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Falls, cognitive impairment, and gait performance: results from the GOOD Initiative

Citation

Allali, G and Launay, CP and Blumen, HM and Callisaya, ML and De Cock, A-M and Kressig, RW and Srikanth, V and Steinmetz, J-P and Verghese, J and Beauchet, O and the Biomathics Consortium, Falls, cognitive impairment, and gait performance: results from the GOOD Initiative, Journal of The American Medical Directors Association, 18, (4) pp. 335-340. ISSN 1525-8610 (2017) [Refereed Article]

Copyright Statement

Copyright 2016 AMDA e The Society for Post-Acute and Long-Term Care Medicine.

DOI: doi:10.1016/j.jamda.2016.10.008

Abstract

Objectives: Falls are highly prevalent in individuals with cognitive decline. The complex relationship between falls and cognitive decline (including both subtype and severity of dementia) and the influence of gait disorders have not been studied. This study aimed to examine the association between the subtype (Alzheimer disease [AD] versus non-AD) and the severity (from preclinical to moderate dementia) of cognitive impairment and falls, and to establish an association between falls and gait parameters during the course of dementia.

Design: Multicenter cross-sectional study.

Setting: "Gait, cOgnitiOn & Decline" (GOOD) initiative.

Participants: A total of 2496 older adults (76.6 7.6 years; 55.0% women) were included in this study (1161 cognitively healthy individuals [CHI], 529 patients with mild cognitive impairment [MCI], 456 patients with mild dementia, and 350 with moderate dementia) from 7 countries.

Measurements: Falls history was collected retrospectively at baseline in each study. Gait speed and stride time variability were recorded at usual walking pace with the GAITRite system.

Results: The prevalence of individuals who fall was 50% in AD and 64% in non-AD; whereas it was 25% in CHIs. Only mild and moderate non-AD dementia were associated with an increased risk for falls in comparison with CHI. Higher stride time variability was associated with falls in older adults without dementia (CHI and each MCI subgroup) and mild non-AD dementia, whereas lower gait speed was associated with falls in all participant groups, except in mild AD dementia. When gait speed was adjusted for, higher stride time variability was associated with falls only in CHIs (odds ratio 1.14; P = .012), but not in MCI or in patients with dementia.

Conclusions: These findings suggest that non-AD, but not AD dementia, is associated with increased falls in comparison with CHIs. The association between gait parameters and falls also differs across cognitive status, suggesting different mechanisms leading to falls in older individuals with dementia in comparison with CHIs who fall.

Item Details

Item Type:Refereed Article
Keywords:falls, gait disorders, dementia, mild cognitive impairment
Research Division:Medical and Health Sciences
Research Group:Clinical Sciences
Research Field:Geriatrics and Gerontology
Objective Division:Health
Objective Group:Specific Population Health (excl. Indigenous Health)
Objective Field:Health Related to Ageing
Author:Callisaya, ML (Dr Michele Callisaya)
Author:Srikanth, V (Dr Velandai Srikanth)
ID Code:113025
Year Published:2017 (online first 2016)
Web of Science® Times Cited:1
Deposited By:Menzies Institute for Medical Research
Deposited On:2016-12-07
Last Modified:2017-11-06
Downloads:0

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