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

Muhaidat, J., Kerr, A., Evans, J.J. , Pilling, M. and Skelton, D.A. (2014) Validity of simple gait-related dual-task tests in predicting falls in community-dwelling older adults. Archives of Physical Medicine and Rehabilitation, 95(1), pp. 58-64. (doi: 10.1016/j.apmr.2013.07.027)

Abstract

Objective: To investigate the predictive validity of simple gait-related dual-task (DT) tests in predicting falls in community-dwelling older adults.<p></p> Design: A validation cohort study with 6 months' follow-up.<p></p> Setting: General community.<p></p> 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.<p></p> Interventions Not applicable.<p></p> 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.<p></p> 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.<p></p> 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.<p></p>

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Evans, Professor Jonathan
• Authors: Muhaidat, J., Kerr, A., Evans, J.J., Pilling, M., and Skelton, D.A.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
• Journal Name: Archives of Physical Medicine and Rehabilitation
• ISSN: 0003-9993
• ISSN (Online): 1532-821X