Rowe, Meredeth",
volume="97",
number="11",
pages="1963-1968",
abstract="OBJECTIVES: The aim of this pilot study is to examine how intra-individual changes in ambulation characteristics may be used to predict falls. <br><br>DESIGN: Longitudinal study design. SETTING: Assisted Living Facility (ALF). PARTICIPANTS: Ambulatory older adults (N=26, mean age 79). MAIN OUTCOME MEASURES: Continuous measure of average weekly ambulation characteristics [time and distance walked, speed, path measures (e.g., path time and distance, number of paths (where at path is at least 60 seconds of uninterrupted walking separated by at least a 30 second stop)], accounting for weekly changes in these ambulation characteristics on an individual-level over time, along with falls (yes/no) and cognitive impairment (CI; measured by the Montreal Cognitive Assessment). <br><br>RESULTS: In Hierarchical Linear Models (HLM) accounting for intra-individual changes in ambulation characteristics over the eight month course of the study and level of CI, path distance (OR=1.02; p≤0.001) was associated with an increased risk for a fall. In the short term, intra-individual changes in path distance were associated with a fall within the 4-week interval the change was noted. Path distance had fair sensitivity (0.74) and specificity (0.66) to a fall (AUC=0.70). <br><br>CONCLUSION: Study findings suggest that falls may have specific predictors - specifically that older adults with CI are more likely to fall when walking continuously with little/no breaks. Interventions focused on reducing path-associated fatigue may effectively reduce fall incidence in this population.<br><br>Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0003-9993",
doi="10.1016/j.apmr.2016.05.013",
url="http://dx.doi.org/10.1016/j.apmr.2016.05.013"
}