Article

OBJECTIVE: To investigate the predictive validity of simple gait-related
dual-task (DT) tests in predicting falls in community-dwelling older adults.
DESIGN: A validation cohort study with 6 months' follow-up. SETTING: General
community. PARTICIPANTS: Independently ambulant community-dwelling adults (N=66)
aged >/=65 years, with normal cognitive function. Sixty-two completed the
follow-up. No participants required frames for walking. INTERVENTIONS: Not
applicable. MAIN OUTCOME MEASURES: 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. RESULTS: 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 showed 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 was not clinically useful for predicting falls.
CONCLUSIONS: This study identified the most important outcome measures in
predicting falls using simple DT tests. The results showed that measures of
change in performance were not useful in a multivariate model when compared with
an "allocated all to falls" rule.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS