Association of gait speed and handgrip strength with falls in older adults: the role of cognition

Background/aim: Fall risk assessment is crucial for older adults because falls are associated with morbidity and mortality. This study investigated the relationship of gait speed (GS) and handgrip strength (HGS) with falls and assessed whether cognition mediates this causality. Materials and methods: The study was conducted in a tertiary referral geriatric outpatient clinic. The physical performance of participants was evaluated by GS and HGS. All falls in the previous year were noted and factors associated with falls were analyzed using multivariate regression analysis. Results: A total of 1018 older adults with a mean age of 78.8 +/- 7.2 years, 64.2% of whom were female, were stratified into two groups: those who were cognitively impaired (n = 331) and those who were cognitively healthy (n = 660). In the study population, 22.8% (n = 226) had a history of falls in the previous year. The rates of low GS and HGS were 29.1% and 80.6%, respectively. After adjusting for confounding factors, low GS (OR = 2.01, 95% CI: 1.10-3.77, p = 0.019), low HGS (OR = 3.57, 95% CI: 1.10-11.35, p = 0.038), and low GS plus low HGS (OR = 4.52, 95% CI: 1.14-15.78, p = 0.024) in the cognitively impaired group and low GS (OR = 2.13, 95% CI: 1.39-3.52, p = 0.003) in the cognitively healthy group were independently associated with falls. Conclusion: GS is an efficient and practical assessment tool for identifying older adults at risk of falls regardless of their cognitive status.