Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Master of Science

Program

Epidemiology and Biostatistics

Supervisor

Speechley, Mark

2nd Supervisor

Montero-Odasso, Manuel

Co-Supervisor

Abstract

Medication use and gait impairment are two of the most important risk factors for falls. Several drug classes have been classified as fall risk-increasing drugs (FRIDs). Gait is an important marker of overall health and independence in older adults. The overall aim of this thesis was to examine the relationship between FRIDs and gait performance in older adults through two studies. Firstly, our systematic review of twenty studies on the association between FRIDs and gait performance found that the use of drugs with sedative properties is associated with reduced gait speed. Secondly, we conducted a cross-sectional analysis of data from the Gait and Brain Study. We found that among community-dwelling older adults aged 65 years old and over, diuretic use was associated with significantly reduced gait speed and statin use was associated with significantly increased stride time variability. Future longitudinal studies are required to determine the clinical relevance of our findings.

Summary for Lay Audience

Falls in older adults are a major public health concern in older adults. Medication use and gait (walking) impairment are two of the most important risk factors for falls. Several drug classes have been identified as fall risk-increasing drugs. Gait is also important marker of overall health and independence in older adults therefore the aim of this thesis was to examine the relationship between fall risk-increasing drugs and gait performance in older adults through two studies. Our first study was a systematic review of the current published evidence on the relationship between fall risk-increasing drugs and gait. We found that using drugs with sedative properties is associated with reduced gait speed in older adults. Our second study analyzed data collected from the Gait and Brain Study which is a study of community-dwelling older adults aged 65 years old and over living in London, Ontario. We found that the use of diuretics was associated with significantly reduced gait speed and that statin use was associated with significantly increased stride time variability which is a marker of gait (walking) instability and a predictor of future falls. Future studies following up patients over a period of time are needed to determine the relevance of our findings in a clinical setting.

Creative Commons License

Creative Commons Attribution-Share Alike 4.0 License
This work is licensed under a Creative Commons Attribution-Share Alike 4.0 License.

Available for download on Wednesday, August 31, 2022

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