Prevalence of Falls, Physical Performance, and Dual-Task Cost While Walking in Older Adults at High Risk of Falling with and Without Cognitive Impairment

Fuzhong Li,1 Peter Harmer2 1Oregon Research Institute, Eugene, OR 97403, USA; 2Department of Exercise and Health Science, Willamette University, Salem, OR, 97301, USACorrespondence: Fuzhong LiOregon Research Institute, 1776 Millrace Dr., Eugene, OR 97403, USAEmail fuzhongl@ori.orgPurpose: To compare...

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Autores principales:	Li F, Harmer P
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	cognitive impairment dual-task falls elderly physical performance Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/755bda58ee3643f28f112e1c1181c4c7
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spelling	oai:doaj.org-article:755bda58ee3643f28f112e1c1181c4c72021-12-02T13:11:51ZPrevalence of Falls, Physical Performance, and Dual-Task Cost While Walking in Older Adults at High Risk of Falling with and Without Cognitive Impairment1178-1998https://doaj.org/article/755bda58ee3643f28f112e1c1181c4c72020-06-01T00:00:00Zhttps://www.dovepress.com/prevalence-of-falls-physical-performance-and-dual-task-cost-while-walk-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Fuzhong Li,1 Peter Harmer2 1Oregon Research Institute, Eugene, OR 97403, USA; 2Department of Exercise and Health Science, Willamette University, Salem, OR, 97301, USACorrespondence: Fuzhong LiOregon Research Institute, 1776 Millrace Dr., Eugene, OR 97403, USAEmail fuzhongl@ori.orgPurpose: To compare the prevalence of falls, physical performance, and dual-task cost during walking between cognitively healthy and impaired older adults at high risk of falling.Methods: A cross-sectional analysis of 670 community-dwelling older adults who were considered at high risk of falling, operationalized as 1) having fallen at least once in the preceding 12 months and having a health-care practitioner’s referral indicating that the participant was at risk of falls or 2) having impaired mobility as evidenced by a Timed Up and Go (TUG) result ≥ 13.5 s. Participants (mean age = 77.7 years, SD = 5.6) were divided into cognitively healthy (n = 461) or cognitively impaired (n = 209) groups using a cutoff score of < 23 on the Montreal Cognitive Assessment test. Assessment included self-reported number of falls over the previous 12 months, functional reach, TUG, Short Physical Performance Battery (SPPB), and single- and dual-task walk performance. Data were analyzed using Poisson regression to estimate the prevalence ratios of falls and analysis of variance to examine between-group differences on physical performance and dual-task cost during walking performance.Results: In the analysis, 82.3% of older adults with cognitive impairment and 69.4% of unimpaired older adults reported 1 or more falls in the previous 12 months. Compared with cognitively healthy participants, those with cognitive impairment were 2.57 (95% confidence interval [CI] = 2.17 to 3.05) times more likely to have any fall and 2.33 (95% CI = 1.95 to 2.78) times more likely to have multiple falls. Older adults with cognitive impairment performed worse on functional reach (mean difference [MD] = − 2.33 cm, 95% CI = − 3.21 to − 1.46), TUG (MD = 3.05 s, 95% CI = 2.22 to 3.88), and SPPB (MD = − 1.24 points, 95% CI = − 1.55 to − 0.92) and showed increase in dual-task costs (MD = 6.59%, 95% CI = 4.19 to 9.03) compared to those without cognitive impairment.Conclusion: Older adults at high risk for falls and who have cognitive impairment are associated with a greater risk for falls and decrements in physical and dual-task performance.Keywords: cognitive impairment, dual-task, falls, elderly, physical performanceLi FHarmer PDove Medical Pressarticlecognitive impairmentdual-taskfallselderlyphysical performanceGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 15, Pp 945-952 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	cognitive impairment dual-task falls elderly physical performance Geriatrics RC952-954.6
spellingShingle	cognitive impairment dual-task falls elderly physical performance Geriatrics RC952-954.6 Li F Harmer P Prevalence of Falls, Physical Performance, and Dual-Task Cost While Walking in Older Adults at High Risk of Falling with and Without Cognitive Impairment
description	Fuzhong Li,1 Peter Harmer2 1Oregon Research Institute, Eugene, OR 97403, USA; 2Department of Exercise and Health Science, Willamette University, Salem, OR, 97301, USACorrespondence: Fuzhong LiOregon Research Institute, 1776 Millrace Dr., Eugene, OR 97403, USAEmail fuzhongl@ori.orgPurpose: To compare the prevalence of falls, physical performance, and dual-task cost during walking between cognitively healthy and impaired older adults at high risk of falling.Methods: A cross-sectional analysis of 670 community-dwelling older adults who were considered at high risk of falling, operationalized as 1) having fallen at least once in the preceding 12 months and having a health-care practitioner’s referral indicating that the participant was at risk of falls or 2) having impaired mobility as evidenced by a Timed Up and Go (TUG) result ≥ 13.5 s. Participants (mean age = 77.7 years, SD = 5.6) were divided into cognitively healthy (n = 461) or cognitively impaired (n = 209) groups using a cutoff score of < 23 on the Montreal Cognitive Assessment test. Assessment included self-reported number of falls over the previous 12 months, functional reach, TUG, Short Physical Performance Battery (SPPB), and single- and dual-task walk performance. Data were analyzed using Poisson regression to estimate the prevalence ratios of falls and analysis of variance to examine between-group differences on physical performance and dual-task cost during walking performance.Results: In the analysis, 82.3% of older adults with cognitive impairment and 69.4% of unimpaired older adults reported 1 or more falls in the previous 12 months. Compared with cognitively healthy participants, those with cognitive impairment were 2.57 (95% confidence interval [CI] = 2.17 to 3.05) times more likely to have any fall and 2.33 (95% CI = 1.95 to 2.78) times more likely to have multiple falls. Older adults with cognitive impairment performed worse on functional reach (mean difference [MD] = − 2.33 cm, 95% CI = − 3.21 to − 1.46), TUG (MD = 3.05 s, 95% CI = 2.22 to 3.88), and SPPB (MD = − 1.24 points, 95% CI = − 1.55 to − 0.92) and showed increase in dual-task costs (MD = 6.59%, 95% CI = 4.19 to 9.03) compared to those without cognitive impairment.Conclusion: Older adults at high risk for falls and who have cognitive impairment are associated with a greater risk for falls and decrements in physical and dual-task performance.Keywords: cognitive impairment, dual-task, falls, elderly, physical performance
format	article
author	Li F Harmer P
author_facet	Li F Harmer P
author_sort	Li F
title	Prevalence of Falls, Physical Performance, and Dual-Task Cost While Walking in Older Adults at High Risk of Falling with and Without Cognitive Impairment
title_short	Prevalence of Falls, Physical Performance, and Dual-Task Cost While Walking in Older Adults at High Risk of Falling with and Without Cognitive Impairment
title_full	Prevalence of Falls, Physical Performance, and Dual-Task Cost While Walking in Older Adults at High Risk of Falling with and Without Cognitive Impairment
title_fullStr	Prevalence of Falls, Physical Performance, and Dual-Task Cost While Walking in Older Adults at High Risk of Falling with and Without Cognitive Impairment
title_full_unstemmed	Prevalence of Falls, Physical Performance, and Dual-Task Cost While Walking in Older Adults at High Risk of Falling with and Without Cognitive Impairment
title_sort	prevalence of falls, physical performance, and dual-task cost while walking in older adults at high risk of falling with and without cognitive impairment
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/755bda58ee3643f28f112e1c1181c4c7
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Prevalence of Falls, Physical Performance, and Dual-Task Cost While Walking in Older Adults at High Risk of Falling with and Without Cognitive Impairment

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