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老年人时空步态参数描述及其与跌倒史的关联:基于人群的横断面KORA-Age研究结果

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.

作者信息

Thaler-Kall Kathrin, Peters Annette, Thorand Barbara, Grill Eva, Autenrieth Christine S, Horsch Alexander, Meisinger Christa

机构信息

Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstraße 1, Neuherberg, 85764, Germany.

Institute for Medical Statistics and Epidemiology (IMSE), Technical University Munich (TUM), Ismaninger Str. 22, Munich, 81675, Germany.

出版信息

BMC Geriatr. 2015 Mar 25;15:32. doi: 10.1186/s12877-015-0032-1.

Abstract

BACKGROUND

In this epidemiological study we described the characteristics of spatio-temporal gait parameters among a representative, population-based sample of 890 community-dwelling people aged 65 to 90 years. In addition, we investigated the associations between certain gait parameters and a history of falls in study participants.

METHODS

In descriptive analyses spatio-temporal gait parameters were assessed according to history of falls, frailty, multimorbidity, gender, multiple medication use, disability status, and age group. Logistic regression models were calculated to examine the association between gait velocity and stride length with a history of falls (at least one fall in the last 12 month). Data on gait were collected on an electronic walkway on which participants walked at their usual pace.

RESULTS

We found significant differences within gait parameters when stratifying by frailty, multimorbidity, disability and multiple medication use as well as age (cut point 75 years) and sex, with p < 0.05 for all gait parameters (velocity, cadence, time, stride duration, stride length, step width). After stratification by history of falls, only stride length showed a significant difference (p < 0.05) between the groups of fallers and non-fallers. Logistic regression models showed that a decreased stride length was independently associated with falls in men aged older than 74 years (OR 1.34 (CI: 1.05-1.70 per 10 cm decrease)), while this was neither the case for women of similar age nor for men or women aged 65 to 74 years. A decreased walking speed was not associated with falls.

CONCLUSION

Age, frailty, multimorbidity, disability, history of falls, sex, and multiple medication use show an association with different gait parameters measured during gait assessment on an electronic walkway in elderly people. Furthermore, stride length is a good indicator to differentiate fallers from non-fallers in older men from the general population.

摘要

背景

在这项流行病学研究中,我们描述了890名年龄在65至90岁的社区居民代表性样本中的时空步态参数特征。此外,我们调查了研究参与者中某些步态参数与跌倒史之间的关联。

方法

在描述性分析中,根据跌倒史、虚弱、多种疾病、性别、多种药物使用、残疾状况和年龄组评估时空步态参数。计算逻辑回归模型以检验步态速度和步幅与跌倒史(过去12个月内至少跌倒一次)之间的关联。步态数据通过电子步道收集,参与者以平常的步伐行走。

结果

当按虚弱、多种疾病、残疾和多种药物使用以及年龄(分界点75岁)和性别分层时,我们发现步态参数存在显著差异,所有步态参数(速度、步频、时间、步幅持续时间、步幅长度、步宽)的p值均<0.05。按跌倒史分层后,仅步幅长度在跌倒者和未跌倒者组之间显示出显著差异(p<0.05)。逻辑回归模型显示,步幅长度减少与74岁以上男性的跌倒独立相关(每减少10厘米,比值比为1.34(置信区间:1.05-1.70)),而同龄女性以及65至74岁的男性或女性则不然。步行速度降低与跌倒无关。

结论

年龄、虚弱、多种疾病、残疾、跌倒史、性别和多种药物使用与老年人在电子步道上进行步态评估时测量的不同步态参数相关。此外,步幅长度是区分一般人群中老年男性跌倒者和未跌倒者的良好指标。

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