Multitasking: Association Between Poorer Performance and a History of Recurrent Falls

Authors

  • Kimberly A. Faulkner PhD,

    1. From the Departments of *Epidemiology, Bioengineering, and Geriatric Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania§Department of Mathematics and Computer Science, Duquesne University, Pittsburgh, PennsylvaniaDepartment of Clinical Research, National Institute on Aging, Baltimore, MarylandDepartment of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland#University of Tennessee, Memphis, Tennessee**Department of Epidemiology and Biostatistics, University of California, San Francisco, California.
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  • Mark S. Redfern PhD,

    1. From the Departments of *Epidemiology, Bioengineering, and Geriatric Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania§Department of Mathematics and Computer Science, Duquesne University, Pittsburgh, PennsylvaniaDepartment of Clinical Research, National Institute on Aging, Baltimore, MarylandDepartment of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland#University of Tennessee, Memphis, Tennessee**Department of Epidemiology and Biostatistics, University of California, San Francisco, California.
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  • Jane A. Cauley DrPH,

    1. From the Departments of *Epidemiology, Bioengineering, and Geriatric Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania§Department of Mathematics and Computer Science, Duquesne University, Pittsburgh, PennsylvaniaDepartment of Clinical Research, National Institute on Aging, Baltimore, MarylandDepartment of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland#University of Tennessee, Memphis, Tennessee**Department of Epidemiology and Biostatistics, University of California, San Francisco, California.
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  • Douglas P. Landsittel PhD,

    1. From the Departments of *Epidemiology, Bioengineering, and Geriatric Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania§Department of Mathematics and Computer Science, Duquesne University, Pittsburgh, PennsylvaniaDepartment of Clinical Research, National Institute on Aging, Baltimore, MarylandDepartment of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland#University of Tennessee, Memphis, Tennessee**Department of Epidemiology and Biostatistics, University of California, San Francisco, California.
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  • Stephanie A. Studenski MD, MPH,

    1. From the Departments of *Epidemiology, Bioengineering, and Geriatric Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania§Department of Mathematics and Computer Science, Duquesne University, Pittsburgh, PennsylvaniaDepartment of Clinical Research, National Institute on Aging, Baltimore, MarylandDepartment of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland#University of Tennessee, Memphis, Tennessee**Department of Epidemiology and Biostatistics, University of California, San Francisco, California.
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  • Caterina Rosano MD, MPH,

    1. From the Departments of *Epidemiology, Bioengineering, and Geriatric Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania§Department of Mathematics and Computer Science, Duquesne University, Pittsburgh, PennsylvaniaDepartment of Clinical Research, National Institute on Aging, Baltimore, MarylandDepartment of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland#University of Tennessee, Memphis, Tennessee**Department of Epidemiology and Biostatistics, University of California, San Francisco, California.
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  • Eleanor M. Simonsick PhD,

    1. From the Departments of *Epidemiology, Bioengineering, and Geriatric Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania§Department of Mathematics and Computer Science, Duquesne University, Pittsburgh, PennsylvaniaDepartment of Clinical Research, National Institute on Aging, Baltimore, MarylandDepartment of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland#University of Tennessee, Memphis, Tennessee**Department of Epidemiology and Biostatistics, University of California, San Francisco, California.
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  • Tamara B. Harris MD, MS,

    1. From the Departments of *Epidemiology, Bioengineering, and Geriatric Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania§Department of Mathematics and Computer Science, Duquesne University, Pittsburgh, PennsylvaniaDepartment of Clinical Research, National Institute on Aging, Baltimore, MarylandDepartment of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland#University of Tennessee, Memphis, Tennessee**Department of Epidemiology and Biostatistics, University of California, San Francisco, California.
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  • Ronald I. Shorr MD, MS,

    1. From the Departments of *Epidemiology, Bioengineering, and Geriatric Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania§Department of Mathematics and Computer Science, Duquesne University, Pittsburgh, PennsylvaniaDepartment of Clinical Research, National Institute on Aging, Baltimore, MarylandDepartment of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland#University of Tennessee, Memphis, Tennessee**Department of Epidemiology and Biostatistics, University of California, San Francisco, California.
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  • Hilsa N. Ayonayon PhD,

    1. From the Departments of *Epidemiology, Bioengineering, and Geriatric Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania§Department of Mathematics and Computer Science, Duquesne University, Pittsburgh, PennsylvaniaDepartment of Clinical Research, National Institute on Aging, Baltimore, MarylandDepartment of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland#University of Tennessee, Memphis, Tennessee**Department of Epidemiology and Biostatistics, University of California, San Francisco, California.
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  • Anne B. Newman MD, MPH,

    1. From the Departments of *Epidemiology, Bioengineering, and Geriatric Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania§Department of Mathematics and Computer Science, Duquesne University, Pittsburgh, PennsylvaniaDepartment of Clinical Research, National Institute on Aging, Baltimore, MarylandDepartment of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland#University of Tennessee, Memphis, Tennessee**Department of Epidemiology and Biostatistics, University of California, San Francisco, California.
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  • for the Health, Aging, and Body Composition Study

    1. From the Departments of *Epidemiology, Bioengineering, and Geriatric Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania§Department of Mathematics and Computer Science, Duquesne University, Pittsburgh, PennsylvaniaDepartment of Clinical Research, National Institute on Aging, Baltimore, MarylandDepartment of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland#University of Tennessee, Memphis, Tennessee**Department of Epidemiology and Biostatistics, University of California, San Francisco, California.
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  • This paper was presented in part at the 2005 Gerontological Society of America national meeting in Orlando, Florida.

Address correspondence to Kimberly A. Faulkner, PhD, 130 DeSoto Street, Parran 509, Pittsburgh, PA 15261. E-mail: kaf24@pitt.edu

Abstract

OBJECTIVES: To examine the association between poorer performance on concurrent walking and reaction time and recurrent falls.

DESIGN: Cross-sectional analysis.

SETTING: Community.

PARTICIPANTS: Three hundred seventy-seven older community-dwelling adults (mean age±standard deviation 78±3).

MEASUREMENTS: Reaction times on push-button and visual-spatial decision tasks were assessed while seated and while walking a 20-m course (straight walk) and a 20-m course with a turn at 10 m (turn walk). Walking times were recorded while walking only and while performing a reaction-time response. Dual-task performance was calculated as the percentage change in task times when done in dual-task versus single-task conditions. A history of recurrent falls (≥2 vs ≤1 falls) in the prior 12 months was self-reported. Multivariate logistic regression models were used to predict the standardized odds ratios (ORs) of recurrent falls history. The standardized unit for dual-task performance ORs was interquartile range/2.

RESULTS: On the push-button task during the turn walk, poorer reaction time response (slower) was associated with 28% lower (P=.04) odds of recurrent fall history. On the visual-spatial task, poorer walking-time response (slower) was associated with 34% (P=.02) and 42% (P=.01) higher odds of recurrent falls history on the straight and turn walks, respectively.

CONCLUSION: These findings suggest that walking more slowly in response to a visual-spatial decision task may identify individuals at risk for multiple falls. Prospective studies are needed to confirm the prognostic value of poor walking responses in a dual-task setting for multiple falls.

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