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Can Dual-Task Assessment Be Used to Discriminate Recurrent Fallers in Older Populations? A Systematic Review
Nora L Curtin1, Alexa Lauinger2, Frederic Montz1
1Kansas City University College of Osteopathic Medicine, Kansas City University, Kansas City, MO, USA.
Objectives:
To evaluate whether dual-task assessment (DTA) can discriminate single/nonfallers from recurrent fallers in older adults, and to identify specific DTA protocols and outcome measures most predictive of recurrent falls.
Design:
Systematic review.
Setting And Participants:
This systematic review followed Cochrane and PRISMA reporting guidelines. A search was conducted in August 2025 using PubMed, Embase, Scopus, Web of Science, CINHAL, SPORTDiscuss, and PsycINFO. Keywords associated with dual task, older populations, and recurrent falls were included in the search strategy. Prospective and retrospective cohort studies were included if they assessed adults ≥60 years old with DTA and recorded ≥2 falls over at least 3 months. Studies with neurologically impaired individuals with motor deficits were excluded. A total of 2472 community-dwelling adults across 9 studies were included in this review.
Methods:
Two independent reviewers screened studies, assessed quality using Standard Quality Assessment, and extracted data on demographics, methodology, and outcomes. DTA protocol heterogeneity precluded meta-analysis.
Results:
Six studies (66.7%), which is equivalent to 56.3% of the study participants, found that DTA could discriminate recurrent fallers from single/nonfallers. Gait variability as measured by swing time variability and longer completion time for DTA were most predictive for identifying older individuals at risk for recurrent falls.
Conclusions And Implications:
Decline in DTA performance, particularly the time to complete the DTA, may be associated with recurrent falling in older adults. Time to complete the DTA is a feasible screening tool for outpatient use. Currently, protocol variations limit generalizability, warranting standardization of methods and further validation for clinical adoption.
