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Validity of simple gait-related dual-task tests in predicting falls in community-dwelling older adults.

Accepted version
Peer-reviewed

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Type

Article

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Authors

Muhaidat, Jennifer 
Kerr, Andrew 
Evans, Jonathan J 
Skelton, Dawn A 

Abstract

OBJECTIVE: To investigate the predictive validity of simple gait-related dual-task (DT) tests in predicting falls in community-dwelling older adults. DESIGN: A validation cohort study with 6 months' follow-up. SETTING: General community. PARTICIPANTS: Independently ambulant community-dwelling adults (N=66) aged ≥65 years, with normal cognitive function. Sixty-two completed the follow-up. No participants required frames for walking. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Occurrence of falls in the follow-up period and performance on primary and secondary tasks of 8 DT tests and 1 triple-task (TT) test. RESULTS: A random forest classification analysis identified the top 5 predictors of a fall as (1) absolute difference in time between the Timed Up & Go (TUG) as a single task (ST) and while carrying a cup; (2) time required to complete the walking task in the TT test; (3 and 4) walking and avoiding a moving obstacle as an ST and while carrying a cup; and (5) performing the TUG while carrying a cup. Separate bivariate logistic regression analyses showed that performance on these tasks was significantly associated with falling (P<.01). Despite the random forest analysis being a more robust approach than multivariate logistic regression, it was not clinically useful for predicting falls. CONCLUSIONS: This study identified the most important outcome measures in predicting falls using simple DT tests. The results showed that measures of change in performance were not useful in a multivariate model when compared with an "allocated all to falls" rule.

Description

Keywords

Accidental falls, Aged, CI, Cognition, DT, EXIT-15, FES-I, Falls Efficacy Scale–International, Gait, HADS, Hospital Anxiety and Depression Scale, IQR, MMSE, Mini-Mental State Examination, OOB, OR, POMA, Performance Oriented Mobility Assessment, RF, Rehabilitation, ST, TT, TUG, Timed Up & Go, abbreviated Executive Interview, confidence interval, dual task, interquartile range, odds ratio, out-of-bag, random forest, single task, triple task, Accidental Falls, Age Factors, Aged, Aged, 80 and over, Cohort Studies, Female, Gait, Geriatric Assessment, Humans, Male, Residence Characteristics, Risk Assessment, Time Factors

Journal Title

Arch Phys Med Rehabil

Conference Name

Journal ISSN

0003-9993
1532-821X

Volume Title

95

Publisher

Elsevier BV