Beauchet Olivier, Dubost Véronique, Herrmann François, Rabilloud Muriel, Gonthier Régis, Kressig Reto W
Department of Rehabilitation and Geriatrics, Geneva University Hospitals, CH-1226 Thonex-Geneva, Switzerland.
Aging Clin Exp Res. 2005 Aug;17(4):270-5. doi: 10.1007/BF03324609.
Gait changes in dual-task conditions have been associated with an increased risk of falling in older adults, and become more important in increasingly frail older adults. We studied the relationship between commonly known intrinsic risk factors for falls and dual-task related gait changes among transitional frail older adults.
Walking time and number of steps were measured while walking alone and while walking with counting backward on a 10-m walkway in 66 transitional frail older adults (mean age 83.6+/-6.1, 84.9% women). Uni- and multiple linear regression analyses were performed to explore the relationship between dual-task related gait changes (walking time and number of steps) and age over 85 years, polymedication, psychoactive drugs, poor distance vision, abnormal mobility and cognitive impairment.
Compared with walking alone, both walking time and number of steps increased significantly while counting backward (p<0.001). Polymedication and abnormal mobility were associated with a significant increase of walking time and number of steps (p<0.01 for unadjusted change, p<0.05 for adjusted change).
Dual-task related gait changes were closely correlated with polymedication and impaired mobility in our sample of transitional frail older adults. These findings give some insight into the complexity of performing attention-demanding tasks while walking and accentuate the need for multi-factorial, personalized intervention strategies, to prevent decline in dual-task performance in this fall-prone population.
在双重任务条件下的步态变化与老年人跌倒风险增加有关，并且在日益衰弱的老年人中变得更为重要。我们研究了常见的跌倒内在风险因素与过渡性衰弱老年人中与双重任务相关的步态变化之间的关系。
在66名过渡性衰弱老年人（平均年龄83.6±6.1岁，女性占84.9%）中，在10米长的通道上分别测量他们单独行走以及倒着数数行走时的步行时间和步数。进行单因素和多因素线性回归分析，以探讨与双重任务相关的步态变化（步行时间和步数）与85岁以上年龄、多种药物治疗、精神活性药物、远距离视力差、行动能力异常和认知障碍之间的关系。
与单独行走相比，倒着数数时步行时间和步数均显著增加（p<0.001）。多种药物治疗和行动能力异常与步行时间和步数的显著增加相关（未调整变化时p<0.01，调整变化时p<0.05）。
在我们的过渡性衰弱老年人样本中，与双重任务相关的步态变化与多种药物治疗和行动能力受损密切相关。这些发现为行走时执行需要注意力的任务的复杂性提供了一些见解，并强调了针对这一易跌倒人群采取多因素、个性化干预策略以防止双重任务表现下降的必要性。
