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Vol. 22. Num. 5.01 September 2018
Pages 345-434
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Vol. 22. Num. 5.01 September 2018
Pages 345-434
Original Research
DOI: 10.1016/j.bjpt.2018.03.011
Dual-task as a predictor of falls in older people with mild cognitive impairment and mild Alzheimer's disease: a prospective cohort study
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Jessica Gonçalvesa, Juliana Hotta Ansaib,
Corresponding author
juliana.h.ansai@ufms.br

Corresponding author at: Universidade Federal de Mato Grosso do Sul, Curso de Fisioterapia, Instituto Integrado de Saúde, Cidade Universitária, CEP 79070-900 Campo Grande, Mato Grosso do Sul, Brazil.
, Fernando Arturo Arriagada Massea, Francisco Assis Carvalho Valec, Anielle Cristhine de Medeiros Takahashia, Larissa Pires de Andradea
a Departamento de Fisioterapia, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil
b Curso de Fisioterapia, Instituto Integrado de Saúde, Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil
c Departamento de Medicina, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil
Highlights

  • Older people with MCI or mild AD presented a high prevalence of falls during the 6-month follow up.

  • A dual-task test can be used as a screening tool for determining risk of falls in people with MCI.

  • The dual-task in this experiment did not predict falls among people with mild AD.

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Figures (1)
Tables (4)
Table 1. Sociodemographic and clinical characteristics between fallers and non-fallers in MCI and AD Groups.
Table 2. Dual-task and isolated motor-cognitive task performances between fallers and non-fallers in MCI and mild AD groups.
Table 3. Univariate predictors of falls in older people with MCI and mild AD using dual-task and isolated motor-cognitive task measures.
Table 4. Cross tabulation of fall risk assessment using TUG-DT in the MCI Group.
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Abstract
Background

A dual-task tool with a challenging and daily secondary task, which involves executive functions, could facilitate the screening for risk of falls in older people with mild cognitive impairment or mild Alzheimer's disease.

Objective

To verify if a motor-cognitive dual-task test could predict falls in older people with mild cognitive impairment or mild Alzheimer's disease, and to establish cutoff scores for the tool for both groups.

Methods

A prospective study was conducted with community-dwelling older adults, including 40 with mild cognitive impairment and 38 with mild Alzheimer's disease. The dual-task test consisted of the Timed up and Go Test associated with a motor-cognitive task using a phone to call. Falls were recorded during six months by calendar and monthly telephone calls and the participants were categorized as fallers or non-fallers.

Results

In the Mild cognitive impairment Group, fallers presented higher values in time (35.2s), number of steps (33.7 steps) and motor task cost (116%) on dual-task compared to non-fallers. Time, number of steps and motor task cost were significantly associated with falls in people with mild cognitive impairment. Multivariate analysis identified higher number of steps spent on the test to be independently associated with falls. A time greater than 23.88s (sensitivity=80%; specificity=61%) and a number of steps over 29.50 (sensitivity=65%; specificity=83%) indicated prediction of risk of falls in the Mild cognitive impairment Group. Among people with Alzheimer's disease, no differences in dual-task between fallers and non-fallers were found and no variable of the tool was able to predict falls.

Conclusion

The dual-task predicts falls only in older people with mild cognitive impairment.

Keywords:
Accidental falls
Alzheimer disease
Locomotion
Mild cognitive impairment

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