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Updated: Jun 23, 2026
Using Motion Capture Technology in the Instrumented Timed Up and Go Test to Detect the Risk of Falling in Aged Adults
Published on: October 25, 2024
Subregion-Specific Prefrontal Activation Predicts Fall Risk and Fall Timing in Older Adults With Mild Cognitive
1Department of Rehabilitation Center, National Health Insurance Ilsan Hospital, Goyang, South Korea; Graduate School of Sports Medicine, CHA University, Pocheon, South Korea.
Objective:
To investigate whether time-varying prefrontal cortex (PFC) activation during dual-task (DT) walking is associated with fall risk and time to first fall in older adults with mild cognitive impairment (MCI).
Design:
Prospective longitudinal cohort study.
Setting:
Community-based assessment with 12-month follow-up.
Participants:
One hundred ten community-dwelling older adults with MCI (N=110).
Interventions:
Not applicable.
Main Outcome Measures:
Oxygenated hemoglobin changes in PFC subregions during DT walking were measured using functional near-infrared spectroscopy. Baseline global cognition and functional mobility were assessed. The primary outcomes were fall occurrence and time to first fall during 12 months of prospective follow-up. Associations with fall risk and time to first fall were examined using multivariable logistic regression, Cox proportional hazards models with time-varying coefficients, and Kaplan-Meier analyses, adjusting for age, sex, and global cognition.
Results:
During follow-up, 39 participants (35.5%) experienced ≥1 fall. Greater early-phase dorsolateral PFC (DLPFC) activation during DT walking was independently associated with higher odds of falling (odds ratio, 2.36; 95% CI, 1.02-5.59; P=.048) and shorter time to first fall (hazard ratio, 3.00; 95% CI, 1.49-6.04; P=.002). This association attenuated significantly over time, supported by a significant DLPFC-by-time interaction (hazard ratio, 0.24; 95% CI, 0.15-0.40; P<.001). Slower timed Up and Go performance was also independently associated with higher fall risk and shorter time to first fall.
Conclusions:
Exaggerated early-phase DLPFC activation during cognitively demanding walking represents a time-sensitive neural prognostic marker of fall vulnerability in older adults with MCI. Integrating cortical activation measures with functional mobility assessment may enhance fall risk stratification in clinical and community settings.
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