The Use of Posturography in Investigating the Risk of Falling in Frail or Prefrail Older People with Diabetes.
Identifieur interne : 000031 ( Main/Exploration ); précédent : 000030; suivant : 000032The Use of Posturography in Investigating the Risk of Falling in Frail or Prefrail Older People with Diabetes.
Auteurs : H. Domergue [France] ; L. Rodríguez-Ma As ; O. Laosa Zafra ; K. Hood ; D. Gasq ; S. Regueme ; A J Sinclair ; I. Bourdel-MarchassonSource :
- The Journal of frailty & aging [ 2260-1341 ] ; 2020.
Descripteurs français
- KwdFr :
- Appréciation des risques (méthodes), Chutes accidentelles (MeSH), Diabète (épidémiologie), Femelle (MeSH), France (épidémiologie), Humains (MeSH), Mâle (MeSH), Personne âgée fragile (statistiques et données numériques), Reproductibilité des résultats (MeSH), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH), Équilibre postural (physiologie), Études prospectives (MeSH).
- MESH :
- méthodes : Appréciation des risques.
- physiologie : Équilibre postural.
- statistiques et données numériques : Personne âgée fragile.
- épidémiologie : Diabète, France.
- Chutes accidentelles, Femelle, Humains, Mâle, Reproductibilité des résultats, Sujet âgé, Sujet âgé de 80 ans ou plus, Études prospectives.
- Wicri :
- geographic : France.
English descriptors
- KwdEn :
- Accidental Falls (MeSH), Aged (MeSH), Aged, 80 and over (MeSH), Diabetes Mellitus (epidemiology), Female (MeSH), Frail Elderly (statistics & numerical data), France (epidemiology), Humans (MeSH), Male (MeSH), Postural Balance (physiology), Prospective Studies (MeSH), Reproducibility of Results (MeSH), Risk Assessment (methods).
- MESH :
- geographic , epidemiology : France.
- epidemiology : Diabetes Mellitus.
- methods : Risk Assessment.
- physiology : Postural Balance.
- statistics & numerical data : Frail Elderly.
- Accidental Falls, Aged, Aged, 80 and over, Female, Humans, Male, Prospective Studies, Reproducibility of Results.
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.
DOI: 10.14283/jfa.2019.27
PubMed: 32150213
Affiliations:
Links toward previous steps (curation, corpus...)
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Rodríguez-Ma As</name></author><author><name sortKey="Laosa Zafra, O" sort="Laosa Zafra, O" uniqKey="Laosa Zafra O" first="O" last="Laosa Zafra">O. Laosa Zafra</name></author><author><name sortKey="Hood, K" sort="Hood, K" uniqKey="Hood K" first="K" last="Hood">K. Hood</name></author><author><name sortKey="Gasq, D" sort="Gasq, D" uniqKey="Gasq D" first="D" last="Gasq">D. Gasq</name></author><author><name sortKey="Regueme, S" sort="Regueme, S" uniqKey="Regueme S" first="S" last="Regueme">S. Regueme</name></author><author><name sortKey="Sinclair, A J" sort="Sinclair, A J" uniqKey="Sinclair A" first="A J" last="Sinclair">A J Sinclair</name></author><author><name sortKey="Bourdel Marchasson, I" sort="Bourdel Marchasson, I" uniqKey="Bourdel Marchasson I" first="I" last="Bourdel-Marchasson">I. Bourdel-Marchasson</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32150213</idno><idno type="pmid">32150213</idno><idno type="doi">10.14283/jfa.2019.27</idno><idno type="wicri:Area/Main/Corpus">000110</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000110</idno><idno type="wicri:Area/Main/Curation">000110</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000110</idno><idno type="wicri:Area/Main/Exploration">000110</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">The Use of Posturography in Investigating the Risk of Falling in Frail or Prefrail Older People with Diabetes.</title><author><name sortKey="Domergue, H" sort="Domergue, H" uniqKey="Domergue H" first="H" last="Domergue">H. Domergue</name><affiliation wicri:level="1"><nlm:affiliation>Hélène Domergue, Centre Hospitalier Universitaire de Bordeaux, France, helene.domergue@chu-bordeaux.fr.</nlm:affiliation><country wicri:rule="url">France</country><wicri:regionArea>Hélène Domergue, Centre Hospitalier Universitaire de Bordeaux, France</wicri:regionArea><wicri:noRegion>France</wicri:noRegion><wicri:noRegion>France</wicri:noRegion></affiliation></author><author><name sortKey="Rodriguez Ma As, L" sort="Rodriguez Ma As, L" uniqKey="Rodriguez Ma As L" first="L" last="Rodríguez-Ma As">L. Rodríguez-Ma As</name></author><author><name sortKey="Laosa Zafra, O" sort="Laosa Zafra, O" uniqKey="Laosa Zafra O" first="O" last="Laosa Zafra">O. Laosa Zafra</name></author><author><name sortKey="Hood, K" sort="Hood, K" uniqKey="Hood K" first="K" last="Hood">K. Hood</name></author><author><name sortKey="Gasq, D" sort="Gasq, D" uniqKey="Gasq D" first="D" last="Gasq">D. Gasq</name></author><author><name sortKey="Regueme, S" sort="Regueme, S" uniqKey="Regueme S" first="S" last="Regueme">S. Regueme</name></author><author><name sortKey="Sinclair, A J" sort="Sinclair, A J" uniqKey="Sinclair A" first="A J" last="Sinclair">A J Sinclair</name></author><author><name sortKey="Bourdel Marchasson, I" sort="Bourdel Marchasson, I" uniqKey="Bourdel Marchasson I" first="I" last="Bourdel-Marchasson">I. Bourdel-Marchasson</name></author></analytic><series><title level="j">The Journal of frailty & aging</title><idno type="ISSN">2260-1341</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Accidental Falls (MeSH)</term><term>Aged (MeSH)</term><term>Aged, 80 and over (MeSH)</term><term>Diabetes Mellitus (epidemiology)</term><term>Female (MeSH)</term><term>Frail Elderly (statistics & numerical data)</term><term>France (epidemiology)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Postural Balance (physiology)</term><term>Prospective Studies (MeSH)</term><term>Reproducibility of Results (MeSH)</term><term>Risk Assessment (methods)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Appréciation des risques (méthodes)</term><term>Chutes accidentelles (MeSH)</term><term>Diabète (épidémiologie)</term><term>Femelle (MeSH)</term><term>France (épidémiologie)</term><term>Humains (MeSH)</term><term>Mâle (MeSH)</term><term>Personne âgée fragile (statistiques et données numériques)</term><term>Reproductibilité des résultats (MeSH)</term><term>Sujet âgé (MeSH)</term><term>Sujet âgé de 80 ans ou plus (MeSH)</term><term>Équilibre postural (physiologie)</term><term>Études prospectives (MeSH)</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>France</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Diabetes Mellitus</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Risk Assessment</term></keywords><keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Appréciation des risques</term></keywords><keywords scheme="MESH" qualifier="physiologie" xml:lang="fr"><term>Équilibre postural</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Postural Balance</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Frail Elderly</term></keywords><keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Personne âgée fragile</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Diabète</term><term>France</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Accidental Falls</term><term>Aged</term><term>Aged, 80 and over</term><term>Female</term><term>Humans</term><term>Male</term><term>Prospective Studies</term><term>Reproducibility of Results</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Chutes accidentelles</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Reproductibilité des résultats</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Études prospectives</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>France</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>OBJECTIVES</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>DESIGN</b></p><p>This is a prospective observational cohort.</p></div><div type="abstract" xml:lang="en"><p><b>SETTINGS</b></p><p>frail or pre-frail diabetic patients, in Bordeaux, France.</p></div><div type="abstract" xml:lang="en"><p><b>PARTICIPANTS</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>MEASUREMENTS</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>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.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">32150213</PMID><DateCompleted><Year>2020</Year><Month>03</Month><Day>18</Day></DateCompleted><DateRevised><Year>2020</Year><Month>03</Month><Day>18</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">2260-1341</ISSN><JournalIssue CitedMedium="Print"><Volume>9</Volume><Issue>1</Issue><PubDate><Year>2020</Year></PubDate></JournalIssue><Title>The Journal of frailty & aging</Title><ISOAbbreviation>J Frailty Aging</ISOAbbreviation></Journal><ArticleTitle>The Use of Posturography in Investigating the Risk of Falling in Frail or Prefrail Older People with Diabetes.</ArticleTitle><Pagination><MedlinePgn>44-50</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.14283/jfa.2019.27</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="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.</AbstractText><AbstractText Label="OBJECTIVES" NlmCategory="OBJECTIVE">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.</AbstractText><AbstractText Label="DESIGN" NlmCategory="METHODS">This is a prospective observational cohort.</AbstractText><AbstractText Label="SETTINGS" NlmCategory="METHODS">frail or pre-frail diabetic patients, in Bordeaux, France.</AbstractText><AbstractText Label="PARTICIPANTS" NlmCategory="METHODS">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.</AbstractText><AbstractText Label="MEASUREMENTS" NlmCategory="METHODS">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.</AbstractText><AbstractText Label="RESULTS" NlmCategory="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.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">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.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Domergue</LastName><ForeName>H</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Hélène Domergue, Centre Hospitalier Universitaire de Bordeaux, France, helene.domergue@chu-bordeaux.fr.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rodríguez-Mañas</LastName><ForeName>L</ForeName><Initials>L</Initials></Author><Author ValidYN="Y"><LastName>Laosa Zafra</LastName><ForeName>O</ForeName><Initials>O</Initials></Author><Author ValidYN="Y"><LastName>Hood</LastName><ForeName>K</ForeName><Initials>K</Initials></Author><Author ValidYN="Y"><LastName>Gasq</LastName><ForeName>D</ForeName><Initials>D</Initials></Author><Author ValidYN="Y"><LastName>Regueme</LastName><ForeName>S</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Sinclair</LastName><ForeName>A J</ForeName><Initials>AJ</Initials></Author><Author ValidYN="Y"><LastName>Bourdel-Marchasson</LastName><ForeName>I</ForeName><Initials>I</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D064888">Observational Study</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>France</Country><MedlineTA>J Frailty Aging</MedlineTA><NlmUniqueID>101604797</NlmUniqueID><ISSNLinking>2260-1341</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000058" MajorTopicYN="Y">Accidental Falls</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003920" MajorTopicYN="N">Diabetes Mellitus</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016330" MajorTopicYN="N">Frail Elderly</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005602" MajorTopicYN="N" Type="Geographic">France</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004856" MajorTopicYN="N">Postural Balance</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="Y">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015203" MajorTopicYN="N">Reproducibility of Results</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018570" MajorTopicYN="N">Risk Assessment</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Diabetes</Keyword><Keyword MajorTopicYN="N">evaluation</Keyword><Keyword MajorTopicYN="N">falls</Keyword><Keyword MajorTopicYN="N">frailty</Keyword><Keyword MajorTopicYN="N">posturography</Keyword></KeywordList><CoiStatement>The authors declare that they have no competing interest.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>3</Month><Day>10</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>3</Month><Day>10</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>3</Month><Day>19</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32150213</ArticleId><ArticleId IdType="doi">10.14283/jfa.2019.27</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>France</li></country></list><tree><noCountry><name sortKey="Bourdel Marchasson, I" sort="Bourdel Marchasson, I" uniqKey="Bourdel Marchasson I" first="I" last="Bourdel-Marchasson">I. Bourdel-Marchasson</name><name sortKey="Gasq, D" sort="Gasq, D" uniqKey="Gasq D" first="D" last="Gasq">D. Gasq</name><name sortKey="Hood, K" sort="Hood, K" uniqKey="Hood K" first="K" last="Hood">K. Hood</name><name sortKey="Laosa Zafra, O" sort="Laosa Zafra, O" uniqKey="Laosa Zafra O" first="O" last="Laosa Zafra">O. Laosa Zafra</name><name sortKey="Regueme, S" sort="Regueme, S" uniqKey="Regueme S" first="S" last="Regueme">S. Regueme</name><name sortKey="Rodriguez Ma As, L" sort="Rodriguez Ma As, L" uniqKey="Rodriguez Ma As L" first="L" last="Rodríguez-Ma As">L. Rodríguez-Ma As</name><name sortKey="Sinclair, A J" sort="Sinclair, A J" uniqKey="Sinclair A" first="A J" last="Sinclair">A J Sinclair</name></noCountry><country name="France"><noRegion><name sortKey="Domergue, H" sort="Domergue, H" uniqKey="Domergue H" first="H" last="Domergue">H. Domergue</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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