Enhanced Gait Variability Index in Older Asian Adults and Increased Physiological Fall Risk: Results from the Yishun Study

There is no consensus on a composite gait variability (GV) score as an overall GV for the various spatial and temporal gait parameters. This had dampened the reporting and acceptance of GV, with little work on this topic in Asian population. This cross-sectional study derived an Enhanced Gait Variability Index (EGVI) and reference values in an Asian population and evaluated its validity as an indicator of physiological fall risk. It was conducted in a large residential town of Yishun in Singapore with community-dwelling adults aged 21–90 years of age categorized into 3 groups—reference group, low fall-risk and high fall-risk. Physiological Profile Assessment (PPA) score of ≥ 2.0 was used to differentiate high fall-risk and low fall-risk groups. EGVI were derived from five spatiotemporal parameters: step length (cm), step time (s), stance time (s), single support time (s) and stride velocity (cm/s), with those participants aged less than 65 years old as reference group. Our Asian population showed greater overall gait variability compared to an European cohort. This Asian EGVI displayed a non-linear relationship with both ageing and gait speed—significant changes in the EGVI were observed for those older than 60 years of age and in those whose habitual gait speed was lesser than 120 cm/s. The EGVI discriminated between older adults with and without high fall risk and showed weak to moderate correlation with a number of the functional mobility and balance tests in both high and low fall risk groups. We derived an Asian EGVI with reference values and validated its ability to discriminate fall risk among older adults.