TY - JOUR
PY - 2010//
TI - Increased intra-individual variability in stride length and reaction time in recurrent older fallers
JO - Aging clinical and experimental research
A1 - Reelick, Miriam F.
A1 - Kessels, Roy P. C.
A1 - Faes, Miriam C.
A1 - Weerdesteyn, Vivian
A1 - Esselink, Rianne A. J.
A1 - Olde Rikkert, Marcel G. M.
SP - 393
EP - 399
VL - 23
IS - 5-6
N2 - Aims: To study and compare both the mean performance measures as well as the intra-individual variability measures of stride length and reaction time in vulnerable recurrent and non-recurrent older fallers. Methods: Stride length during walking, and walking while dual-tasking (GAITRite®), and choice reaction time (CANTAB®) were assessed in geriatric outpatients and their informal caregivers (N=60, ≥60 yrs). Using logistic regression and Receiver Operating Characteristic (ROC) analysis, models were obtained with mean performance measures and with intra-individual variability measures (coefficients of variation; CV=[sd/mean]x100)), as risk factors for recurrent falls. Results: Reaction-time CV was higher in recurrent fallers compared to non-recurrent fallers: 21.3% [9.3-47.7] versus 15.8% [8.3-34.9] (p=0.04). Also, stride-length CV was higher in recurrent fallers during performance of the verbal fluency dual-task: 4.5% [1.2-31.4] versus 3.5% [0.9-9.7] (p=0.017). The model with CVs provided an explained variance of 23.7%, and an area under the curve (AUC) of 0.73, which was higher than the model including the mean performance measures (8.6% and 0.65 respectively). Conclusions: Older recurrent fallers are characterized by increased within-task variability in reaction time and stride length while dual-tasking. Moreover, variability in performance is a more sensitive measure in discrimination of recurrent falls than the mean performance itself, suggesting deterioration in neurocognitive regulation mechanisms as part of the causal pathway for recurrent falls. Language: en
LA - en
SN - 1594-0667
UR - http://dx.doi.org/10.3275/7327
ID - ref1
ER -