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

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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.