Validity of simple gait-related dual-task tests in predicting falls in community-dwelling older adults.
OBJECTIVE
To investigate the predictive validity of simple gait-related dual-task (DT) tests in predicting falls in community-dwelling older adults.


METHODS
A validation cohort study with 6 months' follow-up.


METHODS
General community.


METHODS
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.


METHODS
Not applicable.


METHODS
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.
School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom. Electronic address: j.muhaidat@ju.edu.jo.
Jennifer
J
Muhaidat
Bioengineering Unit, University of Strathclyde, Glasgow, Scotland, United Kingdom.
Andrew
A
Kerr
Institute of Health and Wellbeing, University of Glasgow, Gartnavel Royal Hospital, Glasgow, Scotland, United Kingdom.
Jonathan J
JJ
Evans
School of Nursing, Midwifery & Social Work, the University of Manchester, Manchester, United Kingdom.
Mark
M
Pilling
School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom.
Dawn A
DA
Skelton
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005684:Gait; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D012111:Residence Characteristics; D018570:Risk Assessment; D013997:Time Factors
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