File
H.-L. Chiu1, C.-Y. Tsai2, Y.-L. Liu3, C.-W. Kang4, S.-C. Lee1
1Taipei Medical University, School of Gerontology Health Management, Taipei, Taiwan, 2Soochow University, Department of Psychology, Taipei, Taiwan, 3National Chengchi University, MA Program of Counseling and Guidance, Taipei, Taiwan, 4Taipei Medical University Hospital, Department of Physical and Rehabilitation Medicine, Taipei, Taiwan
Background: Frailty is a common geriatric syndrome and is characterized by decreased physiological reserve and increased vulnerability towards adverse health outcomes, including falls, hospitalization, institutionalization, and death. Turning is a challenging task and is reported to be one of the daily activities that leads to falling in older populations. The incidence rate of falls among frail older people in residential care settings was twice the rates in old people’s homes and senior citizens’ apartments. The most common activities at the time of falling among frail ambulatory elderly are walking and postural change such as turning. Research related to turning has been widely conducted in older populations, but limited in frail older adults.
Purpose: We investigated differences in 180° walking turns and 360° turning on the spot among frail, pre-frail, and non-frail older adults, and determined cutoff points of the turning measures that best discriminated older adults with frailty from those without.
Methods: A cross-sectional study was conducted with 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.
Results: 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 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 180° (sensitivity 83.3%, specificity 71.1%, AUC 0.796) and 360° (sensitivity 91.7%, specificity 74.2%, AUC 0.857) turn tasks.
Conclusion(s): Our study concludes that the longer duration and slower angular velocity in the 1800 and 3600 turning tasks are promising to identify frail older people from pre-frail and non-frail older people living in the community. Cutoff times of 2.45 and 3.46 s for the 180° and 360° turns respectively were the best values in discriminating people with frailty from those without.
Implications: 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.
Funding, acknowledgements: This work was supported by the Taiwan Ministry of Science and Technology (MOST108-2314-B-038-012) and by Taipei Medical University (TMU107-AE1-B07).
Keywords: Frailty, Inertial Sensor, Turning
Topic: Older people
Did this work require ethics approval? Yes
Institution: Taipei Medical University
Committee: TMU-Joint Institutional Review Board
Ethics number: JIRB: N201809043
All authors, affiliations and abstracts have been published as submitted.
