The Complexity of Standing Postural Sway Associates with Future Falls in Community-Dwelling Older Adults: The MOBILIZE Boston Study

Standing postural control is complex, meaning that it is dependent upon numerous inputs interacting across multiple temporal-spatial scales. Diminished physiologic complexity of postural sway has been linked to reduced ability to adapt to stressors. We hypothesized that older adults with lower postu...

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Bibliographic Details
Published in:Scientific reports 2017-06, Vol.7 (1), p.2924-8, Article 2924
Main Authors: Zhou, Junhong, Habtemariam, Daniel, Iloputaife, Ikechukwu, Lipsitz, Lewis A., Manor, Brad
Format: Article
Language:English
Subjects:
692/53/2422
692/700/1518
9/10
Accidental Falls
Aged
Aged, 80 and over
Ankle
Comorbidity
Entropy
Falls
Female
Geriatric Assessment
Humanities and Social Sciences
Humans
Magnetism
Male
Models, Statistical
multidisciplinary
Older people
Postural Balance
Posture
Public Health Surveillance
Risk Factors
Science
Science (multidisciplinary)
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Summary:Standing postural control is complex, meaning that it is dependent upon numerous inputs interacting across multiple temporal-spatial scales. Diminished physiologic complexity of postural sway has been linked to reduced ability to adapt to stressors. We hypothesized that older adults with lower postural sway complexity would experience more falls in the future. 738 adults aged ≥70 years completed the Short Physical Performance Battery test (SPPB) test and assessments of single and dual-task standing postural control. Postural sway complexity was quantified using multiscale entropy. Falls were subsequently tracked for 48 months. Negative binomial regression demonstrated that older adults with lower postural sway complexity in both single and dual-task conditions had higher future fall rate (incident rate ratio (IRR) = 0.98, p = 0.02, 95% Confidence Limits (CL) = 0.96–0.99). Notably, participants in the lowest quintile of complexity during dual-task standing suffered 48% more falls during the four-year follow-up as compared to those in the highest quintile (IRR = 1.48, p = 0.01, 95% CL = 1.09–1.99). Conversely, traditional postural sway metrics or SPPB performance did not associate with future falls. As compared to traditional metrics, the degree of multi-scale complexity contained within standing postural sway-particularly during dual task conditions- appears to be a better predictor of future falls in older adults.
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-017-03422-4