Attention, Frailty, and Falls: The Effect of a Manual Task on Basic Mobility

Abstract

OBJECTIVE: To investigate the effect of a second task on balance and gait maneuvers used in everyday life. Our hypothesis was that those who were more distracted by a familiar manual task performed concurrently with functional maneuvers were more frail and more prone to falls. DESIGN: A cross‐sectional design with prospective follow‐up for falls. SETTING: Sheltered accommodation in Umeå, Sweden. PARTICIPANTS: Forty‐two residents (30 women, 12 men; mean age ± SD = 79.7 ± 6.1 years), ambulant with or without a walking aid, able to follow simple instructions and able to carry a tumbler. MEASUREMENTS: Timed Up & Go (TUG), i.e., the time taken to rise from an armchair, walk 3 meters, turn round, and sit down again. TUG was repeated with an added manual task (TUGmanual), which was to carry a glass of water while walking. The Montgomery‐Åsberg Depression Rating Scale, Barthel Index, Functional Reach, Mini‐Mental State Examination, and Line Bisection test were used to assess for frailty. The subjects were followed‐up prospectively regarding falls indoors for a period of 6‐months. RESULTS: Subjects with a time difference (diffTUG) between TUGmanual and TUG of ≥ 4.5 seconds were considered to be distracted by the second task. Ten subjects had a difference in time of ≥ 4.5 seconds. These subjects were more frail, and seven of them fell indoors during the follow‐up period (odds ratio 4.7, 95% Confidence Interval (CI) 1.5–14.2). CONCLUSION: The time difference between the TUGmanual and the TUG appears to be a valid marker of frailty and a useful tool for identifying older persons prone to falling.