Fall Risk Prediction Using Instrumented Footwear in Institutionalized Older Adults

This study presents a novel framework that utilizes instrumented footwear to predict fall risk in institutionalized older adults by leveraging stride-to-stride gait data. The older adults are categorized into fallers and non-fallers using three distinct criteria: retrospective fall history, prospective fall occurrence, and a combination of both retrospective and prospective data. Three types of data collected from N=95 institutionalized older adults are analyzed: traditional timed mobility tests, gait data collected from a validated electronic walkway, and gait data collected with instrumented footwear developed by our team. The importance of each type of data is assessed using a brute-force search method, through which the optimal features are selected. AdaBoost algorithms are then utilized to develop predictive models based on the selected features. The models are evaluated using leave-one-out cross-validation and 10-fold cross-validation. The results show that models using gait data from the instrumented footwear outperformed those based on traditional tests and walkway data, with area under the receiver operating characteristic curve (AUC) values for predicting prospective falls being 0.47, 0.66, and 0.80, respectively. The sensitivity of the models increases when they are trained using both past and future falls data, rather than relying solely on past or future falls data. This study demonstrates the potential of instrumented footwear for fall risk assessment in elderly individuals. The findings provide valuable insights for fall prevention and care, highlighting the superior predictive capabilities of the developed system compared to traditional methods.