Gait Metrics in Elderly Fallers and Non-Fallers with Varying Levels of Glaucoma: A Longitudinal Prospective Cohort Study

TL;DR

This study found that older adults with glaucoma and visual impairment showed similar gait changes over time, regardless of whether they fell or not.

Contribution

The study provides new insights into gait adaptation in visually impaired older adults, showing no significant gait differences between fallers and non-fallers.

Findings

Stride length decreased in both fallers and non-fallers over time.

Stride velocity slowed only among fallers, while stride velocity variability decreased only among non-fallers.

No significant gait differences were found between fallers and non-fallers or between those with and without injurious falls.

Abstract

To understand the impact of falls on gait in those with poor sight, we examined how gait changed after falls in older adults with varying degrees of visual impairment from glaucoma. Participants were classified as fallers or non-fallers based on prospective falls data from the first study year. Injurious fallers were those who suffered injuries from falls. The GAITRite Electronic Walkway characterized gait at baseline and three annual follow-ups. Parameters examined included stride length, variability in stride length (CV), stride velocity, stride velocity CV, base of support, base of support CV, and cadence. Longitudinal gait changes were assessed using generalized estimating equation models. Stride length significantly decreased in both fallers (β = −0.09 z-score unit/year) and non-fallers (β = −0.08 z-score unit/year), stride velocity slowed only among fallers (β = −0.08 z-score unit/year), and, in contrast, stride velocity CV decreased only among non-fallers (β = −0.07 z-score unit/year). No longitudinal differences were noted between groups. Additionally, no significant differences in gait metrics were observed between non-fallers, one-time fallers, and multiple fallers, nor between those with and without an injurious fall. Amongst older adults, and enriched for those with visual impairment, fallers and non-fallers adopted a more cautious gait over time, with similar gait changes across groups. Our results suggest that, in visual impairment, many falls may not lead to significant changes in gait.