Departamento de Fisioterapia, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil.
Curso de Fisioterapia, Instituto Integrado de Saúde, Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil.
Braz J Phys Ther. 2018 Sep-Oct;22(5):417-423. doi: 10.1016/j.bjpt.2018.03.011. Epub 2018 Apr 4.
A dual-task tool with a challenging and daily secondary task, which involves executive functions, could facilitate the screening for risk of falls in older people with mild cognitive impairment or mild Alzheimer's disease.
To verify if a motor-cognitive dual-task test could predict falls in older people with mild cognitive impairment or mild Alzheimer's disease, and to establish cutoff scores for the tool for both groups.
A prospective study was conducted with community-dwelling older adults, including 40 with mild cognitive impairment and 38 with mild Alzheimer's disease. The dual-task test consisted of the Timed up and Go Test associated with a motor-cognitive task using a phone to call. Falls were recorded during six months by calendar and monthly telephone calls and the participants were categorized as fallers or non-fallers.
In the Mild cognitive impairment Group, fallers presented higher values in time (35.2s), number of steps (33.7 steps) and motor task cost (116%) on dual-task compared to non-fallers. Time, number of steps and motor task cost were significantly associated with falls in people with mild cognitive impairment. Multivariate analysis identified higher number of steps spent on the test to be independently associated with falls. A time greater than 23.88s (sensitivity=80%; specificity=61%) and a number of steps over 29.50 (sensitivity=65%; specificity=83%) indicated prediction of risk of falls in the Mild cognitive impairment Group. Among people with Alzheimer's disease, no differences in dual-task between fallers and non-fallers were found and no variable of the tool was able to predict falls.
The dual-task predicts falls only in older people with mild cognitive impairment.
一项具有挑战性和日常次要任务的双重任务工具，涉及执行功能，可以促进轻度认知障碍或轻度阿尔茨海默病老年人的跌倒风险筛查。
验证运动认知双重任务测试是否可以预测轻度认知障碍或轻度阿尔茨海默病老年人的跌倒，并为两组工具建立截断分数。
对社区居住的老年人进行前瞻性研究，包括 40 名轻度认知障碍患者和 38 名轻度阿尔茨海默病患者。双重任务测试包括计时站起测试和使用电话进行运动认知任务。在六个月内通过日历和每月电话记录跌倒情况，并将参与者归类为跌倒者或非跌倒者。
在轻度认知障碍组中，与非跌倒者相比，跌倒者在双重任务中的时间（35.2 秒）、步数（33.7 步）和运动任务成本（116%）更高。时间、步数和运动任务成本与轻度认知障碍患者的跌倒显著相关。多变量分析确定在测试中花费的步数较高与跌倒独立相关。时间大于 23.88 秒（敏感性=80%；特异性=61%）和步数超过 29.50（敏感性=65%；特异性=83%）表明可以预测轻度认知障碍组的跌倒风险。在阿尔茨海默病患者中，未发现跌倒者和非跌倒者之间的双重任务存在差异，且工具的任何变量均无法预测跌倒。
双重任务仅可预测轻度认知障碍老年人的跌倒。
