Dual-task as a predictor of falls in older people with mild cognitive impairment and mild Alzheimer's disease: a prospective cohort study

Gonçalves, Jessica; Ansai, Juliana Hotta; Masse, Fernando Arturo Arriagada; Vale, Francisco Assis Carvalho; Takahashi, Anielle Cristhine de Medeiros; Andrade, Larissa Pires de

doi:10.1016/j.bjpt.2018.03.011

Cited by 28 publications

(49 citation statements)

References 23 publications

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“…Our findings of an increased likelihood of falls in older adults with stroke or dementia are consistent with previous studies [6,[15][16][17]. There are a variety of factors that contribute to increased fall risk in the older adult population, including demographics (e.g., age, sex, race) [18,19], medical history (e.g., prior injuries, surgeries, pain, arthritis, diabetes, neurological disorders, cognitive dysfunction) [15,[19][20][21][22][23][24][25], increased health care needs (e.g., medical comorbidities, medications) [17,26], prior history of falls [18,[27][28][29][30], physical impairments [24,29], and environmental factors [30]. Older adults with neurological disorders may have increased fall risk in part because of their complex health care needs [6,16,17].…”

Section: Discussionsupporting

confidence: 84%

Fall risk in stroke survivors: Effects of stroke plus dementia and reduced motor functional capacity

Whitney

Dutt-Mazumder

Peterson

et al. 2019

Journal of the Neurological Sciences

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Background: Despite extensive research on falls among individuals with stroke, little is known regarding the impact of neurological conditions with comorbid diagnoses and motor functional capacity on the risk of falls in these individuals. Hence, the purpose of this study was to determine the fall risk and the contribution of reduced motor functional capacity to fall risk in individuals with stroke, dementia, and stroke plus dementia.Methods: Data from the National Health and Aging Trends Study (NHATS), a nationallyrepresentative sample of Medicare beneficiaries, were analyzed for this cross-sectional study. The odds of self-reported falls within the past month in three subgroups of neurological conditions [stroke (n=751), dementia (n=369), and stroke plus dementia (n=141)] were evaluated with a reference group of individuals with no stroke/dementia [i.e., controls (n=6337)] using logistic regression models. Results:The prevalence of a recent fall was significantly higher (P<0.05) in the three neurological disorder groups compared with controls. After adjusting for sociodemographics, mobility device use, and other comorbidities (i.e., chronic disease, vision impairment, and major surgery), the odds of a recent fall were significantly elevated in individuals with stroke (odds ratio [OR]=1.45), dementia (OR=2.45), and stroke plus dementia (OR=2.64) compared with controls. After further adjustment for the lower motor functional capacity, the elevated odds in individuals with stroke were attenuated (OR=1.16); however, the odds remained significantly elevated in individuals with dementia (OR=1.67) and stroke plus dementia (OR=1.82).

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Section: Discussionsupporting

confidence: 84%

Fall risk in stroke survivors: Effects of stroke plus dementia and reduced motor functional capacity

Whitney

Dutt-Mazumder

Peterson

et al. 2019

Journal of the Neurological Sciences

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“…The difference between fallers and non-fallers in CoP area and medio-lateral CoP velocity during parallel stance was unchanged when a cognitive task was added, while the difference in CoP antero-posterior velocity increased (SMD from 0.26 to 0.37). Previous studies have shown that dual task-based tests are very useful in predicting falls in older people with cognitive impairment [95]. Similarly, the capability of the Timed-Up-and-Go test to classify fallers and non-fallers was also shown to increase with the addition of a cognitive task [96].…”

Section: Discussionmentioning

confidence: 92%

Diagnostic Balance Tests for Assessing Risk of Falls and Distinguishing Older Adult Fallers and Non-Fallers: A Systematic Review with Meta-Analysis

et al. 2020

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Falls are a major cause of injury and morbidity in older adults. To reduce the incidence of falls, a systematic assessment of the risk of falling is of paramount importance. The purpose of this systematic review was to provide a comprehensive comparison of the diagnostic balance tests used to predict falls and for distinguishing older adults with and without a history of falls. We conducted a systematic review of the studies in which instrumented (force plate body sway assessment) or other non-instrumented balance tests were used. We analyzed the data from 19 prospective and 48 retrospective/case-control studies. Among the non-instrumented tests, the single-leg stance test appears to be the most promising for discrimination between fallers and non-fallers. In terms of body sway measures, the center-of-pressure area was most consistently associated with falls. No evidence was found for increased benefit of the body sway test when cognitive tasks were added, or the vision was eliminated. While our analyses are limited due to the unbalanced representation of different test and outcome measures across studies, we can recommend the single-leg test for the assessment of the risk of falling, and the measurements of body sway for a more comprehensive assessment.

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“…Furthermore, in order to infer information relative to specific neural areas and cognitive functions, protocols involving the so-called brain stress tests are employed [85]. These are the dual-task tests that are composed of walking while performing an additional motorcognitive task such as calling a phone number [86], talking or counting [87], or carrying a glass of water [88]. However, a considerable number of works in the related literature do not specify the testing protocol used to assess gait parameters, so it is difficult to compare and assess the results.…”

Section: Protocols For Gait Analysismentioning

confidence: 99%

Human Gait Analysis in Neurodegenerative Diseases: A Review

Cicirelli

Impedovo

Dentamaro

et al. 2022

IEEE J. Biomed. Health Inform.

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This paper reviews the recent literature on technologies and methodologies for quantitative human gait analysis in the context of neurodegnerative diseases. The use of technological instruments can be of great support in both clinical diagnosis and severity assessment of these pathologies. In this paper, sensors, features and processing methodologies have been reviewed in order to provide a highly consistent work that explores the issues related to gait analysis. First, the phases of the human gait cycle are briefly explained, along with some nonnormal gait patterns (gait abnormalities) typical of some neurodegenerative diseases. The work continues with a survey on the publicly available datasets principally used for comparing results. Then the paper reports the most common processing techniques for both feature selection and extraction and for classification and clustering. Finally, a conclusive discussion on current open problems and future directions is outlined.

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Dual-task as a predictor of falls in older people with mild cognitive impairment and mild Alzheimer's disease: a prospective cohort study

Abstract: The dual-task predicts falls only in older people with mild cognitive impairment.

Cited by 28 publications

References 23 publications

Fall risk in stroke survivors: Effects of stroke plus dementia and reduced motor functional capacity

Fall risk in stroke survivors: Effects of stroke plus dementia and reduced motor functional capacity

Diagnostic Balance Tests for Assessing Risk of Falls and Distinguishing Older Adult Fallers and Non-Fallers: A Systematic Review with Meta-Analysis

Human Gait Analysis in Neurodegenerative Diseases: A Review

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