Validity of Simple Gait-Related Dual-Task Tests in Predicting Falls in Community-Dwelling Older Adults.

The purpose of this study was to investigate the predictive validity of simple gait-related dual-task (DT) tests in predicting falls in community-dwelling older adults. A validation cohort study with 6 months’ follow-up consisting of independently ambulant community-dwelling adults (N=66) aged ≥65 years, with normal cognitive function was conducted. Sixty-two completed the follow-up. No participants required frames for walking. Occurrence of falls in the follow-up period and performance on primary and secondary tasks of 8 DT tests and 1 triple-task (TT) test served as primary measurements. A random forest classification analysis identified the top 5 predictors of a fall as (1) absolute difference in time between the Timed Up & Go (TUG) as a single task (ST) and while carrying a cup; (2) time required to complete the walking task in the TT test; (3 and 4) walking and avoiding a moving obstacle as an ST and while carrying a cup; and (5) performing the TUG while carrying a cup. Separate bivariate logistic regression analyses revealed that performance on these tasks was significantly associated with falling (P<.01). Despite the random forest analysis being a more robust approach than multivariate logistic regression, it wasn’t clinically useful for the prediction of falls.

This study identified the most significant outcome measures in predicting falls using simple DT tests. The results showed that measures of variation in performance weren’t useful in a multivariate model when compared with an “allocated all to falls” rule.