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Gait parameters and characteristics associated with increased risk of falls in people with dementia: a systematic review

Published online by Cambridge University Press:  06 December 2018

Shirin Modarresi ,
Alison Divine ,
Jessica A. Grahn ,
Tom J. Overend  and
Susan W. Hunter
Shirin Modarresi*
Affiliation:
Health & Rehabilitation Sciences, University of Western Ontario, London, ON, Canada
Alison Divine
Affiliation:
Health & Rehabilitation Sciences, University of Western Ontario, London, ON, Canada
Jessica A. Grahn
Affiliation:
Brain and Mind Institute, Department of Psychology, University of Western Ontario, London, ON, Canada
Tom J. Overend
Affiliation:
Health & Rehabilitation Sciences, University of Western Ontario, London, ON, Canada School of Physical Therapy, Elborn College, University of Western Ontario, London, ON, Canada
Susan W. Hunter
Affiliation:
Health & Rehabilitation Sciences, University of Western Ontario, London, ON, Canada School of Physical Therapy, Elborn College, University of Western Ontario, London, ON, Canada
*
Correspondence should be addressed to: Shirin Modarresi, Health and Rehabilitation Sciences, University of Western Ontario, London, ON, Canada. Phone: +1(226) 884-9910. Email: [email protected].
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Abstract

Background:

People with dementia fall twice as often and have more serious fall-related injuries than healthy older adults. While gait impairment as a generic term is understood as a fall risk factor in this population, a clear elaboration of the specific components of gait that are associated with falls risk is needed for knowledge translation to clinical practice and the development of fall prevention strategies for people with dementia.

Objective:

To review gait parameters and characteristics associated with falls in people with dementia.

Methods:

Electronic databases CINAHL, EMBASE, MedLine, PsycINFO, and PubMed were searched (from inception to April 2017) to identify prospective cohort studies evaluating the association between gait and falls in people with dementia.

Results:

Increased double support time variability, use of mobility aids, walking outdoors, higher scores on the Unified Parkinson’s Disease Rating Scale, and lower average walking bouts were associated with elevated risk of any fall. Increased double support time and step length variability were associated with recurrent falls. The reviewed articles do not support using the Performance Oriented Mobility Assessment and the Timed Up-and-Go tests to predict any fall in this population. There is limited research on the use of dual-task gait assessments for predicting falls in people with dementia.

Conclusion:

This systematic review shows the specific spatiotemporal gait parameters and features that are associated with falls in people with dementia. Future research is recommended to focus on developing specialized treatment methods for these specific gait impairments in this patient population.

Keywords

systematic reviewdementiagaitmobilityaccidental fallsrisk assessment
Type
Review Article
Information
International Psychogeriatrics , Volume 31 , Issue 9: Issue Theme: Self-Esteem, Resilience, and Emotional Intelligence , September 2019 , pp. 1287 - 1303
Copyright
© International Psychogeriatric Association 2018 

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