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Affiliation
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Department of Physiotherapy, School of Allied Health, La Trobe University, Bundoora, Victoria, Australia. |
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Abstract
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BACKGROUND: Cognitive impairment increases fall risk in older adults. Dual-task testing is an accepted way to assess the interaction between cognition and mobility; however, there is a lack of evidence-based recommendations for dual-task testing to evaluate fall risk in clinical practice.
OBJECTIVES: To evaluate the association between dual-task testing protocols and future fall risk, and to identify the specific dual-task test protocols associated with elevated risk. DATA SOURCES: MEDLINE, Pubmed and EMBASE electronic databases were searched from January 1988 to September 2013. STUDY SELECTION: Two independent raters identified prospective cohort studies (duration of at least 1 year) of dual-task assessment in community-dwelling participants aged ≥60 years, with 'falls' as the primary outcome. STUDY APPRAISAL AND SYNTHESIS METHODS: Methodological quality was scored independently by two raters using a published checklist of criteria for evaluating threats to the validity of observational studies.
RESULTS: Deterioration in gait during dual-task testing compared with single-task performance was associated with increased fall risk. Shortcomings within the literature significantly limit knowledge translation of dual-task gait protocols into clinical practice. LIMITATIONS: There is a paucity of prospective studies on the association of dual-task gait assessment with fall risk.
CONCLUSION AND IMPLICATIONS OF KEY FINDINGS: Changes in gait under dual-task testing are associated with future fall risk, and this association is stronger than that for single-task conditions. Limitations in the available literature preclude development of detailed recommendations for dual-task gait testing procedures in clinical practice to identify and stratify fall risk in older adults.
Language: en |