Abstract
Purpose :
Fear of falling (FoF) has a detrimental impact on functioning in older adults and may lead to increased fall risk and a significant reduction in quality of life. The purpose of this study is to examine if FoF leads to gait changes reflective of more cautious walking.
Methods :
Participants were recruited into a 3-year, prospective cohort study conducted at the Johns Hopkins Wilmer Eye Institute. FoF was evaluated using the University of Illinois at Chicago FoF Questionnaire, with lower Rasch-analyzed FoF scores indicating less fear. The GAITRite Electronic Walkway was used to characterize participants’ baseline gait metrics and to record subsequent changes over 3 annual follow-up visits. Gait metrics included were: stride length, stride length coefficient of variation (CV), stride velocity, stride velocity CV, base of support, base of support CV and cadence. Change rates for each gait metric were derived from models utilizing generalized estimating equations and adjusting for age, race, sex, integrated visual field, comorbidity, and polypharmacy. Patients were categorized into two FoF groups with a cut-off at zero logits.
Results :
Participants were on average 70 years old; about half (48%) were female and about third (29%) were Black. Stride length decreased over time in the low and high FoF groups (β = -0.08 z-score unit/year (p <0.001), β = -0.10 z-score unit/year (p<0.01), respectively), while base of support increased only among patients with lower FoF levels (FoF≤0). Both FoF groups also exhibited decreasing stride velocity over time (β = -0.06 z-score unit/year, β = -0.13 z-score unit/year, respectively (p<0.01 for all)). Base of support CV, stride length CV, stride velocity CV, and cadence did not significantly change over the study period for both groups (p>0.05 for all). No differences in change rates were noted for higher as compared to lower FoF levels (p>0.05 for all).
Conclusions :
Adoption of more cautious walking was observed in this group of glaucoma patients, with primary changes including decreased stride length and stride velocity, as well as increased base of support in those with low FoF. However, FoF did not seem to drive longitudinal changes in gait.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.