Chiu Huei-Ling, Tsai Chen-Ying, Liu Yu-Lin, Kang Chun-Wei, Lee Shu-Chun
School of Gerontology Health Management, College of Nursing, Taipei Medical University, 250 Wuxing Street, Xinyi District, Taipei, 11031, Taiwan.
Department of Psychology, Soochow University, No.70, Linhsi Road, Shihlin District, Taipei City, 111002, Taiwan.
Gait Posture. 2021 May;86:327-333. doi: 10.1016/j.gaitpost.2021.04.004. Epub 2021 Apr 6.
Frailty is a common geriatric syndrome and is characterized by decreased physiological reserve and increased vulnerability towards adverse health outcomes including falls. Turning is a challenging task and is reported to be one of the daily activities that leads to falling in older populations.
Does 180° walking turns and 360° turning on the spot differ among frail, pre-frail, and non-frail older adults? Can 180° walking turns and 360° turning on the spot cutoffs discriminate older adults with frailty from those without?
A cross-sectional study was conducted on community-dwelling older adults aged over 65 years. Frailty was assessed using Fried's phenotype method, and turning tasks were measured by inertial sensors. The turn duration (s) and angular velocity (°/s) were recorded for analysis.
In total, 109 participants were enrolled including 50 pre-frail and 12 frail individuals. Frail older adults took significantly longer and had slower angular velocities to complete the 180° and 360° turning than did either pre-frail (p = 0.002 and p < 0.001, respectively) or non-frail (p = 0.03 and p < 0.001, respectively) older adults. Cutoff times of 2.45 and 3.46 s were found to best discriminate frail people from those without frailty in both the 180° (sensitivity 83.3 %, specificity 71.1 %, area under the receiver operating characteristic curve (AUC) 0.796) and 360° (sensitivity 91.7 %, specificity 74.2 %, AUC 0.857) turn tasks.
Older individuals with frailty syndrome had difficulty turning as evidenced by a longer turning duration and a slower angular velocity. The turn duration could be a potential biomarker of frailty in older populations. Assessing the turning performance can facilitate early detection of the onset of frailty and inform early prevention and rehabilitation interventions in clinical practice.
衰弱是一种常见的老年综合征，其特征是生理储备下降，对包括跌倒在内的不良健康结局的易感性增加。翻身是一项具有挑战性的任务，据报道是导致老年人群跌倒的日常活动之一。
在衰弱、衰弱前期和非衰弱的老年人中，180°行走转身和360°原地转身是否存在差异？180°行走转身和360°原地转身的临界值能否区分衰弱老年人和非衰弱老年人？
对65岁以上的社区居住老年人进行了一项横断面研究。使用弗里德表型法评估衰弱情况，并通过惯性传感器测量转身任务。记录转身持续时间（秒）和角速度（度/秒）进行分析。
总共招募了109名参与者，包括50名衰弱前期和12名衰弱个体。与衰弱前期（分别为p = 0.002和p < 0.001）或非衰弱（分别为p = 0.03和p < 0.001）老年人相比，衰弱老年人完成180°和360°转身的时间明显更长，角速度更慢。发现在180°（敏感性83.3%，特异性71.1%，受试者工作特征曲线下面积（AUC）0.796）和360°（敏感性91.7%，特异性74.2%，AUC 0.857）转身任务中，2.45秒和3.46秒的临界时间最能区分衰弱人群和非衰弱人群。
衰弱综合征的老年人转身困难，表现为转身持续时间更长，角速度更慢。转身持续时间可能是老年人群衰弱的潜在生物标志物。评估转身表现有助于早期发现衰弱的发生，并为临床实践中的早期预防和康复干预提供依据。
