Back to Journals » Clinical Interventions in Aging » Volume 15

Prevalence of Falls, Physical Performance, and Dual-Task Cost While Walking in Older Adults at High Risk of Falling with and Without Cognitive Impairment

Authors Li F, Harmer P

Received 20 March 2020

Accepted for publication 29 May 2020

Published 22 June 2020 Volume 2020:15 Pages 945—952


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Richard Walker

Fuzhong Li,1 Peter Harmer2

1Oregon Research Institute, Eugene, OR 97403, USA; 2Department of Exercise and Health Science, Willamette University, Salem, OR, 97301, USA

Correspondence: Fuzhong Li
Oregon Research Institute, 1776 Millrace Dr., Eugene, OR 97403, USA

Purpose: To compare the prevalence of falls, physical performance, and dual-task cost during walking between cognitively healthy and impaired older adults at high risk of falling.
Methods: A cross-sectional analysis of 670 community-dwelling older adults who were considered at high risk of falling, operationalized as 1) having fallen at least once in the preceding 12 months and having a health-care practitioner’s referral indicating that the participant was at risk of falls or 2) having impaired mobility as evidenced by a Timed Up and Go (TUG) result ≥ 13.5 s. Participants (mean age = 77.7 years, SD = 5.6) were divided into cognitively healthy (n = 461) or cognitively impaired (n = 209) groups using a cutoff score of < 23 on the Montreal Cognitive Assessment test. Assessment included self-reported number of falls over the previous 12 months, functional reach, TUG, Short Physical Performance Battery (SPPB), and single- and dual-task walk performance. Data were analyzed using Poisson regression to estimate the prevalence ratios of falls and analysis of variance to examine between-group differences on physical performance and dual-task cost during walking performance.
Results: In the analysis, 82.3% of older adults with cognitive impairment and 69.4% of unimpaired older adults reported 1 or more falls in the previous 12 months. Compared with cognitively healthy participants, those with cognitive impairment were 2.57 (95% confidence interval [CI] = 2.17 to 3.05) times more likely to have any fall and 2.33 (95% CI = 1.95 to 2.78) times more likely to have multiple falls. Older adults with cognitive impairment performed worse on functional reach (mean difference [MD] = − 2.33 cm, 95% CI = − 3.21 to − 1.46), TUG (MD = 3.05 s, 95% CI = 2.22 to 3.88), and SPPB (MD = − 1.24 points, 95% CI = − 1.55 to − 0.92) and showed increase in dual-task costs (MD = 6.59%, 95% CI = 4.19 to 9.03) compared to those without cognitive impairment.
Conclusion: Older adults at high risk for falls and who have cognitive impairment are associated with a greater risk for falls and decrements in physical and dual-task performance.

Keywords: cognitive impairment, dual-task, falls, elderly, physical performance

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]