To estimate the validity of neurological gait evaluations in predicting falls in older adults. We studied 632 adults age 70
and over (mean age 80.6 years, 62% women) enrolled in the Einstein Aging Study whose walking patterns were evaluated by study
clinicians using a clinical gait rating scale. Association of neurological gaits and six subtypes (hemiparetic, frontal, Parkinsonian,
unsteady, neuropathic, and spastic) with incident falls was studied using generalized estimation equation procedures adjusted
for potential confounders, and reported as risk ratio with 95% confidence intervals (CI). Over a mean follow-up of 21 months,
244 (39%) subjects fell. Mean fall rate was 0.47 falls per person year. At baseline, 120 subjects were diagnosed with neurological
gaits. Subjects with neurological gaits were at increased risk of falls (risk ratio 1.49, 95% CI 1.11–2.00). Unsteady (risk
ratio 1.52, 95% CI 1.04–2.22), and neuropathic gait (risk ratio 1.94, 95% CI 1.07–3.11) were the two gait subtypes that predicted
risk of falls. The results remained significant after accounting for disability and cognitive status, and also with injurious
falls as the outcome. Neurological gaits and subtypes are independent predictors of falls in older adults. Neurological gait
assessments will help clinicians identify and institute preventive measures in older adults at high risk for falls.
Keywords Gait - Clinical neurology - Incidence studies - Falls - Epidemiology