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KMID : 1120320150010010046
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Osteoporosis and Sarcopenia
2015 Volume.1 No. 1 p.46 ~ p.52
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Diagnosis of knee osteoarthritis and gait variability increases risk of falling for osteoporotic older adults: The GAINA study
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Matsumoto Hiromi
Hagino Hiroshi
Sageshima Hirofumi
Osaki Mari
Tanishima Shinji
Tanimura Chika
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Abstract
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Objectives: To examine the relationship between history of falling, and musculoskeletal disease, bone mass, muscle strength, muscle mass, kyphosis, and gait speed and variability in osteoporotic older adults.
Methods: The GAINA study, which began in 2014, is a population-based prospective study of subject cohorts from the town of Hino, Tottori Prefecture, Japan. Participants were recruited from among individuals who had an annual town-sponsored medical check-up in 2014, between May and June. A total 223 of residents were screened for our study. Inclusion criteria were osteoporotic older adults who had: (1) a ≤70% young adult mean (YAM) bone mass as assessed using quantitative ultrasound (QUS) methods, (2) a prior hip fracture or vertebral fracture, (3) fragility fractures other than hip and vertebral fractures and <80% YAM of bone mass. From the total screened, 91 residents (mean age, 76.0 ± 8.0 years; 22 men and 69 women) met the eligibility criteria. History of falling, diagnosis of musculoskeletal disease, bone mass, grip strength, muscle mass, kyphosis, and gait speed were assessed. Gait variability analysis was based on acceleration in three directions: mediolateral (ML), vertical (VT), and anteroposterior (AP) using a wireless triaxial accelerometer. Subjects were classified as belonging to a nonfall group or fall group based on their history of falling.
Results: During the previous 12 months, 26 falls were reported by 16 subjects (5 men and 11 women). Sixteen of the 91 included patients (17.6%) fell (22% men and 15% women), and 8 of the 16 subjects reported multiple falls. In a multivariable analysis, diagnosis of knee osteoarthritis and higher gait variability had a significant independent relationship with falling in these osteoporotic adults.
Conclusions: Diagnosis of knee osteoarthritis and gait variability are associated with previous falls in osteoporotic older adults. Accelerometry-based gait analysis may be a useful tool with which to assess the risk of falling in this population.
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KEYWORD
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Osteoporosis, Falling, Knee osteoarthritis, Gait variability
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