title: Dual-tasking over an extended walking distance is associated with falls among community-dwelling older adults.
abstract: OBJECTIVE
  Dual-task methods, in which walking is the primary task, are not sufficient for accurately screening for the risk of falls among healthy older adults. Therefore, the goal of this research was to investigate whether using a dual-task method over an extended walking distance can predict falls among community-dwelling older adults.
  
  
  METHODS
  We enrolled independent community-dwelling adults aged ≥65 years. Physical performance, cognitive function, psychological function, and a dual-task test were assessed at baseline. Our dual-task test required the subjects to walk 60 m while stepping over lines. The intervals between the lines ranged from 50-100 cm and were unequal. Falls and fall-related injuries were measured over a 12-month follow-up period using monthly postal surveys.
  
  
  RESULTS
  Ninety-two of 118 subjects (mean age, 75.4±5.5 years) completed the 12-month follow-up. Sixteen (17.4%) of fallers had injurious falls or fell more than or equal to two times. There were no significant differences between the fallers and non-fallers, except in age and in the number of missteps during the dual-task test when walking ≥40 m. The Kaplan-Meier analysis revealed that those who had more than one misstep while walking ≥40 m had a significantly higher incidence of injurious or multiple falls than those who had no missteps.
  
  
  CONCLUSIONS
  Our findings suggest that the dual-task method with an extended walking distance may be able to predict falls among community-dwelling older adults.
authors.affiliation: Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino Campus, Habikino City, Osaka, Japan ; Faculty of Health and Welfare, Department of Physical Therapy, Tokushima Bunri University, Nishihamaboji, Yamashiro Town, Tokushima City, Tokushima, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Hirashima
authors.affiliation: Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino Campus, Habikino City, Osaka, Japan.
authors.forename: Yumi
authors.initials: Y
authors.lastname: Higuchi
authors.affiliation: Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino Campus, Habikino City, Osaka, Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Imaoka
authors.affiliation: Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino Campus, Habikino City, Osaka, Japan.
authors.forename: Emiko
authors.initials: E
authors.lastname: Todo
authors.affiliation: Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino Campus, Habikino City, Osaka, Japan.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Kitagawa
authors.affiliation: Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino Campus, Habikino City, Osaka, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ueda
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003071:Cognition; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006304:Health Status; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D012307:Risk Factors; D012737:Sex Factors; D016138:Walking
keywords: cohort study; community-dwelling older adults; dual-task; falls