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The Use of Posturography in Investigating the Risk of Falling in Frail or Prefrail Older People with Diabetes

  • Original Research
  • Physical Frailty
  • Published:
The Journal of Frailty & Aging Aims and scope Submit manuscript

Abstract

Background

In older people, diabetes is associated with an increased risk of falls and frailty. The value of using posturography for evaluating the risk of falling is unclear. In theory, a time-scale analysis should increase the metrological properties of the posturography assessment.

Objectives

This study aimed to determine which posturographic parameters can be used to identify fall-risk patients in a frail diabetic older population and to assess their interest in comparison to usual clinical trials for gait and balance.

Design

This is a prospective observational cohort.

Settings

Frail or pre-frail diabetic patients, in Bordeaux, France.

Participants

84 patients were included in the study (mean age 80.09 years, 64.5% of men). Criteria for inclusion were: age over 70 years, diabetes mellitus for over 2 years, and at least one of the Fried’s frailty criteria.

Measurements

Gait and balance assessments were undertaken at baseline: Static posturography, the timed up and go test, short physical performance battery, and (gait) walking speed. Raw data from posturography were used for wavelet analysis. Data on self reported new falls were collected prospectively during 6 months.

Results

The posturography parameter most useful was area of 90% confidence ellipse of statokinesigram (COP90area): area under the ROC curve AUC = 0.617 (95% CI, 0.445–0.789) and OR=1.003 (95%CI 1.000–1.005) p =0.05. The optimum clinical test was the time to walk over 4m AUC=0.735 (95%CI, 0.587–0.882) and OR=1.42 (95%CI 1.08–1.87) p=0.013.

Conclusion

Posturography has limited utility for assessment of falls risk in frail older people with diabetes. Gait and balance clinical assessments such as walking speed continue to retain their value.

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Funding

Funding: The research leading to these results has received funding from the European Union’s Seventh Framework Programme (FP7/2007-2013) under grant agreement n°278803, MID-Frail Project.

Author information

Authors and Affiliations

  1. Université de Bordeaux, Bordeaux, France

    Hélène Domergue, S. Regueme & I. Bourdel-Marchasson

  2. Centre Hospitaliser Universitaire de Bordeaux, Bordeaux, France

    Hélène Domergue, S. Regueme & I. Bourdel-Marchasson

  3. Hospital Universitario de Getafe, Madrid, Spain

    L. Rodríguez-Mañas

  4. Fundacion para la investigation biomedica del hospital universitario de Getafe, Madrid, Spain

    O. Laosa Zafra

  5. Cardiff University, Cardiff, UK

    K. Hood

  6. Toulouse Neuroimaging Center, University, University of Toulouse, Inserm UMR1214, UPS, Toulouse, France

    D. Gasq

  7. department of functional physiological explorations, Centre Hospitalier Universitaire, Hôpital Rangueil, Toulouse, France

    D. Gasq

  8. Aston University and Foundation for diabetes Research in older people, Diabetes Frail Ltd, Droitwich Spa, WR9 0QH, UK

    A. J. Sinclair

Authors
  1. Hélène Domergue
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  2. L. Rodríguez-Mañas
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  3. O. Laosa Zafra
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  4. K. Hood
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  5. D. Gasq
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  6. S. Regueme
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  7. A. J. Sinclair
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  8. I. Bourdel-Marchasson
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Corresponding author

Correspondence to Hélène Domergue.

Ethics declarations

Disclosure of Interest Statement: The authors declare that they have no competing interest.

Ethical Standards: This article complies with the current laws. The study received approval from «Comité de protection des personnes Sud Ouest et Outre-mer III». Participants gave their written informed consent.

Electronic supplementary material

Figure 3 : Class Distribution by HbA1c Rate and Faller/ Non-Faller Category p = 0.446 (Pearson)

42415_2019_71_MOESM2_ESM.pdf

Table 4: Comparison of posturographic parameters between fallers and non-fallers : T Test with APCoP and MLCoP because normal distribution ; Mann-Whitney’s test for all another variables.

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Domergue, H., Rodríguez-Mañas, L., Laosa Zafra, O. et al. The Use of Posturography in Investigating the Risk of Falling in Frail or Prefrail Older People with Diabetes. J Frailty Aging 9, 44–50 (2020). https://doi.org/10.14283/jfa.2019.27

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  • DOI: https://doi.org/10.14283/jfa.2019.27

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