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. 2023 May 25;23(1):328.
doi: 10.1186/s12877-023-03890-6.

Change in gait speed and fall risk among community-dwelling older adults with and without mild cognitive impairment: a retrospective cohort analysis

Claire E Adam  1   2 , Annette L Fitzpatrick  3   4   5 , Cindy S Leary  6   7 , Anjum Hajat  4 , Sindana D Ilango  4 , Christina Park  4 , Elizabeth A Phelan  8   9 , Erin O Semmens  6   7
Affiliations

Change in gait speed and fall risk among community-dwelling older adults with and without mild cognitive impairment: a retrospective cohort analysis

Claire E Adam et al. BMC Geriatr. .

Abstract

Background: Although slow gait speed is an established risk factor for falls, few studies have evaluated change in gait speed as a predictor of falls or considered variability in effects by cognitive status. Change in gait speed may be a more useful metric because of its potential to identify decline in function. In addition, older adults with mild cognitive impairment are at an elevated risk of falls. The purpose of this research was to quantify the association between 12-month change in gait speed and falls in the subsequent 6 months among older adults with and without mild cognitive impairment.

Methods: Falls were self-reported every six months, and gait speed was ascertained annually among 2,776 participants in the Ginkgo Evaluation of Memory Study (2000-2008). Adjusted Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for fall risk relative to a 12-month change in gait speed.

Results: Slowing gait speed over 12 months was associated with increased risk of one or more falls (HR:1.13; 95% CI: 1.02 to 1.25) and multiple falls (HR:1.44; 95% CI: 1.18 to 1.75). Quickening gait speed was not associated with risk of one or more falls (HR 0.97; 95% CI: 0.87 to 1.08) or multiple falls (HR 1.04; 95% CI: 0.84 to 1.28), relative to those with a less than 0.10 m/s change in gait speed. Associations did not vary by cognitive status (pinteraction = 0.95 all falls, 0.25 multiple falls).

Conclusions: Decline in gait speed over 12 months is associated with an increased likelihood of falls among community-dwelling older adults, regardless of cognitive status. Routine checks of gait speed at outpatient visits may be warranted as a means to focus fall risk reduction efforts.

Keywords: Change in gait speed; Falls; Mild cognitive impairment.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
Participants excluded from analyses, by reason for exclusion
Fig. 2
Fig. 2
Timing of gait speed and fall measurements in GEMS
Fig. 3
Fig. 3
Interactions between change in gait speed and cognition status, for all falls
Fig. 4
Fig. 4
Interactions between change in gait speed and cognition status, for multiple falls
See this image and copyright information in PMC

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