Dual-task gait test provides limited additional value for fall prediction in care-requiring older adults: A prospective study.

Abstract

Aim: Decline in cognitive and motor functions is apparent in care-requiring older adults. The dual-task method assesses both functions simultaneously by observing changes in task performance; thus, the dual-task method might accurately reflect the fall risk. This study aimed to examine the predictive validity of the dual-task method for fall-risk assessment in care-requiring older adults.

Methods: This prospective observational study was designed as a multicenter collaborative study that included five daycare service facilities and 1 day-rehabilitation facility. In total, 204 participants met the inclusion criteria. Data on falls were collected over a 12-month period. The gait test was performed on a 4-m smooth walkway under no-task (single-task gait test) and dual-task conditions (dual-task gait test). After inputting the missing data using the multiple imputation method, logistic multivariate regression models were constructed to investigate the association between fall occurrence and the single-task gait and dual-task gait test times. The predictive ability of the two models was compared using DeLong's test.

Results: The single-task gait test time was not significantly associated with the occurrence of falls after adjusting for confounders (odds ratio 1.12, 95% CI 0.93-1.35). In contrast, the dual-task gait test time was significantly associated with the occurrence of falls after adjusting for confounders (odds ratio 1.12, 95% CI 1.01, 1.23). The DeLong's test showed no significant difference between the two models.

Conclusion: Only the dual-task gait test significantly predicted falls in this population, but there was no difference in its predictive ability compared to the single-task gait test. Additional studies are needed to strengthen the clinical validity of the dual-task gait test. Geriatr Gerontol Int 2025; ••: ••-••.