Article

Impaired gait may contribute to the increased rate of falls in cognitively
impaired older people. We investigated whether gait under simple and dual task
conditions could predict falls in this group. The study sample consisted of 64
community dwelling older people with mild to moderate cognitive impairment.
Participants walked at their preferred speed under three conditions: (a) simple
walking, (b) walking while carrying a glass of water and (c) walking while
counting backwards from 30. Spatiotemporal gait parameters were measured using
the GAITRite((R)) mat. Falls were recorded prospectively for 12months with the
assistance of carers. Twenty-two (35%) people fell two or more times in the
12month follow-up period. There was a significant main effect of gait condition
and a significant main effect of faller status for mean value measures (velocity,
stride length, double support time and stride width) and for variability measures
(swing time variability and stride length variability). Examination of individual
gait parameters indicated that the multiple fallers walked more slowly, had
shorter stride length, spent longer time in double support, had a wider support
width and showed more variability in stride length and swing time (p<0.05). There
was no significant interaction between gait condition and faller status for any
of the gait variables. In conclusion, dual task activities adversely affect gait
in cognitively impaired older people. Multiple fallers performed worse in each
gait condition but the addition of a functional or cognitive secondary task
provided no added benefit in discriminating fallers from non-fallers with
cognitive impairment.
CI - Copyright (c) 2012 Elsevier B.V. All rights reserved.

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