Age-Associated Changes on Gait Smoothness in the Third and the Fourth Age

Although gait disorders represent a highly prevalent condition in older adults, the alterations associated with physiologic aging are often not easily differentiable from those originated by concurrent neurologic or orthopedic conditions. Thus, the detailed quantitative assessment of gait patterns represents a crucial issue. In this context, the study of trunk accelerations may represent an effective proxy of locomotion skills in terms of symmetry. This can be carried out by calculating the Harmonic Ratio (HR), a parameter obtained through the processing of trunk accelerations in the frequency domain. In this study, trunk accelerations during level walking of 449 healthy older adults (of age > 65) who were stratified into three groups (Group 1: 65-74 years, n = 175; Group 2: 75-85 years, n = 227; Group 3: >85 years, n = 47) were acquired by means of a miniaturized Inertial Measurement Unit located in the low back and processed to obtain spatio-temporal parameters of gait and HR, in antero-posterior (AP), medio-lateral (ML) and vertical (V) directions. The results show that Group 3 exhibited a 16% reduction in gait speed and a 10% reduction in stride length when compared with Group 1 (p < 0.001 in both cases). Regarding the cadence, Group 3 was characterized by a 5% reduction with respect to Groups 1 and 2 (p < 0.001 in both cases). The analysis of HR revealed a general trend of linear decrease with age in the three groups. In particular, Group 3 was characterized by HR values significantly lower (-17%) than those of Group 1 in all three directions and significantly lower than Group 2 in ML and V directions (-10%). Taken together, such results suggest that HR may represent a valid measure to quantitatively characterize the progressive deterioration of locomotor abilities associated with aging, which seems to occur until the late stages of life.