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

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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.

Original languageEnglish (US)
Pages (from-to)1572-1576
Number of pages5
JournalJournal of the American Geriatrics Society
Volume50
Issue number9
DOIs
StatePublished - Sep 2002

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Walking
Odds Ratio
Confidence Intervals
Reproducibility of Results
Sample Size
Longitudinal Studies
Cohort Studies
Prospective Studies
Sensitivity and Specificity
Incidence
Wounds and Injuries

Keywords

  • Divided attention
  • Falls
  • Older people
  • Screening
  • Walking

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

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title = "Validity of divided attention tasks in predicting falls in older individuals: A preliminary study",
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.",
keywords = "Divided attention, Falls, Older people, Screening, Walking",
author = "Joe Verghese and Herman Buschke and Lisa Viola and Katz, {Mindy Joy} and Hall, {Charles B.} and Gail Kuslansky and Lipton, {Richard B.}",
year = "2002",
month = "9",
doi = "10.1046/j.1532-5415.2002.50415.x",
language = "English (US)",
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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 Joy

AU - Hall, Charles B.

AU - Kuslansky, Gail

AU - Lipton, Richard B.

PY - 2002/9

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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.

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