Does dual-tasking provide additional value in timed "up and go" test for predicting the occurrence of falls? A longitudinal observation study by age group (young-older or old-older adults)

Abstract

Background Previous studies using relatively large samples and longitudinal observational designs reported dual-tasking had additional value in timed "up and go" test (TUG) for falls assessment among well-functioning older adults. Aim To elucidate the additional value of dual-tasking in TUG for predicting the occurrence of falls among community-dwelling older adults by age group using a predictive model. Methods This longitudinal observation study included 987 community-dwelling older adults at baseline. A TUG without performing another task (single-TUG) and a TUG while counting aloud backward from 100 were conducted at baseline. We computed the dual-task cost (DTC) value, which is used to quantify trends in subjects' execution of motor tests under dual-task conditions. Data on fall history were obtained using a self-administered questionnaire at the 1-year follow-up. The final analysis included 649 individuals divided into a young-older adult group (aged 60-74 years) and an old-older adult group (aged >= 75 years). Associations between the occurrence of falls and TUG-related values were analyzed by age group using multivariate logistic regression models. Results For old-older adults, there were significant associations between the occurrence of falls and single-TUG time (odds ratio [OR] 1.143, 95% confidence interval [CI] 1.018-1.285) and DTC value (OR 0.981, 95% CI 0.963-0.999). No significant associations were observed for young-older adults. Conclusions Slower single-TUG time and lower DTC value are associated with the occurrence of falls among old-older adults but not among young-older adults. Dual tasking may provide an additional value in TUG for predicting falls among old-older adults.