Multitasking: association between poorer performance and a history of recurrent falls.
OBJECTIVE
To examine the association between poorer performance on concurrent walking and reaction time and recurrent falls.


METHODS
Cross-sectional analysis.


METHODS
Community.


METHODS
Three hundred seventy-seven older community-dwelling adults (mean age+/-standard deviation 78+/-3).


METHODS
Reaction times on push-button and visual-spatial decision tasks were assessed while seated and while walking a 20-m course (straight walk) and a 20-m course with a turn at 10 m (turn walk). Walking times were recorded while walking only and while performing a reaction-time response. Dual-task performance was calculated as the percentage change in task times when done in dual-task versus single-task conditions. A history of recurrent falls (> or = 2 vs < or = 1 falls) in the prior 12 months was self-reported. Multivariate logistic regression models were used to predict the standardized odds ratios (ORs) of recurrent falls history. The standardized unit for dual-task performance ORs was interquartile range/2.


RESULTS
On the push-button task during the turn walk, poorer reaction time response (slower) was associated with 28% lower (P=.04) odds of recurrent fall history. On the visual-spatial task, poorer walking-time response (slower) was associated with 34% (P=.02) and 42% (P=.01) higher odds of recurrent falls history on the straight and turn walks, respectively.


CONCLUSIONS
These findings suggest that walking more slowly in response to a visual-spatial decision task may identify individuals at risk for multiple falls. Prospective studies are needed to confirm the prognostic value of poor walking responses in a dual-task setting for multiple falls.
Faulkner
Kimberly A
KA
Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. kaf24@pitt.edu
Redfern
Mark S
MS
Cauley
Jane A
JA
Landsittel
Douglas P
DP
Studenski
Stephanie A
SA
Rosano
Caterina
C
Simonsick
Eleanor M
EM
Harris
Tamara B
TB
Shorr
Ronald I
RI
Ayonayon
Hilsa N
HN
Newman
Anne B
AB
D000058:Accidental Falls; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D015438:Health Behavior; D006801:Humans; D016015:Logistic Models; D008297:Male; D011930:Reaction Time; D013647:Task Performance and Analysis; D016138:Walking