Hirashima Kenichi, Higuchi Yumi, Imaoka Masakazu, Todo Emiko, Kitagawa Tomomi, Ueda Tetsuya
Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino Campus, Habikino City, Osaka, Japan ; Faculty of Health and Welfare, Department of Physical Therapy, Tokushima Bunri University, Nishihamaboji, Yamashiro Town, Tokushima City, Tokushima, Japan.
Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Habikino Campus, Habikino City, Osaka, Japan.
Clin Interv Aging. 2015 Apr 1;10:643-8. doi: 10.2147/CIA.S77432. eCollection 2015.
Dual-task methods, in which walking is the primary task, are not sufficient for accurately screening for the risk of falls among healthy older adults. Therefore, the goal of this research was to investigate whether using a dual-task method over an extended walking distance can predict falls among community-dwelling older adults.
We enrolled independent community-dwelling adults aged ≥65 years. Physical performance, cognitive function, psychological function, and a dual-task test were assessed at baseline. Our dual-task test required the subjects to walk 60 m while stepping over lines. The intervals between the lines ranged from 50-100 cm and were unequal. Falls and fall-related injuries were measured over a 12-month follow-up period using monthly postal surveys.
Ninety-two of 118 subjects (mean age, 75.4±5.5 years) completed the 12-month follow-up. Sixteen (17.4%) of fallers had injurious falls or fell more than or equal to two times. There were no significant differences between the fallers and non-fallers, except in age and in the number of missteps during the dual-task test when walking ≥40 m. The Kaplan-Meier analysis revealed that those who had more than one misstep while walking ≥40 m had a significantly higher incidence of injurious or multiple falls than those who had no missteps.
Our findings suggest that the dual-task method with an extended walking distance may be able to predict falls among community-dwelling older adults.
以行走为主要任务的双任务方法不足以准确筛查健康老年人的跌倒风险。因此，本研究的目的是调查在更长的行走距离上使用双任务方法是否能够预测社区居住老年人的跌倒情况。
我们纳入了年龄≥65岁的独立社区居住成年人。在基线时评估身体功能、认知功能、心理功能和一项双任务测试。我们的双任务测试要求受试者在跨过线条的同时行走60米。线条之间的间隔为50 - 100厘米，且不相等。在为期12个月的随访期间，通过每月的邮政调查来测量跌倒及与跌倒相关的伤害。
118名受试者中的92名（平均年龄75.4±5.5岁）完成了12个月的随访。16名（17.4%）跌倒者发生了有伤害性的跌倒或跌倒次数≥2次。跌倒者和未跌倒者之间没有显著差异，除了年龄以及在双任务测试中行走≥40米时的失足次数。Kaplan-Meier分析显示，在行走≥40米时失足次数超过一次的人发生有伤害性跌倒或多次跌倒的发生率显著高于没有失足的人。
我们的研究结果表明，延长行走距离的双任务方法可能能够预测社区居住老年人的跌倒情况。
