Citation

Muhaidat J, Kerr A, Evans JJ, Pilling M, Skelton DA. Arch. Phys. Med. Rehabil. 2014; 95(1): 58-64.

Affiliation

School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, G4 0BA, Scotland, United Kingdom. Electronic address: j.muhaidat@ju.edu.jo.

Copyright

(Copyright © 2014, Elsevier Publishing)

DOI

10.1016/j.apmr.2013.07.027

PMID

24071555

Abstract

OBJECTIVE: To investigate the predictive validity of simple gait-related dual task tests in predicting falls in community-dwelling older adults. DESIGN: A validation-cohort study with six months follow-up. SETTING: General community. PARTICIPANTS: Sixty-six independently ambulant community-dwelling adults aged 65 years or older, with normal cognitive function. Sixty-two completed the follow-up. No participants required frames for walking. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Occurrence of falls in the follow-up period and performance on primary and secondary tasks of eight dual and one triple task tests. RESULTS: A random forest classification analysis identified the top five predictors of a fall as 1) absolute difference in time between the timed up and go as a single task and while carrying a cup; 2) time required to complete the walking task in the triple task test; 3 & 4) walking and avoiding a moving obstacle as a single task and while carrying a cup and 5) performing the timed up and go while carrying a cup. Separate bivariate logistic regression analyses showed that performance on these tasks was significantly associated with falling (p < 0.01). 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 dual task tests. The results showed that measures of change in performance were not useful in a multivariate model when compared to an "allocated all to falls" rule.

Language: en