Walking and Talking as Predictors of Falls in the General Population: The Leiden 85-Plus Study

Authors

  • Annetje Bootsma-van der Wiel MD,

    1. From the Section of Gerontology and Geriatrics, Department of General Internal Medicine, Leiden University Medical Center, the Netherlands
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  • Jacobijn Gussekloo PhD,

    1. From the Section of Gerontology and Geriatrics, Department of General Internal Medicine, Leiden University Medical Center, the Netherlands
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  • Anton J.M. De Craen PhD,

    1. From the Section of Gerontology and Geriatrics, Department of General Internal Medicine, Leiden University Medical Center, the Netherlands
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  • Eric Van Exel MD,

    1. From the Section of Gerontology and Geriatrics, Department of General Internal Medicine, Leiden University Medical Center, the Netherlands
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  • Bastiaan R. Bloem PhD,

    1. Department of Neurology, University Medical Center St Radboud, Nijmegen, the Netherlands.
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  • Rudi G. J. Westendorp PhD

    1. From the Section of Gerontology and Geriatrics, Department of General Internal Medicine, Leiden University Medical Center, the Netherlands
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  • This study was supported by an unrestricted grant from the Dutch Ministry of Health, Welfare and Sports.

Address correspondence to Jacobijn Gussekloo, MD, PhD, Section of Gerontology and Geriatrics, Department of General Internal Medicine, Leiden University Medical Center, C-2-R, PO Box 9600, 2300 RC Leiden, the Netherlands. E-mail: jgussekloo@lumc.nl

Abstract

Objectives: To compare the value of dual tasking in predicting falling in the general population of oldest old with that of easy-to-administer single tasks.

Design: Prospective population-based follow-up study.

Setting: Municipality of Leiden, the Netherlands.

Participants: Representative cohort of 380 individuals, all aged 85 at baseline.

Measurements: During enrollment, walking time over a 12-meter distance was measured, as well as the verbal fluency to recite names of animals or professions during a 30-second period. In the dual task, performance was assessed when participants combined walking with reciting names. Incidence of falls and fractures was assessed by interviewing participants and checking their medical histories.

Results: After 1 year of follow-up, 42% of the participants reported one or more falls, and 4% suffered a fracture. Total walking time, number of steps, and verbal fluency were all strongly related to incident falls (P for trend for all <.01), but dual-task performance was not a better predictor for incident falls than single-task performance.

Conclusion: The dual-task test in this study had no predictive value above that of a single-task test to predict falling. Dual tasks with more-sensitive measures of impaired dual-task execution might have better test characteristics. In this study, history of falls and performance on an easy-to-administer single walking task identified old persons at higher risk for falling who could benefit from fall preventive strategies.

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