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Table 6 Summary table of Dual Task Assessments as falls assessment tools

From: Predicting falls in older adults: an umbrella review of instruments assessing gait, balance, and functional mobility

Review Review characteristics Risk of bias Summary of key findings Interpretation
Zijlstra [37] Systematic review without meta-analysis
(n = 2)
High Two prospective studies suggested that dual balance tasks may have added value for fall prediction over single balance tasks. The low sensitivity (i.e., 55%) reported for fall prediction indicates that only a part of all fallers were identified by the dual-task assessment.
Balance tasks included: standing on a force platform, timed up and go, gait speed. Cognitive tasks included: sentence completion, counting backwards verbal response, answering questions.
Bayot [23] Systematic review without meta-analysis
(n = 30)
Unclear Promising added value of dual tasks including turns and other transfers, such as in the Timed Up and Go test, for prediction of falls. Inconsistent
Beauchet [23] Meta-analysis
(n = 15)
Mixed settings
Unclear Pooled OR for falling was 1.62 (95% CI 0.96–2.72) for retrospectives studies and 6.84 (95% CI 3.06–15.28) for prospective studies, when subjects had changes in gait or attention-demanding task performance whilst dual tasking.
The pooled odds ratio for falling when analysis included all studies was 5.3 (95% CI 3.1–9.1).
Walking task incldued: Timed Up and Go and usual gait speed. Attention demanding tasks included: conversations, arithmetic tests carrying a glass of water.
Yang [36] Systematic review without meta-analysis
(n = 26)
Unclear Both static and walking balance assessment tools had good reliability but were not useful to predict falls.
In most of the studies, the participants were living independently and had normal cognition. The psychometric properties of dual-task assessment tools may differ depending on the cognitive status.
Reviews included primary task of standing or walking balance and secondary task included mental tracking, verbal fluency, working memory, reaction time and discrimination and decision making.
Not favourable
Chantanachai [38] Meta-analysis
(n = 16)
Older people with cognitive impairment living in the community
Low Association between poor dual task performance and falls (n = 1) favourable
Muir-Hunter [32] Systematic review without meta-analysis
(n = 7)
Low Association between dual-task test performance and future fall risk reported.
Dual tasks included in the reviews: Primary tasks included gait speed stepping task and postural sway. Secondary tasks included cognitive activities such as verbal fluency tests and motor activity such as carrying a tray with a cup.
Changes in gait performance under dual-task testing are associated with future fall risk, and this association is stronger than that for single-task conditions.
Menant [41] Meta-analysis
(n = 30)
Mixed settings
Low Dual tasks primarily included walking test with secondary cognitive task.
Single task and dual task tests across all domains significantly discriminated between fallers and non-fallers (< 0.05).
The pooled MD (95%CI) for gait speed between fallers and non-fallers in the single task (0.069 (0.045 0.094) was not significantly different to that in the dual task condition (0.074 (0.046–0.103)
  1. Abbreviations: CI Confidence interval, n number of included studies, MD Mean difference, OR Odds ratio*This study did meta-analyses, but not on dual task, which was only reported in one paper