Effect of a dual task on quantitative Timed Up and Go performance in community-dwelling older adults: A preliminary study

Erin Smith, Lorcan Walsh, Julie Doyle, Barry Greene, Catherine Blake
Geriatrics & Gerontology International 2017, 17 (8): 1176-1182

AIM: The Timed Up and Go test (TUG) is used as a measure of functional ability in older adults; however, the method of measurement does not allow us to determine which aspects of the test deficits occur in. The aim of the present study was to examine the ability of the quantitative TUG (QTUG) to measure performance during the TUG test under three different conditions - single task, motor task and cognitive dual task - and to compare performance between fallers and non-fallers in high-functioning community-dwelling older adults.

METHODS: A total of 37 community-dwelling older adults, 16 with a self-reported falls history in the previous year, were recruited. Participants underwent a falls risk assessment with a physiotherapist including the QTUG under three conditions (single task, motor task, cognitive dual-task). A total of 10 clinical parameters were chosen for analysis using mancova and a series of ancova, with age, sex and body mass index included as covariates.

RESULTS: The mancova analysis showed a significant difference across the three task conditions (Wilk's Lambda F20,186  = 3.37, P < 0.001. No overall significant difference between faller and non-faller groups (Wilk's Lambda F10,96  = 1.469, P = 0.163) or significant interaction between task and faller status (Wilk's Lambda F20,192  = 1.131, P = 0.321) was found. ancova results for each of the parameters showed overall differences between single, motor and cognitive tasks for all of the variables, except time in double support. When faller and non-faller differences were explored, cadence and stride velocity was greater, and stride time longer in those with a prior history of falls.

CONCLUSIONS: In community-dwelling older adults, these preliminary results show that a cognitive dual-task significantly (P < 0.025) affects QTUG performance in almost all parameters, with a significant (P < 0.025) reduction in time-to-stand observed with a motor task. Although no statistical difference was found between fallers and non-fallers for many of the parameters, cadence, stride time and stride velocity were statistically different (P < 0.05). A larger sample size and more assessment points might lead to more definitive findings. These results highlight the need for further research to examine QTUG performance under dual-task conditions between fallers and non-fallers in this population, and to look at the ability of dual-task QTUG assessment to measure change longitudinally and the effectiveness of therapeutic interventions. Geriatr Gerontol Int 2017; 17: 1176-1182.

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