Falls are a leading cause of injury, hospitalization, and death among older adults due to a variety of factors, but 2 are key: 1) Changes to the medio-lateral margin of stability, pace, and base of support, which typically occur as part of the aging process; and 2) Increased use of multiple medications for a variety of chronic illnesses, which can lead to unsteadiness, impaired alertness, or dizziness. Given that most falls occur during ambulation, many fall prevention guidelines recommend gait assessments. This study sought to analyze factors affecting spatio-temporal gait parameters in older adults of different ages with differing risks of fall, fall history, and medications.
Researchers used the Downton Fall Risk Index to assess the risk of falls in 210 community-dwelling adults (156 females, 54 males; mean age, 72.84± 6.26 yrs), but they added a question about medication intake (all prescribed drugs). The Zebris FDM platform was used to assess gait parameters. Gait parameters and Downton Fall Risk Index, stratified by participants’ history of falls, multiple medication use (0/1/2+), gender, age, and medication categories, were statistically analyzed using the Mann–Whitney U-test and Kruskal–Wallis test.
When comparing different medication categories, a Downton Fall Risk Index score indicating a high risk of falls was observed in the psychotropic medication category (3.56±1.67). A gait velocity suggesting a higher risk of falls (≤3.60 km/h) was observed in the psychotropic (2.85±1.09 km/h) and diabetes (2.80±0.81 km/h) medication categories, in the age groups 70–79 years (3.30±0.89 km/h) and 80+ years (2.67±0.88 km/h), and in participants using 2 or more medications (3.04±0.93 km/h).
These results confirm previous observations and show that higher age and multiple medications (polypharmacy) negatively affect gait, and that the higher risk of falls is associated with psychotropic and diabetes medication use. These results provide important information for future fall prevention programs for the elderly that would be especially beneficial for elderly people taking psychotropic and diabetes medication.
Source: Gimunová M, Sebera M, Kasović M, Svobodová L, Vespalec T. Spatio-temporal gait parameters in association with medications and risk of falls in the elderly. Clin Interv Aging. 2022;17:873-883. doi: 10.2147/CIA.S363479. Use is per CC BY.
