The interaction of gait characteristics and concerns about falling in community-dwelling older adults

Concerns about falling (CaF) are common in older adults and are associated with increased falls. Although cautious gait-a gait pattern linked to CaF-has been described, the specific gait parameters most strongly associated with CaF remain unclear. This study investigates the association between gait characteristics at normal and maximal gait speed and CaF in community-dwelling older adults. This cross-sectional analysis merged data from two studies including participants aged 65 years and older: the FEARFALL-study, an intervention study to reduce CaF and improving walking stability, and from the MOGA-study, investigating the harmonization of supervised short-walk test protocols. Gait analysis was performed using an instrumented walkway and CaF was assessed by the Falls Efficacy Scale International (FES-I). Multiple stepwise regression models were used to explore the association of gait parameters with CaF and the associations of individual FES-I items with gait speed. Data from 261 participants (MOGA-study n = 150; FEARFALL-study n = 111; mean age 80.0 (± 4.6) years; 67% women) were analysed. Increasing FES-I levels were associated with decreasing walking performance across most gait parameters. Normal walking speed explained 24.9% of the variance in FES-I increasing to 29.2% by adding maximum gait speed and walk ratio. Four FES-I items dedicated to dynamic balance could be used to screen for cautious gait (adjusted R² = .201). Gait variables, especially gait speed, are strongly associated with CaF. FES-I items related to dynamic balance might be used to screen for cautious gait in community-dwelling older adults.