BACKGROUND: While divided attention tasks are recognized as predictors of falls in older adults, a comprehensive examination of this association is lacking. OBJECTIVE: We examined the validity of a 'walking while talking' (WWT) task for predicting falls. METHODS: We studied the associations of 8 selected gait markers measured during WWT (individually as well as domains derived by factor analysis) with incident falls in 646 adults (mean age 79.9 years; 61% women) enrolled in an aging study who received quantitative gait assessments. Cox regressions adjusted for multiple potential confounders and normal-pace walking were used to examine the associations. RESULTS: Over a mean follow-up of 2.6 years, 337 participants (52%) fell. Step length was the only individual WWT parameter that predicted falls [hazard ratio (HR) 0.98; p = 0.034]. Factor analysis identified 3 gait domains, of which only the pace factor predicted falls (HR 1.31; p = 0.002). Results remained robust after adjusting for multiple potential confounders and accounting for normal-pace walking. CONCLUSIONS: WWT performance was a significant predictor of falls. Gait domains in WWT should be further studied to improve current fall risk assessments and to develop new interventions.
BACKGROUND: While divided attention tasks are recognized as predictors of falls in older adults, a comprehensive examination of this association is lacking. OBJECTIVE: We examined the validity of a 'walking while talking' (WWT) task for predicting falls. METHODS: We studied the associations of 8 selected gait markers measured during WWT (individually as well as domains derived by factor analysis) with incident falls in 646 adults (mean age 79.9 years; 61% women) enrolled in an aging study who received quantitative gait assessments. Cox regressions adjusted for multiple potential confounders and normal-pace walking were used to examine the associations. RESULTS: Over a mean follow-up of 2.6 years, 337 participants (52%) fell. Step length was the only individual WWT parameter that predicted falls [hazard ratio (HR) 0.98; p = 0.034]. Factor analysis identified 3 gait domains, of which only the pace factor predicted falls (HR 1.31; p = 0.002). Results remained robust after adjusting for multiple potential confounders and accounting for normal-pace walking. CONCLUSIONS: WWT performance was a significant predictor of falls. Gait domains in WWT should be further studied to improve current fall risk assessments and to develop new interventions.
Authors: Joe Verghese; Herman Buschke; Lisa Viola; Mindy Katz; Charles Hall; Gail Kuslansky; Richard Lipton Journal: J Am Geriatr Soc Date: 2002-09 Impact factor: 5.562
Authors: Stephanie Studenski; Subashan Perera; Dennis Wallace; Julie M Chandler; Pamela W Duncan; Earl Rooney; Michael Fox; Jack M Guralnik Journal: J Am Geriatr Soc Date: 2003-03 Impact factor: 5.562
Authors: Richard B Lipton; Mindy J Katz; Gail Kuslansky; Martin J Sliwinski; Walter F Stewart; Joe Verghese; Howard A Crystal; Herman Buschke Journal: J Am Geriatr Soc Date: 2003-10 Impact factor: 5.562
Authors: M E Tinetti; D I Baker; G McAvay; E B Claus; P Garrett; M Gottschalk; M L Koch; K Trainor; R I Horwitz Journal: N Engl J Med Date: 1994-09-29 Impact factor: 91.245
Authors: Brenda R Malcolm; John J Foxe; John S Butler; Sophie Molholm; Pierfilippo De Sanctis Journal: J Neurophysiol Date: 2018-08-01 Impact factor: 2.714