Fear of falling and motor functionality. A longitudinal and multidimensional study among older adults in a long-term residential care setting

Journal title PSICOLOGIA DELLA SALUTE
Author/s Paolo R. Brustio, Daniele Magistro, Gabriele Patrucco, Marcella M. Caglio, Emanuela Rabaglietti, Monica E. Liubicich
Publishing Year 2017 Issue 2017/2 Language Italian
Pages 16 P. 5-20 File size 235 KB
DOI 10.3280/PDS2017-002001
DOI is like a bar code for intellectual property: to have more infomation click here

Below, you can see the article first page

If you want to buy this article in PDF format, you can do it, following the instructions to buy download credits

Article preview

FrancoAngeli is member of Publishers International Linking Association, Inc (PILA), a not-for-profit association which run the CrossRef service enabling links to and from online scholarly content.

In everyday life, older adults may often find difficulties to deal situations requiring the performance of different actions simultaneously. This study investigates the walking per-formance during dual-task conditions and the possible relationship with fear of falling in a group of older adults living in a long-term care setting. Fifteen older adults (average age M = 79±10 years) carried out a walking test in single-task and the same test in different dual-task conditions. Data on the fear of falling were collected. Results showed a reduction of walking speed under dual-task condition. Moreover a performance decline over the time was observed. Significant correlations were observed between dual-task conditions and fear of falling. The results underline the difficulties during dual-task condition in old age and the relationship with the fear of falling. This information may be useful for the development of specific physical and cognitive interventions.

Keywords: Dual-task, walking, fear of falling, long-term care setting.

  1. Al-Yahya E., Dawes H., Smith L., Dennis A., Howells K. and Cockburn J. (2011). Cognitive motor interference while walking: a systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 35(3): 715-728.
  2. Asai T., Misu S., Doi T., Yamada M. and Ando H. (2014). Effects of dual-tasking on control of trunk movement during gait: respective effect of manual- and cognitive-task. Gait & Posture, 39(1): 54-59.
  3. Beauchet O., Annweiler C., Allali G., Berrut G., Herrmann F.R. and Dubost V. (2008). Recurrent falls and dual task-related decrease in walking speed: is there a relationship? Journal of the American Geriatrics Society, 56(7): 1265-1269.
  4. Brandler T.C., Wang C., Oh-Park M., Holtzer R., Verghese J. (2012). Depressive symptoms and gait dysfunction in the elderly. Am J Geriatr Psychiatry, 20(5): 425-432.
  5. Brauer S.G. and Morris M.E. (2004). Effects of dual task interference on postural control, movement and physical activity in healthy older people and those with movement disorders. In: Morris M.E. and Schoo A.M.M. (eds.), Optimizing exercise and physical activity in older people. Edinburgh: Butterworth-Heinemann, pp. 267-287.
  6. Brustio P.R., Magistro D., Ivaldi S., Caglio M.M., Rabaglietti E. and Liubicich M.E. (2015). Neuromotor training in older women living in long-term care setting: a pilot study. Geriatrics Nursering, 36(5): 361-366.
  7. Brustio P.R., Magistro D. and Liubicich M.E. (2014). Changes in temporal parameters during performance of the Step Test in older adults. Gait & Posture.
  8. Brustio P.R., Magistro D., Rabaglietti E. and Liubicich M.E. (2015). Age-related differences in dual task performance: A cross-sectional study on women. Geriatrics & Gerontology International, 17, 2: 315-321.
  9. Candela F., Zucchetti G., Magistro D., Ortega E. and Rabaglietti E. (2014). Real and perceived physical functioning in Italian elderly population: associations with BADL and IADL. Advances in Aging Research, 3(5).
  10. Candela F., Zucchetti G., Ortega E., Rabaglietti E. and Magistro D. (2015). Preventing Loss of Basic Activities of Daily Living and Instrumental Activities of Daily Living in Elderly: Identification of Individual Risk Factors in a Holistic Perspective. Holist Nurs Pract, 29(5): 313-322.
  11. Chodzko-Zajko W.J., Proctor D.N., Fiatarone Singh M.A., Minson C.T., Nigg C.R., Salem G.J. and Skinner J.S. (2009). American College of Sports Medicine position stand. Exercise and physical activity for older adults. Medicine & Science in Sports & Exercise, 41(7): 1510-1530.
  12. Chu Y.H., Tang P.F., Peng Y.C. and Chen H.Y. (2013). Meta-analysis of type and complexity of a secondary task during walking on the prediction of elderly falls. Geriatrics & Gerontology International, 13(2): 289-297.
  13. Delbaere K., Close J.C., Mikolaizak A.S., Sachdev P.S., Brodaty H. and Lord S.R. (2010). The Falls Efficacy Scale International (FES-I). A comprehensive longitudinal validation study. Age & Ageing, 39(2): 210-216.
  14. Donoghue O.A., Cronin H., Savva G.M., O’Regan C. and Kenny R.A. (2013). Effects of fear of falling and activity restriction on normal and dual task walking in community dwelling older adults. Gait & Posture, 38(1): 120-124.
  15. Donoghue O.A., Horgan N.F., Savva G.M., Cronin H., O’Regan C. and Kenny R.A. (2012). Association between timed up-and-go and memory, executive function and processing speed. J Am Geriatr Soc, 60(9): 1681-1686.
  16. Gagnon N., Flint A.J., Naglie G. and Devins G.M. (2005). Affective correlates of fear of falling in elderly persons. Am J Geriatr Psychiatry, 13(1): 7-14.
  17. Granacher U., Bridenbaugh S.A., Muehlbauer T., Wehrle A. and Kressig R.W. (2011). Age-related effects on postural control under multi-task conditions. Gerontology, 57(3): 247-255. DOI: 10.1159/00032219
  18. Granacher U., Muehlbauer T., Gollhofer A., Kressig R.W. and Zahner L. (2011). An interge-nerational approach in the promotion of balance and strength for fall prevention–a mini-review. Gerontology, 57(4): 304-315.
  19. Hall C.D., Echt K.V., Wolf S.L. and Rogers W.A. (2011). Cognitive and motor mechanisms underlying older adults’ ability to divide attention while walking. Physical Therapy, 91(7): 1039-1050.
  20. Hauer K., Pfisterer M., Weber C., Wezler N., Kliegel M. and Oster P. (2003). Cognitive impairment decreases postural control during dual tasks in geriatric patients with a history of severe falls. Journal of the American Geriatrics Society, 51(11): 1638-1644.
  21. Hausdorff J.M., Schweiger A., Herman T., Yogev-Seligmann G. and Giladi N. (2008). Dual-task decrements in gait: contributing factors among healthy older adults. J Gerontol A Biol Sci Med Sci, 63(12): 1335-1343.
  22. Hofheinz M. and Schusterschitz C. (2010). Dual task interference in estimating the risk of falls and measuring change: a comparative, psychometric study of four measurements. Clinical Rehabilitation, 24(9): 831-842. DOI: 10.1177/0269215510367993
  23. Hollman J.H., Kovash F.M., Kubik J.J. and Linbo R.A. (2007). Age-related differences in spatiotemporal markers of gait stability during dual task walking. Gait & Posture, 26(1): 113-119.
  24. Holtzer R., Wang C. and Verghese J. (2012). The relationship between attention and gait in aging: facts and fallacies. Motor Control, 16(1): 64-80.
  25. Jung D., Shin S. and Kim H. (2014). A fall prevention guideline for older adults living in long-term care facilities. Int Nurs Rev, 61(4): 525-533.
  26. Kressig R.W., Herrmann F.R., Grandjean R., Michel J.P. and Beauchet O. (2008). Gait variability while dual-tasking: fall predictor in older inpatients? Aging Clin Exp Res, 20(2): 123-130.
  27. Lach H.W. and Parsons J.L. (2013). Impact of fear of falling in long term care: an integrative review. J Am Med Dir Assoc, 14(8): 573-577.
  28. Laessoe U., Hoeck H.C., Simonsen O. and Voigt M. (2008). Residual attentional capacity amongst young and elderly during dual and triple task walking. Human Movement Science, 27(3): 496-512.
  29. Lezak M.D. (2004). Neuropsychological asessment 4 Ed: Oxford: Oxford University Press, Incorporated.
  30. Lundin-Olsson L., Nyberg L. and Gustafson Y. (1997). “Stops walking when talking” as a predictor of falls in elderly people. The Lancet, 349(9052): 617. DOI: 10.1016/S0140-6736(97)24009-
  31. Magistro D., Candela F., Brustio P.R., Liubicich M.E. and Rabaglietti E. (2014). Longitudinal Study on the Relationship Between Aerobic Endurance and Lower Body Strength in Italian Sedentary Older Adults. J Aging Phys Act, 23, 3: 444-451.
  32. Mielke M.M., Roberts R.O., Savica R., Cha R., Drubach D.I., Christianson T., Pankratz V.S., Geda Y.E., Machulda M.M., Ivnik R.J., Knopman D.S., Boeve B.F., Rocca W.A., Petersen R.C. (2013). Assessing the temporal relationship between cognition and gait: slow gait predicts cognitive decline in the Mayo clinic study of aging. Journals of Ger-ontology Series A: Biological Sciences and Medical Sciences, 68(8): 929-937.
  33. Montero-Odasso M., Bergman H., Phillips N.A., Wong C.H., Sourial N. and Chertkow H. (2009). Dual-tasking and gait in people with mild cognitive impairment. The effect of working memory. BMC Geriatrics, 9, 41. DOI: 10.1186/1471-2318-9-4
  34. Nordin E., Moe-Nilssen R., Ramnemark A. and Lundin-Olsson L. (2010). Changes in step-width during dual-task walking predicts falls. Gait & Posture, 32(1): 92-97.
  35. Park D.C. and Reuter-Lorenz P. (2009). The adaptive brain: aging and neurocognitive scaffolding. The Annual Review of Psychology, 60: 173-196.
  36. Park H.L., O’Connell J.E. and Thomson R.G. (2003). A systematic review of cognitive decline in the general elderly population. Int J Geriatr Psychiatry, 18(12): 1121-1134.
  37. Patel P., Lamar M. and Bhatt T. (2014). Effect of type of cognitive task and walking speed on cognitive-motor interference during dual-task walking. Neuroscience, 260(0): 140-148.
  38. Pellecchia G.L. (2003). Postural sway increases with attentional demands of concurrent cognitive task. Gait & Posture, 18(1): 29-34. DOI: 10.1016/S0966-6362(02)00138-
  39. Pothier K., Benguigui N., Kulpa R. and Chavoix C. (2015). Multiple Object Tracking While Walking: Similarities and Differences Between Young, Young-Old and Old-Old Adults. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 70(6): 840-849.
  40. Reelick M.F., Kessels R.P., Faes M.C., Weerdesteyn V., Esselink R.A. and Olde Rikkert M.G. (2011). Increased intra-individual variability in stride length and reaction time in recurrent older fallers. Aging Clin Exp Res, 23(5-6): 393-399. DOI: 10.3275/732
  41. Reelick M.F., van Iersel M.B., Kessels R.P. and Rikkert M.G. (2009). The influence of fear of falling on gait and balance in older people. Age and ageing, 38(4): 435-440.
  42. Schneider W. and Chein J.M. (2003). Controlled & automatic processing: behavior, theory and biological mechanisms. Cognitive Science, 27(3): 525-559.
  43. Shumway-Cook A., Guralnik J.M., Phillips C.L., Coppin A.K., Ciol M.A., Bandinelli S. and Ferrucci L. (2007). Age-associated declines in complex walking task performance: the Walking InCHIANTI toolkit. Journal of the American Geriatrics Society, 55(1): 58-65.
  44. Shumway-Cook A. and Woollacott M. (2000). Attentional demands and postural control: the effect of sensory context. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 55(1): M10-16.
  45. Shumway-Cook A. and Woollacott M. (2012). Motor Control: Translating Research Into Clinical Practice Fourth Edition. Baltimore, MD: Wolters Kluwer Health/Lippincott Williams & Wilkins.
  46. Srygley J.M., Mirelman A., Herman T., Giladi N. and Hausdorff J.M. (2009). When does walking alter thinking? Age and task associated findings. Brain Res, 1253: 92-99.
  47. Tang P.F., Yang H.J., Peng Y.C. and Chen H.Y. (2015). Motor dual-task Timed Up & Go test better identifies prefrailty individuals than single-task Timed Up & Go test. Geriatrics & Gerontology International, 15(2): 204-210.
  48. Taylor M.E., Delbaere K., Mikolaizak A.S., Lord S.R. and Close J.C. (2013). Gait parameter risk factors for falls under simple and dual task conditions in cognitively impaired older people. Gait & Posture, 37(1): 126-130.
  49. Theill N., Martin M., Schumacher V., Bridenbaugh S.A. and Kressig R.W. (2011). Simultaneously measuring gait and cognitive performance in cognitively healthy and cognitively impaired older adults: the Basel motor-cognition dual-task paradigm. Journal of the American Geriatrics Society, 59(6): 1012-1018.
  50. Uemura K., Yamada M., Nagai K., Tanaka B., Mori S. and Ichihashi N. (2012). Fear of falling is associated with prolonged anticipatory postural adjustment during gait initiation under dual-task conditions in older adults. Gait & Posture, 35(2): 282-286.
  51. van Haastregt J.C., Zijlstra G.A., van Rossum E., van Eijk J.T. and Kempen G.I. (2008). Feelings of anxiety and symptoms of depression in community-living older persons who avoid activity for fear of falling. The American Journal of Geriatric Psychiatry, 16(3): 186-193.
  52. Verghese J., Wang C., Lipton R.B. and Holtzer R. (2013). Motoric cognitive risk syndrome and the risk of dementia. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 68(4): 412-418.
  53. Visschedijk J.H., Caljouw M.A., Bakkers E., van Balen R. and Achterberg W.P. (2015). Longitudinal follow-up study on fear of falling during and after rehabilitation in skilled nursing facilities. BMC Geriatrics, 15: 161.
  54. Woollacott M. and Shumway-Cook A. (2002). Attention and the control of posture and gait: a review of an emerging area of research. Gait & Posture, 16(1): 1-14. DOI: 10.1016/S0966-6362(01)00156-
  55. Wrightson J.G., Ross E.Z. and Smeeton N.J. (2015). The Effect of Cognitive Task Type and Walking Speed on Dual-Task Gait in Healthy Adults. Motor Control, 20, 1: 109-121.
  56. Yamada M., Aoyama T., Arai H., Nagai K., Tanaka B., Uemura K., Mori S., Ichihashi N. (2011). Dual-task walk is a reliable predictor of falls in robust elderly adults. Journal of the American Geriatrics Society, 59(1): 163-164.
  57. Yardley L., Beyer N., Hauer K., Kempen G., Piot-Ziegler C. and Todd C. (2005). Development and initial validation of the Falls Efficacy Scale-International (FES-I). Age & Ageing, 34(6): 614-619.
  58. Yardley L. and Smith H. (2002). A prospective study of the relationship between feared consequences of falling and avoidance of activity in community-living older people. Gerontologist, 42(1): 17-23.
  59. Yogev-Seligmann G., Hausdorff J.M. and Giladi N. (2008). The role of executive function and attention in gait. Movement Disorders, 23(3): 329-342.

Paolo R. Brustio, Daniele Magistro, Gabriele Patrucco, Marcella M. Caglio, Emanuela Rabaglietti, Monica E. Liubicich, Paura di cadere e funzionalità motoria. Uno studio longitudinale e multidimensionale tra anziani ospiti in struttura residenziale in "PSICOLOGIA DELLA SALUTE" 2/2017, pp 5-20, DOI: 10.3280/PDS2017-002001