TY - JOUR
T1 - Validity of divided attention tasks in predicting falls in older individuals
T2 - A preliminary study
AU - Verghese, Joe
AU - Buschke, Herman
AU - Viola, Lisa
AU - Katz, Mindy
AU - Hall, Charles
AU - Kuslansky, Gail
AU - Lipton, Richard
PY - 2002/9
Y1 - 2002/9
N2 - OBJECTIVES: Although cognitive impairment is known to be a major risk factor for falls in older individuals, the role of cognitive tests in predicting falls has not been established. Limited attentional resources may increase the risk for falls in older individuals. We examined the reliability and validity of divided attention tasks, walking while talking (WWT), in predicting falls. DESIGN: A prospective cohort study of 12-months' duration. SETTING: Community-based longitudinal aging study, the Einstein Aging Study. PARTICIPANTS: Sixty nondemented community-living subjects, aged 65 to 98 (mean age ± standard deviation = 79.6 ± 6.3). MEASUREMENTS: Simple and complex versions of the WWT task in addition to standard balance and cognitive assessments. The primary outcome was cumulative incidence of falls at 12 months. RESULTS: Thirteen subjects fell over the 12 months, four of whom had major injuries. The WWT task had good interrater reliability (r = 0.602, P < .001). Poor performance on simple (odds ratio (OR) = 7.02, 95% confidence interval (CI) = 1.7-29.4) and complex WWT tasks (OR = 13.7, 95% CI = 2.3-83.6) was highly predictive of falls. The simple task had a sensitivity of 46% and specificity of 89%. For the complex task, sensitivity was 39%, and specificity was 96%. CONCLUSIONS: The WWT is a reliable and valid test to identify older individuals at high risk for falls. Future studies with larger sample sizes and in different settings are needed to confirm the findings of this study.
AB - OBJECTIVES: Although cognitive impairment is known to be a major risk factor for falls in older individuals, the role of cognitive tests in predicting falls has not been established. Limited attentional resources may increase the risk for falls in older individuals. We examined the reliability and validity of divided attention tasks, walking while talking (WWT), in predicting falls. DESIGN: A prospective cohort study of 12-months' duration. SETTING: Community-based longitudinal aging study, the Einstein Aging Study. PARTICIPANTS: Sixty nondemented community-living subjects, aged 65 to 98 (mean age ± standard deviation = 79.6 ± 6.3). MEASUREMENTS: Simple and complex versions of the WWT task in addition to standard balance and cognitive assessments. The primary outcome was cumulative incidence of falls at 12 months. RESULTS: Thirteen subjects fell over the 12 months, four of whom had major injuries. The WWT task had good interrater reliability (r = 0.602, P < .001). Poor performance on simple (odds ratio (OR) = 7.02, 95% confidence interval (CI) = 1.7-29.4) and complex WWT tasks (OR = 13.7, 95% CI = 2.3-83.6) was highly predictive of falls. The simple task had a sensitivity of 46% and specificity of 89%. For the complex task, sensitivity was 39%, and specificity was 96%. CONCLUSIONS: The WWT is a reliable and valid test to identify older individuals at high risk for falls. Future studies with larger sample sizes and in different settings are needed to confirm the findings of this study.
KW - Divided attention
KW - Falls
KW - Older people
KW - Screening
KW - Walking
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U2 - 10.1046/j.1532-5415.2002.50415.x
DO - 10.1046/j.1532-5415.2002.50415.x
M3 - Article
C2 - 12383157
AN - SCOPUS:0036715517
SN - 0002-8614
VL - 50
SP - 1572
EP - 1576
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 9
ER -