Turning assessment for discrimination of frailty syndrome among community-dwelling older adults

Huei Ling Chiu, Chen Ying Tsai, Yu Lin Liu, Chun Wei Kang, Shu Chun Lee

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Background: Frailty is a common geriatric syndrome and is characterized by decreased physiological reserve and increased vulnerability towards adverse health outcomes including falls. Turning is a challenging task and is reported to be one of the daily activities that leads to falling in older populations. Research question: Does 180° walking turns and 360° turning on the spot differ among frail, pre-frail, and non-frail older adults? Can 180° walking turns and 360° turning on the spot cutoffs discriminate older adults with frailty from those without? Methods: A cross-sectional study was conducted on community-dwelling older adults aged over 65 years. Frailty was assessed using Fried's phenotype method, and turning tasks were measured by inertial sensors. The turn duration (s) and angular velocity (°/s) were recorded for analysis. Results: In total, 109 participants were enrolled including 50 pre-frail and 12 frail individuals. Frail older adults took significantly longer and had slower angular velocities to complete the 180° and 360° turning than did either pre-frail (p = 0.002 and p < 0.001, respectively) or non-frail (p = 0.03 and p < 0.001, respectively) older adults. Cutoff times of 2.45 and 3.46 s were found to best discriminate frail people from those without frailty in both the 180° (sensitivity 83.3 %, specificity 71.1 %, area under the receiver operating characteristic curve (AUC) 0.796) and 360° (sensitivity 91.7 %, specificity 74.2 %, AUC 0.857) turn tasks. Significance: Older individuals with frailty syndrome had difficulty turning as evidenced by a longer turning duration and a slower angular velocity. The turn duration could be a potential biomarker of frailty in older populations. Assessing the turning performance can facilitate early detection of the onset of frailty and inform early prevention and rehabilitation interventions in clinical practice.

Original languageEnglish
Pages (from-to)327-333
Number of pages7
JournalGait and Posture
Publication statusPublished - May 2021


  • Cutoff point
  • Frailty
  • Inertial sensor
  • Turning

ASJC Scopus subject areas

  • Biophysics
  • Orthopedics and Sports Medicine
  • Rehabilitation


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