Validity of divided attention tasks in predicting falls in older individuals: a preliminary study.

Full Abstract

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.

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Author information

Author/s: Verghese, Joe (J); Buschke, Herman (H); Viola, Lisa (L); Katz, Mindy (M); Hall, Charles (C); Kuslansky, Gail (G); Lipton, Richard (R);

Affiliation: Departments of Neurology and Epidemiology and Social Medicine, Albert Einstein College of Medicine, Bronx, New York 10461, USA. jverghes(-atsign-)aecom.yu.edu

Grants: AG 03949 (Agency:United States NIA)

Journal and publication information

Publication Type: Journal Article; Research Support, U.S. Gov't, P.H.S.

Journal: Journal of the American Geriatrics Society (J Am Geriatr Soc), published in United States. (Language: eng)

Reference: 2002-Sep; vol 50 (issue 9) : pp 1572-6

Dates: Created 2002/10/17; Completed 2002/11/20; Revised 2008/03/10;

PMID: 12383157, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: J Am Geriatr Soc. 2005 Apr;53(4):735-7. (PMID: 15817033)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Accidental Falls
Aged - psychology
Aged, 80 and over
Attention
Female
Follow-Up Studies
Gait

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