Stops walking when talking: a predictor of falls in older adults?

被引:298
作者
Beauchet, O. [1 ,2 ,3 ]
Annweiler, C. [1 ,2 ,3 ]
Dubost, V. [4 ]
Allali, G. [5 ,6 ]
Kressig, R. W. [7 ,8 ]
Bridenbaugh, S. [7 ,8 ]
Berrut, G. [9 ,10 ,11 ]
Assal, F. [5 ,6 ]
Herrmann, F. R. [6 ,12 ,13 ]
机构
[1] Angers Univ Hosp, Dept Geriatr, F-49933 Angers 9, France
[2] Angers Univ Hosp, Fac Med, F-49933 Angers 9, France
[3] Univ Angers, UNAM, Angers, France
[4] Formadep Korian, Paris, France
[5] Univ Hosp Geneva, Dept Neurol, Geneva, Switzerland
[6] Univ Hosp Geneva, Fac Med, Geneva, Switzerland
[7] Univ Basel, Dept Geriatr, CH-4003 Basel, Switzerland
[8] Univ Basel Hosp, Basel, Switzerland
[9] Nantes Univ Hosp, Dept Geriatr, Nantes, France
[10] Nantes Univ Hosp, Fac Med, Nantes, France
[11] Univ Nantes, UNAM, F-44035 Nantes, France
[12] Univ Hosp Geneva, Dept Rehabil & Geriatr, Geneva, Switzerland
[13] Univ Geneva, CH-1211 Geneva 4, Switzerland
关键词
dual-task-related gait changes; falling; gait; older adult; GAIT VARIABILITY; RECURRENT FALLS; DUAL-TASKING; RISK-FACTORS; COMMUNITY; ATTENTION; PEOPLE; INTERFERENCE; ASSOCIATION; PERFORMANCE;
D O I
10.1111/j.1468-1331.2009.02612.x
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
The objective of this study was to systematically review all published articles examining the relationship between the occurrence of falls and changes in gait and attention-demanding task performance whilst dual tasking amongst older adults. An English and French Medline and Cochrane library search ranging from 1997 to 2008 indexed under 'accidental falls', 'aged OR aged, 80 and over', 'dual task', 'dual tasking', 'gait', 'walking', 'fall' and 'falling' was performed. Of 121 selected studies, fifteen met the selection criteria and were included in the final analysis. The fall rate ranged from 11.1% to 50.0% in retrospective studies and from 21.3% to 42.3% in prospective ones. Amongst the three retrospective and eight prospective studies, two and six studies, respectively, showed a significant relationship between changes in gait performance under dual task and history of falls. The predictive value for falling was particularly efficient amongst frail older adults compared with healthy subjects. Two prospective studies challenged the usefulness of the dual-task paradigm as a significant predictor compared to single task performance and three studies even reported that gait changes whilst dual tasking did not predict falls. The pooled odds ratio for falling was 5.3 (95% CI, 3.1-9.1) when subjects had changes in gait or attention-demanding task performance whilst dual tasking. Despite conflicting early reports, changes in performance whilst dual tasking were significantly associated with an increased risk for falling amongst older adults and frail older adults in particular. Description of health status, standardization of test methodology, increase of sample size and longer follow-up intervals will certainly improve the predictive value of dual-task-based fall risk assessment tests.
引用
收藏
页码:786 / 795
页数:10
相关论文
共 43 条
[1]  
ABERNETHY B, 1988, J HUM MOVEMENT STUD, V14, P101
[2]   How to identify potential fallers in a stroke unit:: Validity indexes of four test methods [J].
Andersson, ÅG ;
Kamwendo, K ;
Seiger, Å ;
Appelros, P .
JOURNAL OF REHABILITATION MEDICINE, 2006, 38 (03) :186-191
[3]   Predicting fallers in a community-based sample of people with Parkinson's disease [J].
Ashburn, A ;
Stack, E ;
Pickering, RM ;
Ward, CD .
GERONTOLOGY, 2001, 47 (05) :277-281
[4]   A community-dwelling sample of people with Parkinson's disease: characteristics of fallers and non-fallers [J].
Ashburn, A ;
Stack, E ;
Pickering, RM ;
Ward, CD .
AGE AND AGEING, 2001, 30 (01) :47-52
[5]  
Beauchet O, 2005, AGING CLIN EXP RES, V17, P270
[6]   Recurrent falls and dual task-related decrease in walking speed: Is there a relationship? [J].
Beauchet, Olivier ;
Annweiler, Cedric ;
Allali, Gilles ;
Berrut, Gilles ;
Herrmann, Francois R. ;
Dubost, Veronique .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2008, 56 (07) :1265-1269
[7]   Does change in gait while counting backward predict the occurrence of a first fall in older adults? [J].
Beauchet, Olivier ;
Allali, Gilles ;
Annweiler, Cedric ;
Berrut, Gilles ;
Maarouf, Nabil ;
Herrmann, Francois R. ;
Dubost, Veronique .
GERONTOLOGY, 2008, 54 (04) :217-223
[8]   'Faster counting while walking' as a predictor of falls in older adults [J].
Beauchet, Olivier ;
Dubost, Veronique ;
Allai, Gilles ;
Gonthier, Regis ;
Hermann, Francois R. ;
Kressig, Reto W. .
AGE AND AGEING, 2007, 36 (04) :418-423
[9]   Risk factors for serious fall related injury in elderly women living at home [J].
Bergland, A ;
Wyller, TB .
INJURY PREVENTION, 2004, 10 (05) :308-313
[10]  
Bloem BR, 2000, ANN NEUROL, V48, P268, DOI 10.1002/1531-8249(200008)48:2<268::AID-ANA21>3.0.CO