Relationship between dual-task related gait changes and intrinsic risk factors for falls among transitional frail older adults
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Background and aims: Gait changes in dual-task conditions have been associated with an increased risk of falling in older adults, and become more important in increasingly frail older adults. We studied the relationship between commonly known intrinsic risk factors for falls and dual-task related gait changes among transitional frail older adults. Methods: Walking time and number of steps were measured while walking alone and while walking with counting backward on a 10-m walkway in 66 transitional frail older adults (mean age 83.6±6.1, 84.9% women). Uni- and multiple linear regression analyses were performed to explore the relationship between dual-task related gait changes (walking time and number of steps) and age over 85 years, polymedication, psychoactive drugs, poor distance vision, abnormal mobility and cognitive impairment. Results: Compared with walking alone, both walking time and number of steps increased significantly while counting backward (p<0.001). Polymedication and abnormal mobility were associated with a significant increase of walking time and number of steps (p<0.01 for unadjusted change, p<0.05 for adjusted change). Conclusions: Dual-task related gait changes were closely correlated with polymedication and impaired mobility in our sample of transitional frail older adults. These findings give some insight into the complexity of performing attention-demanding tasks while walking and accentuate the need for multi-factorial, personalized intervention strategies, to prevent decline in dual-task performance in this fall-prone population.
- Tinetti ME. Preventing falls in elderly persons. N Engl J Med 2003; 348: 42–9. CrossRef
- Tinetti ME, Speechley M, Ginter SE. Risk factors for falls among elderly persons living in the community. N Engl J Med 1988; 319: 1701–7. CrossRef
- Thapa PB, Gideon P, Cost TW, Milam AB, Ray WA. Antidepressants and the risk of falls among nursing home residents. N Engl J Med 1998; 339: 875–82. CrossRef
- Lord ST, Dayhew J. Visual risk factors for falls in older people. J Am Geriatr Soc 2001; 49: 508–15. CrossRef
- Van Doorn C, Gruber-Baldini AL, Zimmerman S, et al. Dementia as a risk factor for falls and fall injuries among nursing home residents. J Am Geriatr Soc 2003; 51: 1213–8. CrossRef
- Sihvonen S, Era P, Helenius M. Postural balance and health-related factors in middle-aged and older women with injurious falls and non-fallers. Aging Clin Exp Res 2004; 16: 139–46.
- Janssen HC, Samson MM, Meeuwsen IB, Duursma SA, Verhaar HJ. Strength, mobility and falling in women referred to a geriatric outpatient clinic. Aging Clin Exp Res 2004; 16: 122–5.
- Oliver D, Daly F, Martin FC, McMurdo ME. Risk factors and risk assessment tools for falls in hospital in-patients: a systematic review. Age Ageing 2004; 33: 122–30. CrossRef
- Woollacott M, Shumway-Cook A. Attention and the control of posture and gait: a review of an emerging area of research. Gait Posture 2002; 16: 1–14. CrossRef
- Beauchet O, Najafi B, Dubost V, Kamiar A, Mourey F, Kressig R. Age-related decline of gait control under a dual-task condition. J Am Geriatr Soc 2003; 51: 1187–8. CrossRef
- Beauchet O, Dubost V, Gonthier R, Kressig RW. Dual-task related gait changes in transitionally frail older adults: the type of the walking-associated cognitive task matters. Gerontology 2005; 51: 48–52. CrossRef
- Bloem BR, Steijns JAG, Smits-Engelsman BC. An update on falls. Curr Opin Neurol 2003; 16: 15–26. CrossRef
- Lundin-Olsson L, Nyberg L, Gustafson Y. “Stops walking when talking” as a predictor of falls in elderly people. Lancet 1997; 349: 617. CrossRef
- Lundin-Olsson L, Nyberg L, Gustafson Y. Attention, frailty, and falls: the effect of a manual task on basic mobility. J Am Geriatr Soc 1998; 46: 758–61.
- Camicioli R, Howieson D, Lehman S. Kaye J. Talking while walking: the effect of a dual task in aging and Alzheimer’s disease. Neurology 1997; 48: 955–8.
- O’Shea S, Morris ME, Iansek R. Dual-task interference during gait in people with Parkinson’s disease: effects of motor versus cognitive secondary tasks. Phys Ther 2002; 82: 888–97.
- Fried LP, Bandeen-Roche K, Kasper JD, Guralnik JM. Association of comorbidity with disability in older women: the Women’s Health and Aging Study. J Clin Epidemiol 1999; 52: 27–37. CrossRef
- Speechley M, Tinetti M. Falls and injuries in frail and vigorous community elderly persons. J Am Geriatr Soc 1991; 39: 46–52.
- Folstein MF, Folstein SE, McHugh PR. Mini Mental State: a pratical method for grading the cognitive state of the patient for the clinician. J Psychiatr Res 1975; 12: 189–98. CrossRef
- Sheik JI, Yesavage JA. Geriatric Depression Scale. Recent evidence and development of a shorter version. In Brink TL, ed. Clinical gerontology: a guide to assessment and intervention. New York: Howarth Press, 1986, pp. 165–73.
- Lord SR, Ward JA, Williams P, et al. Physiological factors associated with falls in older community-dwelling women. J Am Geriatr Soc 1994; 42: 1110–7.
- Podsiadlo D, Richardson S. “The Timed Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991; 39: 142–9.
- Verhaeghen P, Cerella J. Aging, executive control, and attention: a review of meta-analyses. Neurosci Biobehav Rev 2002; 26: 849–57. CrossRef
- Cumming RG, Miller JP, Kelsey JL, et al. Medications and multiple falls in elderly: the St Louis OASIS study. Age Ageing 1991; 20: 455–61. CrossRef
- Campbell AJ. Drug treatment as a cause of falls in old age. A review of the offending agents. Drug Aging 1991; 1: 289–302. CrossRef
- Gunter KB, White KN, Hayes WC, Snow CM. Functional mobility discriminates nonfallers from one-time and frequent fallers. J Gerontol 2000; 55A: M672–6.
- Lord ST, Dayhew J, Howland A. Multifocal glasses impaired edge-contrast sensitivity and depth perception and increase the risk of falls in older people. J Am Geriatr Soc 2002; 50: 1760–6. CrossRef
- Relationship between dual-task related gait changes and intrinsic risk factors for falls among transitional frail older adults
Aging Clinical and Experimental Research
Volume 17, Issue 4 , pp 270-275
- Cover Date
- Print ISSN
- Online ISSN
- Springer International Publishing
- Additional Links
- fall risk
- Author Affiliations
- 1. Department of Rehabilitation and Geriatrics, Geneva University Hospitals, CH-1226, Thonex-Geneva, Geneva, Switzerland
- 2. Department of Geriatrics, Saint-Etienne University Hospitals, Saint-Etienne, France
- 3. Department of Biostatistics, Lyon University Hospitals, Lyon, France