Can dual-task paradigms predict Falls better than single task? - A systematic literature review

Area of Science:

• Gerontology
• Biomechanics
• Public Health

Background:

• Falls are a major public health concern for adults aged 65+, leading to disability and mortality.
• Identifying fall risk in healthy older adults is essential for effective fall prevention strategies.
• Dual-task testing, assessing cognition and motor control interaction, has shown potential in predicting falls.

Purpose of the Study:

• To systematically review recent literature (last 7 years) on lab-based dual tasks for identifying fall risk in healthy older adults.
• To address the debate on the discriminative and predictive powers of dual tasks (gait with concurrent tasks) for fall prediction.
• To explore the superiority of dual tasks over single tasks in fall-risk prediction and investigate dual tasks involving postural control and transfers.

Main Methods:

• Systematic literature review focusing on studies published within the last 7 years.
• Inclusion of dual tasks involving posture, gait initiation, gait, and turning.
• Analysis of the predictive value of dual-task performance and costs for identifying future fallers.

Main Results:

• Despite heterogeneity in studies, dual tasks involving turns and transfers demonstrated promising added value for fall prediction.
• Dual tasks, particularly those incorporating elements like the Timed Up and Go test with dual-tasking, show potential.
• Further research is warranted to confirm the predictive capabilities of these specific dual-task paradigms.

Conclusions:

• Dual tasks involving complex motor actions like turns and transfers are valuable for predicting falls in older adults.
• These specific dual-task tests offer a promising avenue for easily applicable fall-risk identification in clinical settings.
• Continued investigation into dual-tasking paradigms focusing on postural control and transfers is recommended for enhanced fall prevention.