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Johansson, Jonas
Publications (10 of 13) Show all publications
Scott, D., Johansson, J., McMillan, L. B., Ebeling, P. R., Nordström, P. & Nordström, A. (2019). Associations of Sarcopenia and Its Components with Bone Structure and Incident Falls in Swedish Older Adults. Calcified Tissue International, 105(1), 26-36
Open this publication in new window or tab >>Associations of Sarcopenia and Its Components with Bone Structure and Incident Falls in Swedish Older Adults
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2019 (English)In: Calcified Tissue International, ISSN 0171-967X, E-ISSN 1432-0827, Vol. 105, no 1, p. 26-36Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to compare bone structure parameters and likelihood of falls across European Working Group on Sarcopenia in Older People (EWGSOP2) sarcopenia categories. 3334 Swedish 70-year olds had appendicular lean mass (normalized to height; ALMHt), lumbar spine and total hip areal BMD (aBMD) estimated by dual-energy X-ray absorptiometry. Volumetric BMD (vBMD) and structure at the distal and proximal tibia and radius were estimated by peripheral quantitative computed tomography. Hand grip strength and timed up-and-go were assessed, and sarcopenia was defined according to EWGSOP2 criteria. Incident falls were self-reported 6 and 12 months after baseline. Only 0.8% and 1.0% of participants had probable and confirmed sarcopenia, respectively. Almost one-third of participants with confirmed sarcopenia reported incident falls, compared with 20% for probable sarcopenia and 14% without sarcopenia (P = 0.025). Participants with confirmed sarcopenia had poorer bone parameters (all P < 0.05) except endosteal circumference at the proximal radius and tibia, while those with probable sarcopenia had lower cortical area at the proximal radius (B = - 5.9; 95% CI - 11.7, - 0.1 mm2) and periosteal and endosteal circumferences at the proximal tibia (- 3.3; - 6.4, - 0.3 and - 3.8; - 7.5, - 0.1 mm2, respectively), compared with those without sarcopenia. Compared with probable sarcopenia, confirmed sarcopenic participants had significantly lower lumbar spine and total hip aBMD, distal radius and tibia total vBMD, and proximal radius and tibia cortical vBMD, area and thickness (all P < 0.05). Swedish 70-year olds with confirmed sarcopenia demonstrate poorer BMD and bone architecture than those with probable and no sarcopenia, and have increased likelihood of incident falls.

Place, publisher, year, edition, pages
Springer, 2019
Keywords
Bone, Falls, Muscle, Older adults, Osteoporosis, Sarcopenia
National Category
Geriatrics
Identifiers
urn:nbn:se:umu:diva-157881 (URN)10.1007/s00223-019-00540-1 (DOI)000469477400003 ()30899995 (PubMedID)
Funder
Swedish Research Council, 2011-2976
Available from: 2019-04-05 Created: 2019-04-05 Last updated: 2019-06-17Bibliographically approved
Vikberg, S., Sörlén, N., Brandén, L., Johansson, J., Nordström, A., Hult, A. & Nordström, P. (2019). Effects of Resistance Training on Functional Strength and Muscle Mass in 70-Year-Old Individuals With Pre-sarcopenia: A Randomized Controlled Trial. Journal of the American Medical Directors Association, 20(1), 28-34
Open this publication in new window or tab >>Effects of Resistance Training on Functional Strength and Muscle Mass in 70-Year-Old Individuals With Pre-sarcopenia: A Randomized Controlled Trial
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2019 (English)In: Journal of the American Medical Directors Association, ISSN 1525-8610, E-ISSN 1538-9375, Vol. 20, no 1, p. 28-34Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Sarcopenia has been defined as age-related loss of muscle mass and function. The aim of this randomized controlled trial was to examine the effects of a 10-week instructor-led resistance training program on functional strength and body composition in men and women aged 70 years with pre-sarcopenia.

DESIGN, SETTING, AND PARTICIPANTS: Participants were randomized to either 10 weeks of a physical training regimen including optional nutritional supplementation (n = 36) or to a control group (n = 34) (ClinicalTrials.gov, no. NCT03297632). The main outcome was changes in the Short Physical Performance Battery (SPPB) score. Secondary outcomes included the Timed Up and Go test, chair sit-stand time, lean body mass, and fat mass.

RESULTS: The intervention had no significant effect on SPPB in the total cohort (P = .18), when comparing changes in the intervention group with the control group. However, those given the intervention in the male subcohort increased 0.5 ± 0.4 (mean ± standard error for the difference) points in SPPB during follow-up (P = .02) compared to male controls. With respect to secondary outcomes, the intervention group decreased 0.9 ± 0.6 seconds in chair sit-stand time compared to controls (P = .01). Furthermore, the intervention resulted in significantly greater improvements for the training group than control group in all measures of body composition (P ≤ .01 for all). For example, lean body mass increased by a mean of 1147 ± 282 g (P < .001), and total fat mass decreased by a mean of 553 ± 225 g (P = .003), favoring the intervention group.

CONCLUSION/IMPLICATIONS: The main finding of this intervention study is that an easy-to-use, functional resistance training program was effective in maintaining functional strength and increasing muscle mass in older adults with pre-sarcopenia.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Resistance training, functional strength, muscle mass
National Category
Physiotherapy Gerontology, specialising in Medical and Health Sciences Geriatrics
Identifiers
urn:nbn:se:umu:diva-153603 (URN)10.1016/j.jamda.2018.09.011 (DOI)000454138000005 ()30414822 (PubMedID)2-s2.0-85055969854 (Scopus ID)
Note

Available online 7 November 2018.

Available from: 2018-11-23 Created: 2018-11-23 Last updated: 2019-01-15Bibliographically approved
Scott, D., Johansson, J., McMillan, L. B., Ebeling, P. R., Nordström, A. & Nordström, P. (2019). Mid-calf skeletal muscle density and its associations with physical activity, bone health and incident 12-month falls in older adults: The Healthy Ageing Initiative. Bone, 120, 446-451
Open this publication in new window or tab >>Mid-calf skeletal muscle density and its associations with physical activity, bone health and incident 12-month falls in older adults: The Healthy Ageing Initiative
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2019 (English)In: Bone, ISSN 8756-3282, E-ISSN 1873-2763, Vol. 120, p. 446-451Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Lower skeletal muscle density, indicating greater infiltration of adipose tissue into muscles, is associated with higher fracture risk in older adults. We aimed to determine whether mid-calf muscle density is associated with falls risk and bone health in community-dwelling older adults.

METHODS: 2214 community-dwelling men and women who participated in the Healthy Ageing Initiative (Sweden) study at age 70 were included in this analysis. Mid-calf muscle density (mg/cm3) at the proximal tibia, and volumetric bone mineral density (vBMD) and architecture at the distal and proximal tibia and radius, were assessed by peripheral quantitative computed tomography. Whole-body lean and fat mass, lumbar spine and total hip areal bone mineral density (aBMD) were assessed by dual-energy X-ray absorptiometry. Participants completed seven-day accelerometer measurements of physical activity intensity, and self-reported falls data were collected 6 and 12 months later.

RESULTS: 302 (13.5%) participants reported a fall at the 6- or 12-month interview, and 29 (1.3%) reported a fall at both interviews. After adjustment for confounders, each standard deviation decrease in mid-calf muscle density was associated with a trend towards greater likelihood of experiencing a fall (OR 1.13; 95% CI 1.00, 1.29 per SD lower) and significantly greater likelihood of multiple falls (1.61; 1.16, 2.23). Higher muscle density was not associated with total hip aBMD, and was associated with lower lumbar spine aBMD (B = -0.003; 95% CI -0.005, -0.001 per mg/cm3) and higher proximal cortical vBMD (0.74; 0.20, 1.28) at the radius. At the tibia, muscle density was positively associated with distal total and trabecular vBMD, and proximal total and cortical vBMD, cortical thickness, cortical area and stress-strain index (all P < 0.05). Only moderate/vigorous (%) intensity physical activity, not sedentary time or light activity, was associated with higher mid-calf muscle density (0.086; 0.034, 0.138).

CONCLUSIONS: Lower mid-calf muscle density is independently associated with higher likelihood for multiple incident falls and appears to have localised negative effects on bone structure in older adults.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Bone density, Falls, Muscle density, Osteoporosis, Physical activity, Sarcopenia
National Category
Geriatrics
Identifiers
urn:nbn:se:umu:diva-156222 (URN)10.1016/j.bone.2018.12.004 (DOI)000458471700052 ()30537557 (PubMedID)
Available from: 2019-02-08 Created: 2019-02-08 Last updated: 2019-04-16Bibliographically approved
Hult, A., Johansson, J., Nordström, P. & Nordström, A. (2019). Objectively Measured Physical Activity in Older Adults With and Without Diabetes. Clinical Diabetes, 37(2), 142-149, Article ID cd180041.
Open this publication in new window or tab >>Objectively Measured Physical Activity in Older Adults With and Without Diabetes
2019 (English)In: Clinical Diabetes, ISSN 0891-8929, E-ISSN 1945-4953, Vol. 37, no 2, p. 142-149, article id cd180041Article in journal (Refereed) Published
Abstract [en]

Background: Increased physical activity (PA) is ordinated to increase glycemic control in subjects with diabetes. We evaluated objectively measured as well as self-reported PA in elderly individuals with and without diabetes.

Method: The study included 1872 community-dwelling individuals (49% women), all aged 70 years. Objective PA was measured by accelerometers worn for 1 week. Physical activity patterns in subjects with and without diabetes were evaluated using multivariable adjustable regression models.

Results: In the cohort 210 subjects (138 men and 72 women) were found to have diabetes. Self-reported PA showed a weak association with objective PA (r = 0.06, p = 0.01).  Individuals with known diabetes had fewer steps per day (mean 5,754) than those with detected diabetes at baseline (mean 6,359) or no diabetes (mean 7,375, all p < 0.05). A cut-off value of at least 6,000 steps per day discriminated best between individuals with and without diabetes (multi-adjusted odds ratio (OR), 0.50, 95% CI, 0.36–0.69), and overall step-count also showed the strongest correlation with objective visceral adipose tissue (VAT, β = 0.29, p < 0.001). In contrast, objectively measured PA in at least 10-minute bouts, as recommended by WHO, did not discriminate between individuals with a without diabetes (OR, 0.92, 95% CI, 0.66–1.28).

Conclusion: Despite recommendations given to subjects with diabetes, objectively measured PA was more than 20% lower in elderly individuals with diabetes. Daily step-counts was also associated with VAT, a potential mediator of the effects of PA.

Place, publisher, year, edition, pages
American Diabetes Association, 2019
National Category
Clinical Medicine Endocrinology and Diabetes
Research subject
Public health
Identifiers
urn:nbn:se:umu:diva-154288 (URN)10.2337/cd18-0041 (DOI)
Available from: 2018-12-14 Created: 2018-12-14 Last updated: 2019-06-12Bibliographically approved
Johansson, J., Jarocka, E., Westling, G., Nordström, A. & Nordström, P. (2019). Predicting incident falls: Relationship between postural sway and limits of stability in older adults. Human Movement Science, 66, 117-123
Open this publication in new window or tab >>Predicting incident falls: Relationship between postural sway and limits of stability in older adults
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2019 (English)In: Human Movement Science, ISSN 0167-9457, E-ISSN 1872-7646, Vol. 66, p. 117-123Article in journal (Refereed) Published
Abstract [en]

Background We have previously shown that objective measurements of postural sway predicts fall risk, although it is currently unknown how limits of stability (LOS) might influence these results.

Research question: How integrated postural sway and LOS measurements predict the risk of incident falls in a population-based sample of older adults.

Methods: The sample for this prospective observational study was drawn from the Healthy Ageing Initiative cohort and included data collected between June 2012 and December 2016 for 2396 men and women, all 70 years of age. LOS was compared to postural sway with measurements during eyes-open (EO) and eyes-closed (EC) trials, using the previously validated Wii Force Plate. Fall history was assessed during baseline examination and incident falls were collected during follow-up at 6 and 12 months. Independent predictors of incident falls and additional covariates were investigated using multiple logistic regression models.

Results: During follow-up, 337 out of 2396 participants (14%) had experienced a fall. Unadjusted regression models from the EO trial revealed increased fall risk by 6% (OR 1.06, 95% CI 1.02–1.11) per each centimeter squared increase in sway area and by 16% (OR 1.16, 95% CI 1.07–1.25) per 1-unit increase in Sway-Area-to-LOS ratio. Odds ratios were generally lower when analyzing EC trials and only slightly attenuated in fully adjusted models.

Significance: Integrating postural sway and LOS parameters provides valid fall risk prediction and a holistic analysis of postural stability. Future work should establish normative values and evaluate clinical utility of these measures.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Incident falls, LOS, Postural sway, Cohort study, Objective measures
National Category
Public Health, Global Health, Social Medicine and Epidemiology Neurosciences Psychology Sport and Fitness Sciences
Identifiers
urn:nbn:se:umu:diva-143872 (URN)10.1016/j.humov.2019.04.004 (DOI)000480664000013 ()30981147 (PubMedID)
Note

First published in thesis in manuscript form with the title: Predicting incident falls: relationship between postural sway and functional limits of stability in older adults

Available from: 2018-01-11 Created: 2018-01-11 Last updated: 2019-09-02Bibliographically approved
Hallkvist, O. M., Johansson, J., Nordström, A., Nordström, P. & Hult, A. (2018). Dairy product intake and bone properties in 70-year-old men and women. Archives of Osteoporosis, 13(1), Article ID 9.
Open this publication in new window or tab >>Dairy product intake and bone properties in 70-year-old men and women
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2018 (English)In: Archives of Osteoporosis, ISSN 1862-3514, Vol. 13, no 1, article id 9Article in journal (Refereed) Published
Abstract [en]

SUMMARY: In the present population-based study including 70-year-old men and women, total dairy product intake was associated with a weak positive association with tibia trabecular and cortical cross-sectional areas.

PURPOSE: Milk consumption has recently been suggested to increase fracture risk. Therefore, we aimed to investigate associations between dairy product consumption and peripheral bone properties. Furthermore, we explored whether consumption of milk and fermented dairy products affected bone properties differently.

METHODS: The Healthy Aging Initiative is a population-based, cross-sectional study investigating the health of 70-year-old men and women. Out of the 2904 individuals who met the inclusion criteria, data on self-reported daily dairy product consumption (dl/day), peripheral quantitative computed tomography (pQCT) examinations at the 4 and 66% scan sites of the tibia and radius, and dual-energy X-ray absorptiometry (DXA) scans were collected from 2040 participants. Associations between dairy product consumption and bone properties were examined using multiple linear regression models adjusted for sex, muscle area, meal size, dietary protein proportion, current smoking status, and objectively measured physical activity.

RESULTS: Total dairy product intake was associated with larger trabecular (2.296 (95% CI, 0.552-4.039) mm2, per dl/day increase, p = 0.01) and cortical cross-sectional areas (CSAs) in the tibia (1.757 (95% CI, 0.683-2.830 mm2, p = 0.001) as measured by pQCT and higher areal bone mineral density (aBMD) of the radius (3.231 (95% CI, 0.764-5.698) mg/cm2, p = 0.01) as measured by DXA. No other measurement in the tibia, radius, femoral neck, or lower spine was associated significantly with dairy product intake. Bone properties did not differ according to the type of dairy product consumed.

CONCLUSION: No evidence of a negative association between dairy product consumption and bone health was found. Furthermore, total dairy product consumption was associated with increased CSAs in the tibia, regardless of dairy product type. Collectively, our findings indicate the existence of a weak but significant positive association between dairy product consumption bone properties in older adults.

Place, publisher, year, edition, pages
Springer, 2018
Keywords
Bone mineral density, Dairy product, Older adults, Peripheral quantitative computed tomography
National Category
Nutrition and Dietetics
Identifiers
urn:nbn:se:umu:diva-144507 (URN)10.1007/s11657-018-0420-1 (DOI)000423631300001 ()29380156 (PubMedID)
Available from: 2018-02-05 Created: 2018-02-05 Last updated: 2018-06-09Bibliographically approved
Johansson, J., Hult, A., Morseth, B., Nordström, A. & Nordström, P. (2018). Self-reported protein intake and properties of bone in community-dwelling older individuals. Archives of Osteoporosis, 13(1), Article ID 10.
Open this publication in new window or tab >>Self-reported protein intake and properties of bone in community-dwelling older individuals
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2018 (English)In: Archives of Osteoporosis, ISSN 1862-3514, Vol. 13, no 1, article id 10Article in journal (Refereed) Published
Abstract [en]

SUMMARY:This study revealed that a quick and simple estimation of protein intake was related to measures of bone density and area in 70-year-old individuals. Furthermore, these associations were mediated by muscle mass when investigating peripheral measurement sites such as arms and legs.

PURPOSE: Recent evidence suggests that dietary protein is beneficial for bone health in older individuals, but less is known about the influence of muscle mass on this relationship. This cross-sectional study aimed to investigate associations among protein intake, bone health, and muscle mass in 2332 men and women aged 70 years.

METHODS: Volumetric bone mineral density of the radius and tibia was measured using peripheral quantitative computed tomography. Using dual-energy X-ray absorptiometry, we measured areal bone mineral density (aBMD) at the L1-L4 vertebrae, radius, and femoral neck, together with appendicular lean mass. Participants reported their average meal size and proportion of meat/fish intake. Associations were investigated using multiple linear regression models, adjusted for multiple covariates.

RESULTS: Self-reported protein intake was associated with aBMD of the femoral neck (β = 0.082) and L1-L4 vertebrae (β = 0.063) in men (both p < 0.05) after adjusting for multiple covariates, including appendicular muscle mass. No significant association was detected among women. In addition, protein intake was associated with tibial cortical area (β = 0.08), periosteal circumference (β = 0.072), radial aBMD (β = 0.064), and trabecular area (β = 0.078) in men (all p < 0.05), although these associations were attenuated after adjustment for appendicular muscle mass (all p > 0.05).

CONCLUSION: Self-reported protein intake was associated with bone properties in 70-year-old men. The strength of these associations in peripheral bone sites may be partially mediated by muscle mass from protein intake.

Place, publisher, year, edition, pages
Springer, 2018
Keywords
Appendicular muscle mass, Bone mineral density, Community dwelling, Peripheral quantitative computed tomography, Protein intake
National Category
Nutrition and Dietetics
Identifiers
urn:nbn:se:umu:diva-144514 (URN)10.1007/s11657-018-0421-0 (DOI)000423810200001 ()29388047 (PubMedID)
Available from: 2018-02-05 Created: 2018-02-05 Last updated: 2018-06-09Bibliographically approved
Johansson, J. (2018). The Healthy Ageing Initiative: Prevention of falls and fractures. (Doctoral dissertation). Umeå: Umeå universitet
Open this publication in new window or tab >>The Healthy Ageing Initiative: Prevention of falls and fractures
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The world is currently experiencing a dramatic increase in the number of older individuals, an amount that is expected to double between 2015 and 2050. This increase will likely affect the prevalence of age-related functional impairments, such as those caused by fractures. Fractures are often immobilizing events leading to increased individual suffering and vast healthcare costs. Prevention of these events and detection of underlying risk factors are hence of utmost importance. Fracture prevention strategies have traditionally focused on strengthening the skeleton by improving bone mineral density, partly through the mechanical load of increased physical activity. However, research has shown that nine out of ten hip fractures are attributed to falls. While several risk factors behind falls have been identified, there is less knowledge about how aspects such as gait patterns and postural stability predict future falls. The aim of this thesis was to expand upon the current knowledge by investigating objective measures of physical activity in relation to bone parameters, and measures of gait patterns and postural stability in relation to incident falls, in a large population-based sample of 70-year-olds.

The samples investigated in the four included studies were drawn from the Healthy Ageing Initiative (HAI) cohort. Study I examined associations between physical activity, objectively measured using accelerometers, and bone parameters, measured by Dual-energy X-ray Absorptiometry and Peripheral Quantitative Computed Tomography. Study II examined how gait variability, measured using the GAITRite electronic walkway system, predicted incident falls in men and women. Studies III and IV examined how center of pressure (COP) sway and limits of stability (LOS), measured using a force platform, predicted incident falls. Independent prediction of bone parameters and incident falls were investigated using multiple linear and logistic regression models.

Study I revealed that moderate-to-vigorous physical activity and vertical peak acceleration independently predicted parameters of bone in the weight-bearing skeleton. Study II showed that women’s increased risk of falling could be explained by increased gait variability during dual-task assignments. Study III revealed that the risk of falling was increased by 75-90% for individuals in the highest quintile of COP sway. Study IV integrated COP and LOS data, showing that fall risk was increased by 9-16% per 1-unit increase in COP-LOS ratio. In conclusion, this thesis highlighted several objective predictors of incident falls among older adults. Future studies and recommendations should emphasize strategies to improve balance, muscle strength and physical activity in order to prevent falls and fractures.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2018. p. 52
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1944
Keywords
prospective falls, cohort study, fall risk, gait variability, postural stability, physical activity, bone properties, objective measurements, older individuals
National Category
Public Health, Global Health, Social Medicine and Epidemiology Geriatrics
Identifiers
urn:nbn:se:umu:diva-143873 (URN)978-91-7601-830-9 (ISBN)
Public defence
2018-02-09, KBE303 (Stora hörsalen), KBC-huset, Umeå, 09:00 (Swedish)
Opponent
Supervisors
Funder
Swedish Research Council, 2011-2976
Available from: 2018-01-19 Created: 2018-01-15 Last updated: 2018-06-09Bibliographically approved
Johansson, J., Nordström, A., Gustafson, Y., Westling, G. & Nordström, P. (2017). Increased postural sway during quiet stance as a risk factor for prospective falls in community-dwelling elderly individuals. Age and Ageing, 46(6), 964-970
Open this publication in new window or tab >>Increased postural sway during quiet stance as a risk factor for prospective falls in community-dwelling elderly individuals
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2017 (English)In: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 46, no 6, p. 964-970Article in journal (Refereed) Published
Abstract [en]

Objective: fall-related injuries constitute major health risks in older individuals, and these risks are projected to increase in parallel with increasing human longevity. Impaired postural stability is a potential risk factor related to falls, although the evidence is inconclusive, partly due to the lack of prospective studies. This study aimed to investigate how objective measures of postural sway predict incident falls.

Design, setting and participants: this prospectively observational study included 1,877 community-dwelling individuals aged 70 years who participated in the Healthy Ageing Initiative between June 2012 and December 2015.

Measurements: postural sway was measured during eyes-open (EO) and eyes-closed (EC) trials using the Wii Balance Board. Functional mobility, muscle strength, objective physical activity and cognitive performance were also measured. Participants reported incident falls 6 and 12 months after the examination.

Results: during follow-up, 255 (14%) prospective fallers were identified. Division of centre of pressure (COP) sway lengths into quintiles revealed a nonlinear distribution of falls for EO trial data, but not EC trial data. After adjustment for multiple confounders, fall risk was increased by 75% for participants with COP sway lengths ≥400 mm during the EO trial (odds ratio [OR] 1.75, 95% confidence interval [CI] 1.09-2.79), and approximately doubled for sway lengths ≥920 mm during the EC trial (OR 1.90, 95% CI 1.12-3.22).

Conclusion: objective measures of postural sway independently predict incident falls in older community-dwelling men and women. Further studies are needed to evaluate whether postural sway length is of interest for the prediction of incident falls in clinical settings.

Place, publisher, year, edition, pages
Oxford University Press, 2017
Keywords
incident fall, postural sway, older people, cohort study, posturography
National Category
Physiotherapy Geriatrics
Identifiers
urn:nbn:se:umu:diva-135433 (URN)10.1093/ageing/afx083 (DOI)000413549300016 ()28531243 (PubMedID)
Available from: 2017-05-29 Created: 2017-05-29 Last updated: 2018-06-09Bibliographically approved
Johansson, J., Nordström, A. & Nordström, P. (2016). Greater Fall Risk in Elderly Women Than in Men Is Associated With Increased Gait Variability During Multitasking. Journal of the American Medical Directors Association, 17(6), 535-540
Open this publication in new window or tab >>Greater Fall Risk in Elderly Women Than in Men Is Associated With Increased Gait Variability During Multitasking
2016 (English)In: Journal of the American Medical Directors Association, ISSN 1525-8610, E-ISSN 1538-9375, Vol. 17, no 6, p. 535-540Article in journal (Refereed) Published
Abstract [en]

Objective: As 90% of fractures are caused by falls, and as fractures are more common in elderly women than in elderly men, a better understanding of potential sex differences in fall rates and underlying mechanisms is needed. The purpose of this study was to determine whether women are more prone than men to falling, and to evaluate whether the risk of falling is associated with variations in gait patterns.

Design, setting, and participants: The cohort for this prospective observational study consisted of 1390 community-dwelling men and women aged 70 years, examined in a health survey between July 2012 and November 2014.

Measurements: Gait patterns were measured using a computerized walkway system during normal-speed, fast-speed, and dual-task trials. Triaxial accelerometers were used to collect objective data on physical activity, and self-reported fall data were collected by telephone 6 and 12 months after examination. Incident low-energy falls were defined as unexpected events in which participants came to rest on the ground.

Results: During the follow-up period, 148 study participants (88 women, 60 men; P = .01) reported falls. After adjusting for multiple confounders, including objective measures of physical activity, socioeconomic factors, cardiovascular disease, and cognitive function, the odds ratio for falling in women was 1.49 (95% confidence interval [CI] 1.02–2.19). Variations in gait pattern were significantly (20%–40%) increased in fallers compared with nonfallers during the dual-task trial for step width, step length, stride length, step time, stance time, stride velocity, and single support time (all P < .05). Furthermore, women showed 15% to 35% increased variability in all of these gait parameters during the dual-task trial compared with men (all P < .01).

Conclusion: In the present cohort, 70-year-old women were at greater risk of falls compared with their male counterparts. This increased risk was associated with increased variation in gait pattern during dual-task activities, and may contribute to women's greater fracture risk compared with men.

Place, publisher, year, edition, pages
Elsevier, 2016
Keywords
Incident falls, gait variability, dual-task, elderly, physical activity
National Category
Geriatrics
Identifiers
urn:nbn:se:umu:diva-123443 (URN)10.1016/j.jamda.2016.02.009 (DOI)000377400500013 ()27006336 (PubMedID)
Funder
Swedish Research Council
Available from: 2016-07-20 Created: 2016-07-04 Last updated: 2018-06-07Bibliographically approved
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