The association between walking ability and falls in elderly Japanese living in the community using a path analysis

The aim of this study is to investigate the association between falls and physiological factors primarilly the toe-gap force and the Good Walker's Index using a path analysis. Three hundred and sixty-two (362) elderly people, over 65 years of age, undertook five types of walking ability and physiological tests, The Toe-gap Force and the Good Walker's Index, which consists of 10-m walking time, Maximal Step Length (MSL), 40/20 cm step test, and tandem gait. Questions concerning demographic characteristics, instrumental activities of daily living (IADL), subjective well-being, long-term care needs, and characteristics of falls were asked. Ninety participants (24.9%) reported one or more falls within the past year. The results showed that a lower toe-gap force and a lower good-walker's Index score were significantly associated with falls. Fallers scored worse on Toe-gap force R, 10-m walking time, and Maximal Step strength. The Good Walker's Index was significantly associated with all test measures. The path analysis model revealed the association between the Good Walker's Index and falls. Toe-gap force and the Good Walker's Index can serve as an effective predictive factor for older people who are living independently in the community. This study provided a model of the inter-relationships among physiological factors such as the Good walker's Index, Toe-gap force and falls, as well as vision and falls.