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双重任务测试在计时“起立行走”测试中预测跌倒发生方面是否提供额外价值?按年龄组(年轻老年人或年老老年人)进行的纵向观察研究。

Does dual-tasking provide additional value in timed "up and go" test for predicting the occurrence of falls? A longitudinal observation study by age group (young-older or old-older adults).

机构信息

Department of Physical Therapy, Faculty of Rehabilitation, Kobe Gakuin University, 518 Arise, Ikawadani-cho, Nishi-ku, Kobe, Hyogo, 651-2180, Japan.

Faculty of Rehabilitation, Kobe Gakuin University Graduate School, 518 Arise, Ikawadani-cho, Nishi-ku, Kobe, Hyogo, 651-2180, Japan.

出版信息

Aging Clin Exp Res. 2021 Jan;33(1):77-84. doi: 10.1007/s40520-020-01510-6. Epub 2020 Feb 21.

Abstract

BACKGROUND

Previous studies using relatively large samples and longitudinal observational designs reported dual-tasking had additional value in timed "up and go" test (TUG) for falls assessment among well-functioning older adults.

AIM

To elucidate the additional value of dual-tasking in TUG for predicting the occurrence of falls among community-dwelling older adults by age group using a predictive model.

METHODS

This longitudinal observation study included 987 community-dwelling older adults at baseline. A TUG without performing another task (single-TUG) and a TUG while counting aloud backward from 100 were conducted at baseline. We computed the dual-task cost (DTC) value, which is used to quantify trends in subjects' execution of motor tests under dual-task conditions. Data on fall history were obtained using a self-administered questionnaire at the 1-year follow-up. The final analysis included 649 individuals divided into a young-older adult group (aged 60-74 years) and an old-older adult group (aged ≥ 75 years). Associations between the occurrence of falls and TUG-related values were analyzed by age group using multivariate logistic regression models.

RESULTS

For old-older adults, there were significant associations between the occurrence of falls and single-TUG time (odds ratio [OR] 1.143, 95% confidence interval [CI] 1.018-1.285) and DTC value (OR 0.981, 95% CI 0.963-0.999). No significant associations were observed for young-older adults.

CONCLUSIONS

Slower single-TUG time and lower DTC value are associated with the occurrence of falls among old-older adults but not among young-older adults. Dual tasking may provide an additional value in TUG for predicting falls among old-older adults.

摘要

背景

先前使用较大样本量和纵向观察设计的研究报告称,在功能良好的老年人中,计时“站起和行走”测试(TUG)中进行双重任务测试对于评估跌倒风险具有额外价值。

目的

通过预测模型,阐明在 TUG 中进行双重任务测试对预测按年龄分组的社区居住老年人跌倒发生的额外价值。

方法

这是一项纵向观察研究,纳入了 987 名基线时的社区居住老年人。在基线时进行了 TUG 测试(不进行其他任务)和 TUG 测试(同时从 100 开始倒数)。我们计算了双重任务成本(DTC)值,用于量化受试者在双重任务条件下执行运动测试的趋势。在 1 年随访时通过自我管理问卷获取跌倒史数据。最终分析纳入了 649 名个体,分为年轻老年人组(60-74 岁)和年老老年人组(≥75 岁)。使用多元逻辑回归模型按年龄组分析 TUG 相关值与跌倒发生之间的关系。

结果

对于年老老年人,跌倒的发生与单 TUG 时间(优势比[OR] 1.143,95%置信区间[CI] 1.018-1.285)和 DTC 值(OR 0.981,95% CI 0.963-0.999)之间存在显著关联。而年轻老年人则没有观察到这种关联。

结论

单 TUG 时间较慢和 DTC 值较低与年老老年人跌倒的发生相关,但与年轻老年人无关。在 TUG 中进行双重任务测试可能为预测年老老年人跌倒提供额外价值。

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