Fear of falling in community-dwelling older adults: What their gait acceleration pattern reveals

Anisha Suri; Zachary L Hubbard; Jessie VanSwearingen; Gelsy Torres-Oviedo; Jennifer S Brach; Mark S Redfern; Ervin Sejdic; Andrea L Rosso

doi:10.1016/j.cmpb.2023.108001

Fear of falling in community-dwelling older adults: What their gait acceleration pattern reveals

Comput Methods Programs Biomed. 2024 Feb:244:108001. doi: 10.1016/j.cmpb.2023.108001. Epub 2023 Dec 27.

Authors

Anisha Suri¹, Zachary L Hubbard², Jessie VanSwearingen³, Gelsy Torres-Oviedo⁴, Jennifer S Brach³, Mark S Redfern⁴, Ervin Sejdic⁵, Andrea L Rosso⁶

Affiliations

¹ Department of Electrical and Computer Engineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
² Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
³ Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
⁴ Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
⁵ Department of Electrical and Computer Engineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Department of Electrical and Computer Engineering, University of Toronto, Toronto, Ontario, Canada; North York General Hospital, Toronto, Ontario, Canada.
⁶ Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. Electronic address: alr143@pitt.edu.

PMID: 38199138
DOI: 10.1016/j.cmpb.2023.108001

Abstract

Background: Fear of Falling (FOF) is common among community-dwelling older adults and is associated with increased fall-risk, reduced activity, and gait modifications.

Objective: In this cross-sectional study, we examined the relationships between FOF and gait quality.

Methods: Older adults (N=232; age 77±6; 65 % females) reported FOF by a single yes/no question. Gait quality was quantified as (1) harmonic ratio (smoothness) and other time-frequency spatiotemporal variables from triaxial accelerometry (Vertical-V, Mediolateral-ML, Anterior-Posterior -AP) during six-minute walk; (2) gait speed, step-time CoV (variability), and walk-ratio (step-length/cadence) on a 4-m instrumented walkway. Mann Whitney U-tests and Random forest classifier compared gait between those with and without FOF. Selected gait variables were used to build Support Vector Machine (SVM) classifier and performance was evaluated using AUC-ROC.

Results: Individuals with FOF had slower gait speed (103.66 ± 17.09 vs. 110.07 ± 14.83 cm/s), greater step time CoV (4.17 ± 1.66 vs. 3.72 ± 1.24 %), smaller walk-ratio (0.53 ± 0.08 vs. 0.56 ± 0.07 cm/steps/minute), smaller standard deviation V (0.15 ± 0.06 vs. 0.18 ± 0.09 m/s²), and smaller harmonic-ratio V (2.14 ± 0.73 vs. 2.38 ± 0.58), all p<.01. Linear SVM yielded an AUC-ROC of 67 % on test dataset, coefficient values being gait speed (-0.19), standard deviation V (-0.23), walk-ratio (-0.36), and smoothness V (-0.38) describing associations with presence of FOF.

Conclusion: Older adults with FOF have reduced gait speed, acceleration adaptability, walk-ratio, and smoothness. Disrupted gait patterns during fear of falling could provide insights into psychosocial distress in older adults. Longitudinal studies are warranted.

Keywords: Actigraphy; Fear of falling; Gait; Machine learning; Older adults.

MeSH terms

Acceleration
Aged
Aged, 80 and over
Cross-Sectional Studies
Fear* / psychology
Female
Gait
Humans
Independent Living*
Male

Abstract

MeSH terms

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