Single and dual task tests of gait speed are equivalent in the prediction of falls in older people: A systematic review and meta-analysis

Although simple assessments of gait speed have been shown to predict falls as well as hospitalisation, functional decline and mortality in older people, dual task gait speed paradigms have been increasingly evaluated with respect to fall prediction. Some studies have found that dual task walking paradigms can predict falls in older people. A systematic review and meta-analysis was conducted to determine whether dual task walking paradigms involving a secondary cognitive task have greater ability to predict falls than single walking tasks. The meta-analytic findings indicate single and dual task tests of gait speed are equivalent in the prediction of falls in older people and sub-group analyses revealed similar findings for studies that included only cognitively impaired participants, slow walkers or used secondary mental-tracking or verbal fluency tasks.

[1]  S. Lord,et al.  The comparative ability of eight functional mobility tests for predicting falls in community-dwelling older people. , 2008, Age and ageing.

[2]  Wendy A Rogers,et al.  Cognitive and Motor Mechanisms Underlying Older Adults' Ability to Divide Attention While Walking , 2011, Physical Therapy.

[3]  R. Kessels,et al.  The influence of fear of falling on gait and balance in older people. , 2009, Age and ageing.

[4]  P. Tang,et al.  Meta‐analysis of type and complexity of a secondary task during walking on the prediction of elderly falls , 2013, Geriatrics & gerontology international.

[5]  M. Ashe,et al.  Dual-task gait performance among community-dwelling senior women: the role of balance confidence and executive functions. , 2009, The journals of gerontology. Series A, Biological sciences and medical sciences.

[6]  V. Srikanth,et al.  Gait, gait variability and the risk of multiple incident falls in older people: a population-based study. , 2011, Age and ageing.

[7]  E. Olsson,et al.  Effects of new, individually adjusted, progressive balance group training for elderly people with fear of falling and tend to fall: a randomized controlled trial , 2011, Clinical rehabilitation.

[8]  Stephen R Lord,et al.  Effects of spatial and nonspatial memory tasks on choice stepping reaction time in older people. , 2008, The journals of gerontology. Series A, Biological sciences and medical sciences.

[9]  A. Ramnemark,et al.  Changes in step-width during dual-task walking predicts falls. , 2010, Gait & posture.

[10]  C. Annweiler,et al.  Stops walking when talking: a predictor of falls in older adults? , 2009, European journal of neurology.

[11]  Noriaki Ichihashi,et al.  DUAL‐TASK WALK IS A RELIABLE PREDICTOR OF FALLS IN ROBUST ELDERLY ADULTS , 2011, Journal of the American Geriatrics Society.

[12]  Mike Martin,et al.  Simultaneously Measuring Gait and Cognitive Performance in Cognitively Healthy and Cognitively Impaired Older Adults: The Basel Motor–Cognition Dual‐Task Paradigm , 2011, Journal of the American Geriatrics Society.

[13]  V. Weerdesteyn,et al.  Increased intra-individual variability in stride length and reaction time in recurrent older fallers , 2011, Aging clinical and experimental research.

[14]  Jeffrey M. Hausdorff,et al.  Executive control deficits as a prodrome to falls in healthy older adults: a prospective study linking thinking, walking, and falling. , 2010, The journals of gerontology. Series A, Biological sciences and medical sciences.

[15]  H. Dawes,et al.  Cognitive motor interference while walking: A systematic review and meta-analysis , 2011, Neuroscience & Biobehavioral Reviews.

[16]  Bastiaan R. Bloem,et al.  Assessment of dual tasking has no clinical value for fall prediction in Parkinson’s disease , 2012, Journal of Neurology.

[17]  M. Woollacott,et al.  Attention and the control of posture and gait: a review of an emerging area of research. , 2002, Gait & posture.

[18]  N. Ichihashi,et al.  The reliability and preliminary validity of game-based fall risk assessment in community-dwelling older adults. , 2011, Geriatric nursing.

[19]  Cédric Annweiler,et al.  Does Change in Gait while Counting Backward Predict the Occurrence of a First Fall in Older Adults? , 2008, Gerontology.

[20]  L. Nyberg,et al.  “Stops walking when talking” as a predictor of falls in elderly people , 1997, The Lancet.

[21]  Noriaki Ichihashi,et al.  Trail‐Walking Exercise and Fall Risk Factors in Community‐Dwelling Older Adults: Preliminary Results of a Randomized Controlled Trial , 2010, Journal of the American Geriatrics Society.

[22]  D. Altman,et al.  Measuring inconsistency in meta-analyses , 2003, BMJ : British Medical Journal.

[23]  Eling D de Bruin,et al.  A cognitive-motor intervention using a dance video game to enhance foot placement accuracy and gait under dual task conditions in older adults: a randomized controlled trial , 2012, BMC Geriatrics.

[24]  Rose Anne Kenny,et al.  Effects of fear of falling and activity restriction on normal and dual task walking in community dwelling older adults. , 2013, Gait & posture.

[25]  N. Ichihashi,et al.  Effect of dual-tasking on the center of pressure trajectory at gait initiation in elderly fallers and non-fallers , 2012, Aging Clinical and Experimental Research.

[26]  M. Montero‐Odasso,et al.  Dual-task complexity affects gait in people with mild cognitive impairment: the interplay between gait variability, dual tasking, and risk of falls. , 2012, Archives of physical medicine and rehabilitation.

[27]  N. Ichihashi,et al.  Seated stepping exercise in a dual-task condition improves ambulatory function with a secondary task: a randomized controlled trial , 2011 .

[28]  C. Becker,et al.  Development of a Common Outcome Data Set for Fall Injury Prevention Trials: The Prevention of Falls Network Europe Consensus , 2005, Journal of the American Geriatrics Society.

[29]  Li-Shan Chou,et al.  Dual-task interference during obstacle clearance in healthy and balance-impaired older adults , 2008, Aging clinical and experimental research.

[30]  C. Bauer,et al.  First results of evaluation of a falls clinic , 2010 .

[31]  P. Koskas,et al.  Analyse clinique au cours d'une marche simple et avec une double tâche chez une population de sujets âgés ambulatoires consultant en gériatrie , 2010 .

[32]  Julien Barra,et al.  Increasing cognitive load with increasing balance challenge: recipe for catastrophe , 2006, Experimental Brain Research.

[33]  W. Kearns,et al.  Path tortuosity in everyday movements of elderly persons increases fall prediction beyond knowledge of fall history, medication use, and standardized gait and balance assessments. , 2012, Journal of the American Medical Directors Association.

[34]  O. Beauchet,et al.  Gait variability while dual-tasking: fall predictor in older inpatients? , 2008, Aging clinical and experimental research.

[35]  José Luiz Riani Costa,et al.  Gait and risk of falls associated with frontal cognitive functions at different stages of Alzheimer's disease , 2012, Neuropsychology, development, and cognition. Section B, Aging, neuropsychology and cognition.

[36]  Jeffrey M. Hausdorff,et al.  The role of executive function and attention in gait , 2008, Movement disorders : official journal of the Movement Disorder Society.

[37]  A Ashburn,et al.  Interference between balance, gait and cognitive task performance among people with stroke living in the community , 2006, Disability and rehabilitation.

[38]  B. Dubois,et al.  Frontotemporal dementia: Pathology of gait? , 2010, Movement disorders : official journal of the Movement Disorder Society.

[39]  Tamara B Harris,et al.  Multitasking: Association Between Poorer Performance and a History of Recurrent Falls , 2007, Journal of the American Geriatrics Society.

[40]  Li-Shan Chou,et al.  Effects of single-task versus dual-task training on balance performance in older adults: a double-blind, randomized controlled trial. , 2009, Archives of physical medicine and rehabilitation.

[41]  T. Tombaugh,et al.  The Mini‐Mental State Examination: A Comprehensive Review , 1992, Journal of the American Geriatrics Society.

[42]  R. Camicioli,et al.  Dual-tasks and walking fast: Relationship to extra-pyramidal signs in advanced Alzheimer disease , 2006, Journal of the Neurological Sciences.

[43]  Andrew Kerr,et al.  Exploring gait-related dual task tests in community-dwelling fallers and non-faller: A pilot study , 2013, Physiotherapy theory and practice.

[44]  Cédric Annweiler,et al.  Recurrent Falls and Dual Task–Related Decrease in Walking Speed: Is There a Relationship? , 2008, Journal of the American Geriatrics Society.

[45]  René Rizzoli,et al.  Effect of music-based multitask training on gait, balance, and fall risk in elderly people: a randomized controlled trial. , 2011, Archives of internal medicine.

[46]  P. Bossuyt,et al.  BMC Medical Research Methodology , 2002 .

[47]  Ken R. Smith,et al.  Early parental death and late-life dementia risk: findings from the Cache County Study. , 2008, Age and ageing.

[48]  Jeffrey M. Hausdorff,et al.  Cognitive contributions to gait and falls: Evidence and implications , 2013, Movement disorders : official journal of the Movement Disorder Society.

[49]  M. Inzitari,et al.  Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force , 2009, The journal of nutrition, health & aging.

[50]  Charles Hall,et al.  Validity of Divided Attention Tasks In Predicting Falls in Older Individuals: A Preliminary Study , 2002, Journal of the American Geriatrics Society.

[51]  A Stefanie Mikolaizak,et al.  Gait parameter risk factors for falls under simple and dual task conditions in cognitively impaired older people. , 2013, Gait & posture.

[52]  W. Zijlstra,et al.  Do Dual Tasks Have an Added Value Over Single Tasks for Balance Assessment in Fall Prevention Programs? A Mini-Review , 2008, Gerontology.

[53]  Jeffrey M. Hausdorff,et al.  Dual‐tasking effects on gait variability: The role of aging, falls, and executive function , 2006, Movement disorders : official journal of the Movement Disorder Society.

[54]  Roee Holtzer,et al.  Effect of cognitive remediation on gait in sedentary seniors. , 2010, The journals of gerontology. Series A, Biological sciences and medical sciences.

[55]  Eva Negri,et al.  Risk Factors for Falls in Community-dwelling Older People: A Systematic Review and Meta-analysis , 2010, Epidemiology.